Creation of an American Holistic Nurses Association research consultation program.

Science.gov (United States)

Robertson, Sue; Clingerman, Evelyn; Zahourek, Rothlyn P; Mariano, Carla; Lange, Bernadette

2012-12-01

A goal of the American Holistic Nurses Association (AHNA) Research Committee is to prepare holistic nurses to conduct holistic nursing research. This article describes the creation of a Research Consultation Program and how the knowledge gained from the program will contribute to the development of a formal research mentor program.

A case study of the nurse practitioner consultation in primary care: communication processes and social interactions

OpenAIRE

Barratt, J

2016-01-01

Background: Nurse practitioners are increasingly conducting consultations with\\ud patients on the same basis as medical doctors. However little is known about\\ud communication within nurse practitioner consultations. Research on communication\\ud in nurse practitioner consultations has identified nurse practitioners communicate\\ud with patients in a hybrid style, combining biomedical information with the discussion\\ud of subjective information from everyday life. Research has not fully explain...

Guidelines Gas Act. Information and Consultation Document 2001

International Nuclear Information System (INIS)

De Groene, P.; Teljeur, E.; Verdonkschot, I.R.

2001-06-01

This Information and Consultation Document has been drawn up for the consultation period that will be held prior to the approval of the new Guidelines, in accordance with sections 13 and 18 of the Dutch Gas Act. In determining the topics for discussion in the consultation document, DTe has based its decision on the scope and aim of these Guidelines. In doing so, DTe's objective is to achieve these aims in a responsible manner, with limited interventions in the market. The Guidelines focus firstly on gas transport companies, in so far as they transport gas to supply eligible customers. In the year 2002, customers with an annual off-take of 1 million m 3 or more will be eligible. Secondly, the Guidelines focus on gas storage companies that have a dominant position or are deemed to have a dominant position, in accordance with section 18(2) of the Gas Act. In determining the Guidelines, in accordance with section 13(1) of the Gas Act, the Director of DTe has to take into account the promotion of trade and the promotion of the efficient operation of gas transport companies and users of the gas network. In addition, it appears from the Parliamentary Proceedings that the Guidelines also have the aim of preventing abuse of a dominant position. This document indicates the way DTe intends to achieve the statutory aims referred to above. Partly on the basis of experience in other countries, DTe assumes that realising these aims and creating a 'level playing field' on the Dutch gas market is a gradual process that may take several years. It will not be possible to realise all the conditions for achieving the above-mentioned objectives, as outlined by DTe in the Information and Consultation Document, in 2002. DTe therefore intends to limit the Guidelines for the year 2002 to the conditions that have priority. The aim of the consultation process and the responses of the various markets players is partly to determine the conditions that have priority. For the purposes of

Assessment on nursing serviceat hospital external consulting rooms

Directory of Open Access Journals (Sweden)

Mª Dolores Poyatos Ruiz

2013-05-01

Full Text Available The social needs and requests change constantly, so that health care is evolving to a more focused on the users, in order to meet users´ needs and expectations of those who are going to get our assistance. Aim: We have developed a research to evaluate the quality of the assistance received by the patientst in their first encounter in the hospital external consulting rooms of traumathology at Santa Bárbara Hospital, letting us know about the patient´s satisfaction after the consulting has finished. Material and method: A transverse descriptive study on the traumathology consulting room of Santa Bárbara Hospital in Puertollano was developed for two months. The research is formed by the patients who attend this consulting room for their first time. A self made multiple choice questionnaire, which was designe by experts, and patients were asked to answer it once their first consulting at traumathology service had finished. Results: 95.6% of the patients considered as good or very good the nursing kindness (confidence/reliabitity when seeing them; 93.5% of them considered as good or very good the information given to them and 90.6% of them considered as good or very good the medical explanations they got. We also noticed a significant statistical difference among nursing kindness (confidence/reliabitity, enough consultation time and explanations received, with regard to the variant high resolution. Conclusions: The study reveals that more than 90% of the interviewed people considered as good or very good the clinical assistance and service given. The research has allowed us to know the areas that we can work on and improve.

Evaluation of a "Just-in-Time" Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial.

Science.gov (United States)

Roblin, Douglas W; Zelman, David; Plummer, Sally; Robinson, Brandi E; Lou, Yiyue; Edmonds, Stephanie W; Wolinsky, Fredric D; Saag, Kenneth G; Cram, Peter

2017-01-01

Evidence is inconclusive whether a nurse consultation can improve osteoporosis-related patient outcomes. To evaluate whether a nurse consultation immediately after dual-energy x-ray absorptiometry (DXA) produced better osteoporosis-related outcomes than a simple intervention to activate adults in good bone health practices or usual care. Pilot randomized controlled trial, conducted within the larger Patient Activation After DXA Result Notification (PAADRN) trial (NCT01507662). After DXA, consenting adults age 50 years or older were randomly assigned to 3 groups: nurse consultation, PAADRN intervention (mailed letter with individualized fracture risk and an educational brochure), or usual care (control). Nurse consultation included reviewing DXA results, counseling on bone health, and ordering needed follow-up tests or physician referrals. Change from baseline to 52 weeks in participant-reported osteoporosis-related pharmacotherapy, lifestyle, activation and self-efficacy, and osteoporosis care satisfaction. Nurse consultation participants (n = 104) reported 52-week improvements in strengthening and weight-bearing exercise (p = 0.09), calcium intake (p Just-in-time" nurse consultation yielded a few improvements over 52 weeks in osteoporosis-related outcomes; however, most changes were not different from those obtained through the lower-cost PAADRN intervention or usual care.

Prevalence of accurate nursing documentation in patient records

NARCIS (Netherlands)

Paans, Wolter; Sermeus, Walter; Nieweg, Roos; van der Schans, Cees

2010-01-01

AIM: This paper is a report of a study conducted to describe the accuracy of nursing documentation in patient records in hospitals. Background.  Accurate nursing documentation enables nurses to systematically review the nursing process and to evaluate the quality of care. Assessing nurses' reports

Medicaid Reimbursement for School Nursing Services: A Position Paper of the National Association of State School Nurse Consultants.

Science.gov (United States)

Journal of School Health, 1996

1996-01-01

This statement of the National Association of State School Nurse Consultants lists those school nursing services and procedures the organization believes should be reimbursable by Medicaid to school districts. Identified services are in the areas of case finding, nursing care procedures, care coordination, patient/student counseling, and emergency…

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

OpenAIRE

A. Aziz Alimul Hidayat; M. Kes

2015-01-01

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

Evaluation of a “Just-in-Time” Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial

Science.gov (United States)

Roblin, Douglas W; Zelman, David; Plummer, Sally; Robinson, Brandi E; Lou, Yiyue; Edmonds, Stephanie W; Wolinsky, Fredric D; Saag, Kenneth G; Cram, Peter

2017-01-01

Context Evidence is inconclusive whether a nurse consultation can improve osteoporosis-related patient outcomes. Objective To evaluate whether a nurse consultation immediately after dual-energy x-ray absorptiometry (DXA) produced better osteoporosis-related outcomes than a simple intervention to activate adults in good bone health practices or usual care. Design Pilot randomized controlled trial, conducted within the larger Patient Activation After DXA Result Notification (PAADRN) trial (NCT01507662). After DXA, consenting adults age 50 years or older were randomly assigned to 3 groups: nurse consultation, PAADRN intervention (mailed letter with individualized fracture risk and an educational brochure), or usual care (control). Nurse consultation included reviewing DXA results, counseling on bone health, and ordering needed follow-up tests or physician referrals. Main Outcome Measures Change from baseline to 52 weeks in participant-reported osteoporosis-related pharmacotherapy, lifestyle, activation and self-efficacy, and osteoporosis care satisfaction. Results Nurse consultation participants (n = 104) reported 52-week improvements in strengthening and weight-bearing exercise (p = 0.09), calcium intake (p Just-in-time” nurse consultation yielded a few improvements over 52 weeks in osteoporosis-related outcomes; however, most changes were not different from those obtained through the lower-cost PAADRN intervention or usual care. PMID:28746019

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

Science.gov (United States)

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

2017-09-01

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

A rock characterisation facility consultative document

International Nuclear Information System (INIS)

1992-10-01

This U.K. Nirex Ltd., consultative document describes a proposed underground rock characterisation facility, east of Sellafield, for conducting geophysical surveys as a basis for refining long-term safety analysis of an underground repository for intermediate-level and low-level radioactive wastes. Planning application will be submitted in 1993. The construction of shafts and galleries is described and the site's geologic, topographical, climatic and archaeological features discussed. The effects to the local environment and on local populations and other socio-economic factors are discussed. (UK)

Transformation of admission interview to documentation for nursing practice

DEFF Research Database (Denmark)

Højskov, Ida E; Glasdam, Stinne

2014-01-01

's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool......The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission...... interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired...

E-nursing documentation as a tool for quality assurance.

Science.gov (United States)

Rajkovic, Vladislav; Sustersic, Olga; Rajkovic, Uros

2006-01-01

The article presents the results of a project with which we describe the reengineering of nursing documentation. Documentation in nursing is an efficient tool for ensuring quality health care and consequently quality patient treatment along the whole clinical path. We have taken into account the nursing process and patient treatment based on Henderson theoretical model of nursing that consists of 14 basic living activities. The model of new documentation enables tracing, transparency, selectivity, monitoring and analyses. All these factors lead to improvements of a health system as well as to improved safety of patients and members of nursing teams. Thus the documentation was developed for three health care segments: secondary and tertiary level, dispensaries and community health care. The new quality introduced to the documentation process by information and communication technology is presented by a database model and a software prototype for managing documentation.

Nurse and allied health professional consultants: perceptions and experiences of the role.

Science.gov (United States)

Stevenson, Kay; Ryan, Sarah; Masterson, Abigail

2011-02-01

To explore the perceptions and experiences of nurse and allied health professional consultants and key stakeholders. Nurse and allied health professional consultants' roles were introduced in the United Kingdom in 1999 with defined role criteria and a remit to improve patient outcomes. Although these roles have now existed for over a decade, there is a lack of research as to whether these roles have achieved their intended impact on clinical care. Through an exploration of the experiences of consultant nurses and allied health professionals and key stakeholders who work with these practitioners, a greater understanding of the consultant role can be achieved. Qualitative. A purposive sample of seven non-medical consultants (five nurses, one physiotherapist and a pharmacist) and eight stakeholders took part in focus group interviews. Each focus group was audio-taped and lasted between 1.5-2 hours. Content analysis was used to interpret the data. Four main themes were identified: (1) Role interpretation--core features include clinical practice, leadership, education and research. Debate surrounded the need to incorporate managerial responsibilities into the role. (2) Role implementation required political skills and emotional intelligence. (3) Role impact especially on clinical practice was a major priority for both groups. (4) Challenges included lack of organisational and administrative support. There was consensus amongst the two groups regarding the value of the role, key role functions and skills and the emerging impact on clinical practice. Both groups were able to identify the clinical impact of the role including helping patients manage chronic pain, reducing the need for follow-up appointments and managing emergency admissions. To capture the clinical diversity of the roles, a variety of evaluation strategies should be implemented. © 2011 Blackwell Publishing Ltd.

Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views.

Science.gov (United States)

Stenner, Karen L; Courtenay, Molly; Carey, Nicola

2011-01-01

There is a drive to improve the quality of service provision for patients with diabetes and to enable better self-management of this condition. The adoption of prescribing by nurses is increasing worldwide and can potentially enhance service provision. Evidence suggests that patients prefer services where their lifestyle factors and opinions are considered by healthcare professionals within a partnership approach. Few studies have explored patients' views about their consultations with a nurse prescriber. To explore the views patients with diabetes have about their consultations with nurse prescribers and any impact this may have on their medications management. A qualitative study involving semi-structured interviews and thematic analysis. Six primary care sites in which nurses prescribed medications for patients with diabetes in England. Data was collected in 2009. Interviews took place with 41 patients with diabetes from the case loads of 7 nurse prescribers. Findings are reported under three themes; the nurse consultation style, benefits of the nurse prescriber consultation and views on involvement and decision-making. Key aspects of the nurse consultation style were a non-hurried approach, care and rapport, approachability, continuity, and providing clear information based on specialist knowledge. Many benefits were described, including improved access to appropriate advice and medication, greater understanding and ability to self-manage, ability to address problems and improved confidence, trust and wellbeing. While patients were happy with the amount of information received and involvement they had decisions about their treatment, there was some controversy over the consistency of information provided on side-effects of treatment. The study provides new knowledge about what patients with diabetes value and benefit from in respect to care provided by nurse prescribers. Continuity of relationship, flexibility over consultation length, nurses' interpersonal

Improving nurse documentation and record keeping in stoma care.

Science.gov (United States)

Law, Lesley; Akroyd, Karen; Burke, Linda

Evidence suggests that nurse documentation is often inconsistent and lacks a coherent and standardized approach. This article reports on research into the use of nurse documentation on a stoma care ward in a large London hospital, and explores the factors that may affect the process of record keeping by nursing staff. This study uses stoma care as a case study to explore the role of documentation on the ward, focusing on how this can be improved. It is based on quantitative and qualitative methods. The medical notes of 56 patients were analysed and in addition, focus groups with a number of nurses were undertaken. Quantitative findings indicate that although 80% of patients had a chart filed in their medical notes, only a small portion of the form was completed by nursing staff. Focus group findings indicate that this is because forms lacked standardization and because the language used was often ambiguous. Staff also felt that such documentation was not viewed by other nurses and so, was not effective in improving patient care. As a result of this study, significant improvements have been made to documentation used on the stoma care ward. This is an important exploration of record keeping within nursing in the context of the Nursing and Midwifery Council's emphasis on the importance of documentation in achieving effective patient outcomes.

Leadership as part of the nurse consultant role: banging the drum for patient care.

Science.gov (United States)

McIntosh, Jean; Tolson, Debbie

2009-01-01

This paper draws upon an evaluation of the first group of nurse consultants in Scotland. The evaluation aimed to identify the extent to which they fulfilled the remit of their posts which comprised four core functions. One of these functions was to provide professional leadership and this paper focuses on this element of the role and aims to explore it in relation to the attributes of transformational leadership. Nurse consultants were introduced in the UK in 2000. Their purpose was to achieve better outcomes for patients and strengthen leadership. Nursing research identifies leadership as a key element of the role, with postholders adopting transformational leadership approaches. Research from the fields of sociology and psychology identifies difficulties in formulating a coherent theory of leadership, arguing for better understanding of leadership processes. Qualitative. This paper draws on 31 semi-structured interviews with four nurse consultants who were interviewed twice over six to nine months and 23 other 'stakeholders' who worked with them. Varied leadership activity at ward, NHS Trust and strategic levels was identified. Postholders used approaches that resonated with the attributes of transformational leadership. Leadership processes included developing a vision for the service, acting as mediator and champion, and exerting control over complex change initiatives. Techniques of leadership included taking a 'softly softly' approach, pacing change initiatives and arguing assertively with those in senior positions. Interview findings also identified the level of preparation that was required to meet the remit of the posts, highlighting the importance of interpersonal skills and intellectual effort in achieving outcomes. Nurse consultants require considerable technical expertise, cognitive and interpersonal skills, and the ability to take risks. The data suggest that the leadership attributes required are transformational in nature but that they also exceed

Delegate, Collaborate, or Consult? A Capstone Simulation for Senior Nursing Students.

Science.gov (United States)

Nowell, Lorelli S

2016-01-01

Clinical experiences are educational and fulfilling for both students and faculty; however, challenges arise in providing students with a variety of experiences where the leadership skills of prioritizing, collaborating, consulting, and delegating care can be developed. This article reports on a capstone simulation created to develop and sustain the prioritization, organization, and delegation skills of fourth year nursing students. Through the introduction of a multipatient simulation prior to graduation, nursing students will have a better understanding of the high-level leadership skills practicing registered nurses must possess in today's demanding health care environment.

Registered nurses' decision-making regarding documentation in patients' progress notes.

Science.gov (United States)

Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne

2012-10-01

To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive

Improving nurse documentation and record keeping in stoma care

OpenAIRE

Law, Lesley; Akroyd, Karen; Burke, Linda

2010-01-01

Evidence suggests that nurse documentation is often inconsistent and lacks a coherent and standardized approach. This article reports on research into the use of nurse documentation on a stoma care ward in a large London hospital, and explores the factors that may affect the process of record keeping by nursing staff. This study uses stoma care as a case study to explore the role of documentation on the ward, focusing on how this can be improved. It is based on quantitative and qualitative me...

[Support of the nursing process through electronic nursing documentation systems (UEPD) – Initial validation of an instrument].

Science.gov (United States)

Hediger, Hannele; Müller-Staub, Maria; Petry, Heidi

2016-01-01

Electronic nursing documentation systems, with standardized nursing terminology, are IT-based systems for recording the nursing processes. These systems have the potential to improve the documentation of the nursing process and to support nurses in care delivery. This article describes the development and initial validation of an instrument (known by its German acronym UEPD) to measure the subjectively-perceived benefits of an electronic nursing documentation system in care delivery. The validity of the UEPD was examined by means of an evaluation study carried out in an acute care hospital (n = 94 nurses) in German-speaking Switzerland. Construct validity was analyzed by principal components analysis. Initial references of validity of the UEPD could be verified. The analysis showed a stable four factor model (FS = 0.89) scoring in 25 items. All factors loaded ≥ 0.50 and the scales demonstrated high internal consistency (Cronbach's α = 0.73 – 0.90). Principal component analysis revealed four dimensions of support: establishing nursing diagnosis and goals; recording a case history/an assessment and documenting the nursing process; implementation and evaluation as well as information exchange. Further testing with larger control samples and with different electronic documentation systems are needed. Another potential direction would be to employ the UEPD in a comparison of various electronic documentation systems.

Supporting clinical leadership through action: The nurse consultant role.

Science.gov (United States)

Rosser, Elizabeth; Grey, Rachael; Neal, Deborah; Reeve, Julie; Smith, Caroline; Valentine, Janine

2017-12-01

To evaluate the effectiveness of an action learning set to enhance clinical leadership and extend their scope and confidence more strategically. As the most senior clinical role in most healthcare systems, the consultant nurse role is a solitary one. They are required to develop personal resilience, commitment and a belief in their ability to lead, with new consultants needing a strong support network to succeed. Following a 2-year action learning set, four nurse consultants, one therapy consultant, and a university educationalist engaged in a cooperative inquiry approach using four cycles of discussion, reflection, analysis and action over an 18-month period from March 2015-July 2016, to learn how to change and enhance their working practices. Data were analysed thematically. Four themes emerged where the action learning set (i) offered structure and support, (ii) enabled a wider influence and (iii) empowered them to lead. The cooperative inquiry helped them realise how much they had gained from their collective learning and they felt empowered to lead. Their motivation to "make a difference" remains palpable. The outcomes of the cooperative inquiry included an enhanced understanding of the importance of openness and trust and a willingness to share and learn from each other in a respectful and confidential environment with a receptiveness to change. Self-leadership has clearly been accepted and embraced, and their collaboration has improved communication across the organisation, enhanced their strategic leadership capability and given confidence to disseminate externally. The action learning set offered structure to support these clinical leaders to keep them focused across the breadth of their role. Additionally, peer review with external facilitation has enabled these clinical leaders to gain a wider influence and empowered them to lead. © 2017 John Wiley & Sons Ltd.

Determining the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant: a cross-sectional survey.

Science.gov (United States)

Fernandez, Ritin S; Sheppard-Law, Suzanne; Manning, Vicki

2017-06-01

Globally, many nurses and midwives are working at an advanced practice level. The role of a Nurse and/or Midwife Consultant encompasses a diverse and complex interaction between five specified domains namely Clinical Service and Consultancy, Clinical Leadership, Research, Education, and Clinical Services Planning and Management. The objective of this replication study was to identify the key drivers and mitigating factors that impact the role of Australian Nurse and/or Midwife Consultants. Cross-sectional survey. The study was conducted in a large metropolitan health district in Sydney, Australia. Participants for this study consisted of all Nurse and/or Midwife Consultants working within a health district in New South Wales (NSW). Data were collected by an anonymous online survey. Key drivers and mitigating factors perceived to influence their role were identified using previously implemented instruments. Data were analysed using SPSS version 21. Responses were obtained from 122 Nurse and/or Midwife Consultants. The number of years of experience as a Nurse and/or Midwife Consultant ranged from 6 months to 25.5 years. Personal attributes which included personal motivation and own communication skills were identified as key drivers to role performance with a mean score of 7.7±0.6. Other key drivers included peer support, organisational culture, personal attributes, professional learning, Nurse and/or Midwife Consultant experience, and collaborative relationships. Of the 14 mitigating factors to the role, the most common factors were lack of resources to set up and develop the role (2.6 ± 0.9), lack of secretarial support (2.6 ± 1.1), lack of managerial support (2.45 ± 1.1), and lack of understanding of the role by other health professionals (2.40 ± 0.8). Understanding the key drivers and mitigating factors that influence the role of the Nurse and/or Midwife Consultant is important for healthcare managers. Given the changing landscape of nursing

Abstract: Identifying Nurse Education Needs with Documentation ...

African Journals Online (AJOL)

Cultural differences have led to the development and implementation of educational topics not reflected in the documentation audit such as professional and institutional accountability rules and regulations for nurses. Conclusions: As nurses in Rwanda implement the change in clinical practice following this study, detailed ...

A Standard, Knowledge Integrated Consultation Document for Pediatric HIV Information Exchange

Directory of Open Access Journals (Sweden)

Debkumar Patra

2011-01-01

Full Text Available HIV/AIDS is one of life-threatening diseases over which human currently does not have enough control. Study and research on HIV and its prevention are being carried out by different organizations. However, they are mostly area specific, thereby, failing to provide a nation-wide or region-wide overview of HIV infection. One of the major bottlenecks in having a wider study is the lack of interoperability among systems managing HIV patient information. Besides, such lack of interoperability also hinders forming larger HIV care network where telemedicine could be accomplished more effectively. We have addressed this interoperability issue through HL7 clinical document architecture (CDA, a document-based messaging standard for clinical interaction. This article introduces a document architecture that conforms to HL7 CDA standard and contains all relevant information of a pediatric HIV patient. We extended the existing architecture of CDA consultation note in three dimensions: (1 HIV specific content, (2 HIV specific knowledgebase and (3 HIV specific presentation of content and knowledge. An example CDA consultation note is demonstrated following the proposed extension.

Vascular neurology nurse practitioner provision of telemedicine consultations.

Science.gov (United States)

Demaerschalk, Bart M; Kiernan, Terri-Ellen J; Investigators, Starr

2010-01-01

Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP) in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS) scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2 +/- 9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0 +/- 9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.

Therapeutic abortion: the psychiatric nurse as therapist, liaison, and consultant.

Science.gov (United States)

Zahourek, R; Tower, M

1971-01-01

It is noted that as abortion becomes an accepted medical practice, more nurses will be involved in the treatment and counseling of the therapeutic abortion patient. The authors, psychiatric nurses in a Colorado comprehensive urban mental health center, became involved in the treatment of the therapeutic abortion patient with the passing of the State's liberalized 1967 abortion law. As they became involved with all aspects of therapeutic abortion patients' care, they identified 3 specific roles for the psychiatric nurse: 1) providing direct They treatment, 2) providing liaison service and promoting continuity of care for the patient, and 3) providing consultation service to the staff involved with the patient. As the psychiatric nurses shared their own mixed feelings about abortion with the obstetrical staff, the staff began to feel less guilty and less alone with their feelings. The became more involved with the patients and benefited them more.

Are nurse-led chemotherapy clinics really nurse-led? An ethnographic study.

Science.gov (United States)

Farrell, Carole; Walshe, Catherine; Molassiotis, Alex

2017-04-01

The number of patients requiring ambulatory chemotherapy is increasing year on year, creating problems with capacity in outpatient clinics and chemotherapy units. Although nurse-led chemotherapy clinics have been set up to address this, there is a lack of evaluation of their effectiveness. Despite a rapid expansion in the development of nursing roles and responsibilities in oncology, there is little understanding of the operational aspects of nurses' roles in nurse-led clinics. To explore nurses' roles within nurse-led chemotherapy clinics. A focused ethnographic study of nurses' roles in nurse-led chemotherapy clinics, including semi-structured interviews with nurses. Four chemotherapy units/cancer centres in the UK PARTICIPANTS: Purposive sampling was used to select four cancer centres/units in different geographical areas within the UK operating nurse-led chemotherapy clinics. Participants were 13 nurses working within nurse-led chemotherapy clinics at the chosen locations. Non-participant observation of nurse-led chemotherapy clinics, semi-structured interviews with nurse participants, review of clinic protocols and associated documentation. 61 nurse-patient consultations were observed with 13 nurses; of these 13, interviews were conducted with 11 nurses. Despite similarities in clinical skills training and prescribing, there were great disparities between clinics run by chemotherapy nurses and those run by advanced nurse practitioners. This included the number of patients seen within each clinic, operational aspects, nurses' autonomy, scope of practice and clinical decision-making abilities. The differences highlighted four different levels of nurse-led chemotherapy clinics, based on nurses' autonomy and scope of clinical practice. However, this was heavily influenced by medical consultants. Several nurses perceived they were undertaking holistic assessments, however they were using medical models/consultation styles, indicating medicalization of nurses' roles

Impact of the nursing consultation in the External Fixatives Clinic of National Children Hospital

Directory of Open Access Journals (Sweden)

Virginia Salas Cerdas

2013-04-01

Full Text Available This article presents the results of a study which analyzed 10 cases (8 female and 2 male aged betweentwo and 17 years, with a number of bone defects, and conducted over a period of three months in the externalfixator Clinic National Children's Hospital. Aimed to provide a clear vision about the need of this pediatricpopulation to have a consultation with Clinical Nursing. The exploratory study was conducted using anobservation guide and interviews with users, parents and interdisciplinary team, and implemented the nursingsegmented into three stages: pre-consultation, consultation and post-consultation, evaluating each the problemsand needs of each user (a, as well as the achievements of the children in this research and the role played by thenurse in the consultations. The results show specifically the educational aspects in physical and emotional healthnurse that gave the users and their families and at-hospital benefits through the implementation of the nursing. Weconclude that children participating in the study achieve proper assimilation and implementation of healtheducation regarding: skin healing fixer, signs and symptoms of infection, operation keys, administration ofantibiotics, plaster care and healthy food choices. In addition, awareness was achieved in children and theirparents in monitoring medical indications allowing satisfactory results in treatment.

Practical Nursing Education: Criteria and Procedures for Accreditation.

Science.gov (United States)

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

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

Vascular Neurology Nurse Practitioner Provision of Telemedicine Consultations

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Bart M. Demaerschalk

2010-01-01

Full Text Available Objective. The objective was to define and evaluate a role for the Vascular Neurology-Nurse Practitioner (VN-NP in the delivery of telemedicine consultations in partnership with a vascular neurologist. Methods. Prospective stroke alert patients at participating hospitals underwent a two-way audio video telemedicine consultation with a VN-NP at a remotely located stroke center in partnership with a vascular neurologist. Demographic information, National Institutes of Health Stroke Scale (NIHSS scores, diagnoses, CT contraindications to thrombolysis, thrombolysis eligibility, and time interval data were collected. The inter-rater agreement between VN-NP and vascular neurologist assessments was calculated. Results. Ten patients were evaluated. Four were determined to have ischemic stroke, one had a transient ischemic attack, two had intracerebral hemorrhages, and three were stroke mimics. Overall, three patients received thrombolysis. The inter-rater agreement between VN-NP and vascular neurologist assessments were excellent, ranging from 0.9 to 1.0. The duration of VN-NP consultation was 53.2±9.0 minutes, which included the vascular neurologist supervisory evaluation time of 12.0±9.6 minutes. Conclusion. This study illustrated that a stroke center VN-NP, in partnership with a vascular neurologist, could deliver timely telemedicine consultations, accurate diagnoses, and correct treatments in acute stroke patients who presented to remotely located rural emergency departments within a hub and spoke network. VN-NPs may fulfill the role of a telestroke provider.

Accuracy of nurse documentation of delirium symptoms in medical charts.

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Voyer, Philippe; Cole, Martin G; McCusker, Jane; St-Jacques, Sylvie; Laplante, Johanne

2008-04-01

The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.

An exploration of the role and scope of the clinical nurse consultant (CNC) in a metropolitan health service.

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Bloomer, Melissa J; Cross, Wendy M

2011-01-01

Clinical nurse consultants have been a part of the nursing workforce for some time however a lack of clarity regarding this role has led to significant variations in health service expectations, workloads and scope for the Clinical nurse consultants working within this metropolitan health service. The aim of this study was to explore the role of the CNC as it is perceived by them, in the context of this health service. A qualitative approach was used for this study. Following ethics approval a single audio-taped focus group was undertaken to gather data. Guiding questions were used to elicit responses from the group, moderated by the co-investigators. The focus group was transcribed verbatim. Each researcher independently analysed the narrative data, using coding and clustering the data to develop primary and sub-themes. Whilst each participant experiences their role individually, there were four themes derived from comments expressed by the participants: 'Diversity and conflict', 'Leaders but powerless', 'Support systems' and 'The portfolio holder role'. The role of the Clinical nurse consultant is complex and diverse. The variability in the role suggests that organisational consensus of the role, scope and purpose of the CNC position has not been actualised, resulting in a lack of support systems, and an underutilisation of the Clinical nurse consultants as leaders, where they can challenge existing practice and guide future directions in care delivery.

Teaching home care electronic documentation skills to undergraduate nursing students.

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Nokes, Kathleen M; Aponte, Judith; Nickitas, Donna M; Mahon, Pamela Y; Rodgers, Betsy; Reyes, Nancy; Chaya, Joan; Dornbaum, Martin

2012-01-01

Although there is general consensus that nursing students need knowledge and significant skill to document clinical findings electronically, nursing faculty face many barriers in ensuring that undergraduate students can practice on electronic health record systems (EHRS). External funding supported the development of an educational innovation through a partnership between a home care agency staff and nursing faculty. Modules were developed to teach EHRS skills using a case study of a homebound person requiring wound care and the Medicare-required OASIS documentation system. This article describes the development and implementation of the module for an upper-level baccalaureate nursing program located in New York City. Nursing faculty are being challenged to develop creative and economical solutions to expose nursing students to EHRSs in nonclinical settings.

The changes in caregivers' perceptions about the quality of information and benefits of nursing documentation associated with the introduction of an electronic documentation system in a nursing home.

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Munyisia, Esther N; Yu, Ping; Hailey, David

2011-02-01

To date few studies have compared nursing home caregivers' perceptions about the quality of information and benefits of nursing documentation in paper and electronic formats. With the increased interest in the use of information technology in nursing homes, it is important to obtain information on the benefits of newer approaches to nursing documentation so as to inform investment, organisational and care service decisions in the aged care sector. This study aims to investigate caregivers' perceptions about the quality of information and benefits of nursing documentation before and after the introduction of an electronic documentation system in a nursing home. A self-administered questionnaire survey was conducted three months before, and then six, 18 and 31 months after the introduction of an electronic documentation system. Further evidence was obtained through informal discussions with caregivers. Scores for questionnaire responses showed that the benefits of the electronic documentation system were perceived by the caregivers as provision of more accurate, legible and complete information, and reduction of repetition in data entry, with consequential managerial benefits. However, caregivers' perceptions of relevance and reliability of information, and of their communication and decision-making abilities were perceived to be similar either using an electronic or a paper-based documentation system. Improvement in some perceptions about the quality of information and benefits of nursing documentation was evident in the measurement conducted six months after the introduction of the electronic system, but were not maintained 18 or 31 months later. The electronic documentation system was perceived to perform better than the paper-based system in some aspects, with subsequent benefits to management of aged care services. In other areas, perceptions of additional benefits from the electronic documentation system were not maintained. In a number of attributes, there

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

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Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and

Health Information Technology, Patient Safety, and Professional Nursing Care Documentation in Acute Care Settings.

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Lavin, Mary Ann; Harper, Ellen; Barr, Nancy

2015-04-14

The electronic health record (EHR) is a documentation tool that yields data useful in enhancing patient safety, evaluating care quality, maximizing efficiency, and measuring staffing needs. Although nurses applaud the EHR, they also indicate dissatisfaction with its design and cumbersome electronic processes. This article describes the views of nurses shared by members of the Nursing Practice Committee of the Missouri Nurses Association; it encourages nurses to share their EHR concerns with Information Technology (IT) staff and vendors and to take their place at the table when nursing-related IT decisions are made. In this article, we describe the experiential-reflective reasoning and action model used to understand staff nurses' perspectives, share committee reflections and recommendations for improving both documentation and documentation technology, and conclude by encouraging nurses to develop their documentation and informatics skills. Nursing issues include medication safety, documentation and standards of practice, and EHR efficiency. IT concerns include interoperability, vendors, innovation, nursing voice, education, and collaboration.

Nursing documentation: experience of the use of the nursing process model in selected hospitals in Ibadan, Oyo State, Nigeria.

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Ofi, Bola; Sowunmi, Olanrewaju

2012-08-01

The descriptive study was conducted to determine the extent of utilization of the nursing process for documentation of nursing care in three selected hospitals, Ibadan, Nigeria. One hundred fifty nurses and 115 discharged clients' records were selected from the hospitals. Questionnaires and checklists were used to collect data. Utilization of nursing process for care was 100%, 73.6% and 34.8% in the three hospitals. Nurses encountered difficulties in history taking, formulation of nursing diagnoses, objectives, nursing orders and evaluation. Most nurses disagreed or were undecided with the use of authorized abbreviations and symbols (34.3%, 40.3% and 69.5%), recording errors that occurred during care (37.1%, 56.1% and 52.2%) and inclusion of change in clients' condition (54.3%, 56.1% and 73.8%). Most nurses appreciated the significance of documentation. Lack of time, knowledge and need for extensive writing are the major barriers against documentation. Seventy-seven point four per cent of the 115 clients' records from one hospital showed evidence of documentation, no evidence from the other two. Study findings have implications for continuing professional education, practice and supervision. © 2012 Blackwell Publishing Asia Pty Ltd.

Global Nursing Issues and Development: Analysis of World Health Organization Documents.

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Wong, Frances Kam Yuet; Liu, Huaping; Wang, Hui; Anderson, Debra; Seib, Charrlotte; Molasiotis, Alex

2015-11-01

To analyze World Health Organization (WHO) documents to identify global nursing issues and development. Qualitative content analysis. Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus. Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8). The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened. Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health. © 2015 Sigma Theta Tau International.

ANALYZED FACTORS THAT LEADS TO THE BALANCED SCORECARD NURSING CARE DOCUMENTATION AT RUMAH SAKIT JIWA MENUR SURABAYA

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Yuli Anggraini

2017-04-01

Full Text Available Introduction: Nursing documentation is an important aspect of nursing practice so that should be assessed comprehensively. The objective of the study was to analyze the causing factor of nursing care documentation at Rumah Sakit Jiwa Menur Surabaya through balanced scorecard. Method: This research was an analytical descriptive conducted out on January 2010 at Rumah Sakit Jiwa Menur Surabaya that measured nursing care documentation through four perspectives of balanced scorecard by distributing quisioner to 55 nurses and 69 customers (patient families using inclusion criteria, and holding personal interview to 3 structural offi cial, 2 functional official, and 6 ward supervisors. Data of nurse education, percentage of trained nurse was gained by checklist. Data were analyzed using content analysis to fi nd the causing factor of nursing documentation within balanced scorecard. Result: The result showed that financial, internal business processes, and learning and growth perspectives had causal relationship with nursing care documentation at Rumah Sakit Jiwa Menur Surabaya, but customer perspective didn’t have direct causal relationship with it. Discussion: It can be concluded that impractical nursing documentation form especially in dimension of time on assessment, implementation, and evaluation, and comprehension on assessment, absence of physical nursing standards, limited knowledge on nursing documentation evoked by absence of inhouse training about nursing documentation, ineffective supervision and audit were factors which affecting nursing documentation at Rumah Sakit Jiwa Menur Surabaya. The researcher recommended that the hospital manager should modificate the nursing documentation form using NIC & NOC of NANDA and computerized system, compose physical nursing standards, carry out advanced nursing education and inhouse training about nursing care documentation, improve supervision program, and nursing documentation audit.

Quality improvement in documentation of postoperative care nursing using computer-based medical records

DEFF Research Database (Denmark)

Olsen, Susanne Winther

2013-01-01

on the template with quantitative data showed satisfactory documentation of postoperative care nursing in 67% (18% to 92%; mean [min-max]) of the scores. The template for documentation using qualitative descriptions was used by 63% of the nurses, but the keywords were used to a varying degree, that is, from 0......Postanesthesia nursing should be documented with high quality. The purpose of this retrospective case-based study on 49 patients was to analyze the quality of postoperative documentation in the two existing templates and, based on this audit, to suggest a new template for documentation. The audit...

Report on AECB consultative document C-70: The use of fault trees in licensing submissions

International Nuclear Information System (INIS)

1984-01-01

The Atomic Energy Control Board (AECB) has issued Consultative Document C-70, 'The Use of Fault Trees in Licensing Submissions', for public comment. The Advisory Committee on Nuclear Safety (ACNS) has examined this document and ACNS members have met with AECB staff and representatives of the nuclear industry to discuss it. The ACNS presents its comments and recommendations in this report. The consultative document defines a fault tree as a hierarchically-structured graphical representation of system failures and their potential causes. The document then states certain basic characteristics or attributes which fault trees should possess, and certain conditions affecting the use of fault trees. It defines fault tree fundamentals, sets criteria for the application of fault trees to systems and defines ground rules for a fault tree format. Finally, in two appendices, it includes specific rules for fault tree symbols and fault tree description files for computer use. The appendices are referred to in the text as 'acceptable' standards or methods

Applying language technology to nursing documents: pros and cons with a focus on ethics.

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Suominen, Hanna; Lehtikunnas, Tuija; Back, Barbro; Karsten, Helena; Salakoski, Tapio; Salanterä, Sanna

2007-10-01

The present study discusses ethics in building and using applications based on natural language processing in electronic nursing documentation. Specifically, we first focus on the question of how patient confidentiality can be ensured in developing language technology for the nursing documentation domain. Then, we identify and theoretically analyze the ethical outcomes which arise when using natural language processing to support clinical judgement and decision-making. In total, we put forward and justify 10 claims related to ethics in applying language technology to nursing documents. A review of recent scientific articles related to ethics in electronic patient records or in the utilization of large databases was conducted. Then, the results were compared with ethical guidelines for nurses and the Finnish legislation covering health care and processing of personal data. Finally, the practical experiences of the authors in applying the methods of natural language processing to nursing documents were appended. Patient records supplemented with natural language processing capabilities may help nurses give better, more efficient and more individualized care for their patients. In addition, language technology may facilitate patients' possibility to receive truthful information about their health and improve the nature of narratives. Because of these benefits, research about the use of language technology in narratives should be encouraged. In contrast, privacy-sensitive health care documentation brings specific ethical concerns and difficulties to the natural language processing of nursing documents. Therefore, when developing natural language processing tools, patient confidentiality must be ensured. While using the tools, health care personnel should always be responsible for the clinical judgement and decision-making. One should also consider that the use of language technology in nursing narratives may threaten patients' rights by using documentation collected

QUALITY OF NURSING DOCUMENTATION AND NURSE’S OBJECTIVE WORKLOAD BASED ON TIME AND MOTION STUDY (TMS

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Mira Amelynda Prakosa

2017-02-01

Full Text Available Introduction. The quality of documentation can decrease because of bad admission filling of documentation. Workload is one of the factor that can influence admission filling of documentation. This study was aimed to analyze the correlation between nurse’s objective workload and the quality of nursing documentation in RSU Haji. Method. The design of this study was descriptive correlation with cross-sectional approach. The population on this study was the nurse that works in Marwah 3 and 4 inpatient care in RSU Haji Surabaya. The number of the sample was 14 respondents were selected by simple random sampling. The independent variable was nurse’s objective workload and the dependent variable was quality of nursing documentation. The data were analyzed by using regression logistic. Result. Nurse’s objective workload in RSU Haji was 72%. There was no correlational between nurse’s objective workload with the completeness of nursing documentation (P= 0,999, also nurse’s objective workload with accurate of nursing documentation (P= 0,999. Discussion. This study concluded that nurse’s objective workload was low and quality of nursing documentation was accurate enough and complete enough. Next researcher should provide precise operational so the factors that affected the quality of documentation can be reached and the workload of the nurses in RSU Haji become ideal. Keyword:  nurses, quality of nursing documentation, objective workload

Using an Educational Electronic Documentation System to Help Nursing Students Accurately Identify Nursing Diagnoses

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Pobocik, Tamara J.

2013-01-01

The use of technology and electronic medical records in healthcare has exponentially increased. This quantitative research project used a pretest/posttest design, and reviewed how an educational electronic documentation system helped nursing students to identify the accurate related to statement of the nursing diagnosis for the patient in the case…

Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA

DEFF Research Database (Denmark)

Sørensen, Jan; Primdahl, J; Horn, Hc

2014-01-01

per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Conclusions: Shared care and nurse care seem to cost less but provide broadly similar......Objectives: To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). Method: In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse...... consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient...

Patients' level of satisfaction and self-reports of intention to comply following consultation with nurses and midwives with prescriptive authority: a cross-sectional survey.

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Drennan, Jonathan; Naughton, Corina; Allen, Deirdre; Hyde, Abbey; O'Boyle, Kathy; Felle, Patrick; Treacy, Margaret Pearl; Butler, Michelle

2011-07-01

Prescriptive authority for nurses and midwives was introduced in Ireland in 2007. This allows nurses and midwives who have completed a prescribing preparation programme to independently prescribe a wide-range of medications. To date little is known of patient outcomes such as satisfaction with the consultation process and intention to comply as a consequence of the introduction of nurse and midwife prescribing. There are four principal objectives within this study: (1) to measure the level of patients' satisfaction with education and advice received from a nurse or midwife with a prescribing remit; (2) to measure patients' satisfaction with the consultation process; (3) to measure patients' self-reports of their intention to comply with the prescriber's prescription and advice; and (4) to identify the variables that predict patients' intention to comply with the prescription and advice provided by a nurse or midwife with prescriptive authority. Cross-sectional descriptive survey. A total of one hundred and forty respondents completed the survey. Respondents consisted of adult patients who had received a prescription from a nurse prescriber in a general hospital, women who had received a prescription from a midwife in a maternity hospital and parents whose child received a prescription from a nurse in a children's hospital. Instruments used to measure patient outcomes included the Consultation Satisfaction Questionnaire (CSQ) and the compliance intent subscale of the Medical Interview Satisfaction Scale (MISS). A linear multiple regression model was performed to identify the variables that predicted patients' intent to comply. Patients and parents surveyed were highly satisfied with the care they received from nurses and midwives with prescriptive authority. Respondents also reported that they received comprehensive education and advice. Predictors of compliance intent included patient satisfaction with the time spent with the nurse or midwife during the prescribing

Falls documentation in nursing homes: agreement between the minimum data set and chart abstractions of medical and nursing documentation.

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Hill-Westmoreland, Elizabeth E; Gruber-Baldini, Ann L

2005-02-01

To assess the agreement between falls as recorded in the Minimum Data Set (MDS) and fall events abstracted from chart documentation of elderly nursing home (NH) residents. Secondary analysis of data from a longitudinal panel study. Fifty-six randomly selected NHs in Maryland stratified by facility size and geographic region. Four hundred sixty-two NH residents, aged 65 and older, in NHs for 1 year. Falls were abstracted from resident charts and compared with MDS fall variables. Fall events data obtained from other sources of chart documentation were matched for the corresponding periods of 30 and 180 days before the 1-year MDS assessment date. For a 30-day period, concordance between the MDS and chart abstractions of falls occurred in 65% of cases, with a kappa coefficient of 0.29 (Pfalls the MDS missed indicated that these residents had significantly more activity of daily living impairment and significantly less unsteady gait and cane/walker use. The MDS underreported falls. Nurses completing MDS assessments must carefully review residents' medical records for falls documentation. Future studies should use caution when employing MDS data as the only indicator of falls.

IMPROVING PERFORMANCE OF NURSING DOCUMENTATION BASED ON KNOWLEDGE MANAGEMENT THROUGH SECI CONCEPT MODEL’S

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R. Arief Santoso

2017-04-01

Full Text Available Introduction: Documentation of nursing care in Kalianget RSI in 2011 was totaled average 58,1% and in 2012 achieve was still low. According the lowest component was nursing diagnosis. This research aims to improve the performance of nursing care documentation based on knowledge management through the SECI Model’s concept in Garam Kalianget RSI Sumenep District. Method: Design of this research was action research. Population and sample in the research of knowledge, motivation and work responsibility were all nurses total ed 29 people. The dependent variable were knowledge, performance, motivation, work responsibility, and performance after intervention knowledge management (KM and as independent variable in this research was knowledge, performance, and intervention research knowledge management in documentation nursing care. Data were collected by using questionnaires and checklists. Result: The results after the SECI model’s intervention and using Paired t Test with a 95% confidence level of knowledge obtained p = 0.0001 which means that there was a significant knowledge difference between before and after intervention, comparison of performance documenting of nursing care obtained value ρ = 0.004, which means there was a difference significant performance between before and after intervention. Comparison of SBAR effective communication performance values obtained ρ = 0.001, which means there was a significant performance difference between before and after intervention. Discussion: Knowledge management through SECI model’s has important role in improving performance documentation of nursing care and SBAR effective communication. It is recommended to do in forum sharing nurse’s experience or informant in practical communication in periodic, recording, documentation, and keep document well and doing supervision continously especially form nursing care and SBAR effective communication.

[Forensic nursing in Germany? Nurses' perceptions of domestic violence].

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Blättner, Beate; Georgy, Sascha; Krüger, Kerstin

2008-12-01

More than one of three women has been a victim of domestic violence at least once. Victims would like to have a well-informed contact person within the healthcare system who knows about support programs. In many countries that is the responsibility of the healthcare system and is called Forensic Nursing. Therefore, it is interesting to know how nurses in Germany perceive domestic violence and under what circumstances they could imagine taking on tasks in the fields of documentation and nursing. The data for this qualitative study was collected via four focus groups consisting of 38 nurses--3 men and 35 women--with work experience in a hospital. Nurses seem to have difficulties in recognising domestic violence. Whether the subject of domestic violence is addressed explicitly depends on the relationship built up between the patient and the nurses. Nurses do not necessarily take further steps. They could imagine providing help by listening actively, providing information about support programs and providing consulting services. Only occasionally nurses agree to document the case to be used as forensic evidence. Another open issue is appropriate remuneration. It is necessary to integrate that subject systematically into basic and advanced training on different levels of qualification.

Nurses' Perceptions of Nursing Care Documentation in the Electronic Health Record

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Jensen, Tracey A.

2013-01-01

Electronic health records (EHRs) will soon become the standard for documenting nursing care. The EHR holds the promise of rapid access to complete records of a patient's encounter with the healthcare system. It is the expectation that healthcare providers input essential data that communicates important patient information to support quality…

2008 HIMSS Survey results: best practices in implementing nursing/interdisciplinary documentation systems.

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Newbold, Susan K; Kimmel, Kathleen C; O'Steen, Randy; Morgan, Gina Sauls

2008-11-06

Health care organizations are increasingly using computer systems to support nursing care documentation; however, processes used to deploy such systems are widely varied. The purpose of this survey was to understand current practices related to implementation of computerized nursing and interdisciplinary documentation systems with the goal to establish best practice guidelines. In Spring 2007, members from the Healthcare Information Management and Systems Society Nursing Informatics Working Group interviewed a sample of 15 hospitals to solicit information regarding the following processes: leadership activities, clinical transformation processes, project management activities, implementation processes, evaluation metrics, terminology and other standards used, and methods used to facilitate end-user adoption. This poster will report the results of this survey. Implications for Nurses will be discussed. The results are valuable to nursing informatics professionals who plan to implement systems and to their nursing executives responsible for the systems that are implemented.

The Basic Documentation for Psycho-Oncology (PO-Bado): an innovative tool to combine screening for psychological distress and patient support at cancer diagnosis.

Science.gov (United States)

Stadelmaier, Nena; Duguey-Cachet, Odile; Saada, Yael; Quintard, Bruno

2014-03-01

The Basic Documentation for Psycho-Oncology (PO-Bado) is a semi-directive instrument for assessing psychosocial difficulties in cancer patients. It is based on subjective status and not on degree of symptom severity. Our objectives were to assess whether use of the PO-Bado during post-cancer-diagnosis consultations improves the quality of communication by establishing a supportive relationship between nurses and patients and to assess nurses' satisfaction of their communication skills. Data were collected from post-diagnosis 'bad-news' consultations across four Cancer treatment centres in South West France. Eleven nurses who had never used the PO-Bado ('inexperienced group') received training on the instrument (short-form). Twenty-one pre-training consultations without the PO-Bado were recorded and compared with 21 post-training consultations with the PO-Bado. Twenty consultations with four nurses with experience using the PO-Bado ('experienced group') were included for between-group comparisons. Nurses' satisfaction was evaluated through semi-directive consultations at the end of the study and completed by a visual analogue scale. We transcribed and analysed 62 consultations. We observed greater use of techniques encouraging patient expression in consultations with PO-Bado-experienced nurses (p communications skills after PO-Bado training and stated that they felt more competent, particularly for referrals to psychologists. The PO-Bado is beneficial for the quality of the communication between nurses and patients at bad-news delivery consultations and for the satisfaction of nurses with regard to their relational skills. Copyright © 2013 John Wiley & Sons, Ltd.

Nurse management of 'same day' consultation for patients with minor illnesses: results of an extended programme in primary care in Catalonia.

Science.gov (United States)

Fabrellas, Núria; Vidal, Angel; Amat, Gemma; Lejardi, Yolanda; del Puig Deulofeu, Maria; Buendia, Carmen

2011-08-01

This paper is a report of a study to assess the feasibility and efficacy of a programme of nurse management for patients requesting same day consultation for minor illnesses in primary care. The efficacy of such programmes has been demonstrated in randomized studies but there is little information on these programmes in highly populated areas. Patients seeking same day consultation for one of 23 preselected minor illnesses (16 for adults, 7 for paediatric patients) from March 2009 to April 2010 were seen by trained nurses who followed predefined algorithms. If signs of alarm were detected, patients were referred to a general practitioner. A total of 629,568 consultations were performed, 575,189 in adults and 54,379 in paediatric patients. Case resolution was achieved in 61.8% of adult and 75.6% of paediatric patients. In adults, the highest resolution rates (>90%) were obtained for burns, skin injury and emergency contraception, and the lowest for lower urinary symptoms (46.7%), sore throat (45.7%), pink eye (45.5%) and upper respiratory symptoms (41.4%). In paediatric patients, the highest resolution rates (>90%) were obtained for stomach cramps and burns and the lowest for cough (36.2%). A return to consultation during a 7-day period for the same reason as the first consultation was low, 4% for adults and 2.4% for paediatric patients. An extended programme of nurse management for same day consultation of patients with minor illnesses showed an acceptably high rate of resolution and low rate of return to consultation. The application of such programmes in extensive areas is feasible and effective. © 2011 Blackwell Publishing Ltd.

3 CFR - Tribal Consultation

Science.gov (United States)

2010-01-01

.... Recommendations for improving the plans and making the tribal consultation process more effective, if any, should... 3 The President 1 2010-01-01 2010-01-01 false Tribal Consultation Presidential Documents Other Presidential Documents Memorandum of November 5, 2009 Tribal Consultation Memorandum for the Heads of Executive...

Shared consultant physician posts.

LENUS (Irish Health Repository)

Cooke, J

2012-01-31

Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.

Nurse telephone triage in out-of-hours GP practice: determinants of independent advice and return consultation

Directory of Open Access Journals (Sweden)

Klazinga Niek S

2006-12-01

Full Text Available Abstract Background Nowadays, nurses play a central role in telephone triage in Dutch out-of-hours primary care. The percentage of calls that is handled through nurse telephone advice alone (NTAA appears to vary substantially between GP cooperatives. This study aims to explore which determinants are associated with NTAA and with subsequent return consultations to the GP. Methods For the ten most frequently presented problems, a two-week follow-up cohort study took place in one cooperative run by 25 GPs and 8 nurses, serving a population of 62,291 people. Random effects logistic regression analysis was used to study the determinants of NTAA and return consultation rates. The effect of NTAA on hospital referral rates was also studied as a proxy for severity of illness. Results The mean NTAA rate was 27.5% – ranging from 15.5% to 39.4% for the eight nurses. It was higher during the night (RR 1.63, CI 1.48–1.76 and lower with increasing age (RR 0.96, CI 0.93–0.99, per ten years or when the patient presented >2 problems (RR 0.65; CI 0.51–0.83. Using cough as reference category, NTAA was highest for earache (RR 1.49; CI 1.18–1.78 and lowest for chest pain (RR 0.18; CI 0.06–0.47. After correction for differences in case mix, significant variation in NTAA between nurses remained (p Conclusion Important inter-nurse variability may indicate differences in perception on tasks and/or differences in skill to handle telephone calls alone. Future research should focus more on modifiable determinants of NTAA rates.

Psychometric Evaluation of the D-Catch, an Instrument to Measure the Accuracy of Nursing Documentation.

Science.gov (United States)

D'Agostino, Fabio; Barbaranelli, Claudio; Paans, Wolter; Belsito, Romina; Juarez Vela, Raul; Alvaro, Rosaria; Vellone, Ercole

2017-07-01

To evaluate the psychometric properties of the D-Catch instrument. A cross-sectional methodological study. Validity and reliability were estimated with confirmatory factor analysis (CFA) and internal consistency and inter-rater reliability, respectively. A sample of 250 nursing documentations was selected. CFA showed the adequacy of a 1-factor model (chronologically descriptive accuracy) with an outlier item (nursing diagnosis accuracy). Internal consistency and inter-rater reliability were adequate. The D-Catch is a valid and reliable instrument for measuring the accuracy of nursing documentation. Caution is needed when measuring diagnostic accuracy since only one item measures this dimension. The D-Catch can be used as an indicator of the accuracy of nursing documentation and the quality of nursing care. © 2015 NANDA International, Inc.

Achieving IT-supported standardized nursing documentation through participatory design

DEFF Research Database (Denmark)

Rasmussen, Stine Loft; Lyng, Karen Marie; Jensen, Sanne

2012-01-01

that support guideline-based highly structured standard documentation in a large organization with many stakeholders. Applying a participatory design (PD) approach at many organizational levels has involved the stakeholders actively in the design process. Developing a set of design principles has concurrently......In the Capital Region of Denmark a full-scale pilot project on IT-supported nursing documentation is - after running for two months at one full university hospital - showing promising results. In this paper we discuss participatory design as a method to design clinical documentation templates...

The impact of an intervention for nurse prescribers on consultations to promote patient medicine-taking in diabetes

DEFF Research Database (Denmark)

Latter, Sue; Sibley, Andrew; Skinner, Timothy C.

2010-01-01

Background: Nurse prescribers are in a key position to promote medicine-taking in diabetes. Although patients' beliefs about medicines are important predictors of medicine-taking, evidence suggests nurses do not routinely explore these. Objectives: To evaluate a theory-based intervention designed......-efficacy framework in the intervention, to promote nurses' confidence in working in a different way, may have been instrumental in effecting the changes found. Contextual factors influencing beliefs exploration in medicine-taking consultations were identified.......Background: Nurse prescribers are in a key position to promote medicine-taking in diabetes. Although patients' beliefs about medicines are important predictors of medicine-taking, evidence suggests nurses do not routinely explore these. Objectives: To evaluate a theory-based intervention designed...... to increase nurse prescribers' exploration of medicines' beliefs with people with diabetes. Design: Mixed methods concurrent triangulation design. Settings: Nurse prescribers were recruited from 7 Trusts in England. Participants: A purposive sample of 14 nurse prescribers attended four 1 day workshops...

Using an educational electronic documentation system to help nursing students accurately identify patient data.

Science.gov (United States)

Pobocik, Tamara

2015-01-01

This quantitative research study used a pretest/posttest design and reviewed how an educational electronic documentation system helped nursing students to identify the accurate "related to" statement of the nursing diagnosis for the patient in the case study. Students in the sample population were senior nursing students in a bachelor of science nursing program in the northeastern United States. Two distinct groups were used for a control and intervention group. The intervention group used the educational electronic documentation system for three class assignments. Both groups were given a pretest and posttest case study. The Accuracy Tool was used to score the students' responses to the related to statement of a nursing diagnosis given at the end of the case study. The scores of the Accuracy Tool were analyzed, and then the numeric scores were placed in SPSS, and the paired t test scores were analyzed for statistical significance. The intervention group's scores were statistically different from the pretest scores to posttest scores, while the control group's scores remained the same from pretest to posttest. The recommendation to nursing education is to use the educational electronic documentation system as a teaching pedagogy to help nursing students prepare for nursing practice. © 2014 NANDA International, Inc.

Use of public health nurse competencies to develop a childcare health consultant workforce.

Science.gov (United States)

Wold, Judith Lupo; Gaines, Sherry K; Leary, Janie M

2006-01-01

The purpose of this article is to describe the efforts in the state of Georgia to train public health nurse-childcare health consultants (PHN-CCHCs) using the framework of the "Core competencies for public health practice." The goal of the training was twofold: (1) to prepare a statewide cadre of PHNs as the primary workforce for Georgia's emerging childcare health consultation (CCHC) system and (2) to prepare their district nurse directors to lead and support CCHCs. Administrators attended a 2-day workshop followed by access to executive coaching for their management teams. PHNs participated in a three-phase training program, with phases 1 and 3 offered as 3-day workshops with field experiences, and phase 2 offered online and as a practicum. Forty-four administrators and over 85 PHN-CCHCs completed the training. Graduates of the program reported satisfaction with training and reported the use of PHN core competencies in CCHC. Graduates also found enhanced skills in using core competencies to be applicable to a variety of population-based practices. Beyond CCHC being instituted in selected health districts, interest in CCHC has occurred statewide. The PHN-CCHC program enhanced the knowledge and use of core competencies and heightened interest in CCHC statewide.

Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations.

Science.gov (United States)

Weiss, Marjorie C; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea

2015-09-01

Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy. There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups. Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

Science.gov (United States)

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, Ppaper-based system (Ppaper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright �

Improving the Quality of Nursing Documentation in Home Health Care Setting

Science.gov (United States)

Obioma, Chidiadi

2017-01-01

Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the…

Carrying out Electronic Nursing Documentation : Use and Development in Primary Health Care

OpenAIRE

Törnvall, Eva

2008-01-01

Communication of care is essential in the multidisciplinary health care system and the patient record is an important tool for communication. The electronic patient record was introduced to facilitate the documentation of care, as well as the communication and evaluation of care. District nurses met the patient independently of other caregivers at the surgery or in the patient’s home. Documentation by district nurses is assumed to contribute to the view of the patient so that safe care can be...

Strategies to Promote Adherence to Antiretroviral Therapy Applied by Dutch HIV Nurse Consultants : A Descriptive Qualitative Study

NARCIS (Netherlands)

Vervoort, Sigrid C. J. M.; Grypdonck, Mieke H. F.; Dijkstra, Boukje M.; Hazelzet, Esther E. B.; Fledderus, Bert; Borleffs, Jan C. C.; Hoepelman, Andy I. M.

2010-01-01

This study describes strategies used by Dutch HIV nurse consultants to promote adherence to anti retroviral therapy (ART) and the assumptions on which these strategies were based. The study used a descriptive qualitative design with individual and focus group interviews. Individual semi-structured

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

Science.gov (United States)

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

2011-01-01

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

Benefits of a telepsychiatry consultation service for rural nursing home residents.

Science.gov (United States)

Rabinowitz, Terry; Murphy, Katharine M; Amour, Judith L; Ricci, Michael A; Caputo, Michael P; Newhouse, Paul A

2010-01-01

Psychiatric care for nursing home residents is difficult to obtain, especially in rural areas, and this deficiency may lead to significant morbidity or death. Providing this service by videoconference may be a helpful, cost-effective, and acceptable alternative to face-to-face treatment. We analyzed data for 278 telepsychiatry encounters for 106 nursing home residents to estimate potential cost and time savings associated with this modality compared to in-person care. A total of 843.5 hours (105.4 8-hour work days) of travel time was saved compared to in-person consultation for each of the 278 encounters if they had occurred separately. If four resident visits were possible for each trip, the time saved would decrease to 26.4 workdays. Travel distance saved was 43,000 miles; 10,750 miles if four visits per trip occurred. More than $3,700 would be spent on gasoline for 278 separate encounters; decreased to $925 for four visits per roundtrip. Personnel cost savings estimates ranged from $33,739 to $67,477. Physician costs associated with additional travel time ranged from $84,347 to $253,040 for 278 encounters, or from $21,087 to $63,260 for four encounters per visit. The telepsychiatry approach was enthusiastically accepted by virtually all residents, family members, and nursing home personnel, and led to successful patient management. Providing psychiatric care to rural nursing home residents by videoconference is cost effective and appears to be a medically acceptable alternative to face-to-face care. In addition, this approach will allow many nursing homes to provide essential care that would not otherwise be available.

Nursing documentation in inpatient psychiatry: The relevance of nurse-patient interactions in progress notes-A focus group study with mental health staff.

Science.gov (United States)

Myklebust, Kjellaug K; Bjørkly, Stål; Råheim, Målfrid

2018-02-01

To gain insight into mental health staff's perception of writing progress notes in an acute and subacute psychiatric ward context. The nursing process structures nursing documentation. Progress notes are intended to be an evaluation of a patient's nursing diagnoses, interventions and outcomes. Within this template, a patient's status and the care provided are to be recorded. The therapeutic nurse-patient relationship is recognised as a key component of psychiatric care today. At the same time, the biomedical model remains strong. Research literature exploring nursing staff's experiences with writing progress notes in psychiatric contexts, and especially the space given to staff-patient relations, is sparse. Qualitative design. Focus group interviews with mental health staff working in one acute and one subacute psychiatric ward were conducted. Systematic text condensation, a method for transverse thematic analysis, was used. Two main categories emerged from the analysis: the position of the professional as an expert and distant observer in the progress notes, and the weak position of professional-patient interactions in progress notes. The participants did not perceive that the current recording model, which is based on the nursing process, supported a focus on patients' resources or reporting professional-patient interactions. This model appeared to put ward staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Essential aspects of nursing care related to recovery and person-centred care were not prioritised for documentation. This study contributes to the critical examination of the documentation praxis, as well as to the critical examination of the documentation tool as to what is considered important to document. © 2017 John Wiley & Sons Ltd.

Implementation of an Arranged Preventive Consultation in Danish General Practice

DEFF Research Database (Denmark)

Junge, Anne Gram; Kirkegaard, Pia; Thomsen, Janus Laust

Background: In 2006 an arranged preventive consultation (0106-service) was implemented in Danish general practice. The purpose of the consultation is an attempt to improve the systematic prevention of the main chronic lifestyle diseases. Aim: This study examines the GP's experiences...... with the arranged preventive consultation with focus on facilitators and barriers in the implementation of the consultation. Material & Method: Semi-structured interviews with 10 GPs and nurses in general practice. Results & Conclusions: Economically lucrative services are not an isolated motivation for the GPs....../nurses, but must be accompanied with a basic belief in the effect of preventive consultations in general practice. The better payment of the 0106-service is used to spend more time per consultation and it makes the GPs/nurses feel rewarded for the preventive work they perform. The consultation frames a social...

Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms.

NARCIS (Netherlands)

Kat, M.G.; Zuidema, S.U.; Ploeg, T. van der; Kalisvaart, K.J.; Gool, W.A. van; Eikelenboom, P.; Jonghe, J.F. de

2008-01-01

OBJECTIVE: To study psychiatric consultation referrals of nursing home patients with dementia and to compare referral reasons with normative data on prevalence of neuropsychiatric symptoms. METHODS: This is part of a cross-sectional study of 787 patients residing in 14 nursing homes in the

Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms

NARCIS (Netherlands)

Kat, Martin G.; Zuidema, Sytse U.; van der Ploeg, Tjeerd; Kalisvaart, Kees J.; van Gool, Willem A.; Eikelenboom, Piet; de Jonghe, Jos F. M.

2008-01-01

Objective To study psychiatric consultation referrals of nursing home patients with dementia and to compare referral reasons with normative data on prevalence of neuropsychiatric symptoms. Methods This is part of a cross-sectional study of 787 patients residing in 14 nursing homes in the

Reasons for psychiatric consultation referrals in Dutch nursing home patients with dementia: a comparison with normative data on prevalence of neuropsychiatric symptoms

NARCIS (Netherlands)

Kat, M.G.; Zuidema, S.U.; van der Ploeg, T.; Kalisvaart, K.J.; van Gool, W.A.; Eikelenboom, P.; de Jonghe, J.F.M.

2008-01-01

Objective: To study psychiatric consultation referrals of nursing home patients with dementia and to compare referral reasons with normative data on prevalence of neuropsychiatric symptoms. Methods: This is part of a cross-sectional study of 787 patients residing in 14 nursing homes in the

Electronic consultation system demonstrates educational benefit for primary care providers.

Science.gov (United States)

Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

2017-01-01

Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

Field-Testing a PC Electronic Documentation System using the Clinical Care Classification© System with Nursing Students

Directory of Open Access Journals (Sweden)

Jennifer E. Mannino

2011-01-01

Full Text Available Schools of nursing are slow in training their students to keep up with the fast approaching era of electronic healthcare documentation. This paper discusses the importance of nursing documentation, and describes the field-testing of an electronic health record, the Sabacare Clinical Care Classification (CCC© system. The PC-CCC©, designed as a Microsoft Access® application, is an evidence-based electronic documentation system available via free download from the internet. A sample of baccalaureate nursing students from a mid-Atlantic private college used this program to document the nursing care they provided to patients during their sophomore level clinical experience. This paper summarizes the design, training, and evaluation of using the system in practice.

The ratio of nurse consultation and physician efficiency index of senior rheumatologists is significantly higher than junior physicians in rheumatology residency training

DEFF Research Database (Denmark)

Emamifar, Amir; van Bui Hansen, Morten Hai; Jensen Hansen, Inger Marie

2017-01-01

To elucidate the difference between ratios of nurse consultation sought by senior rheumatologists and junior physicians in rheumatology residency training, and also to evaluate physician efficiency index respecting patients with rheumatoid arthritis (RA). Data regarding outpatient visits for RA...... patients between November 2013 and 2015 were extracted. The mean interval (day) between consultations, the nurse/physician visits ratio, and physician efficiency index (nurse/physician visits ratio × mean interval) for each senior and junior physicians were calculated. Disease Activity Score in 28 joints....../physician visits ratio (P = .01) and mean efficiency index (P = .04) of senior rheumatologists were significantly higher than that of junior physicians. Regression analysis showed a positive correlation between physician postgraduate experience and physician efficiency index adjusted for DAS28 at baseline...

The role and functions of Clinical Nurse Consultants, an Australian advanced practice role: a descriptive exploratory cohort study.

Science.gov (United States)

Baldwin, Richard; Duffield, Christine Margaret; Fry, Margaret; Roche, Michael; Stasa, Helen; Solman, Annette

2013-03-01

The NSW Health Policy Directive (NSW Department of Health, 2000) lists clinical service and consultancy; clinical leadership; research; education; clinical services planning and management as the five domains of practice for nurses appointed as Clinical Nurse Consultants (CNCs), an Australian advanced practice nurse (APN) role. However, there is no clear definition of what is meant by advanced practice in the Australian nursing context. Nowhere is this more evident than in differentiating between the roles of Clinical Nurse Consultants (CNCs) and Nurse Practitioners (NP) in NSW. To date, limited empirical research has been done to characterise or delineate CNC role activity and responsibility. To investigate (i) the nature of CNC roles, activities and responsibilities, (ii) differentiate between CNCs by their work patterns and activities, and (iii) empirically conceptualize and differentiate ways CNCs practice in terms of an APN typology. The study sample was 56 CNCs at one tertiary level public hospital in Australia. A descriptive exploratory cohort study was conducted to explore CNC role characteristics and patterns of activity. Data were triangulated using an online survey, a follow-up survey, and semi-structured interviews. The data were analysed using descriptive statistics to examine differences between CNC work patterns and role activities. The survey data and the individual reports were thematically analysed to investigate for difference across the population of CNCs. Interpretation of survey and interview data led to an analyst-developed CNC typology of four CNC categories based on the work patterns and activities of Sole Practitioner, Clinic Coordinator, Clinical Team Coordinator and Clinical Leader. The typology was based on the themes interprofessional, role focus, clinical focus and setting as these themes distinguished and differentiated CNC roles. The study provides evidence of great diversity and prioritization within CNC roles. The CNC typology

Testing the Q-DIO as an instrument to measure the documented quality of nursing diagnoses, interventions, and outcomes.

NARCIS (Netherlands)

Muller-Staub, M.; Lunney, M.; Lavin, M.A.; Needham, I.; Odenbreit, M.; Achterberg, T. van

2008-01-01

PURPOSE: To describe pilot testing of Quality of Diagnoses, Interventions and Outcomes (Q-DIO), an instrument to measure quality of nursing documentation. DESIGN: Instrument testing was performed using a random, stratified sample of 60 nursing documentations representing hospital nursing with and

Critical discourse analysis of social justice in nursing's foundational documents.

Science.gov (United States)

Valderama-Wallace, Claire P

2017-07-01

Social inequities threaten the health of the global population. A superficial acknowledgement of social justice by nursing's foundational documents may limit the degree to which nurses view injustice as relevant to nursing practice and education. The purpose was to examine conceptualizations of social justice and connections to broader contexts in the most recent editions. Critical discourse analysis examines and uncovers dynamics related to power, language, and inequality within the American Nurses Association's Code of Ethics, Scope and Standards of Practice, and Social Policy Statement. This analysis found ongoing inconsistencies in conceptualizations of social justice. Although the Code of Ethics integrates concepts related to social justice far more than the other two, tension between professionalism and social change emerges. The discourse of professionalism renders interrelated cultural, social, economic, historical, and political contexts nearly invisible. Greater consistency would provide a clearer path for nurses to mobilize and engage in the courageous work necessary to address social injustice. These findings also call for an examination of how nurses can critique and use the power and privilege of professionalism to amplify the connection between social institutions and health equity in nursing education, practice, and policy development. © 2017 Wiley Periodicals, Inc.

D-Catch instrument : development and psychometric testing of a measurement instrument for nursing documentation in hospitals

NARCIS (Netherlands)

Paans, Wolter; Sermeus, Walter; Nieweg, Roos; van der Schans, Cees P.

AIM: This paper is a report of the development and testing of the psychometric properties of an instrument to measure the accuracy of nursing documentation in general hospitals. BACKGROUND: Little information is available about the accuracy of nursing documentation. None of the existing instruments

[Psychometric properties of Q-DIO, an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes].

Science.gov (United States)

Müller-Staub, Maria; Lunney, Margaret; Lavin, Mary Ann; Needham, Ian; Odenbreit, Matthias; van Achterberg, Theo

2010-04-01

The instrument Q-DIO was developed in the years 2005 till 2006 to measure the quality of documented nursing diagnoses, interventions, and nursing sensitive patient outcomes. Testing psychometric properties of the Q-DIO (Quality of nursing Diagnoses, Interventions and Outcomes.) was the study aim. Instrument testing included internal consistency, test-retest reliability, interrater reliability, item analyses, and an assessment of the objectivity. To render variation in scores, a random strata sample of 60 nursing documentations was drawn. The strata represented 30 nursing documentations with and 30 without application of theory based, standardised nursing language. Internal consistency of the subscale nursing diagnoses as process showed Cronbach's Alpha 0.83 [0.78, 0.88]; nursing diagnoses as product 0.98 [0.94, 0.99]; nursing interventions 0.90 [0.85, 0.94]; and nursing-sensitive patient outcomes 0.99 [0.95, 0.99]. With Cohen's Kappa of 0.95, the intrarater reliability was good. The interrater reliability showed a Kappa of 0.94 [0.90, 0.96]. Item analyses confirmed the fulfilment of criteria for degree of difficulty and discriminative validity of the items. In this study, Q-DIO has shown to be a reliable instrument. It allows measuring the documented quality of nursing diagnoses, interventions and outcomes with and without implementation of theory based, standardised nursing languages. Studies for further testing of Q-DIO in other settings are recommended. The results implicitly support the use of nursing classifications such as NANDA, NIC and NOC.

Exploring the leadership role of the clinical nurse specialist on an inpatient palliative care consulting team.

Science.gov (United States)

Stilos, Kalli; Daines, Pat

2013-03-01

Demand for palliative care services in Canada will increase owing to an aging population and the evolving role of palliative care in non-malignant illness. Increasing healthcare demands continue to shape the clinical nurse specialist (CNS) role, especially in the area of palliative care. Clinical nurse specialists bring specialized knowledge, skills and leadership to the clinical setting to enhance patient and family care. This paper highlights the clinical leadership role of the CNS as triage leader for a hospital-based palliative care consulting team. Changes to the team's referral and triage processes are emphasized as key improvements to team efficiency and timely access to care for patients and families.

Improving the quality of nursing documentation: An action research project

Directory of Open Access Journals (Sweden)

Elisha M. Okaisu

2014-12-01

Conclusion: Improving nursing documentation involved complex challenges in this setting and demanded multiple approaches. Evidence-based practise was the foundation of changes in systems required to produce visible improvement in practise. The involved role of leadership in these efforts was very important.

Challenges to nurses' efforts of retrieving, documenting, and communicating patient care information

Science.gov (United States)

Yakel, Elizabeth; Dunn Lopez, Karen; Tschannen, Dana; Ford, Yvonne B

2013-01-01

Objective To examine information flow, a vital component of a patient's care and outcomes, in a sample of multiple hospital nursing units to uncover potential sources of error and opportunities for systematic improvement. Design This was a qualitative study of a sample of eight medical–surgical nursing units from four diverse hospitals in one US state. We conducted direct work observations of nursing staff's communication patterns for entire shifts (8 or 12 h) for a total of 200 h and gathered related documentation artifacts for analyses. Data were coded using qualitative content analysis procedures and then synthesized and organized thematically to characterize current practices. Results Three major themes emerged from the analyses, which represent serious vulnerabilities in the flow of patient care information during nurse hand-offs and to the entire interdisciplinary team across time and settings. The three themes are: (1) variation in nurse documentation and communication; (2) the absence of a centralized care overview in the patient's electronic health record, ie, easily accessible by the entire care team; and (3) rarity of interdisciplinary communication. Conclusion The care information flow vulnerabilities are a catalyst for multiple types of serious and undetectable clinical errors. We have two major recommendations to address the gaps: (1) to standardize the format, content, and words used to document core information, such as the plan of care, and make this easily accessible to all team members; (2) to conduct extensive usability testing to ensure that tools in the electronic health record help the disconnected interdisciplinary team members to maintain a shared understanding of the patient's plan. PMID:22822042

Proposals for Radiation (Emergency Preparedness and Public Information) Regulations (Northern Ireland). Consultative document

International Nuclear Information System (INIS)

2001-06-01

This Consultative Document (CD) contains proposals by the Health and Safety Executive for Northern Ireland (HSENI) for the Radiation (Emergency Preparedness and Public Information) Regulations (Northern Ireland) (REPPIR(NI)), to partly implement, for Northern Ireland, the articles on intervention in cases of radiological emergency contained in Council Directive 96/29/Euratom on the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiation (Euratom BSS96 Directive), insofar as they apply to (a) premises, and (b) transport by rail

Development of an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes: the Q-DIO.

Science.gov (United States)

Müller-Staub, Maria; Lunney, Margaret; Odenbreit, Matthias; Needham, Ian; Lavin, Mary Ann; van Achterberg, Theo

2009-04-01

This paper aims to report the development stages of an audit instrument to assess standardised nursing language. Because research-based instruments were not available, the instrument Quality of documentation of nursing Diagnoses, Interventions and Outcomes (Q-DIO) was developed. Standardised nursing language such as nursing diagnoses, interventions and outcomes are being implemented worldwide and will be crucial for the electronic health record. The literature showed a lack of audit instruments to assess the quality of standardised nursing language in nursing documentation. A qualitative design was used for instrument development. Criteria were first derived from a theoretical framework and literature reviews. Second, the criteria were operationalized into items and eight experts assessed face and content validity of the Q-DIO. Criteria were developed and operationalized into 29 items. For each item, a three or five point scale was applied. The experts supported content validity and showed 88.25% agreement for the scores assigned to the 29 items of the Q-DIO. The Q-DIO provides a literature-based audit instrument for nursing documentation. The strength of Q-DIO is its ability to measure the quality of nursing diagnoses and related interventions and nursing-sensitive patient outcomes. Further testing of Q-DIO is recommended. Based on the results of this study, the Q-DIO provides an audit instrument to be used in clinical practice. Its criteria can set the stage for the electronic nursing documentation in electronic health records.

Shared care or nursing consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis outpatients with low disease activity--patient outcomes from a 2-year, randomised controlled trial

DEFF Research Database (Denmark)

Primdahl, Jette; Sørensen, Jan; Horn, Hans Christian

2014-01-01

were randomised to 2-year follow-up by either: (1) planned rheumatologist consultations, (2) shared care without planned consultations or (3) planned nursing consultations. The primary outcome was change in disease activity. DAS28-CRP, Health Assessment Questionnaire, visual analogue scale (VAS......)-pain, fatigue, global health, confidence and satisfaction, quality-of-life by the Short Form 12 and self-efficacy measured by the RA Self-Efficacy questionnaire and the Arthritis Self-Efficacy Scale, were recorded annually and safety measures were recorded. x-Rays of hands and feet were taken at baseline...... and at 2-year follow-up. Mixed effect models were used to explore differences between the three groups over time. RESULTS: At 2-year follow-up, the group allocated to nursing consultations had lower disease activity than the group that underwent rheumatologist consultations (DAS28-CRP -0.3, p=0...

Electronic medical records in diabetes consultations: participants' gaze as an interactional resource.

Science.gov (United States)

Rhodes, Penny; Small, Neil; Rowley, Emma; Langdon, Mark; Ariss, Steven; Wright, John

2008-09-01

Two routine consultations in primary care diabetes clinics are compared using extracts from video recordings of interactions between nurses and patients. The consultations were chosen to present different styles of interaction, in which the nurse's gaze was either primarily toward the computer screen or directed more toward the patient. Using conversation analysis, the ways in which nurses shift both gaze and body orientation between the computer screen and patient to influence the style, pace, content, and structure of the consultation were investigated. By examining the effects of different levels of engagement between the electronic medical record and the embodied patient in the consultation room, we argue for the need to consider the contingent nature of the interface of technology and the person in the consultation. Policy initiatives designed to deliver what is considered best-evidenced practice are modified in the micro context of the interactions of the consultation.

User needs on Nursing Net (The Kango Net) - analyzing the total consultation page - http://www.kango-net.jp/en/index.html.

Science.gov (United States)

Sakyo, Yumi; Nakayama, Kazuhiro; Komatsu, Hiroko; Setoyama, Yoko

2009-01-01

People are required to take in and comprehend a massive amount of health information and in turn make some serious decisions based on that information. We, at St. Luke's College of Nursing, provide a rich selection of high-quality health information, and have set up Nursing Net (The Kango Net:Kango is Nursing in Japanese). This website provides information for consumers as well as people interested in the nursing profession. In an attempt to identify the needs of users, this study conducted an analysis of the contents on the total consultation page. Many readers voted that responses to nursing techniques and symptoms questions proved instrumental in their queries. Based on the results of this study, we can conclude that this is an easy-to-access, convenient site for getting health information about physical symptoms and nursing techniques.

Development and Implementation of Person-Centred Nursing Documentation

OpenAIRE

Daly, Susan

2017-01-01

Introduction: Irvine et al (2006) assert structured documentation can improve resident care by limiting vague narrative style entries. Nevertheless, in practice the personal and         individual aspects of care can only be recorded through a person-centred approach to care planning   (Broderick & Coffey 2012, Butterworth 2012, Prideaux 2011).  Nurses  are therefore challenged to balance the factual, non-speculative principles of good record keeping with a person-centred approach to writ...

The process of patient enablement in general practice nurse consultations: a grounded theory study.

Science.gov (United States)

Desborough, Jane; Banfield, Michelle; Phillips, Christine; Mills, Jane

2017-05-01

The aim of this study was to gain insight into the process of patient enablement in general practice nursing consultations. Enhanced roles for general practice nurses may benefit patients through a range of mechanisms, one of which may be increasing patient enablement. In studies with general practitioners enhanced patient enablement has been associated with increases in self-efficacy and skill development. This study used a constructivist grounded theory design. In-depth interviews were conducted with 16 general practice nurses and 23 patients from 21 general practices between September 2013 - March 2014. Data generation and analysis were conducted concurrently using constant comparative analysis and theoretical sampling focussing on the process and outcomes of patient enablement. Use of the storyline technique supported theoretical coding and integration of the data into a theoretical model. A clearly defined social process that fostered and optimised patient enablement was constructed. The theory of 'developing enabling healthcare partnerships between nurses and patients in general practice' incorporates three stages: triggering enabling healthcare partnerships, tailoring care and the manifestation of patient enablement. Patient enablement was evidenced through: 1. Patients' understanding of their unique healthcare requirements informing their health seeking behaviours and choices; 2. Patients taking an increased lead in their partnership with a nurse and seeking choices in their care and 3. Patients getting health care that reflected their needs, preferences and goals. This theoretical model is in line with a patient-centred model of health care and is particularly suited to patients with chronic disease. © 2016 John Wiley & Sons Ltd.

Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province.

Science.gov (United States)

Shihundla, Rhulani C; Lebese, Rachel T; Maputle, Maria S

2016-05-13

Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who

The effects of the application of SIMPRO on the completeness and time efficiency of nursing documentation in the outpatient instalation at Dompet Dhuafa Hospital Parung

Science.gov (United States)

Dwisatyadini, M.; Hariyati, R. T. S.; Afifah, E.

2018-03-01

Nursing documentation is clinical information that has a vital role in nursing services. The nursing process includes assessment, diagnosis, intervention, implementation, and evaluation. The purpose of this study was to determine the effects of the application of SIMPRO on the completeness and the efficiency of nursing documentation in the outpatient installation at Dompet Dhuafa Hospital Parung. This study used quantitative method with pre experimental (pre and posttest without control group) design. The mean of the documentation completeness marks before the application of SIMPRO was 1.87 (SD 0.922), and after SIMPRO was applied increased to 3.61 (0.588). This increase indicated an improvement of the nursing documentation completeness after the implementation of SIMPRO. The mean of time needed by nurses in documenting the nursing care before the application of SIMPRO was 476.13 seconds (SD 78.896). The mean of documenting time decreased more than a half after the application of SIMPRO which was 202.52 seconds (SD 196.723). SIMPRO made a nurse easier to take a decision analysis and decision support system to nursing care plan and documentation.

Implementation of a documentation model comprising nursing terminologies--theoretical and methodological issues.

Science.gov (United States)

von Krogh, Gunn; Nåden, Dagfinn

2008-04-01

To describe and discuss theoretical and methodological issues of implementation of a nursing services documentation model comprising NANDA nursing diagnoses, Nursing Intervention Classification and Nursing Outcome Classification terminologies. The model is developed for electronic patient record and was implemented in a psychiatric hospital on an organizational level and on five test wards in 2001-2005. The theory of Rogers guided the process of innovation, whereas the implementation procedure of McCloskey and Bulecheck combined with adult learning principals guided the test site implementation. The test wards managed in different degrees to adopt the model. Two wards succeeded fully, including a ward with high percentage of staff with interdisciplinary background. Better planning regarding the impact of the organization's innovative aptitude, the innovation strategies and the use of differentiated methods regarding the clinician's individual premises for learning nursing terminologies might have enhanced the adoption to the model. To better understand the nature of barriers and the importance of careful planning regarding the implementation of electronic patient record elements in nursing care services, focusing on nursing terminologies. Further to indicate how a theory and specific procedure can be used to guide the process of implementation throughout the different levels of management.

The impact of an oral hygiene education module on patient practices and nursing documentation.

Science.gov (United States)

Coke, Lola; Otten, Karine; Staffileno, Beth; Minarich, Laura; Nowiszewski, Candice

2015-02-01

Oral hygiene is inconsistent among patients with cancer and is a national patient care issue. To promote comfort and nutritional status, oral hygiene for patients with cancer is important. The purpose of this study was to develop an evidence-based oral hygiene educational module (EM) for nursing and patient care technician (PCT) staff to promote consistent oral hygiene patient education; evaluate patient understanding of oral hygiene practices post-EM; and determine staff documentation frequency of oral hygiene care. Pre- and post-EM data were collected using a developed oral hygiene assessment tool; nursing documentation data were collected by chart review. Post-EM data were collected eight weeks post-EM. Data were analyzed using frequencies and the Mann-Whitney U test. Twenty-two patient documentation pairs were collected. Compared to pre-EM, admission teaching, patient education, and patient oral hygiene practices improved post-EM. Post-EM oral hygiene documentation and PCT teaching increased.

Danish Perioperative Nurses' Documentation

DEFF Research Database (Denmark)

Søndergaard, Susanne Friis; Lorentzen, Vibeke; Sørensen, Erik E

2017-01-01

of 2015 to 2016, six participants tested an EHR containing a Danish edition of a selected section of the Perioperative Nursing Data Set. This study relied on realistic evaluation and participant observations to generate data. We found that nursing leadership was essential for improving perioperative...

Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

Science.gov (United States)

Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

Analysis And Comments On The Consultative Document: International Framework For Liquidity Risk Measurement, Standards And Monitoring

OpenAIRE

Jacques Prefontaine; Jean Desrochers; Lise Godbout

2010-01-01

The market turmoil that began in mid-2007 re-emphasized the importance of liquidity to the functioning of financial markets and the banking sector. In December 2009, the Basel Committee on Banking Supervision (BCBS) of the Bank for International Settlements (BIS) released a consultative document entitled: “International Framework for Liquidity Risk Measurement, Standards and Monitoring”. Interested parties were invited to provide written comments by April 16th 2010. Given our interest in prom...

Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA: cost-effectiveness based on a 2-year randomized trial.

Science.gov (United States)

Sørensen, J; Primdahl, J; Horn, H C; Hørslev-Petersen, K

2015-01-01

To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse consultations. Effectiveness measures included disease activity (Disease Activity Score based on 28 joint counts and C-reactive protein, DAS28-CRP), functional status (Health Assessment Questionnaire, HAQ), and health-related quality of life (EuroQol EQ-5D). Cost measures included activities in outpatient clinics and general practice, prescription and non-prescription medicine, dietary supplements, other health-care resources, and complementary and alternative care. Measures of effectiveness and costs were collected by self-reported questionnaires at inclusion and after 12 and 24 months. Incremental cost-effectiveness rates (ICERs) were estimated in comparison with rheumatologist consultations. Changes in disease activity, functional status, and health-related quality of life were not statistically significantly different for the three groups, although the mean scores were better for the shared care and nurse care groups compared with the rheumatologist group. Shared care and nurse care were non-significantly less costly than rheumatologist care. As both shared care and nurse care were associated with slightly better EQ-5D improvements and lower costs, they dominated rheumatologist care. At EUR 10,000 per quality-adjusted life year (QALY) threshold, shared care and nurse care were cost-effective with more than 90% probability. Nurse care was cost-effective in comparison with shared care with 75% probability. Shared care and nurse care seem to cost less but provide broadly similar health outcomes compared with rheumatologist outpatient care. However, it is still uncertain whether nurse care and shared care are cost-effective in comparison with rheumatologist outpatient care.

The Future Development of the European Union Education, Training and Youth Programmes After 2006: A Public Consultation Document.

Science.gov (United States)

Commission of the European Communities, Brussels (Belgium). Directorate-General for Education and Culture.

This document launches a wide public consultation with all those involved in and with an interest in the European Union's (EU's) education, training, and youth programs called Socrates, Tempus, Leonardo da Vinci, and Youth for Europe. It is the first step toward preparing the new generation of programs to start in 2007 and will inform the…

On becoming a consultant: A study exploring the journey to consultant practice

International Nuclear Information System (INIS)

Henwood, S.; Booth, L.

2016-01-01

Background: This paper reports a qualitative study exploring the establishment of non-medical consultant roles in Radiography. Given the difficulties reported in recruiting and retaining staff in these posts, we hope this paper offers a historical documentation of those consultants who were some of the first in post, sharing their stories of how they obtained and transitioned into their roles. Methods: This paper is part of a two year case study exploring the leadership domain of consultant practice. The focus of this paper is a reflection, by the consultants, of their journey to becoming a consultant; a documentation of some of the practical issues in establishing the roles; and the transition to higher levels of practice. Eight consultant radiographers participated in the initial interviews (two consultants withdrew from the study subsequent to this). In-depth iterative interviewing was used to explore and record individual stories and experiences. Findings: The consultants shared their perceptions of being in post, including their own motivation to progress to a new role, how prepared they felt initially, the lack of role models, the lack of clarity surrounding the role and a perception of ‘being on display’. Conclusions: The paper offers insight into the journey of these consultants and some of the common characteristics they share. These characteristics give some indication of what motivated them to step into higher level roles, in particular the need to drive change and improvement. The paper also offers suggestions for how the transition into the role could be more effectively supported. - Highlights: • Identifies characteristics thought to contribute to effective consultant practice. • A desire to change practice is a major motivator in applying for a consultant post. • The consultant role was a natural evolution for some, not a desired career pathway. • There is recognition that the initial consultants were pioneers for the profession. �

Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial

International Nuclear Information System (INIS)

Schofield, Penelope; Gough, Karla; Lotfi-Jam, Kerryann; Bergin, Rebecca; Ugalde, Anna; Dudgeon, Paul; Crellin, Wallace; Schubach, Kathryn; Foroudi, Farshard; Tai, Keen Hun; Duchesne, Gillian; Sanson-Fisher, Rob; Aranda, Sanchia

2016-01-01

Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer. This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index −26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data. Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life. Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group

42 CFR 431.105 - Consultation to medical facilities.

Science.gov (United States)

2010-10-01

... State agencies furnish consultative services to hospitals, nursing homes, home health agencies, clinics... 42 Public Health 4 2010-10-01 2010-10-01 false Consultation to medical facilities. 431.105 Section 431.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN...

Mapping selected general literature of international nursing.

Science.gov (United States)

Shams, Marie-Lise Antoun; Dixon, Lana S

2007-01-01

This study, part of a wider project to map the literature of nursing, identifies core journals cited in non-US nursing journals and determines the extent of their coverage by indexing services. Four general English-language journals were analyzed for format types and publication dates. Core titles were identified and nine bibliographic databases were scanned for indexing coverage. Findings show that 57.5% (13,391/23,271) of the cited references from the 4 core journals were to journal articles, 27.8% (6,471/23,271) to books, 9.5% (2,208/23,271) to government documents, 4.9% (1,131/23,271) to miscellaneous sources, and less than 1% (70/23,271) to Internet resources. Eleven journals produced one-third of the citations; the next third included 146 journals, followed by a dispersion of 1,622 titles. PubMed received the best database coverage scores, followed by CINAHL and Science Citation Index. None of the databases provided complete coverage of all 11 core titles. The four source journals contain a diverse group of cited references. The currency of citations to government documents makes these journals a good source for regulatory and legislative awareness. Nurses consult nursing and biomedical journals and must search both nursing and biomedical databases to cover the literature.

Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations.

Science.gov (United States)

Martín-Fernández, Jesús; del Cura-González, Ma Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Ma Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Sanz-Bayona, Ma Teresa; Gil-Lacruz, Ana Isabel

2013-01-01

Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2-15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6-22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.

[Psychometric properties of Q-DIO, an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes].

NARCIS (Netherlands)

Muller-Staub, M.; Lunney, M.; Lavin, M.A.; Needham, I.; Odenbreit, M.; Achterberg, T. van

2010-01-01

The instrument Q-DIO was developed in the years 2005 till 2006 to measure the quality of documented nursing diagnoses, interventions, and nursing sensitive patient outcomes. Testing psychometric properties of the Q-DIO (Quality of nursing Diagnoses, Interventions and Outcomes.) was the study aim.

An exploration of nursing documentation of pressure ulcer care in an acute setting in Ireland.

LENUS (Irish Health Repository)

O Brien, J A Jordan

2012-02-01

OBJECTIVE: To explore the nature and quality of documented care planning for pressure ulcers in a large teaching hospital in the Republic of Ireland. METHOD: A mixed method design was used; this encompassed a descriptive survey that retrospectively evaluated nursing records (n=85) in two wards (orthopaedic and care of the older adult) and a focus group (n=13) that explored nurses\\' perspectives of the factors influencing concordance and the quality of nursing documentation. Only records of at-risk patients (Waterlow score of >10) were included. RESULTS: It was identified that 47% (n=40) were assessed as at high or very high risk of developing a pressure ulcer. Fifty-two patients (61%) had a weekly risk assessment, but 25% (n=21) had only one follow-up assessment. Only 45% (n=38) of charts had some evidence of documented care planning, and of those 53% (n=20) had no evidence of implementation of the care plan and 66% (n=25) had no evidence of outcome evaluation. Only 48% (n=41) of this at-risk population was nutritionally assessed. Of patients admitted with and without a pressure ulcer, there was no record of regular positioning in 70% (n=59) and 60% (n=51) respectively. CONCLUSION: Documentation on pressure ulcer care is not standardised and requires development. Conflict of interest: None.

Nursing Minimum Data Sets for documenting nutritional care for adults in primary healthcare: a scoping review.

Science.gov (United States)

Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bjerrum, Merete; Bygholm, Ann; Peters, Micah D J

2018-01-01

To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients. However, this process of documentation has been criticized from many perspectives as being highly inadequate. A Nursing Minimum Data Set within the nutritional area in primary health care could therefore be beneficial in order to support nurses in their daily documentation and observation of patients. The review considered studies that included adults aged over 18 years of any gender, culture, diagnosis and ethnicity, as well as nutritional experts, patients and their relatives. The concepts of interest were: the nature and content of any nutritional screening tools validated (regardless of the type of validation) in the adult population in primary healthcare; and the views and opinions of eligible participants regarding the appropriateness of nutritional assessment were the concept of interest. Studies included must have been conducted in primary healthcare settings, both within home care and nursing home facilities. This scoping review used a two-step approach as a preliminary step to the subsequent development of a Nursing Minimum Data Set within the nutritional area in primary healthcare: i) a systematic literature search of existing nutritional screening tools validated in primary health care; and ii) a systematic literature search on nutritional experts opinions on the assessment of nutritional nursing care of adults in primary healthcare as well as the views of patients and their relatives

Improved nurse job satisfaction and job retention with the transition from a "mandatory consultation" model to a "semiclosed" surgical intensive care unit: a 1-year prospective evaluation.

Science.gov (United States)

Haut, Elliott R; Sicoutris, Corinna P; Meredith, Denise M; Sonnad, Seema S; Reilly, Patrick M; Schwab, C William; Hanson, C William; Gracias, Vicente H

2006-02-01

The change from a "mandatory consultation" to a "semiclosed" surgical intensive care unit (SICU) model will impact nurses considerably. We hypothesize that nurse job satisfaction, job turnover rates, and hospital costs for temporary agency nurses will improve and these improvements will be more dramatic in SICU sections with greater involvement of a dedicated surgical critical care service (SCCS). Prospective longitudinal survey. Tertiary-care university hospital. SICU staff nurses. Change from mandatory consultation to semiclosed SICU. We surveyed SICU nurses during the year-long transition to a semiclosed SICU service (five time points, 3-month intervals). The first four surveys included ten questions on nurse job satisfaction. The final survey included two additional questions. All questions were on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Nurse job turnover rates and money spent on agency nurses were compared over time; 503 of a possible 914 surveys were completed (55% overall return rate). Nurse job satisfaction scores significantly improved over time for all questions (p job turnover rate dropped from 25% to 16% (p = .15). The scores for both year-end statements ("I am more satisfied with my job now than 1 year ago" and "The SCCS management of all orders has improved my job satisfaction") were significantly higher in sections with greater SCCS involvement (p = .0070 and p job satisfaction improved significantly with the transition to a semiclosed SICU. This higher satisfaction was associated with a significant decrease in spending on temporary agency nurses and a trend toward increased staff nurse job retention. SICU sections with greater SCCS involvement had more dramatic improvements. This semiclosed SICU model may help retain SICU nurses in a competitive job market in which experienced nurses are in short supply.

Development of the Quality of Australian Nursing Documentation in Aged Care (QANDAC) instrument to assess paper-based and electronic resident records.

Science.gov (United States)

Wang, Ning; Björvell, Catrin; Hailey, David; Yu, Ping

2014-12-01

To develop an Australian nursing documentation in aged care (Quality of Australian Nursing Documentation in Aged Care (QANDAC)) instrument to measure the quality of paper-based and electronic resident records. The instrument was based on the nursing process model and on three attributes of documentation quality identified in a systematic review. The development process involved five phases following approaches to designing criterion-referenced measures. The face and content validities and the inter-rater reliability of the instrument were estimated using a focus group approach and consensus model. The instrument contains 34 questions in three sections: completion of nursing history and assessment, description of care process and meeting the requirements of data entry. Estimates of the validity and inter-rater reliability of the instrument gave satisfactory results. The QANDAC instrument may be a useful audit tool for quality improvement and research in aged care documentation. © 2013 ACOTA.

Medication management in Minnesota schools: The need for school nurse-pharmacist partnerships.

Science.gov (United States)

Little, Meg M; Eischens, Sara; Martin, Mary Jo; Nokleby, Susan; Palombi, Laura C; Van Kirk, Cynthia; van Risseghem, Jayme; Wen, Ya-Feng; Wozniak, Jennifer Koziol; Yoney, Erika; Seifert, Randall

Pharmacist participation in school medication management (MM) is minimal. School nurses are responsible for increasingly complex medication administration and management in schools. The purpose of this study was to 1) assess the MM needs of school nurses in Minnesota, and 2) determine if and how interprofessional partnerships between nurses and pharmacists might optimize MM for students. Researchers from the University of Minnesota College of Pharmacy, School Nurse Organization of Minnesota, and Minnesota Department of Health conducted a 32-item online survey of school nurses. Nurses administered the majority of medications at their school (69.9%) compared with unlicensed assistive personnel (29%). Stimulants (37.7%), asthma medications (25.7%), over-the-counter analgesics (17.8%), and insulin (6.6%) were the most commonly administered drug therapies. A clear majority of school nurses were interested in partnering with pharmacists: 90.3% thought that a pharmacist could assist with MM, 80% would consult with a pharmacist, and 12.3% reported that they already have informal access to a pharmacist. Topics that nurses would discuss with a pharmacist included new medications (71.6%), drug-drug interactions (67.1%), proper administration (52%), and storage (39.4%). The top MM concerns included 1) availability of students' medications and required documentation, 2) health literacy, 3) pharmacist consultations, 4) lack of time available for nurses to follow up with and evaluate students, 5) family-centered care, 6) delegation, 7) communication, and 8) professional development. Although the majority of school nurses surveyed indicated that partnerships with pharmacists would improve school MM, few had a formal relationship. Interprofessional partnerships focused on MM and education are high on the list of services that school nurses would request of a consultant pharmacist. Study results suggest that there are opportunities for pharmacists to collaborate with school nurses

Patient and professional accuracy of recalled treatment decisions in out-patient consultations

DEFF Research Database (Denmark)

Skinner, T. C.; Barnard, K.; Cradock, S.

2007-01-01

Aims: To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions. Methods: One hundred and thirty-four consultations between diabetes specialist nurses and diabetes specialist dietitians in an adult out-patien...

Barriers to effective, safe communication and workflow between nurses and non-consultant hospital doctors during out-of-hours.

Science.gov (United States)

Brady, Anne-Marie; Byrne, Gobnait; Quirke, Mary Brigid; Lynch, Aine; Ennis, Shauna; Bhangu, Jaspreet; Prendergast, Meabh

2017-11-01

This study aimed to evaluate the nature and type of communication and workflow arrangements between nurses and doctors out-of-hours (OOH). Effective communication and workflow arrangements between nurses and doctors are essential to minimize risk in hospital settings, particularly in the out-of-hour's period. Timely patient flow is a priority for all healthcare organizations and the quality of communication and workflow arrangements influences patient safety. Qualitative descriptive design and data collection methods included focus groups and individual interviews. A 500 bed tertiary referral acute hospital in Ireland. Junior and senior Non-Consultant Hospital Doctors, staff nurses and nurse managers. Both nurses and doctors acknowledged the importance of good interdisciplinary communication and collaborative working, in sustaining effective workflow and enabling a supportive working environment and patient safety. Indeed, issues of safety and missed care OOH were found to be primarily due to difficulties of communication and workflow. Medical workflow OOH is often dependent on cues and communication to/from nursing. However, communication systems and, in particular the bleep system, considered central to the process of communication between doctors and nurses OOH, can contribute to workflow challenges and increased staff stress. It was reported as commonplace for routine work, that should be completed during normal hours, to fall into OOH when resources were most limited, further compounding risk to patient safety. Enhancement of communication strategies between nurses and doctors has the potential to remove barriers to effective decision-making and patient flow. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

Science.gov (United States)

Martín-Fernández, Jesús; del Cura-González, Mª Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Mª Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Bayona, Mª Teresa Sanz-; Gil-Lacruz, Ana Isabel

2013-01-01

Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of

Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP for nursing consultations.

Directory of Open Access Journals (Sweden)

Jesús Martín-Fernández

Full Text Available BACKGROUND: Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC by its users. METHODS AND RESULTS: Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP of €14.4 (CI 95%: €13.2-15.5; median €10 and an average Willingness to Accept [Compensation] (WTA of €20.9 (CI 95%: €19.6-22.2; median €20. Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively. CONCLUSIONS: The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception

Developing a Culture to Facilitate Research Capacity Building for Clinical Nurse Consultants in Generalist Paediatric Practice

Directory of Open Access Journals (Sweden)

Lesley Wilkes

2013-01-01

Full Text Available This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW, Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge.

BNFL Sellafield further public consultation

International Nuclear Information System (INIS)

1994-01-01

The main issues raised during the further public consultation on the draft Sellafield authorisations for the discharge of radioactive wastes from the British Nuclear Fuel (BNFL) Sellafield site are outlined. An analysis of the categories and numbers of the 42,500 responses is made. The public consultation was based on five documents; a letter to consultees from the Department of the Environment and the Ministry of Agriculture, Fisheries and Food (MAFF); the report by Her Majesty's Inspectorate of Pollution and the Inspectorate of MAFF on their earlier consultation exercise; a paper by BNFL on the economic and commercial justification of the Thermal Oxide Reprocessing Plant (THORP); a statement of the Government's policy on reprocessing and THORP and a document prepared by BNFL on the environmental implication of THORP. (UK)

Interest of a multidisciplinary and two-step consultation in radioiodine therapy to improve patient's support

International Nuclear Information System (INIS)

Guillaumon, C.; Eberle, M.; Deshayes, E.; Savry, B.; Vinson, B.; Kotzki, P.

2015-01-01

Full text of publication follows. Aim: the surgery of differentiated thyroid cancer may be followed by radioiodine therapy (I 131 ). This therapy requires a 3-day hospital stay in an isolation room without family visits, but also many precautions before, during and after the hospital stay. This clinical environment can give rise to increased anxiety for a number of patients. This is why we have set up a dedicated consultation, aimed at improving preparation of the hospital stay. The aim of our work was to assess the efficiency of such consultation for patient's understanding of their disease, related apprehensions, and coordination between the nuclear medicine (NM) unit and inpatient ward. Material and methods: we followed the recommendations of the first French Cancer Plan regarding the diagnosis or treatment announcement and the project was reviewed in the frame of Professional Practices Evaluation. Consultations were carried out according to a 2-step procedure in the NM unit. First, patients were informed by the NM physician about disease and treatment. Then, a technologist evaluated social and psychological conditions, and checked proper understanding of disease and treatment. He/she paid a special attention to radiation protection measures, especially for the discharge period. Patients received a guidance manual document, and when necessary were oriented towards the supportive care staff. A dedicated computerized form was used to share patient information between the NM unit and inpatient ward. These consultations ran every day (2 per day). To evaluate procedure efficiency, patients were asked to fulfill a satisfaction questionnaire. Inpatient ward nurses were also surveyed for patient's understanding of their disease, level of anxiety, and quality of care. Results: at Montpellier Cancer Institute, a total of 30 thyroid cancer patients and 15 nurses were surveyed about their perceptions about the consultation before radioiodine therapy from April to

Exploring the research domain of consultant practice: Perceptions and opinions of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This first part of the study involved electronic questionnaires being sent to all those known in consultant radiographer posts in the United Kingdom. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers, and not all agreed that research should be a core domain of consultant practice. Main facilitators to research were noted as: time; skills and knowledge of the researcher; a well defined research question. Main barriers to research were noted as: lack of allocated time; lack of skills/experience; clinical workload. Conclusion: Research is one of the four core domains of consultant allied health professional and nursing roles but, as yet, it is not fully embedded into those of all consultant radiographers. Many consultant radiographers appear to spend more of their time on the ‘clinical expert’ element of their role at the expense of the research domain. This study concludes that there is an urgent need for consultant radiographers to understand that research is one of the four core domains and to recognise the need to embed research into their clinical practice. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work routinely. • Consultant radiographers allocate little protected time for research due to clinical demands. • Almost half of the consultant radiographers feel research should not be a core part of their roles.

Prevalence of nursing diagnoses in an intensive care unit

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Vinicia de Holanda Cabral

2017-01-01

Full Text Available To identify the main nursing diagnostic titles used in the care of critically ill patients hospitalized in an Intensive Care Unit, verifying the presence thereof in the diagnoses of NANDA International’s Taxonomy II. Methods: descriptive and documental study, in which 69 medical records of patients aged over 18 years were consulted. Results: 22 nursing diagnostic titles were found; the most frequent was risk for infection (99.0%, risk for skin integrity (75.0% and risk for aspiration (61.0%. Most diagnoses were in the domains safety/ protection (43.0% and activity/rest (26.5%. Conclusions: authors identified the main nursing diagnostic titles used in the care of critically ill patients admitted to the Intensive Care Unit and the presence thereof in the diagnoses of NANDA International’s Taxonomy II.

Shoulder dystocia documentation: an evaluation of a documentation training intervention.

Science.gov (United States)

LeRiche, Tammy; Oppenheimer, Lawrence; Caughey, Sharon; Fell, Deshayne; Walker, Mark

2015-03-01

To evaluate the quality and content of nurse and physician shoulder dystocia delivery documentation before and after MORE training in shoulder dystocia management skills and documentation. Approximately 384 charts at the Ottawa Hospital General Campus involving a diagnosis of shoulder dystocia between the years of 2000 and 2006 excluding the training year of 2003 were identified. The charts were evaluated for 14 key components derived from a validated instrument. The delivery notes were then scored based on these components by 2 separate investigators who were blinded to delivery note author, date, and patient identification to further quantify delivery record quality. Approximately 346 charts were reviewed for physician and nurse delivery documentation. The average score for physician notes was 6 (maximum possible score of 14) both before and after the training intervention. The nurses' average score was 5 before and after the training intervention. Negligible improvement was observed in the content and quality of shoulder dystocia documentation before and after nurse and physician training.

Collaborative Care in Ambulatory Psychiatry: Content Analysis of Consultations to a Psychiatric Pharmacist

Science.gov (United States)

Gotlib, Dorothy; Bostwick, Jolene R.; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E.; Fluent, Thomas

2017-01-01

Objectives To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Experimental Design Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Principal Observations Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). Conclusions This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery. PMID:28936009

Collaborative Care in Ambulatory Psychiatry: Content Analysis of Consultations to a Psychiatric Pharmacist.

Science.gov (United States)

Gotlib, Dorothy; Bostwick, Jolene R; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E; Fluent, Thomas

2017-09-15

To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery.

Consultant radiographers: Profile of the first generation

International Nuclear Information System (INIS)

Forsyth, Lesley J.; Maehle, Valerie

2010-01-01

Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

Consultant radiographers: Profile of the first generation

Energy Technology Data Exchange (ETDEWEB)

Forsyth, Lesley J., E-mail: l.forsyth@rgu.ac.u [School of Health Sciences, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom); Maehle, Valerie [Faculty of Health and Social Care, Robert Gordon University, Aberdeen, AB10 7QG (United Kingdom)

2010-11-15

Aim: The aim of this research is to examine the profile of first generation consultant radiographers: their demographics, educational backgrounds, qualifications and training, career experience and progression, teaching, lecturing and research activities. Method: Participant recruitment was drawn from the Society and College of Radiographers consultant radiographer group. Data collection involved a self-administered paper based and web based questionnaire. Results: Participant response rate of 55% (n = 11). Conclusions: The profile of the first consultant radiographer cohort reflects a diverse and eclectic mix. While some aspects of their development such as educational background, clinical training and skills enhancement are comparable to nurse consultants, clinical experience and employment history show some differences. Commitment to development of expert clinical skills is evident within the profile of the first generation cohort of consultant radiographers however research and leadership training are not strong features.

The Impact of the Nurse-Physician Professional Relationship on Nurses' Experience of Ethical Dilemmas in Effective Pain Management.

Science.gov (United States)

Van Niekerk, Leesa Micole; Martin, Frances

2002-01-01

A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…

Documentation of delirium in the VA electronic health record

Science.gov (United States)

2014-01-01

Background Delirium is a life-threatening, clinical syndrome common among the elderly and hospitalized patients. Delirium is under-recognized and misdiagnosed, complicating efforts to study the epidemiology and construct appropriate decision support to improve patient care. This study was primarily conducted to realize how providers documented confirmed cases of delirium in electronic health records as a preliminary step for using computerized methods to identify patients with delirium from electronic health records. Methods The Mental Health Consult (MHC) team reported cases of delirium to the study team during a 6-month study period (December 1, 2009 - May 31, 2010). A chart extraction tool was developed to abstract documentation of diagnosis, signs and symptoms and known risk factors of delirium. A nurse practitioner, and a clinical pharmacist independently reviewed clinical notes during each patients hospital stay to determine if delirium and or sign and symptoms of delirium were documented. Results The MHC team reported 25 cases of delirium. When excluding MHC team notes, delirium was documented for 5 of the 25 patients (one reported case in a physician’s note, four in discharge summaries). Delirium was ICD-9 Coded for 7 of the 25 cases. Signs and symptoms associated with delirium were characterized in 8 physician notes, 11 discharge summaries, and 14 nursing notes, accounting for 16 of the 25 cases with identified delirium. Conclusions Documentation of delirium is highly inconsistent even with a confirmed diagnosis. Hence, efforts to use existing data to precisely estimate the prevalence of delirium or to conduct epidemiological studies based on medical records will be challenging. PMID:24708799

Proposals for the Radioactive Substances (Basic Safety Standards) (England and Wales) Regulations 2000 and the Radioactive Substances (Basic Safety Standards) (England and Wales) Direction 2000. Consultative document

International Nuclear Information System (INIS)

2000-01-01

This document contains proposals for changes to the Radioactive Substances Act 1993 (RSA 93) and proposals for a Direction to be given to the Environment Agency in order to implement aspects of the European Directive 96/29/Euratom concerned with the control of radioactive waste. The Directive lays down basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiation. With the Government pledged to making government more accessible and responsive, an important feature of this approach is effective consultation with all interested organisations. This leads to more realistic and robust proposals, which is particularly important when dealing with proposed legislation. In March this year, the Government published a consultation paper 'The Radioactive Substances Act 1993: Implementing the Revised Basic Safety Standards Directive Euratom 96/29.' This sought comments on the basic principles for change - including the setting of levels of radioactivity below which radioactive material should be considered outside the framework of regulatory control. This document forms the second stage of the consultation process with the aim of gathering views on the proposed legal instruments to implement the Directive. This document: explains the background to the proposed regulations (paragraphs 8-13); summarises the results of the consultation on principles (paragraphs 14-24); describes the proposed changes (paragraphs 25-36); includes draft Regulations (paragraphs 27-29); includes a draft Direction to the Environment Agency (paragraphs 30-36); describes the next steps (paragraphs 37-39); includes a draft Regulatory Impact Assessment (paragraphs 40-41). In general, the devolved administrations in Scotland, Wales and Northern Ireland have assumed responsibility for environmental issues and hence management of radioactive waste policies and legislation affecting their respective countries. However, this

Oral Assessment and Nursing Interventions among Nigerian Nurses ...

African Journals Online (AJOL)

Background: Assessment of oral condition, oral care, and informing the attending doctor of unusual oral findings for possible consultation or referral to a dentist are the advocated roles of hospital nurses. The objective of the study was thus to assess the roles of Nigerian nurses in the assessment of oral conditions of ...

Effects of Real-time Telemedicine Consultations between Hospital-based Nurses and Patients with Severe COPD discharged after Exacerbation Admissions

DEFF Research Database (Denmark)

Sorknæs, Anne Dichmann; Jest, Peder; Bech, Mickael

-time telemedicine video consultations (teleconsultation) between hospital-based nurses specialised in respiratory diseases (telenurses) and patients with severe COPD discharged after AECOPD in addition to conventional treatment compared to the effect of conventional treatment. Methods: Patients admitted with AECOPD...... at two different locations were recruited at hospital discharge and randomly assigned (1:1) to either daily teleconsultation for one week in addition to conventional treatment, the TVC group or to conventional treatment, the CT group. The telemedicine equipment consisted of a briefcase with built...

Do primary health care nurses address cardiovascular risk in diabetes patients?

Science.gov (United States)

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

2014-11-01

To identify factors associated with assessment and nursing management of blood pressure, smoking and other major cardiovascular risk factors by primary health care nurses in Auckland, New Zealand. Primary health care nurses (n = 287) were randomly sampled from the total (n=1091) identified throughout the Auckland region and completed a self-administered questionnaire (n = 284) and telephone interview. Nurses provided details for 86% (n =265) of all diabetes patients they consulted on a randomly selected day. The response rate for nurses was 86%. Of the patients sampled, 183 (69%) patients had their blood pressure measured, particularly if consulted by specialist (83%) and practice (77%) nurses compared with district (23%, p = 0.0003). After controlling for demographic variables, multivariate analyses showed patients consulted by nurses who had identified stroke as a major diabetes-related complication were more likely to have their blood pressure measured, and those consulted by district nurses less likely. Sixteen percent of patients were current smokers. Patients consulted by district nurses were more likely to smoke while, those >66 years less likely. Of those who wished to stop, only 50% were offered nicotine replacement therapy. Patients were significantly more likely to be advised on diet and physical activity if they had their blood pressure measured (p workforce is essential to ensure cardiovascular risk management becomes integrated into diabetes management. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

From Solution Shop to Boutique Consulting? Capturing Recent Developments on the German Consulting Marke

Directory of Open Access Journals (Sweden)

Jörg Jasper DÖTSCH

2016-12-01

Full Text Available Digitalization, globalization, new technologies and shorter product life cycles are only a few keywords underlining the fact that companies are under increasing pressure for faster adaptation, innovation and hence applying a higher knowledge intensity. We assume that these conditions require an increasingly important role of consulting companies, because they seem to be the intermediaries needed to bridge the faster growing gaps between existing business models, organizational structures and accelerating market change. Market pressure is growing on the market for consultant companies as well. New technologies and digitalization should influence both the structure of the consultancy market and the business models of consultancies. Christensen suggested a trend from Dzsolution shop” to Dzboutique consulting.” To track current developments, we concentrate on the German consulting market as one of the most important consultant markets worldwide and explore changes of the last two years based on various studies. Processes of change seem to be both substantially driven by digitalization and to reflect change on the non-consultancy markets. A high willingness to switch among providers documents a high pressure on performance. The impact of digitalisation seem• to be observable in structural and qualitative change. With regard to the German consulting market and the latest available data we cannot validate a tendency from a dominance of “solution shop” consultancies to “boutique” consultancy services.

Quality Improvement Initiative on Pain Knowledge, Assessment, and Documentation Skills of Pediatric Nurses.

Science.gov (United States)

Margonary, Heather; Hannan, Margaret S; Schlenk, Elizabeth A

2017-01-01

Pain treatment begins with a nurse’s assessment, which relies on effective assessment skills. Hospital settings have implemented pain assessment education, but there is limited evidence in pediatric transitional care settings. The purpose of this quality improvement (QI) initiative was to develop, implement, and evaluate an evidence-based pain education session with 20 nurses in a pediatric specialty hospital that provides transitional care. Specific aims were to assess nurses’ knowledge and attitudes of pain, and evaluate assessment skills based on nurses’ documentation. A prospective pre-post design with three assessments (baseline, post-intervention, and one-month follow-up) was used. The Shriner’s Pediatric Nurses’ Knowledge and Attitudes Regarding Pain questionnaire and an electronic health record review were completed at each assessment. There was significant improvement in nurses’ knowledge and attitudes of pain after the education session (F[2,6] = 50.281, p nurses significantly increased from 43.1% at baseline to 64.8% at post-intervention, and 67.7% at follow-up (χ²[2] = 20.55, p Nursing interventions for pain increased significantly, from 33.3% at baseline to 84.0% at post-intervention, and stabilized at 80.0% at follow-up (χ²[2] = 8.91, p = 0.012). Frequency of pain reassessments did not show a statistically significant change, decreasing from 77.8% at baseline to 44.0% at post-intervention and 40.0% at follow-up (χ²[2]= 3.538, p = 0.171). Nurses’ pain knowledge and documentation of assessment skills were improved in this QI initiative.

A New Resource for STD Clinical Providers: The Sexually Transmitted Diseases Clinical Consultation Network.

Science.gov (United States)

Caragol, Laura A; Wendel, Karen A; Anderson, Teri S; Burnside, Helen C; Finkenbinder, Allison; Fitch, John D; Kelley, Destiny H; Stewart, Terry W; Thrun, Mark; Rietmeijer, Cornelis A

2017-08-01

An online consultation tool, the Sexually Transmitted Diseases Clinical Consultation Network is a new resource for sexually transmitted disease clinicians and clinic managers. An initial evaluation shows that most requests (29%) were from medical doctors, followed by nurse practitioners (22%). Syphilis queries comprised 39% of consults followed by gonorrhea (12%) and chlamydia (11%).

Foot examinations of diabetes patients by primary health care nurses in Auckland, New Zealand.

Science.gov (United States)

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

2014-07-01

To identify factors associated with patients receiving foot examinations by primary health care nurses. A cross-sectional survey of 287 randomly sampled primary health care nurses, from a total of 1091 in Auckland, completed a postal self-administered questionnaire and telephone interview. Biographical and diabetes management details were collected for 265 diabetes patients consulted by the nurses on a randomly selected day. A response rate of 86% was achieved. Nurses examined patient's feet in 46% of consultations. Controlling for demographic variables, foot examinations were associated with age, odds ratio (1.25, 95% CI 0.57-2.74) for patients aged 51-65 years and >66 years (2.50, 1.08-5.75) compared with those ≤50 years, consultations by district compared with practice nurses (14.23, 95% CI 3.82-53.05), special programme consultations compared with usual follow-up consults (8.81, 95% CI 2.99-25.93) and length of consultation (1.89, 0.72-4.97) for 15-30 min and (4.45, 95% CI 1.48-13.41) >30 min compared with consultations ≤15 min, or for wound care (2.58, 1.01-6.61). Diabetes foot examinations by primary health care nurses varies greatly, and are associated with characteristics of the patient (age, need for wound care) and the consultation (district nurses, diabetes programme and duration). Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Vision document Energy Market Concentrations

International Nuclear Information System (INIS)

De Maa, J.; Van Gemert, M.; Giesbertz, P.; Vermeulen, M.; Beusmans, P.; Te Velthuis, M.; Drahos, M.

2006-11-01

June 2006 the second consultation document of the Netherlands Competition Authority (NMa) on the title subject (the first was in 2002) was published. The purpose of the consultation is to involve all the relevant and interested parties in the development of the energy market in the Netherlands and to consult those parties on studies that have been carried out by the NMa so far: (1) defining (possible) relevant markets in the electricity sector, and (2) the vision and opinion of the NMa with respect to mergers and take-overs. Also, the consultation document is a contribution to the response of the letter from the Dutch Minister of Economic Affairs of May 2005 in which the NMa was requested to give an overview of the preconditions with regard to competition and it's legal aspects. In this vision document all the relevant parties and stakeholders are informed about the development of energy markets in the Netherlands and abroad. Also an overview is given of the reactions from many stakeholders, involved and interested parties. [nl

Quality improvement in clinical documentation: does clinical governance work?

Directory of Open Access Journals (Sweden)

Dehghan M

2013-12-01

Full Text Available Mahlegha Dehghan,1 Dorsa Dehghan,2 Akbar Sheikhrabori,3 Masoume Sadeghi,4 Mehrdad Jalalian5 1Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 2Department of Pediatric Nursing, School of Nursing and Midwifery, Islamic Azad University Kerman Branch, Kerman, 3Department of Medical Surgical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, 4Research Center for Modeling in Health, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 5Electronic Physician Journal, Mashhad, Iran Introduction: The quality of nursing documentation is still a challenge in the nursing profession and, thus, in the health care industry. One major quality improvement program is clinical governance, whose mission is to continuously improve the quality of patient care and overcome service quality problems. The aim of this study was to identify whether clinical governance improves the quality of nursing documentation. Methods: A quasi-experimental method was used to show nursing documentation quality improvement after a 2-year clinical governance implementation. Two hundred twenty random nursing documents were assessed structurally and by content using a valid and reliable researcher made checklist. Results: There were no differences between a nurse's demographic data before and after 2 years (P>0.05 and the nursing documentation score did not improve after a 2-year clinical governance program. Conclusion: Although some efforts were made to improve nursing documentation through clinical governance, these were not sufficient and more attempts are needed. Keywords: nursing documentation, clinical governance, quality improvement, nursing record

[Access to the internet among nurses and type of information sought].

Science.gov (United States)

Muñoz-Izquierdo, Amparo; Puchades-Simó, Amparo; Marco-Gisbert, Amparo; Piquer-Bosca, Cecilia; Ferrer-Casares, Elena; Canela-Ferrer, Amparo; Gómez-Muñoz, Neus; Costa-Pastrana, M Carmen

2008-01-01

To identify how nurses use the Internet through a survey performed in May 2005. A descriptive cross-sectional study was performed. The information source was a survey sent electronically and through surface mail. The study population consisted of nursing professionals from distinct autonomous regions. The overall response rate was 40% (444 of 1,100). A total of 38.6% (184) of the nursing professionals used the Internet continually, especially men and nursing staff with a high level of English. The 5 most frequent reasons for surfing the net were searching for nursing literature (63% [264]), consulting the web pages of nursing journals (58.6% [256]), seeking information on drugs (55% [230]), seeking protocol manuals (50% [204]), and consulting the web pages of colleges of nursing (48). The behavior of nursing professionals is similar to that found among the general population in the "BBVA Foundation study of the Internet in Spain". Most nursing professionals are women. Male nursing professionals more frequently search for subjects related to nursing theory. Nurses use the Internet to search for nursing literature and consult journals, protocol manuals, and colleges of nursing, as well as to be familiar with the information aimed at patients.

Qualification of contractor/consultant instructors

International Nuclear Information System (INIS)

Hanson, H.D.

1985-01-01

Following a brief discussion of the role of consultant instructors in Public Service Electric and Gas Company's training organization, the qualification process is presented. Consultant instructors are provided with information regarding supervision of the trainees and the instructional process and procedures required. Each individual must have his or her instructional capability, supervisory skills and technical competence verified and documented prior to conducting training independently. Concluding comments describe the overall satisfactory experience with this program

Developing the Australasian Hepatology Association's Consensus-based Guidelines for the Nursing Care of Patients with Liver Disease.

Science.gov (United States)

Richmond, Jacqueline; Wheeler, Emily; Warner, Sherryne; Mason, Susan

2014-05-03

Abstract Purpose: Hepatology nursing is an emerging speciality. To define best practice, the Australasian Hepatology Association developed consensus-based guidelines for the nursing care of patients with liver disease. Methods: Using the Delphi technique, six rounds of consultation were conducted with Australian hepatology nurses and non-nursing hepatology professionals. Input was captured through face-to-face and electronic communication and questionnaires. Results: The experts' opinions were collated and consensus on the delivery of hepatology nursing care was achieved. In total, 90 consensus guidelines were developed. The principles underpinning the Guidelines include patient-centred care, non-discriminatory practice, cultural competence, collaboration and partnership and working within own scope of practice. Conclusion: Internationally, the Australasian Hepatology Association Guidelines are the first to document a consensus on the scope of hepatology nursing practice. The Guidelines reflect the expansion of hepatology nursing, from viral hepatitis to caring for patients with advanced liver disease and hepatocellular carcinoma, and provides a framework for future nursing practice.

Building Interpersonal Relationships as a Key to Effective Speaking Center Consultations

Science.gov (United States)

Ward, Kiya; Schwartzman, Roy

2009-01-01

Although much interest has been generated regarding the functions speaking centers serve and the effects consultations can have, minimal research has addressed the dynamics of consultations themselves. This study documents what speaking center clients and consultants identify as barriers in consultations and how they address them. Analysis of…

Centralized vs. decentralized nursing stations: effects on nurses' functional use of space and work environment.

Science.gov (United States)

Zborowsky, Terri; Bunker-Hellmich, Lou; Morelli, Agneta; O'Neill, Mike

2010-01-01

Evidence-based findings of the effects of nursing station design on nurses' work environment and work behavior are essential to improve conditions and increase retention among these fundamental members of the healthcare delivery team. The purpose of this exploratory study was to investigate how nursing station design (i.e., centralized and decentralized nursing station layouts) affected nurses' use of space, patient visibility, noise levels, and perceptions of the work environment. Advances in information technology have enabled nurses to move away from traditional centralized paper-charting stations to smaller decentralized work stations and charting substations located closer to, or inside of, patient rooms. Improved understanding of the trade-offs presented by centralized and decentralized nursing station design has the potential to provide useful information for future nursing station layouts. This information will be critical for understanding the nurse environment "fit." The study used an exploratory design with both qualitative and quantitative methods. Qualitative data regarding the effects of nursing station design on nurses' health and work environment were gathered by means of focus group interviews. Quantitative data-gathering techniques included place- and person-centered space use observations, patient visibility assessments, sound level measurements, and an online questionnaire regarding perceptions of the work environment. Nurses on all units were observed most frequently performing telephone, computer, and administrative duties. Time spent using telephones, computers, and performing other administrative duties was significantly higher in the centralized nursing stations. Consultations with medical staff and social interactions were significantly less frequent in decentralized nursing stations. There were no indications that either centralized or decentralized nursing station designs resulted in superior visibility. Sound levels measured in all

Entry-to-practice public health nursing competencies: A Delphi method and knowledge translation strategy.

Science.gov (United States)

Schofield, Ruth; Chircop, Andrea; Baker, Cynthia; Dietrich Leurer, Marie; Duncan, Susan; Wotton, Donalda

2018-06-01

Sustaining and strengthening nurses 'contributions to public and population health in the 21st century depends in part on nursing education. Clearly articulated entry-to-practice competencies will contribute to the capacity of undergraduate nursing education programs to prepare graduates to promote local, national and global population health. The Canadian Association of Schools of Nursing created the Public Health Task Force to develop consensus on core, national entry-to-practice competencies in public health nursing for undergraduate nursing students and to support these competencies with corresponding online teaching strategies. Delphi approach. Nurses with public health experience in education and practice, and representatives from other public health professional organizations across Canada. The three-phased competency development included: 1) an environmental scan; 2) an iterative process to draft competencies; and 3) a modified Delphi process to confirm the final competency framework using face to face consultations and a survey. The knowledge translation strategy involved soliciting submissions of teaching strategies for peer-review and subsequent inclusion in an interactive online resource. 242 public health educators and practitioners participated in the consensus consultation. The final document outlined five competency statements with 19 accompanying indicators. A total of 123 teaching strategies were submitted for the online resource, of which 50 were accepted as exemplary teaching strategies. This competency development process can provide guidance for the development of competencies in other countries, thus strengthening public health nursing education globally. The decision to intentionally level the competencies to entry-to-practice, as opposed to an advanced level, enhanced their application to undergraduate nursing education. The development of the additional inventory of teaching strategies created a sustainable innovative resource for public

Exploring gender differences in the working lives of UK hospital consultants.

Science.gov (United States)

Jefferson, Laura; Bloor, Karen; Spilsbury, Karen

2015-05-01

Internationally, increasing numbers of women are practising medicine. Gender differences in doctors' working hours, specialty choices and communication styles are well documented, but studies often neglect contextual factors such as the role of socialised gender expectations on behaviours in the workplace and the medical profession. These may be important as recent studies have reported gender differences in doctors' activity rates that cannot be explained by specialty or contracted hours, suggesting other sources of variation. This study sought to explore the working lives of hospital doctors and how their work is negotiated according to gender and context. Gender differences in the day-to-day work of hospital specialists (consultants) in the NHS were investigated using a qualitative approach, including observation and interview methods. Data were analysed inductively using qualitative observation and interview methods. Two NHS hospital trusts in England. Data were collected from 13 participants working in a variety of specialties and in a range of clinical and non-clinical settings. Various behaviours, attitudes and experiences were explored, such as doctor-patient communication, interactions with colleagues and workload. Influences at both individual and situational levels, appear to affect differentially the work of male and female doctors. Female consultants described awareness of the impact of behaviours on relationships with colleagues, and their interactions appeared to be more carefully performed. Nurses and other colleagues tend to demonstrate less cooperation with female consultants. Gender differences also exist in patient communication, feelings of work-family conflict and barriers to career progression. These variations in hospital consultants' work may have implications for both the quantity and quality of care provided by male and female consultants. This is timely and of importance to the medical workforce as the gender composition approaches

Promoting a Strategic Approach to Clinical Nurse Leader Practice Integration.

Science.gov (United States)

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

2016-01-01

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

Successful collaboration in healthcare-a guide for physicians, nurses and clinical documentation specialists

DEFF Research Database (Denmark)

Larsen, Torben

2010-01-01

methods of economic evaluation are relevant for a societal evaluation of the usefulness of an intervention. Sticking to DRG subtleties, only, the guidance serves private hospital profit instead of societal benefit. In all, these are serious weaknesses for a book aiming to guide the collaboration between......Book review Successful collaboration in healthcare-a guide for physicians, nurses and clinical documentation specialists Colleen Stukenberg New York: CRC Press, Taylor & Francis Group, 2010, pp. 136 ISBN 978 1 4389 1292 1 This book addresses an important topic, especially for health professionals...... engaged in integrated care (IC). Also, the book is easy to read with about 120 pages in a fluent language that you feel is based on first hand personal job experiences. Colleen Stukenberg is a certified nurse with more than 20 years' experience from a variety of hospital areas, a master's of science...

Ionising radiations. Joint consultative document. Supplementary proposals for provision on radiological protection and draft advice from the National Radiological Protection Board to the Health and Safety Commission

International Nuclear Information System (INIS)

1979-01-01

The consultative document is in two parts. Part 1 indicates the amendments to the first consultative document which would be required in order to implement (in the United Kingdom) the 1978 Draft Euratom Directive (on Basic Safety Standards for the health protection of the general public and workers against the dangers of ionising radiations). Part 2 deals with the system of dose limitation contained within the Euratom Directive. This aspect is discussed, in relation to the Articles of the Directive, under the following headings: limitation of doses for controllable exposures, limits of doses for exposed workers, limitation of doses for apprentices and students, planned special exposures, dose limits for members of the public. The Commission of the European Communities proposals for a draft Directive on Radiological Protection are reproduced as an Appendix, without Annexes. (U.K.)

Disruptive Innovation: Implementation of Electronic Consultations in a Veterans Affairs Health Care System.

Science.gov (United States)

Gupte, Gouri; Vimalananda, Varsha; Simon, Steven R; DeVito, Katerina; Clark, Justice; Orlander, Jay D

2016-02-12

Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic information and allows free-text entry of the reason for consult. This triggers a message to the requesting clinician and requested specialty, thereby enabling bidirectional clinician-clinician communication. The aim of this study is to examine the utilization of e-consults in a large Veterans Affairs (VA) health care system. Data from the electronic health record was used to measure frequency of e-consult use by provider type (physician or nurse practitioner (NP) and/or physician assistant), and by the requesting and responding specialty from January 2012 to December 2013. We conducted chart reviews for a purposive sample of e-consults and semi-structured interviews with a purposive sample of clinicians and hospital leaders to better characterize the process, challenges, and usability of e-consults. A total of 7097 e-consults were identified, 1998 from 2012 and 5099 from 2013. More than one quarter (27.56%, 1956/7097) of the e-consult requests originated from VA facilities in New England other than VABHS and were excluded from subsequent analysis. Within the VABHS e-consults (72.44%, 5141/7097), variability in frequency and use of e-consults across provider types and specialties was found. A total of 64 NPs requested 2407 e-consults (median 12.5, range 1-415). In contrast, 448 physicians (including residents and fellows) requested 2349 e-consults (median 2, range 1-116). More than one third (37.35%, 1920/5141) of e-consults were sent from primary care to specialists. While most e-consults

Successful collaboration in healthcare?a guide for physicians, nurses and clinical documentation specialists

OpenAIRE

Larsen, Torben

2010-01-01

Book reviewSuccessful collaboration in healthcare-a guide for physicians, nurses and clinical documentation specialistsColleen Stukenberg New York: CRC Press, Taylor & Francis Group, 2010, pp. 136ISBN 978 1 4389 1292 1This book addresses an important topic, especially for health professionals engaged in integrated care (IC). Also, the book is easy to read with about 120 pages in a fluent language that you feel is based on first hand personal job experiences.Colleen Stukenberg is a certifi...

Discrepancies between patient and professionals recall and perception of an outpatient consultation

DEFF Research Database (Denmark)

Parkin, T.; Skinner, T. C.

2003-01-01

was associated with greater autonomous motivation for self-care (r = 0.31; P perceptions......Aims: To explore the degree of agreement between patient and health care professional's perceptions of consultations. Methods: Immediately after 141 dietitian/nurse specialist consultations, patients and professional's completed the Health Care Climate questionnaire (HCC), Medical Interview...... Satisfaction Scale (MISS) and the Treatment Self-Regulation Questionnaire (TSRQ) In addition, both parties were asked about any key points or issues discussed in the consultation; any decisions that were made about their diabetes treatment today; any goals that were set as a result of today's consultation...

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

Science.gov (United States)

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

2016-12-21

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

International collaboration to enhance the fight against HIV/AIDS: Report of a consultative meeting between the University of Buea in Cameroon and the Goldfarb School of Nursing in the USA

Directory of Open Access Journals (Sweden)

Dickson S. Nsagha

2011-09-01

Full Text Available HIV/AIDS is a major public health pandemic affecting the development, survival and life of young people both in Cameroon and the USA. Youths are more adaptive to change and less hindered by prejudice than adults. Student-to-student peer mentoring is a non-formal way for students to learn new life skills and different cross-cultural values. We report on a two-day consultative meeting on developing international collaboration for the fight against HIV/AIDS between Cameroonian and USA nursing students. We used adult learning approaches consisting of presentations, discussions, questions and answer sessions, role plays and demonstrations. Deliberations and resolutions from the consultative meeting enabled the Vice-Chancellor of the University of Buea to sign a memorandum of understanding with the Goldfarb School of Nursing in the USA on HIV/AIDS international collaboration paving the way forward for more developmental health projects in this domain.

International collaboration to enhance the fight against HIV/AIDS: report of a consultative meeting between the University of Buea in Cameroon and the Goldfarb School of Nursing in the USA.

Science.gov (United States)

Nsagha, Dickson S; Rosenburg, Neal; Diesel, Holly; Sab, Clement M; Taliaferro, Donna

2011-09-05

HIV/AIDS is a major public health pandemic affecting the development, survival and life of young people both in Cameroon and the USA. Youths are more adaptive to change and less hindered by prejudice than adults. Student-to-student peer mentoring is a non-formal way for students to learn new life skills and different cross-cultural values. We report on a two-day consultative meeting in 2010 on developing international collaboration for the fight against HIV/AIDS between Cameroonian and USA nursing students. We used adult learning approaches consisting of presentations, discussions, questions and answer sessions, role plays and demonstrations. Deliberations and resolutions from the consultative meeting enabled the Vice-Chancellor of the University of Buea to sign a memorandum of understanding with the Goldfarb School of Nursing in the USA on HIV/AIDS international collaboration paving the way forward for more developmental health projects in this domain.

How do student nurses learn to care? An analysis of pre-registration adult nursing practice assessment documents.

Science.gov (United States)

Young, Kate; Godbold, Rosemary; Wood, Pat

2018-01-01

There is international concern about the quality of nursing in resource constrained, high technology health care settings. This paper reports findings from a research study which explored the experiences and views of those involved in the education and learning of 'caring' with adult pre-registration students. A novel dataset of 39 practice assessment documents (PADs) were randomly sampled and analysed across both bachelors and masters programmes from September 2014-July 2015. Using an appreciative enquiry approach, the Caring Behaviours Inventory aided analysis of qualitative text from both mentors and students within the PADs to identify how student nurses learn to care and to establish whether there were any differences between Masters and Bachelors students. In contrast with existing research, we found a holistic, melded approach to caring. This combined softer skills with highly technologized care, and flexible, tailored approaches to optimise individualised care delivery. Both of these were highly valued by both students and mentors. Pre-registration MSc students tended to have higher perceptual skills and be more analytical than their BSc counterparts. We found no evidence to suggest that caring behaviour or attitudes diminish over the course of either programme. Copyright © 2017 Elsevier Ltd. All rights reserved.

The representations of adolescents about gynecological consultation

Directory of Open Access Journals (Sweden)

Vera Lúcia de Oliveira Gomes

2014-06-01

Full Text Available Objective: To analyze the social representation of adolescents about gynecological consultation and the influence of those in searching for consultations. Method: Qualitative descriptive study based on the Social Representations Theory, conducted with 50 adolescents in their last year of middle school. The data was collected between April and May of 2010 by Evocations and a Focal Group. The software EVOC and contextual analysis were used in the data treatment. Results: The elements fear and constraint, constant in the central nucleus, can justify the low frequency of adolescents in consultations. The term embarrassment in the peripheral system reinforce current sociocultural norms, while prevention, associated with learning about sex and clarifying doubts, allows to envision an educative function. Obtained testimonies in the focal groups exemplify and reinforce those findings. Conclusion: For an effective health education, professionals, including nurses, need to clarify the youth individually and collectively about their rights to privacy, secrecy, in addition to focus the gynecological consultation as a promotion measure to sexual and reproductive health.

Applying the Model of the Interrelationship of Leadership Environments and Outcomes for Nurse Executives: a community hospital's exemplar in developing staff nurse engagement through documentation improvement initiatives.

Science.gov (United States)

Adams, Jeffrey M; Denham, Debra; Neumeister, Irene Ramirez

2010-01-01

The Model of the Interrelationship of Leadership, Environments & Outcomes for Nurse Executives (MILE ONE) was developed on the basis of existing literature related to identifying strategies for simultaneous improvement of leadership, professional practice/work environments (PPWE), and outcomes. Through existing evidence, the MILE ONE identifies the continuous and dependent interrelationship of 3 distinct concept areas: (1) nurse executives influence PPWE, (2) PPWE influence patient and organizational outcomes, and (3) patient and organizational outcomes influence nurse executives. This article highlights the application of the MILE ONE framework to a community district hospital's clinical documentation performance improvement projects. Results suggest that the MILE ONE is a valid and useful framework yielding both anticipated and unexpected enhancements to leaders, environments, and outcomes.

Nursing documentation and length of stay in orthopedic surgery

NARCIS (Netherlands)

Paans, Wolter; Krijnen, Wim

2016-01-01

Nursing outcome calculation, and future possibilities. An example in orthopedic specialty nursing. Comparing nursing diagnoses in hip prosthesis patients and knee prosthesis patients in a Dutch hospital.

Nurses' and patients' experiences of teleconsultations

DEFF Research Database (Denmark)

Sorknæs, Anne Dichmann; Hounsgaard, Lise; Olesen, Finn

2015-01-01

of the relationship between nurses and patients are little known. This study focused on real-time video consultations (teleconsultations) as experienced by Danish hospitalbased, respiratory nurses (telenurses) and patients with chronic obstructive pulmonary disease, COPD, discharged after hospitalisation with acute...

Teaching statistics to nursing students: an expert panel consensus.

Science.gov (United States)

Hayat, Matthew J; Eckardt, Patricia; Higgins, Melinda; Kim, MyoungJin; Schmiege, Sarah J

2013-06-01

Statistics education is a necessary element of nursing education, and its inclusion is recommended in the American Association of Colleges of Nursing guidelines for nurse training at all levels. This article presents a cohesive summary of an expert panel discussion, "Teaching Statistics to Nursing Students," held at the 2012 Joint Statistical Meetings. All panelists were statistics experts, had extensive teaching and consulting experience, and held faculty appointments in a U.S.-based nursing college or school. The panel discussed degree-specific curriculum requirements, course content, how to ensure nursing students understand the relevance of statistics, approaches to integrating statistics consulting knowledge, experience with classroom instruction, use of knowledge from the statistics education research field to make improvements in statistics education for nursing students, and classroom pedagogy and instruction on the use of statistical software. Panelists also discussed the need for evidence to make data-informed decisions about statistics education and training for nurses. Copyright 2013, SLACK Incorporated.

How Do Nursing Students Use Digital Tools during Lectures?

Science.gov (United States)

Sebri, Isabelle; Bartier, Jean-Claude; Pelaccia, Thierry

2016-01-01

Teachers often wonder what students are doing during lectures, behind their computers, mobile phones and other digital tools. This study aimed to document the type of tools used during lectures by nursing students and what they do with them. We carried out a descriptive, prospective, multicentre study including 1446 nursing students in Alsace (France). The students filled in an anonymous questionnaire at the end of a lesson they had just attended. 99% of the students had taken at least one digital tool to the lesson. 90% had a mobile phone with them. It was mainly used for entertainment (particularly for sending and/or receiving text messages and consulting emails). 52% had a laptop with them. It was essentially used for academic tasks (taking notes, working on other teaching units or revising for exams). Most nursing students take a phone or laptop to lectures with them with the intention of using them for entertainment and learning respectively. These results could guide training establishments in drafting their institutional policy concerning the use of digital tools in class.

How Do Nursing Students Use Digital Tools during Lectures?

Directory of Open Access Journals (Sweden)

Isabelle Sebri

Full Text Available Teachers often wonder what students are doing during lectures, behind their computers, mobile phones and other digital tools. This study aimed to document the type of tools used during lectures by nursing students and what they do with them.We carried out a descriptive, prospective, multicentre study including 1446 nursing students in Alsace (France. The students filled in an anonymous questionnaire at the end of a lesson they had just attended.99% of the students had taken at least one digital tool to the lesson. 90% had a mobile phone with them. It was mainly used for entertainment (particularly for sending and/or receiving text messages and consulting emails. 52% had a laptop with them. It was essentially used for academic tasks (taking notes, working on other teaching units or revising for exams.Most nursing students take a phone or laptop to lectures with them with the intention of using them for entertainment and learning respectively. These results could guide training establishments in drafting their institutional policy concerning the use of digital tools in class.

Treatment of Diabetic Foot Ulcers in the Home: Video Consultations as an Alternative to Outpatient Hospital Care

Directory of Open Access Journals (Sweden)

Jane Clemensen

2008-01-01

Full Text Available The aim of this study was to investigate whether video consultations in the home can support a viable alternative to visits to the hospital outpatient clinic for patients with diabetic foot ulcers. And furthermore whether patients, relatives, visiting nurses, and experts at the hospital will experience satisfaction and increased confidence with this new course of treatment. Participatory design methods were applied as well as field observations, semistructured interviews, focus groups, and qualitative analysis of transcriptions of telemedical consultations conducted during a pilot test. This study shows that it is possible for experts at the hospital to conduct clinical examinations and decision making at a distance, in close cooperation with the visiting nurse and the patient. The visiting nurse experienced increased confidence with the treatment of the foot ulcer and characterized the consultations as a learning situation. All patients expressed satisfaction and felt confidence with this new way of working.

A measure to evaluate classroom teaching practices in nursing.

Science.gov (United States)

Herinckx, Heidi; Munkvold, Julia Paschall; Winter, Elisabeth; Tanner, Christine A

2014-01-01

The Oregon Consortium for Nursing Education (OCNE) Classroom Teaching Fidelity Scale was created to measure the implementation of the OCNE curriculum and its related pedagogy. OCNE is a partnership of eight community colleges and the five-campus state-supported university. OCNE developed a shared competency-based curriculum and pedagogical practices. An essential part of the OCNE evaluation was to measure the extent the curriculum and pedagogical model were implemented on each partner campus. The scale was developed using a multistep methodology, including review of the literature and OCNE guidelines and materials, frequent consultation with local and national advisory boards, and multiple observations of OCNE classrooms over a two-year period. Fidelity scores are reported for 10 OCNE colleges observed in 2009. CONCLUSlON: The creation and use of this fidelity scale and similar measures may contribute to the emerging science of nursing education by more clearly documenting educational reform efforts..

A report on the green plan consultations

International Nuclear Information System (INIS)

1990-08-01

This document is a summary of what Canadians who participated in the consultations had to say about environmental issues and concerns; the solutions, roles and responsibilities, and priorities for action. It is based on detailed reports from 41 information sessions and 17 consultation workshops held across Canada. It is based on some 3,000 pages of comments and suggestions, an analysis of 4,500 question response forms, and written submissions from more than 1,000 individuals and organizations. The report is organized into two sections: improving decision making; and, action on environmental issues. The first section deals with science, education, enforcement, decision-making processes and partnerships. The second section deals with specific environmental issues identified in the consultation document, such as global warming and toxic substances, and other publicly identified issues, including energy and land use. Suggestions for further consideration represent possible policy, program and legislative elements of 'The Green Plan'. They are intended as a basis for a more focused debate which will help in the establishment of priorities

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

Science.gov (United States)

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

2017-09-01

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

The impact of a standardized consultation form for facial trauma on billing and evaluation and management levels.

Science.gov (United States)

Levesque, Andre Y; Tauber, David M; Lee, Johnson C; Rodriguez-Feliz, Jose R; Chao, Jerome D

2014-02-01

Facial trauma is among the most frequent consultations encountered by plastic surgeons. Unfortunately, the reimbursement from these consultations can be low, and qualified plastic surgeons may exclude facial trauma from their practice. An audit of our records found insufficient documentation to justify higher evaluation and management (EM) levels of service resulting in lower reimbursement. Utilizing a standardized consultation form can improve documentation resulting in higher billing and EM levels. A facial trauma consultation form was developed in conjunction with the billing department. Three plastic surgery residents completed 30 consultations without the aid of the consult form followed by 30 consultations with the aid of the form. The EM levels and billing data for each consultation were obtained from the billing department for analysis. The 2 groups were compared using χ2 analysis and t tests to determine statistical significance. Using our standardized consultation form, the mean EM level increased from 2.97 to 3.60 (P = 0.002). In addition, the mean billed amount increased from $391 to $501 per consult (P = 0.051) representing a 28% increase in billing. In our institution, the development and implementation of a facial trauma consultation form has resulted in more complete documentation and a subsequent increase in EM level and billed services.

Evaluation of the AECB's process of consultation with employees of its licensees

International Nuclear Information System (INIS)

Hart, D.; Eedy, W.; Hostovsky, C.; Burt, A.J.; Maghy, R.

1986-03-01

The study involved a review of public consultation methods used by various Federal Government agencies. These were then compared to the existing AECB programs to evaluate potential improvements. These were also referred to in later surveys of employees at licensed facilities to determine their perceived appropriateness. The majority of employees were both aware of AECB and correctly understood its function. Both of these aspects increased as a function of union membership, age, income, male sex and ARW status. However, the use of AECB consultative documents declined with union membership and increased with membership in professional associations. Satisfaction with the AECB consultative process was fairly low. Workers tended to be more satisfied with other agencies or safety associations. Feelings of job safety were greatest among those who received consultative documents or read AECB press releases. Feelings of safety also increased with age, education, income and professional association membership, but declined with union membership. Unionized employees expressed a desire for more consultation with AECB. Recommendations to improve the process of consultation are included

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

OpenAIRE

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

2012-01-01

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

Power is only skin deep: an institutional ethnography of nurse-driven outpatient psoriasis treatment in the era of clinic web sites.

Science.gov (United States)

Winkelman, Warren J; Halifax, Nancy V Davis

2007-04-01

We present an institutional ethnography of hospital-based psoriasis day treatment in the context of evaluating readiness to supplement services and support with a new web site. Through observation, interviews and a critical consideration of documents, forms and other textually-mediated discourses in the day-to-day work of nurses and physicians, we come to understand how the historical gender-determined power structure of nurses and physicians impacts nurses' work. On the one hand, nurses' work can have certain social benefits that would usually be considered untenable in traditional healthcare: nurses as primary decision-makers, nurses as experts in the treatment of disease, physicians as secondary consultants, and patients as co-facilitators in care delivery processes. However, benefits seem to have come at the nurses' expense, as they are required to maintain a cloak of invisibility for themselves and for their workplace, so that the Centre appears like all other outpatient clinics, and the nurses do not enjoy appropriate economic recognition. Implications for this negotiated invisibility on the implementation of new information systems in healthcare are discussed.

The metaethics of nursing codes of ethics and conduct.

Science.gov (United States)

Snelling, Paul C

2016-10-01

Nursing codes of ethics and conduct are features of professional practice across the world, and in the UK, the regulator has recently consulted on and published a new code. Initially part of a professionalising agenda, nursing codes have recently come to represent a managerialist and disciplinary agenda and nursing can no longer be regarded as a self-regulating profession. This paper argues that codes of ethics and codes of conduct are significantly different in form and function similar to the difference between ethics and law in everyday life. Some codes successfully integrate these two functions within the same document, while others, principally the UK Code, conflate them resulting in an ambiguous document unable to fulfil its functions effectively. The paper analyses the differences between ethical-codes and conduct-codes by discussing titles, authorship, level, scope for disagreement, consequences of transgression, language and finally and possibly most importantly agent-centeredness. It is argued that conduct-codes cannot require nurses to be compassionate because compassion involves an emotional response. The concept of kindness provides a plausible alternative for conduct-codes as it is possible to understand it solely in terms of acts. But if kindness is required in conduct-codes, investigation and possible censure follows from its absence. Using examples it is argued that there are at last five possible accounts of the absence of kindness. As well as being potentially problematic for disciplinary panels, difficulty in understanding the features of blameworthy absence of kindness may challenge UK nurses who, following a recently introduced revalidation procedure, are required to reflect on their practice in relation to The Code. It is concluded that closer attention to metaethical concerns by code writers will better support the functions of their issuing organisations. © 2016 John Wiley & Sons Ltd.

Measuring actual scope of nursing practice: a new tool for nurse leaders.

Science.gov (United States)

D'Amour, Danielle; Dubois, Carl-Ardy; Déry, Johanne; Clarke, Sean; Tchouaket, Eric; Blais, Régis; Rivard, Michèle

2012-05-01

: This project describes the development and testing of the actual scope of nursing practice questionnaire. : Underutilization of the skill sets of registered nurses (RNs) is a widespread concern. Cost-effective, safe, and efficient care requires support by management to facilitate the implementation of nursing practice at the full scope. : Literature review, expert consultation, and face validity testing were used in item development. The instrument was tested with 285 nurses in 22 medical units in 11 hospitals in Canada. : The 26-item, 6-dimension questionnaire demonstrated validity and reliability. The responses suggest that nurses practice at less than their optimal scope, with key dimensions of professional practice being implemented infrequently. : This instrument can help nurse leaders increase the effective use of RN time in carrying out the full scope of their professional practice.

WTP (willingness to pay) for tele-health consultation service in Hokkaido, Japan.

Science.gov (United States)

Ogasawara, Katsuhiko; Abe, Tamotsu

2013-01-01

We developed a tele-health consultation system that combines a sphygmomanometer with a tele-conference system. These were placed in pharmacies and the University. We selected five pharmacies to set up a consultation room; one in a local area, two in a suburban area, and the remaining two in an urban area. Nurses with more than 5 years of clinical experience were assigned as consultants. These consultants offer health consultation but do not practice medicine. Some researchers have indicated the economic viability of at-home health management systems, but nothing has been researched on the economic viability of tele-health consultation. The objective of present study was estimated Willingness to Payment (WTP) of Tele-health consultation service. The WTP was estimated by Double-Bounded Dichotomous-Choice model. We performed logistic-regression analysis to confirm factors to affect WTP. The number of the respondent was 480. Mean WTP was calculated 495 yen and the median was 367 yen. There was significant difference for factor of "annual income", "have a willingness to use this system", and "have a child/children".

Workplace stress in nursing: a literature review.

Science.gov (United States)

McVicar, Andrew

2003-12-01

Stress perception is highly subjective, and so the complexity of nursing practice may result in variation between nurses in their identification of sources of stress, especially when the workplace and roles of nurses are changing, as is currently occurring in the United Kingdom health service. This could have implications for measures being introduced to address problems of stress in nursing. To identify nurses' perceptions of workplace stress, consider the potential effectiveness of initiatives to reduce distress, and identify directions for future research. A literature search from January 1985 to April 2003 was conducted using the key words nursing, stress, distress, stress management, job satisfaction, staff turnover and coping to identify research on sources of stress in adult and child care nursing. Recent (post-1997) United Kingdom Department of Health documents and literature about the views of practitioners was also consulted. Workload, leadership/management style, professional conflict and emotional cost of caring have been the main sources of distress for nurses for many years, but there is disagreement as to the magnitude of their impact. Lack of reward and shiftworking may also now be displacing some of the other issues in order of ranking. Organizational interventions are targeted at most but not all of these sources, and their effectiveness is likely to be limited, at least in the short to medium term. Individuals must be supported better, but this is hindered by lack of understanding of how sources of stress vary between different practice areas, lack of predictive power of assessment tools, and a lack of understanding of how personal and workplace factors interact. Stress intervention measures should focus on stress prevention for individuals as well as tackling organizational issues. Achieving this will require further comparative studies, and new tools to evaluate the intensity of individual distress.

Virtual online consultations: advantages and limitations (VOCAL) study.

Science.gov (United States)

Greenhalgh, Trisha; Vijayaraghavan, Shanti; Wherton, Joe; Shaw, Sara; Byrne, Emma; Campbell-Richards, Desirée; Bhattacharya, Satya; Hanson, Philippa; Ramoutar, Seendy; Gutteridge, Charles; Hodkinson, Isabel; Collard, Anna; Morris, Joanne

2016-01-29

Remote video consultations between clinician and patient are technically possible and increasingly acceptable. They are being introduced in some settings alongside (and occasionally replacing) face-to-face or telephone consultations. To explore the advantages and limitations of video consultations, we will conduct in-depth qualitative studies of real consultations (microlevel) embedded in an organisational case study (mesolevel), taking account of national context (macrolevel). The study is based in 2 contrasting clinical settings (diabetes and cancer) in a National Health Service (NHS) acute trust in London, UK. Main data sources are: microlevel--audio, video and screen capture to produce rich multimodal data on 45 remote consultations; mesolevel--interviews, ethnographic observations and analysis of documents within the trust; macrolevel--key informant interviews of national-level stakeholders and document analysis. Data will be analysed and synthesised using a sociotechnical framework developed from structuration theory. City Road and Hampstead NHS Research Ethics Committee, 9 December 2014, reference 14/LO/1883. We plan outputs for 5 main audiences: (1) academics: research publications and conference presentations; (2) service providers: standard operating procedures, provisional operational guidance and key safety issues; (3) professional bodies and defence societies: summary of relevant findings to inform guidance to members; (4) policymakers: summary of key findings; (5) patients and carers: 'what to expect in your virtual consultation'. The research literature on video consultations is sparse. Such consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective), but fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. We

Practice nurses mental health provide space to patients to discuss unpleasant emotions.

Science.gov (United States)

Griep, E C M; Noordman, J; van Dulmen, S

2016-03-01

WHAT IS KNOWN ON THE SUBJECT?: A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Patients with mild psychosocial and psychological problems provide signs of worrying or express a clear unpleasant emotion in 94% of consultations with a practice nurse mental health. Nurses' responses to patients' signs of worrying or clear unpleasant emotions were mostly characterized by providing space for patients to talk about these emotions, by using minimal responses. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Practice nurses' mental health have passive listening skills, and to a lesser extent, use active listening techniques. Accurate emotion detection and the ability to pick out emotional signs during consultations must also be considered as an important skill for health providers to improve patient-centred communication. Patients with physical problems are known to express their emotional concerns in an implicit way only. Whether the same counts for patients presenting mental health problems in primary care is unknown. This study aims to examine how patients with mild psychosocial and psychological complaints express their concerns during consultations with the practice nurse mental health and how practice nurses respond to these expressions. Fifteen practice nurses mental health working in Dutch general practices participated in the study. Their consultations with 116 patients with mild psychosocial or psychological complaints were video recorded. patients' explicitly expressed emotional concerns and more implicit expressions of underlying emotional problems (cues) as well as nurses' responses to these expressions were rated using the Verona Coding Definition of Emotional Sequences. Almost all consultations contained at least one cue or

Integrated assessment and consultation for the preoperative patient.

Science.gov (United States)

Silverman, David G; Rosenbaum, Stanley H

2009-12-01

Assessment of the presurgical patient requires interdisciplinary cooperation over the continuum of documentation and optimization of existing disorders, determination of patient resilience and reserve, and planning for subsequent interventions and care. For many patients, evident or suspected morbidities or anticipated surgical disturbance warrant specialty consultation. There may be uncertainty as to the optimal processes for a given patient, a limitation attributable to myriad factors, not the least of which is that there is often a paucity of evidence that is directly relevant to a given patient in a given setting. The present article discusses these limitations and describes a framework for documentation, optimization, risk assessment, and planning, as well as a uniform grading of existing morbidities and anticipated perioperative disturbances for patients requiring integrated assessment and consultation.

A Proposed Middle-Range Theory of Nursing in Hypertension Care

Directory of Open Access Journals (Sweden)

Eva Drevenhorn

2018-01-01

Full Text Available Nursing in hypertension care comprises counselling about lifestyle changes, blood pressure measurement, and being a translator for the physician. For the patient, changing lifestyle means performing self-care. As not much in the form of research and guidelines for nurses is available, a middle-range theory of nursing in hypertension care was developed to guide nurses in their practice, in order to improve the nursing of patients and design studies for investigating nursing in hypertension care. Concepts are presented related to the patient (attitude and beliefs regarding health and sickness, autonomy, personality and traits, level of perceived vulnerability, hardiness, sense of coherence, locus of control, self-efficacy, and access to social support and network and the nursing (applying theories and models for behavioural change in the consultation and using counselling skills, patient advocacy, empowerment, professional knowledge and health education, and supporting the patient. Then the concepts related to the consultation (communication, shared decision-making, concordance, coping, adherence, and self-care are integrated with Orem’s theory of nursing. Clinical and research implications of the theory are discussed.

Helping nursing homes "at risk" for quality problems: a statewide evaluation.

Science.gov (United States)

Rantz, Marilyn J; Cheshire, Debra; Flesner, Marcia; Petroski, Gregory F; Hicks, Lanis; Alexander, Greg; Aud, Myra A; Siem, Carol; Nguyen, Katy; Boland, Clara; Thomas, Sharon

2009-01-01

The Quality Improvement Program for Missouri (QIPMO), a state school of nursing project to improve quality of care and resident outcomes in nursing homes, has a special focus to help nursing homes identified as "at risk" for quality concerns. In fiscal year 2006, 92 of 492 Medicaid-certified facilities were identified as "at risk" using quality indicators (QIs) derived from Minimum Data Set (MDS) data. Sixty of the 92 facilities accepted offered on-site clinical consultations by gerontological expert nurses with graduate nursing education. Content of consultations include quality improvement, MDS, care planning, evidence-based practice, and effective teamwork. The 60 "at-risk" facilities improved scores 4%-41% for 5 QIs: pressure ulcers (overall and high risk), weight loss, bedfast residents, and falls; other facilities in the state did not. Estimated cost savings (based on prior cost research) for 444 residents who avoided developing these clinical problems in participating "at-risk" facilities was more than $1.5 million for fiscal year 2006. These are similar to estimated savings of $1.6 million for fiscal year 2005 when 439 residents in "at-risk" facilities avoided clinical problems. Estimated savings exceed the total program cost by more than $1 million annually. QI improvements demonstrate the clinical effectiveness of on-site clinical consultation by gerontological expert nurses with graduate nursing education.

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

Science.gov (United States)

Gray, Linda R; Shirey, Maria R

2013-01-01

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

Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study.

Science.gov (United States)

Wong, Ides; Wright, Eryn; Santomauro, Damian; How, Raquel; Leary, Christopher; Harris, Meredith

2018-01-01

To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework. Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available. Over the two-month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient-related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays. Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation. Results suggest that nurse practitioner models can be successfully integrated into a

Relational use of an electronic quality of life and practice support system in hospital palliative consult care: A pilot study.

Science.gov (United States)

Krawczyk, Marian; Sawatzky, Richard

2018-03-08

This study is part of an overarching research initiative on the development and integration of an electronic Quality of Life and Practice Support System (QPSS) that uses patient-reported outcome and experience measures in clinical practice. The current study focused on palliative nurse consultants trialing the QPSS with older hospitalized adults receiving acute care. The primary aim of the study was to better understand consultants' and patients' experiences and perspectives of use. The project involved two nurse specialists within a larger palliative outreach consult team (POCT) and consenting older adult patients (age 55+) in a large tertiary acute care hospital in western Canada. User-centered design of the QPSS was informed by three focus groups with the entire POCT team, and implementation was evaluated by direct observation as well as interviews with the POCT nurses and three patients. Thematic analysis of interviews and field notes was informed by theoretical perspectives from social sciences. Result Over 9 weeks, the POCT nurses used the QPSS at least once with 20 patients, for a total of 47 administrations. The nurses most often assisted patients in using the QPSS. Participants referenced three primary benefits of relational use: enhanced communication, strengthened therapeutic relations, and cocreation of new insights about quality of life and care experiences. The nurses also reported increased visibility of quality of life concerns and positive development as relational care providers. Significance of results Participants expressed that QPSS use positively influenced relations of care and enhanced practices consistent with person-centered care. Results also indicate that electronic assessment systems may, in some instances, function as actor-objects enabling new knowledge and relations of care rather than merely as a neutral technological platform. This is the first study to examine hospital palliative consult clinicians' use of a tablet-based system

Inpatient consultations to an orthopaedic service: the hidden workload.

LENUS (Irish Health Repository)

O'Malley, N T

2011-12-01

While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

Evaluation of the functional performance and technical quality of an Electronic Documentation System of the Nursing Process.

Science.gov (United States)

de Oliveira, Neurilene Batista; Peres, Heloisa Helena Ciqueto

2015-01-01

To evaluate the functional performance and the technical quality of the Electronic Documentation System of the Nursing Process of the Teaching Hospital of the University of São Paulo. exploratory-descriptive study. The Quality Model of regulatory standard 25010 and the Evaluation Process defined under regulatory standard 25040, both of the International Organization for Standardization/International Electrotechnical Commission. The quality characteristics evaluated were: functional suitability, reliability, usability, performance efficiency, compatibility, security, maintainability and portability. The sample was made up of 37 evaluators. in the evaluation of the specialists in information technology, only the characteristic of usability obtained a rate of positive responses of less than 70%. For the nurse lecturers, all the quality characteristics obtained a rate of positive responses of over 70%. The staff nurses of the medical and surgical clinics with experience in using the system) and staff nurses from other units of the hospital and from other health institutions (without experience in using the system) obtained rates of positive responses of more than 70% referent to the functional suitability, usability, and security. However, performance efficiency, reliability and compatibility all obtained rates below the parameter established. the software achieved rates of positive responses of over 70% for the majority of the quality characteristics evaluated.

[Measuring nursing care times--methodologic and documentation problems].

Science.gov (United States)

Bartholomeyczik, S; Hunstein, D

2001-08-01

The time for needed nursing care is one important measurement as a basic for financing care. In Germany the Long Term Care Insurance (LTCI) reimburses nursing care depending on the time family care givers need to complete selected activities. The LTCI recommends certain time ranges for these activities, which are wholly compensatory, as a basic for assessment. The purpose is to enhance assessment justice and comparability. With the example of a German research project, which had to investigate the duration of these activities and the reasons for differences, questions are raised about some definition and interpretation problems. There are definition problems, since caring activities especially in private households are nearly never performed as clearly defined modules. Moreover, often different activities are performed simultaneously. However, the most important question is what exactly time numbers can say about the essentials of nursing care.

Effect of Simulation on Undergraduate Nursing Students' Knowledge of Nursing Ethics Principles.

Science.gov (United States)

Donnelly, Mary Broderick; Horsley, Trisha Leann; Adams, William H; Gallagher, Peggy; Zibricky, C Dawn

2017-12-01

Background Undergraduate nursing education standards include acquisition of knowledge of ethics principles and the prevalence of health-care ethical dilemmas mandates that nursing students study ethics. However, little research has been published to support best practices for teaching/learning ethics principles. Purpose This study sought to determine if participation in an ethics consultation simulation increased nursing students' knowledge of nursing ethics principles compared to students who were taught ethics principles in the traditional didactic format. Methods This quasi-experimental study utilized a pre-test/post-test design with randomized assignment of students at three universities into both control and experimental groups. Results Nursing students' knowledge of nursing ethics principles significantly improved from pre-test to post-test ( p = .002); however, there was no significant difference between the experimental and control groups knowledge scores ( p = .13). Conclusion Further research into use of simulation to teach ethics principles is indicated.

Randomised controlled trial of a complex intervention by primary care nurses to increase walking in patients aged 60–74 years: protocol of the PACE-Lift (Pedometer Accelerometer Consultation Evaluation - Lift trial

Directory of Open Access Journals (Sweden)

Harris Tess

2013-01-01

Full Text Available Abstract Background Physical activity is essential for older peoples’ physical and mental health and for maintaining independence. Guidelines recommend at least 150 minutes weekly, of at least moderate intensity physical activity, with activity on most days. Older people’s most common physical activity is walking, light intensity if strolling, moderate if brisker. Less than 20% of United Kingdom 65–74 year olds report achieving the guidelines, despite most being able to. Effective behaviour change techniques include strategies such as goal setting, self-monitoring, building self-efficacy and relapse prevention. Primary care physical activity consultations allow individual tailoring of advice. Pedometers measure step-counts and accelerometers measure physical activity intensity. This protocol describes an innovative intervention to increase walking in older people, incorporating pedometer and accelerometer feedback within a primary care nurse physical activity consultation, using behaviour change techniques. Methods/Design Design: Randomised controlled trial with intervention and control (usual care arms plus process and qualitative evaluations. Participants: 300 people aged 60–74 years registered with 3 general practices within Oxfordshire and Berkshire West primary care trusts, able to walk outside and with no restrictions to increasing their physical activity. Intervention: 3 month pedometer and accelerometer based intervention supported by practice nurse physical activity consultations. Four consultations based on behaviour change techniques, physical activity diary, pedometer average daily steps and accelerometer feedback on physical activity intensity. Individual physical activity plans based on increasing walking and other existing physical activity will be produced. Outcomes: Change in average daily steps (primary outcome and average time spent in at least moderate intensity physical activity weekly (secondary outcome at 3 months

Communication strategies for a successful inpatient dermatology consultative service: a narrative review.

Science.gov (United States)

Afifi, Ladan; Shinkai, Kanade

2017-03-01

Inpatient dermatology consultative services care for hospitalized patients with skin disease in collaboration with the primary inpatient team. Effective, efficient communication is important. A consultation service must develop strong relationships with primary inpatient teams requesting consults in order to provide optimal patient care. Prior studies have identified effective communication practices for inpatient consultative services. This narrative review provides a summary of effective communication practices for an inpatient dermatology consultation service organized into 5 domains: (1) features of the initial consult request; (2) best practices in responding to the initial consult; (3) effective communication of recommendations; (4) interventions to improve consultations; and (5) handling curbside consultations. Recommendations include identifying the specific reason for consult; establishing urgency; secure sharing of sensitive clinical information such as photographs; ensuring timely responses; providing clear yet brief documentation of the differential diagnosis, problem list, final diagnosis and recommendations; and limiting curbside consultations. Future studies are needed to validate effective strategies to enhance communication practices within an inpatient dermatology consultative service. ©2017 Frontline Medical Communications.

Bedfordshire County Structure Plan. Proposed alterations. Results of public consultation. Policy 97: Nuclear waste

International Nuclear Information System (INIS)

1984-01-01

The document refers to Alterations to the County Structure Plan, proposed by Bedfordshire County Council and submitted to the Secretary of State for the Environment. An additional Alteration initiated at the County Council's meeting, dealing with nuclear waste, had not been the subject of prior public consultation. Consultation had since been arranged, and the present document summarises the responses that have been received, and describes the next action to be taken. (U.K.)

The Smallpox Threat: The School Nurse's Role

Science.gov (United States)

Martin, Mary E.; Didion, Judy

2003-01-01

Today, with the threat of bioterrorism and war, there is a new dimension to the traditional role of the school nurse. The smallpox threat to public health will invoke the school nurse's role as an educator, liaison, and consultant in the community. This article discusses smallpox, the vaccination process, adverse effects, and postvaccination care.…

Job Satisfaction Of Hospital Nursing Staff

Directory of Open Access Journals (Sweden)

Charlotte Pietersen

2005-11-01

Full Text Available Health care managers realize that job satisfaction impacts on nursing staff retention. This study examined the job satisfaction of nursing staff (N = 109 at a government hospital. Just more than half of the respondents were generally satisfied. Feelings that nursing is worthwhile and satisfying, and financial stability at the hospital could promote staff retention. Specific intrinsic - (promotion, and extrinsic factors (routinization, working conditions, pay, interaction with supervisors, and organizational support could impact negatively on retention. Management should use these findings as a basis for staff consultation, developmental strategies, and interventions. Future research on other nursing populations is recommended.

An administrative marketing strategy: a different perspective on the nursing process.

Science.gov (United States)

Beaupre, B A

1988-11-01

Through the methods of the nursing process, nurse administrators were able to sell nursing to nurses. The use of marketing to link the business world with nursing stimulated professional dedication, skill, and responsibility. The program helped to encourage habits of flexibility, ensure continuous learning, acceptance of change, and the opportunity for individuals and institutions to grow and advance. It promoted autonomous, collaborative, and consultative practice. Nurturing the nurse had become a reality.

Management information systems and the role of the nurse vendor.

Science.gov (United States)

Lenkman, S

1985-09-01

Nurse vendors have the ability and motivation to respond to market imperatives faster than most health care institutions. Vendors can contribute important knowledge to nursing literature about the consultant-expert vendor-client relationship and the expectations of both.

Probing community nurses' professional basis

DEFF Research Database (Denmark)

Schaarup, Clara; Pape-Haugaard, Louise; Jensen, Merete Hartun

2017-01-01

Complicated and long-lasting wound care of diabetic foot ulcers are moving from specialists in wound care at hospitals towards community nurses without specialist diabetic foot ulcer wound care knowledge. The aim of the study is to elucidate community nurses' professional basis for treating...... diabetic foot ulcers. A situational case study design was adopted in an archetypical Danish community nursing setting. Experience is a crucial component in the community nurses' professional basis for treating diabetic foot ulcers. Peer-to-peer training is the prevailing way to learn about diabetic foot...... ulcer, however, this contributes to the risk of low evidence-based practice. Finally, a frequent behaviour among the community nurses is to consult colleagues before treating the diabetic foot ulcers....

The emotional labour of nursing -- Defining and managing emotions in nursing work.

Science.gov (United States)

Gray, Benjamin

2009-02-01

Emotions in health organisations tend to remain tacit and in need of clarification. Often, emotions are made invisible in nursing and reduced to part and parcel of 'women's work' in the domestic sphere. Smith (1992) applied the notion of emotional labour to the study of student nursing, concluding that further research was required. This means investigating what is often seen as a tacit and uncodified skill. A follow-up qualitative study was conducted over a period of twelve months to re-examine the role of the emotional labour of nursing. Data were collected primarily from 16 in-depth and semi-structured interviews with nurses. Key themes elicited at interviews touch upon diverse topics in the emotional labour of nursing. In particular, this article will address nurse definitions of emotional labour; the routine aspects of emotional labour in nursing; traditional and modern images of nursing; and gender and professional barriers that involve emotional labour in health work. This is important in improving nurse training and best practice; investigating clinical settings of nurses' emotional labour; looking at changing techniques of patient consultation; and beginning to explore the potential therapeutic value of emotional labour.

Ethical difficulties in nursing, educational needs and attitudes about using ethics resources.

Science.gov (United States)

Leuter, Cinzia; Petrucci, Cristina; Mattei, Antonella; Tabassi, Gianpietro; Lancia, Loreto

2013-05-01

Ethical difficulties arise in healthcare practices. However, despite extensive research findings that demonstrate that most nurses are involved in recurrent ethical problems, institutions are not always able to effectively support nursing care professionals. The limited availability of ethics consultation services and traditional nursing training fails to meet the frequent and strong requests by health workers to support their ethical dilemmas. A questionnaire was administered to 374 nurses attending a specialist training and a lifetime learning programme in Italy. The respondents reported a high frequency of ethically sensitive situations, and they described the poor development of ethics support and a scarcity of ethics training programmes. The results suggest the importance of promoting ethics services that include consultation and ethics training. A need for systematic ethics educational activities was identified for improving the capacity of nurses to manage ethical issues in patient care.

School-based youth health nurses: roles, responsibilities, challenges, and rewards.

Science.gov (United States)

Barnes, Margaret; Courtney, Mary D; Pratt, Jan; Walsh, Anne M

2004-01-01

A case study and focus-group discussions were conducted with 10 youth health nurses (nurses) employed in the recently introduced School-Based Youth Health Nurse Program (SBYHNP) to identify their roles, responsibilities, and professional development needs. Major roles are support, referral, health promotion, and marketing. Clients include high school students, teachers, and parents; the majority of whom are female and aged 13-16 years. Health issues addressed during individual consultations are predominantly psychosocial but also include medical, sexual health and sexuality issues, health surveillance, and risk-taking behaviors. Nurses also provide clients with health information and promote enhanced personal skill development during these consultations. Health promotion strategies undertaken by nurses were predominantly health education and health information displays. Nurses reported marketing their role and function within the school to be an essential and often difficult aspect of their role. Professional development through the SBYHNP was excellent; however, there was concern relating to the availability of future educational opportunities. The SBYHNP provides nurses with a new, challenging, autonomous role within the school environment and the opportunity to expand their role to incorporate all aspects of the health-promoting schools' framework.

The scope of private practice nursing in an Australian sample.

Science.gov (United States)

Wilson, Anne; Averis, Andrea; Walsh, Ken

2004-01-01

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

Otolaryngology Consult Carts: Maximizing Patient Care, Surgeon Efficiency, and Cost Containment.

Science.gov (United States)

Royer, Mark C; Royer, Allison K

2015-11-01

The objective of this study was to develop an otolaryngology consult cart system to ensure prompt delivery to the bedside of all the unique equipment and medications required for emergent and urgent otolaryngology consults. An otolaryngology practice responsible for emergency room and hospital consult coverage sought to create a cart containing all equipment, medications, and supplies for otolaryngology consults. Meetings with hospital administration and emergency room, nursing, pharmacy, central processing, and operating room staff were held to develop a system for the emergent delivery of the cart to the needed location, sterilization and restocking of equipment between uses, and appropriate billing of supplies. Two months were required from conception to implementation. All equipment was purchased new, including flexible scopes and headlights. The cart is sterilized, restocked, and maintained by central processing after each use. The equipment is available to handle all airway emergencies as well as all common otolaryngology consults and is delivered bedside in less than 5 minutes. The development of a self-contained otolaryngology consult cart requires coordination with a wide variety of hospital departments. This system, while requiring initial monetary and time investment, has resulted in improved patient care, cost containment, and surgeon convenience. © The Author(s) 2015.

Evaluation of Evidence-based Nursing Pain Management Practice.

Science.gov (United States)

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

2015-08-01

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

[Identification of the scope of practice for dental nurses with Delphi method].

Science.gov (United States)

Li, Yu-Hong; Lu, Yue-Cen; Huang, Yao; Ruan, Hong; Wu, Zheng-Yi

2016-10-01

To identify the practice scope of dental nurses under the new situations. The draft of scope of practice for dental nurses was based on theoretical analysis, literature review and consultation of advisory panel, and the final scope of practice for dental nurses was established by using the Delphi method. Statistical analysis was implemented using coefficient of variation, Kendall W with SPSS 17.0 software package. Thirty experts were consulted twice by using the Delphi method. The effective rates of two rounds of questionnaire were 100% and 73.3%, respectively. The authority coefficient was 0.837, and the P value of expert coordination coefficients W was less than 0.05. There were totally 116 suggestions from the experts, and 96 were accepted. The scope of practice for dental nurses was finally established, including 4 primary indexes and 25 secondary indexes. The scope of practice for dental nurses under the new situations is established in China through scientific methods. It is favorable for position management of dental nurses and may promote the development of nurse specialists in dental clinic.

Minimal improvement of nurses' motivational interviewing skills in routine diabetes care one year after training: a cluster randomized trial.

Science.gov (United States)

Jansink, Renate; Braspenning, Jozé; Laurant, Miranda; Keizer, Ellen; Elwyn, Glyn; Weijden, Trudy van der; Grol, Richard

2013-03-28

The effectiveness of nurse-led motivational interviewing (MI) in routine diabetes care in general practice is inconclusive. Knowledge about the extent to which nurses apply MI skills and the factors that affect the usage can help to understand the black box of this intervention. The current study compared MI skills of trained versus non-trained general practice nurses in diabetes consultations. The nurses participated in a cluster randomized trial in which a comprehensive program (including MI training) was tested on improving clinical parameters, lifestyle, patients' readiness to change lifestyle, and quality of life. Fifty-eight general practices were randomly assigned to usual care (35 nurses) or the intervention (30 nurses). The ratings of applying 24 MI skills (primary outcome) were based on five consultation recordings per nurse at baseline and 14 months later. Two judges evaluated independently the MI skills and the consultation characteristics time, amount of nurse communication, amount of lifestyle discussion and patients' readiness to change. The effect of the training on the MI skills was analysed with a multilevel linear regression by comparing baseline and the one-year follow-up between the interventions with usual care group. The overall effect of the consultation characteristics on the MI skills was studied in a multilevel regression analyses. At one year follow up, it was demonstrated that the nurses improved on 2 of the 24 MI skills, namely, "inviting the patient to talk about behaviour change" (mean difference=0.39, p=0.009), and "assessing patient's confidence in changing their lifestyle" (mean difference=0.28, p=0.037). Consultation time and the amount of lifestyle discussion as well as the patients' readiness to change health behaviour was associated positively with applying MI skills. The maintenance of the MI skills one year after the training program was minimal. The question is whether the success of MI to change unhealthy behaviour must be

Improved quality of nursing documentation: results of a nursing diagnoses, interventions, and outcomes implementation study.

NARCIS (Netherlands)

Muller-Staub, M.; Needham, I.; Odenbreit, M.; Lavin, M.A.; Achterberg, T. van

2007-01-01

PURPOSE: To evaluate the impact of the quality of nursing diagnoses, interventions, and outcomes in an acute care hospital following the implementation of an educational program. METHOD: In a pretest-posttest experimental design study, nurses from 12 wards of a Swiss hospital received an educational

Academic Incivility in Nursing Education

Science.gov (United States)

Marlow, Sherri

2013-01-01

A well-documented and growing problem impacting the nursing shortage in the United States is the increasing shortage of qualified nursing faculty. Many factors contribute to the nursing faculty shortage such as retirement, dissatisfaction with the nursing faculty role and low salary compensation (American Association of Colleges of Nursing (AACN),…

Consulting Basics for the Teacher-Turned-Technology Consultant.

Science.gov (United States)

Stager, Sue; Green, Kathy

1988-01-01

Discusses the role of educational technology consultants who may be classroom teachers with no formal training in consulting. Consulting models are described, including content-oriented and process-oriented approaches; Schein's process facilitator model is examined; and Kurpius' consulting model is explained and expanded. (LRW)

Nurse Reinvestment Act. Public Law.

Science.gov (United States)

Congress of the U.S., Washington, DC.

This document contains the text of the Nurse Reinvestment Act, which amends the Public Health Service Act to address the increasing shortage of registered nurses by instituting a series of policies to improve nurse recruitment and nurse retention. Title I details two initiatives to boost recruitment of nurses. The first initiative includes the…

Effects of Using Licensed Practical Nurses to Assist with Telephone Consultation Management

National Research Council Canada - National Science Library

Wiley, Jennifer L

2006-01-01

.... The study compared means of pre- and post-implementation provider overall job satisfaction, provider satisfaction with the telephone consult process, average daily hours providers spent on telephone...

Analysis of responses to the microgeneration strategy and low carbon buildings programme consultation

Energy Technology Data Exchange (ETDEWEB)

Gibbard, J; Long, S; McCartney, K; Rushton, K

2005-10-15

This report summarises and analyses the written responses to the consultation document, 'Microgeneration Strategy and Low Carbon Buildings Programme', issued by the Department of Trade and Industry (DTI) in June 2005. Responses were received from 204 different organisations representing 29 stakeholder groups. The consultation document contained 41 core questions divided into eight sections: general; product development and deployment; communications; economics; installation; Low Carbon Buildings Programme; physical infrastructure; and local authorities and regional bodies. In the analysis, the responses to these questions were categorised according to whether they represented a 'clear consensus', a 'majority view', 'supporting themes' and 'divergent themes'. Using these categories, stakeholder agreement on the eight strategic issues is summarised in a matrix. The report is divided into three sections: introduction; summary of responses; and key findings. The respondents are listed in an appendix. Another appendix reproduces the consultation questions.

Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice.

Science.gov (United States)

Cortez, Susan; Dietrich, Mary S; Wells, Nancy

2016-07-01

To measure the effect of clinical decision support (CDS) on oncology nurse evidence-based practice (EBP).
. Longitudinal cluster-randomized design.
. Four distinctly separate oncology clinics associated with an academic medical center.
. The study sample was comprised of randomly selected data elements from the nursing documentation software. The data elements were patient-reported symptoms and the associated nurse interventions. The total sample observations were 600, derived from a baseline, posteducation, and postintervention sample of 200 each (100 in the intervention group and 100 in the control group for each sample).
. The cluster design was used to support randomization of the study intervention at the clinic level rather than the individual participant level to reduce possible diffusion of the study intervention. An elongated data collection cycle (11 weeks) controlled for temporary increases in nurse EBP related to the education or CDS intervention.
. The dependent variable was the nurse evidence-based documentation rate, calculated from the nurse-documented interventions. The independent variable was the CDS added to the nursing documentation software.
. The average EBP rate at baseline for the control and intervention groups was 27%. After education, the average EBP rate increased to 37%, and then decreased to 26% in the postintervention sample. Mixed-model linear statistical analysis revealed no significant interaction of group by sample. The CDS intervention did not result in an increase in nurse EBP.
. EBP education increased nurse EBP documentation rates significantly but only temporarily. Nurses may have used evidence in practice but may not have documented their interventions.
. More research is needed to understand the complex relationship between CDS, nursing practice, and nursing EBP intervention documentation. CDS may have a different effect on nurse EBP, physician EBP, and other medical professional EBP.

Changing adherence-related beliefs about ICS maintenance treatment for asthma: feasibility study of an intervention delivered by asthma nurse specialists.

Science.gov (United States)

Chapman, Sarah C E; Barnes, Neil; Barnes, Mari; Wilkinson, Andrea; Hartley, John; Piddock, Cher; Weinman, John; Horne, Rob

2015-06-05

The Necessity-Concerns Framework (NCF) posits that non-adherence to inhaled corticosteroids (ICS) in asthma is influenced by doubts about the necessity for ICS and concerns about their potential adverse effects. This feasibility study examined whether these beliefs could be changed by briefing asthma nurse specialists on ways of addressing necessity beliefs and concerns within consultations. Pre-post intervention study. Secondary care. Patients with a diagnosis of moderate to severe asthma who were prescribed daily ICS were recruited to either a hospital care group (n=79; 71.0% female) or intervention group (n=57; 66.7% female). Asthma nurse specialists attended a 1.5-day NCF briefing. Beliefs about ICS (primary outcome) and self-reported adherence were measured preconsultation and 1 month postconsultation. Participants also rated their satisfaction with their consultations immediately after the consultation. Consultation recordings were coded to assess intervention delivery. After the NCF briefing, nurse specialists elicited and addressed beliefs about medicine more frequently. The frequency of using the NCF remained low, for example, open questions eliciting adherence were used in 0/59 hospital care versus 14/49 (28.6%) intervention consultations. Doubts about personal necessity for, and concerns about, ICS were reduced at 1 month postbriefing (pchanged nurse consultations, but not sufficiently enough to fully address non-adherence or adherence-related ICS beliefs (necessity and concerns). More effective techniques are needed to support nurse specialists and other practitioners to apply the intervention in hospital asthma review consultations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Developing an integrated career and competency framework for diabetes nursing.

Science.gov (United States)

Davis, Ruth; Turner, Eileen; Hicks, Deborah; Tipson, Margaret

2008-01-01

To describe the development of an integrated career and competency framework for diabetes nursing. The UK Nursing and Midwifery Council provides a definition of competence, but the terminology used in relation to the subject is often ambiguous and confusing. These concepts are explored in relation to nursing practice and the different approaches to competency framework development are described. To work alongside the Royal College of Nursing (RCN) and Skills for Health competency initiatives, a Diabetes Nursing Strategy Group representing nurses working in diabetes care was formed to oversee the development of an integrated career and competency framework for diabetes nursing. At the outset, the design was guided by the RCN Practice Development Team and employed qualitative methodology including the modified Delphi and nominal group technique. A purposive sample of nurses representing all sectors and grades of staff involved in diabetes care was invited to workshops to undertake a values clarification exercise. Content analysis was performed to identify themes. Further workshops identified areas of specialist practice and competence statements were developed and refined in a series of consultations. Competence statements for a range of diabetes-related areas were produced for nurses at the levels of unregistered practitioners, competent nurses, experience/proficient nurses, senior practitioners/expert nurses and consultant nurses. The description of the process of developing of the integrated career and competency framework should help other groups going through the same process. Relevance to clinical practice. In addition to helping groups identify a formula for the development of a competency framework, the framework itself is designed to provide a basis for educational programmes, personal career development and a tool for managers managing career progression within diabetes nursing.

Instant messaging: The way to improve access for young people to their school nurse.

Science.gov (United States)

Schuller, Lynne; Thaker, Kelly

2015-12-01

Children and young people require ease of access to their school nurse. Alongside this, school nurses are charged with the need to work smarter, being cost-effective and timely in response. School nursing teams across the country provide access through text messaging, however, there is presently no access provided to young people to have a consultation as a web-based chat facility. Using digital media, Doncaster school nurses have worked closely with young people to redesign and launch a totally interactive web- based clinic facility. This allows for improved access, reduction in travel costs and consultations to take place outside of the traditional times for accessing school nurses. This paper discusses a pilot project around the establishment of an e-clinic connecting young people and school nurses. It outlines the journey towards providing this innovative service in an attempt to provide cost-effective, timely services while reducing the barriers for service users.

As dimensões do cuidado pré-natal na consulta de enfermagem Las dimensiones del cuidado prenatal en la consulta de enfermería The dimensions of prenatal care embodied in nursing consultation

Directory of Open Access Journals (Sweden)

Helena Eri Shimizu

2009-06-01

Full Text Available O estudo teve como objetivos analisar as representações sociais das gestantes acerca da gestação e a atenção recebida na consulta de enfermagem do pré-natal. Foram realizadas entrevistas semi-estruturadas com quinze gestantes, que foram analisados com o auxílio do software ALCEST. Identificaram-se três eixos temáticos: a vivência da gravidez, constituída pelas classes: o impacto e as mudanças provocadas pela gravidez, as orientações recebidas sobre a gravidez com as classes percepção da consulta de enfermagem e do planejamento familiar e os cuidados com o bebê com as classes como cuidar do recém nascido e como garantir uma boa amamentação. A consulta de enfermagem abarca as dimensões psicossociais dos cuidados com a gestante e com recém-nascido.Esto estudio objectivó analizar las representaciones sociales de las gestantes acerca de la atención recibida en la consulta de enfermería del prenatal. Estudio cualitativo de la atención recibida, realizado por medio de entrevistas semi-estructuradas y analizadas con auxilio del software ALCEST, con quince gestantes atendidas en la consulta de enfermería del programa de prenatal. Se identificaron tres ejes temáticos: la vivencia del embarazo, constituida por las clases: el impacto y los cambios provocados por el embarazo; las orientaciones recibidas sobre el embarazo, con las clases: percepción de la consulta de enfermería y del planeamiento familiar; y el los cuidados del bebé, con las clases: cómo cuidar al recién nacido y cómo garantizar un buen amamantamiento. La consulta de enfermería abarca diversas dimensiones psicosocial tanto de los cuidados durante la gestación como con el recién nacido.This study aimed at analyzing the social representation of pregnant women about pregnancy, regarding care provided in nursing consultations during the prenatal period. A qualitative study conducted by semi-structured interviews, with fifteen pregnant women at the nursing

Radioactive Substances Act 1993. Explanatory document and draft authorisation prepared by the Environment Agency to Assist public consultation on application by Devonport Royal Dockyard Limited to dispose of radioactive wastes from Devonport Royal Dockyard Plymouth Devon

International Nuclear Information System (INIS)

2000-01-01

The Environment Agency (the Agency) is the independent public body responsible for regulating the use of radioactive substances and accumulation and disposal of radioactive wastes in order to ensure protection of people and the environment. Anyone who is proposing activities involving the use of radioactive substances or disposal of radioactive waste must apply for permission from the Agency. In 1993, the Government decided to locate all nuclear submarine refit work at Devonport. This will lead to increased amounts of radioactive waste arisings at Devonport and a decreased amount of waste arisings at Rosyth, where refit work was also previously carried out. In May 2000 Devonport Royal Dockyard Limited (DML) applied to the Agency for a variation to its authorisations under the Radioactive Substances Act 1993 to dispose of gaseous, liquid, and solid radioactive wastes from its site at Devonport in Plymouth. Once the application was received, the Agency made the information publicly available and held a well attended public meeting in Plymouth to highlight the issues. Since then the Agency has required DML to provide additional information in support of its application. Six rounds of questions were asked and responded to, and these responses have also been made publicly available. The application and responses from the company have been made publicly available. The Agency is now consulting widely on this information to assist its decision making. This Explanatory Document and the accompanying draft authorisation has been prepared by the Agency to assist the consultation process. They are intended to help members of the public and other consultees to understand the application and the Agency's considerations so far. The consultation is being carried out to enable the public and other consultees to draw the Agency's attention to any matters they would wish it to consider when reaching its decisions on this application. The Agency has not made any decisions on the DML

Nurses who work outside nursing.

Science.gov (United States)

Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M

2004-09-01

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.

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

Science.gov (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…

Expectations of becoming a nurse and experiences on being a nurse

DEFF Research Database (Denmark)

Hounsgaard, Lise; Thrysøe, L.; Dohn, N. B.

2011-01-01

It is well documented that, in the transition from student to registered nurse, problematic experiences can occur (1, 2, 3). Quite a number of new nursing graduates change job after a short duration of employment (4) or leave the profession within the first years of their career (5). This paper...... is based on a Danish study of the transition from being a nearly graduated nursing student (NGNS) to being a new nursing graduate (NG)....

Reading the least read? Indicators of users' intention to consult privacy statements on municipal websites

NARCIS (Netherlands)

Beldad, Ardion Daroca; de Jong, Menno D.T.; Steehouder, M.F.

2010-01-01

Though seldom read or consulted, privacy statements are often the only means for users to know how their personal data will be used by collecting organizations. While the length and the legalistic nature of most privacy statements are often blamed for people's reluctance to consult such documents,

[Development of a computerized system using standard nursing language for creation of a nursing minimum data set].

Science.gov (United States)

D'Agostino, Fabio; Vellone, Ercole; Tontini, Francesco; Zega, Maurizio; Alvaro, Rosaria

2012-01-01

The aim of a nursing data set is to provide useful information for assessing the level of care and the state of health of the population. Currently, both in Italy and in other countries, this data is incomplete due to the lack of a structured nursing documentation , making it indispensible to develop a Nursing Minimum Data Set (NMDS) using standard nursing language to evaluate care, costs and health requirements. The aim of the project described , is to create a computer system using standard nursing terms with a dedicated software which will aid the decision-making process and provide the relative documentation. This will make it possible to monitor nursing activity and costs and their impact on patients' health : adequate training and involvement of nursing staff will play a fundamental role.

Analysis of responses to the microgeneration strategy and low carbon buildings programme consultation

Energy Technology Data Exchange (ETDEWEB)

Gibbard, J.; Long, S.; McCartney, K.; Rushton, K.

2005-10-15

This report summarises and analyses the written responses to the consultation document, 'Microgeneration Strategy and Low Carbon Buildings Programme', issued by the Department of Trade and Industry (DTI) in June 2005. Responses were received from 204 different organisations representing 29 stakeholder groups. The consultation document contained 41 core questions divided into eight sections: general; product development and deployment; communications; economics; installation; Low Carbon Buildings Programme; physical infrastructure; and local authorities and regional bodies. In the analysis, the responses to these questions were categorised according to whether they represented a 'clear consensus', a 'majority view', 'supporting themes' and 'divergent themes'. Using these categories, stakeholder agreement on the eight strategic issues is summarised in a matrix. The report is divided into three sections: introduction; summary of responses; and key findings. The respondents are listed in an appendix. Another appendix reproduces the consultation questions.

Experiences of Japanese Nurse Scholars: Insights for U.S. Faculty.

Science.gov (United States)

Doutrich, Dawn

2001-01-01

Phenomenological analysis of interviews with 22 Japanese nurses with graduate degrees from U.S. schools and 3 Japanese nurse consultants showed how graduate education changed their ways of being and sense of self. They became more verbal, direct, and articulate about personal preferences. Some experienced a sense of loss or alienation upon…

Medication communication through documentation in medical wards: knowledge and power relations.

Science.gov (United States)

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

2014-09-01

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. © 2013 John Wiley & Sons Ltd.

Quality Assurance in Higher Education: Proposals for Consultation.

Science.gov (United States)

Higher Education Funding Council for England, Bristol.

This document sets out for consultation proposals for a revised method for quality assurance of teaching and learning in higher education. The proposals cover: (1) the objectives and principles of quality assurance; (2) an approach to quality assurance based on external audit principles; (3) the collection and publication of information; (4)…

The nature of leadership style in nursing management.

Science.gov (United States)

Azaare, John; Gross, Janet

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

Top Management Leadership Style and Quality of Care in Nursing Homes

Science.gov (United States)

Castle, Nicholas G.; Decker, Frederic H.

2011-01-01

Purpose: The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Design and Methods: Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style…

External Tank Liquid Hydrogen (LH2) Prepress Regression Analysis Independent Review Technical Consultation Report

Science.gov (United States)

Parsons, Vickie s.

2009-01-01

The request to conduct an independent review of regression models, developed for determining the expected Launch Commit Criteria (LCC) External Tank (ET)-04 cycle count for the Space Shuttle ET tanking process, was submitted to the NASA Engineering and Safety Center NESC on September 20, 2005. The NESC team performed an independent review of regression models documented in Prepress Regression Analysis, Tom Clark and Angela Krenn, 10/27/05. This consultation consisted of a peer review by statistical experts of the proposed regression models provided in the Prepress Regression Analysis. This document is the consultation's final report.

Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45- to 75-Year-Olds: The Pedometer And Consultation Evaluation (PACE-UP Cluster Randomised Clinical Trial.

Directory of Open Access Journals (Sweden)

Tess Harris

2017-01-01

Full Text Available Pedometers can increase walking and moderate-to-vigorous physical activity (MVPA levels, but their effectiveness with or without support has not been rigorously evaluated. We assessed the effectiveness of a pedometer-based walking intervention in predominantly inactive adults, delivered by post or through primary care nurse-supported physical activity (PA consultations.A parallel three-arm cluster randomised trial was randomised by household, with 12-mo follow-up, in seven London, United Kingdom, primary care practices. Eleven thousand fifteen randomly selected patients aged 45-75 y without PA contraindications were invited. Five hundred forty-eight self-reporting achieving PA guidelines were excluded. One thousand twenty-three people from 922 households were randomised between 2012-2013 to one of the following groups: usual care (n = 338; postal pedometer intervention (n = 339; and nurse-supported pedometer intervention (n = 346. Of these, 956 participants (93% provided outcome data (usual care n = 323, postal n = 312, nurse-supported n = 321. Both intervention groups received pedometers, 12-wk walking programmes, and PA diaries. The nurse group was offered three PA consultations. Primary and main secondary outcomes were changes from baseline to 12 mo in average daily step-counts and time in MVPA (in ≥10-min bouts, respectively, measured objectively by accelerometry. Only statisticians were masked to group. Analysis was by intention-to-treat. Average baseline daily step-count was 7,479 (standard deviation [s.d.] 2,671, and average time in MVPA bouts was 94 (s.d. 102 min/wk. At 12 mo, mean steps/d, with s.d. in parentheses, were as follows: control 7,246 (2,671; postal 8,010 (2,922; and nurse support 8,131 (3,228. PA increased in both intervention groups compared with the control group; additional steps/d were 642 for postal (95% CI 329-955 and 677 for nurse support (95% CI 365-989; additional MVPA in bouts (min/wk were 33 for postal (95% CI

Standardized training in nurse model travel clinics.

Science.gov (United States)

Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C

2011-01-01

International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to

[A listening support group for nursing staff].

Science.gov (United States)

Lemoine, Dominique

2016-05-01

The feedback from a consultant nurse in a listening support group for health professionals shows that, for hospital nursing staff, the phenomenon of suffering in the workplace is a reality. In addition to providing help to professionals who request it, the missions of such a group are to promote discussion around psycho-social risks in the framework of a policy of compassionate care for staff. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients - is cultural competence adequately considered?

Science.gov (United States)

Abbott, Penelope; Reath, Jennifer; Gordon, Elaine; Dave, Darshana; Harnden, Chris; Hu, Wendy; Kozianski, Emma; Carriage, Cris

2014-08-13

General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar's generic communication and consultation skills, only 72% referred to culture or to the patient's Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise health supports designed to decrease the

Impact of endocrine and diabetes team consultation on hospital length of stay for patients with diabetes.

Science.gov (United States)

Levetan, C S; Salas, J R; Wilets, I F; Zumoff, B

1995-07-01

To determine whether consultation by an individual endocrinologist or by a multidisciplinary diabetes team (endocrinologist, diabetes nurse educator, and registered dietitian) can impact length of hospital stay of patients with diabetes. Hospital stays of consecutive patients with a principal diagnosis of diabetes were compared. Forty-three patients were seen by an individual endocrine consultant and 27 were managed by the internist alone. Thirty-four patients were seen in consultation by the diabetes team. All consultations were performed at the request of the primary physician. There were no statistically significant differences among groups with respect to age, duration of diabetes, admitting diagnosis, glucose levels, or concomitant acute or chronic illness. Average length of stay of diabetes-team patients was 3.6 +/- 1.7 days, 56% shorter than the value, 8.2 +/- 6.2 days, of patients in the no-consultation group (P team consultation. Three million Americans are hospitalized annually with diabetes at a cost of $65 billion. A team approach to their inpatient care may reduce their hospital stays, resulting in considerable health and economic benefits.

Rational Drug Use of Nurses

Directory of Open Access Journals (Sweden)

Mehtap Sahingoz

2013-02-01

Full Text Available ABSTRACT Objective: At this study to be aimed to assess status of the knowledge of nurses who working in public and private health institutions in Sivas province use of medication fort he treatment during their illnesses and patients and the attitudes of rational drug application. Matherials and methods: the researc planned to attend 750 nurses but it has been completed with participation of 641 nurses (Reaching rate 85,5%. This is a descriptive and cross-sectional study. in the study data were collected with a questionaire, percentages stated and chi square test was used for analysis. Results: %95,3 of nurses were females and mean age of them 29.21±4.85 years. The rate of contacting a doktor in case of illness is higher in 39.1% of nurses in the 21-30 age group and 48.6% of nurses working in primary care institutions. The level of self-treating is higher in 45.5 % of nurses working less than a year in profession .In the case of illness, 53% of nurses stated that they had left the medicine when signs of disease over. %98.8 of nurses expressed that they know effects of drugs used and 99.1% of them stated they know the side effects of drugs used. The entire group of postgraduate education status stated that they have not received the drug recommended by others. The level of suggesting a drug to someone else fort he same disease is higher in 65.8% of the group 31 years and older and group working over 40 hours per week. It were determined that used in consultation with the physician 65.2% of nurses antibiotics, 87.5% of them weiht loss drug and 82.7% of them contraceptive . 99.5% of the nurses have expressed that they inform to patients about use of their medications. Among the issues that expressed informations took place the application form of drugs (51.0 %and information of need to consult one if deemed one unexpected effect (59.6% . Also has been identified that of nurses acquired inform about drugs from drug book (vademecum (87.5 % and they

Putting medical knowledge at nurses' fingertips: Glenville Daniel ...

International Development Research Centre (IDRC) Digital Library (Canada)

A Canadian program helps improve health care in the Caribbean Nursing faculty ... -supported research to improve the quality of care in Caribbean hospitals by ... are Dr Hazel Roberts and information technology consultant Glenville Daniel.

Planning documents: a business planning strategy.

Science.gov (United States)

Kaehrle, P A

2000-06-01

Strategic planning and business plan development are essential nursing management skills in today's competitive, fast paced, continually changing health care environment. Even in times of great uncertainty, nurse managers need to plan and forecast for the future. A well-written business plan allows nurse managers to communicate their expertise and proactively contribute to the programmatic decisions and changes occurring within their patient population or service area. This article presents the use of planning documents as a practical, strategic business planning strategy. Although the model addresses orthopedic services specifically, nurse managers can gain an understanding and working knowledge of planning concepts that can be applied to all patient populations.

Euthanasia and assisted suicide in Dutch hospitals: the role of nurses.

Science.gov (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

2008-06-01

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.

Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care.

Science.gov (United States)

Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew

2018-06-01

The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

Time Spent on Dedicated Patient Care and Documentation Tasks Before and After the Introduction of a Structured and Standardized Electronic Health Record.

Science.gov (United States)

Joukes, Erik; Abu-Hanna, Ameen; Cornet, Ronald; de Keizer, Nicolette F

2018-01-01

Physicians spend around 35% of their time documenting patient data. They are concerned that adopting a structured and standardized electronic health record (EHR) will lead to more time documenting and less time for patient care, especially during consultations. This study measures the effect of the introduction of a structured and standardized EHR on documentation time and time for dedicated patient care during outpatient consultations. We measured physicians' time spent on four task categories during outpatient consultations: documentation, patient care, peer communication, and other activities. Physicians covered various specialties from two university hospitals that jointly implemented a structured and standardized EHR. Preimplementation, one hospital used a legacy-EHR, and one primarily paper-based records. The same physicians were observed 2 to 6 months before and 6 to 8 months after implementation.We analyzed consultation duration, and percentage of time spent on each task category. Differences in time distribution before and after implementation were tested using multilevel linear regression. We observed 24 physicians (162 hours, 439 consultations). We found no significant difference in consultation duration or number of consultations per hour. In the legacy-EHR center, we found the implementation associated with a significant decrease in time spent on dedicated patient care (-8.5%). In contrast, in the previously paper-based center, we found a significant increase in dedicated time spent on documentation (8.3%) and decrease in time on combined patient care and documentation (-4.6%). The effect on dedicated documentation time significantly differed between centers. Implementation of a structured and standardized EHR was associated with 8.5% decrease in time for dedicated patient care during consultations in one center and 8.3% increase in dedicated documentation time in another center. These results are in line with physicians' concerns that the introduction

Nursing Practice and Education in Australia : An Overview(The Research Society of School of Health Sciences The 41st Meeting)

OpenAIRE

吉澤, 豊子; Debra, Anderson; School of Nursing, Queensland University of Technology /

2006-01-01

The many career opportunities open to registered nurses in Australia. They include Registered Nurse Level, Clinical Nurse Level, Clinical Nurse Consultant Level, Nurse Practitioner, Nurse Manager/Nurse Educator, Director of Nursing, Director of Nursing and Chief Executive Officer. In 1984 nurse education was transferred to education sector (universities) and now all nurse education is conducted through a bachelor's degree at universities. This degree is three years long and when students grad...

The valuation of nursing begins with identifying value drivers.

Science.gov (United States)

Rutherford, Marcella M

2010-03-01

Adequate investment in a profession links to its ability to define and document its value. This requires identifying those elements or value drivers that demonstrate its worth. To completely identify nursing's value drivers requires meshing the economic, technical, and caring aspects of its profession. Nursing's valuation includes assessing nursing's tangible and intangible assets and documenting these assets. This information communicates nursing's worth and ensures adequate economic investment in its services.

Yeu and Noirmoutier islands - Electric connection to the offshore wind farm. Brochure 'Electric connection of the offshore wind farm to the Yeu and Noirmoutier islands' - Consultation file, December 2015, District of Vendee. Document of contribution to the public debate. Yeu and Noirmoutier islands offshore wind farm project - Project commissioner file

International Nuclear Information System (INIS)

Boyadjis, Jean-Marc; Corallo, Christian

2015-05-01

After a brief presentation of the context, a first document presents the connection characteristics, the general route of the electrical connection, how the sea and ground environment is taken into account, how the population is consulted for the project, the organisation of the public inquiry. The second document presents the consultation file with a description of the adopted solution and main characteristics of the project of connection of offshore wind farms about the Yeu and Noirmoutier islands, an analysis of the initial condition of the environment (physical and natural environment, landscapes and heritage, human and social-economic context), a description and a comparative analysis of proposed beams for the underwater connection, landfall and underground connection, and the planned continuation of the project (consultation, administrative procedure, planning). The next document aims at presenting the project before public consultation: objectives, underwater and underground connections with some of their technical characteristics, planning. Another document also presents the offshore wind farm project, its energetic and technical characteristics, how it is integrated into its environment (stakes and challenges, impacts on landscape and on activities), how it is an example of the development of offshore wind energy sector. It is completed by several appendices containing a variety of data on these issues. A last document is a presentation of the project by the project commissioner (RTE) which notably addresses how technical and environmental issues are to be addressed

The Contemporary Consultant

DEFF Research Database (Denmark)

Olson, Thomas; Poulfelt, Flemming; Greiner, Larry

This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent to cur...... current management issues facing consulting firms. These cases, together with the handbook, will prepare consultants and other business managers for a successful future in a highly competitive consulting environment.......This book complements The handbook of Management Consulting: The Contemporary Consultant: Insights from Leading Experts, 1e but can also be studied separately. The book consists of 20 cases including Harvard and Stanford cases. The cases present the broad range of topics that are pertinent...... to current management consulting. Each of the four parts of the text presents a cogent introduction by the editors, delineating topics that are critical for today's consultants to understand. The cases represent major practice areas of consulting and afford new insights into change processes and other...

Investigating the role of Clinical Nurse Consultants in one health district from multiple stakeholder perspectives: a cooperative inquiry.

Science.gov (United States)

Walsh, Kenneth; Bothe, Janine; Edgar, Denise; Beaven, Geraldine; Burgess, Bernadette; Dickson, Vhari; Dunn, Stephen; Horning, Lynda; Jensen, Janice; Kandl, Bronia; Nonu, Miriam; Owen, Fran; Moss, Cheryle

2015-01-01

The impetus for this research came from a group of 11 Clinical Nurse Consultants (CNCs) within a health service in NSW, Australia, who wanted to investigate the CNC role from multiple stakeholder perspectives. With support from academic researchers, the CNCs designed and implemented the study. The aim of this research project was to investigate the role of the CNC from the multiple perspectives of CNCs and other stakeholders who work with CNCs in the Health District. This was a co-operative inquiry that utilised qualitative descriptive research approach. Co-operative inquiry methods enabled 11 CNCs to work as co-researchers and to conduct the investigation. The co-researchers implemented a qualitative descriptive design for the research and used interviews (7) and focus groups (16) with CNC stakeholders (n = 103) to gather sufficient data to investigate the role of the CNC in the organisation. Thematic analysis was undertaken to obtain the results. The CNC role is invaluable to all stakeholders and it was seen as the "glue" which holds teams together. Stakeholder expectations of the CNC role were multiple and generally agreed. Five themes derived from the data are reported as "clinical leadership as core", "making a direct difference to patient care", "service development as an outcome", "role breadth or narrowness and boundaries", and "career development". There was clear appreciation of the work that CNCs do in their roles, and the part that the CNC role plays in achieving quality health outcomes. The role of the CNC is complex and the CNCs themselves often negotiate these complexities to ensure beneficial outcomes for the patient and organisation. For the wider audience this study has given further insights into the role of these nurses and the perspectives of those with whom they work.

Embedding the shapes of regions of interest into a Clinical Document Architecture document.

Science.gov (United States)

Minh, Nguyen Hai; Yi, Byoung-Kee; Kim, Il Kon; Song, Joon Hyun; Binh, Pham Viet

2015-03-01

Sharing a medical image visually annotated by a region of interest with a remotely located specialist for consultation is a good practice. It may, however, require a special-purpose (and most likely expensive) system to send and view them, which is an unfeasible solution in developing countries such as Vietnam. In this study, we design and implement interoperable methods based on the HL7 Clinical Document Architecture and the eXtensible Markup Language Stylesheet Language for Transformation standards to seamlessly exchange and visually present the shapes of regions of interest using web browsers. We also propose a new integration architecture for a Clinical Document Architecture generator that enables embedding of regions of interest and simultaneous auto-generation of corresponding style sheets. Using the Clinical Document Architecture document and style sheet, a sender can transmit clinical documents and medical images together with coordinate values of regions of interest to recipients. Recipients can easily view the documents and display embedded regions of interest by rendering them in their web browser of choice. © The Author(s) 2014.

The pattern and impact of infectious diseases consultation on antimicrobial prescription

Directory of Open Access Journals (Sweden)

Jaffar A Al-Tawfiq

2013-01-01

Full Text Available Objectives: Inclusion of infectious disease (ID physicians in the care of patients with possible infection can favorably affect antibiotic usage. The aim of this study was to evaluate the role of the ID consultations in reducing inappropriate antibiotic usage. Materials and Methods: This is a prospective study evaluating all adult ID consultations from January 2006 to December 2009. A total of 1444 consultation requests were recorded during the 4-year period. Results: The most frequent consultations were from cardiology (23.1%, orthopedics (8.2%, general medicine (7.8%, hematology-oncology (7.8%, gastroenterology (7.3%, and pulmonary/critical care (7.1%. The main reason for consultation was for the choice of antibiotics (75%. The commonest diagnoses prior to consultation were fever (14.7%, bacteremia (9.1%, and urinary tract infection (8.4%. Bacteremia was documented in 21.4% of cases and 12.9% were found to have no identifiable focus of infection. Antimicrobial therapy was changed in 58.7% and antimicrobials were discontinued in 14.7% of cases. The number of antimicrobial therapy was one (49.7% and 49.9% and two (24% and 17.6%, P = 0.0001 before and after the consultation, respectively. In addition, 17.3% and 26.9% ( P = 0.0001 received no antimicrobial agents before and after ID consultation. Conclusion: ID consultation is important to reduce inappropriate antimicrobial therapy and to limit the number of dual therapy.

Mental Health promotion of a hospital through the nurse in the liaison psychiatry team

Directory of Open Access Journals (Sweden)

Natalia Cámara Conde

2008-09-01

Full Text Available We show a proposal to increase the quality of nursing cares, improving mental health care of hospitalized patients by creating the figure of the liaison nurse within the liaison psychiatry team. This nurse would not only be a reference to support the nursing staff at the level of patient care, but also the psycho-emotional self-care professional.Objectives: Justifying the need to include the figure of the specialist mental health team liaison psychiatry nurse. Method: The rotation as residents, for a month, with the interconsultation team psychiatric hospital Gregorio Marañón and literature review. Results: There have been partially unmet needs, these could be covered with the existence of a nurse specialist in mental health consultation in this hospital. Discussion: Possibly it poses difficulties in defining the roles of various liaison team professionals, which we expect can be defined at the start implementing the new member.The hospital itself has an own field defined, articulated through the NANDA, NIC, NOC methodology, which covers aspects that so far have not being made, there is not a nurse figure into the psychiatric consultation liaison team.

General Practitioner Supervisor assessment and teaching of Registrars consulting with Aboriginal patients – is cultural competence adequately considered?

Science.gov (United States)

2014-01-01

Background General Practitioner (GP) Supervisors have a key yet poorly defined role in promoting the cultural competence of GP Registrars who provide healthcare to Aboriginal and Torres Strait Islander people during their training placements. Given the markedly poorer health of Indigenous Australians, it is important that GP training and supervision of Registrars includes assessment and teaching which address the well documented barriers to accessing health care. Methods A simulated consultation between a GP Registrar and an Aboriginal patient, which illustrated inadequacies in communication and cultural awareness, was viewed by GP Supervisors and Medical Educators during two workshops in 2012. Participants documented teaching points arising from the consultation which they would prioritise in supervision provided to the Registrar. Content analysis was performed to determine the type and detail of the planned feedback. Field notes from workshop discussions and participant evaluations were used to gain insight into participant confidence in cross cultural supervision. Results Sixty four of 75 GPs who attended the workshops participated in the research. Although all documented plans for detailed teaching on the Registrar’s generic communication and consultation skills, only 72% referred to culture or to the patient’s Aboriginality. Few GPs (8%) documented a plan to advise on national health initiatives supporting access for Aboriginal and Torres Strait Islander people. A lack of Supervisor confidence in providing guidance on cross cultural consulting with Aboriginal patients was identified. Conclusions The role of GP Supervisors in promoting the cultural competence of GP Registrars consulting with Aboriginal and Torres Strait Islander patients could be strengthened. A sole focus on generic communication and consultation skills may lead to inadequate consideration of the health disparities faced by Indigenous peoples and of the need to ensure Registrars utilise

Mapping the literature of nurse practitioners.

Science.gov (United States)

Shams, Marie-Lise Antoun

2006-04-01

This study was designed to identify core journals for the nurse practitioner specialty and to determine the extent of their indexing in bibliographic databases. As part of a larger project for mapping the literature of nursing, this study followed a common methodology based on citation analysis. Four journals designated by nurse practitioners as sources for their practice information were selected. All cited references were analyzed to determine format types and publication years. Bradford's Law of Scattering was applied to identify core journals. Nine bibliographic databases were searched to estimate the index coverage of the core titles. The findings indicate that nurse practitioners rely primarily on journals (72.0%) followed by books (20.4%) for their professional knowledge. The majority of the identified core journals belong to non-nursing disciplines. This is reflected in the indexing coverage results: PubMed/MEDLINE more comprehensively indexes the core titles than CINAHL does. Nurse practitioners, as primary care providers, consult medical as well as nursing sources for their information. The implications of the citation analysis findings are significant for collection development librarians and indexing services.

Personalizing protocol-driven care: the case of specialist heart failure nurses.

Science.gov (United States)

Sanders, Tom; Harrison, Stephen; Checkland, Katherine

2010-09-01

This paper is a report of a study conducted to explore how specialist heart failure nurses negotiate treatment advice with patients, in the context of an increasing expectation that clinical staff in the National Health Services will follow guidelines in their daily work. The development of specialist nurse roles has given rise to questions about their compatibility with patient-centred care. However, research has revealed little about how specialist nurses balance clinical guidelines with traditional caring tasks. Semi-structured interviews (n = 10) were conducted with specialist heart failure nurses in northern England recruited from a heart failure specialist nursing contact list. In addition, non-participant observations were carried out on nurse-patient consultations (n = 16) in one regional nurse-led heart failure clinic. Data were collected between 2003 and 2005, and analysed using a variation of grounded theory. Heart failure nurses sought to combine traditional caring work with the wider goal of improving patient outcomes by 'personalizing' their advice to patients and presenting their heart failure as 'typical'. They accommodated protocol-driven care into their daily routines, and perceived no disjuncture between evidence-based practice and patient-centredness. However, their approach allowed little space for the exploration of each patient's own priorities about their illness. There is a need both to re-examine the appropriateness of traditional caring concepts, and to reflect on the need to incorporate patients' own values into the consultation process.

Development and Psychometric Evaluation of the Nursing Instructors? Clinical Teaching Performance Inventory

OpenAIRE

Farahani, Mansoureh A.; Ghasemi, Hormat Sadat Emamzadeh; Nikpeyma, Nasrin; Fereidouni, Zhila; Rassouli, Maryam

2014-01-01

Evaluation of nursing instructors? clinical teaching performance is a prerequisite to the quality assurance of nursing education. One of the most common procedures for this purpose is using student evaluations. This study was to develop and evaluate the psychometric properties of Nursing Instructors? Clinical Teaching Performance Inventory (NICTPI). The primary items of the inventory were generated by reviewing the published literature and the existing questionnaires as well as consulting wit...

A framework guiding critical thinking through reflective journal documentation: a Middle Eastern experience.

Science.gov (United States)

Simpson, Elaine; Courtney, Mary

2007-08-01

The purpose of this paper is to present a framework to guide critical thinking through reflective journaling, and describe how a group of 20 Middle Eastern nurses used reflective journaling to enhance their practice. Journal documentation was used during clinical practicum to foster the development of critical thinking in order to assist nurses when analysing and evaluating their clinical experiences. The findings from this study demonstrated that nurses accepted the framework for journal documentation because it provided structure for reflection, speculation, synthesis and metacognition of events experienced during clinical practice. Journaling gave nurses the opportunity to transfer thoughts onto paper and write down subjective and objective data, and created dialogue between the nurse educators and nurses. They were engaged in productive and positive activity to enhance their nursing practice. Nurses also commented that writing helped to develop their confidence in writing English.

Introducing Psychiatric Care into Nursing Homes.

Science.gov (United States)

Sakauye, Kenneth M.; Camp, Cameron J.

1992-01-01

Consultation-liaison psychiatry program in teaching nursing home helped implement six guiding principles, including make patient human to the staff; assume no behavior is random; look for depression or psychosis as source of problems; reduce medications and medication doses; create more homelike environment; and use conditions in which learning…

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

Science.gov (United States)

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed

Shaping the nurse of tomorrow.

Science.gov (United States)

Foster, Sam

2017-08-10

Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, explores the strengths and weaknesses of the proposed pre-registration nursing documentation and invites you to add your voice to the debate.

The generaltion gap in nursing

Directory of Open Access Journals (Sweden)

J.G.P. van Niekerk

1984-09-01

Full Text Available Generation gap is one of those catch phrases that we so often use, and misuse, to excuse ourselves or to cover up for our shortcomings. It is like the shortage of nurses behind which we hide from all our nursing problems. Although it is such a commonly used phrase, do we really know what it means? When you consult the Oxford Dictionary, you will find that it defines generation gap as: differences of opinion between those of different generations. It will surprise most people that the generation gap becomes a problem only when there are differences of opinion.

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

Science.gov (United States)

Cooke, Liz; Gemmill, Robin; Grant, Marcia

2008-01-01

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

Advanced Nursing Process quality: Comparing the International Classification for Nursing Practice (ICNP) with the NANDA-International (NANDA-I) and Nursing Interventions Classification (NIC).

Science.gov (United States)

Rabelo-Silva, Eneida Rejane; Dantas Cavalcanti, Ana Carla; Ramos Goulart Caldas, Maria Cristina; Lucena, Amália de Fátima; Almeida, Miriam de Abreu; Linch, Graciele Fernanda da Costa; da Silva, Marcos Barragan; Müller-Staub, Maria

2017-02-01

To assess the quality of the advanced nursing process in nursing documentation in two hospitals. Various standardised terminologies are employed by nurses worldwide, whether for teaching, research or patient care. These systems can improve the quality of nursing records, enable care continuity, consistency in written communication and enhance safety for patients and providers alike. Cross-sectional study. A total of 138 records from two facilities (69 records from each facility) were analysed, one using the NANDA-International and Nursing Interventions Classification terminology (Centre 1) and one the International Classification for Nursing Practice (Centre 2), by means of the Quality of Diagnoses, Interventions, and Outcomes instrument. Quality of Diagnoses, Interventions, and Outcomes scores range from 0-58 points. Nursing records were dated 2012-2013 for Centre 1 and 2010-2011 for Centre 2. Centre 1 had a Quality of Diagnoses, Interventions, and Outcomes score of 35·46 (±6·45), whereas Centre 2 had a Quality of Diagnoses, Interventions, and Outcomes score of 31·72 (±4·62) (p Nursing Diagnoses as Process' dimension, whereas in the 'Nursing Diagnoses as Product', 'Nursing Interventions' and 'Nursing Outcomes' dimensions, Centre 1 exhibited superior performance; acceptable reliability values were obtained for both centres, except for the 'Nursing Interventions' domain in Centre 1 and the 'Nursing Diagnoses as Process' and 'Nursing Diagnoses as Product' domains in Centre 2. The quality of nursing documentation was superior at Centre 1, although both facilities demonstrated moderate scores considering the maximum potential score of 58 points. Reliability analyses showed satisfactory results for both standardised terminologies. Nursing leaders should use a validated instrument to investigate the quality of nursing records after implementation of standardised terminologies. © 2016 John Wiley & Sons Ltd.

The "old internationals": Canadian nurses in an international nursing community.

Science.gov (United States)

Lapeyre, Jaime; Nelson, Sioban

2010-12-01

The vast devastation caused by both the First World War and the influenza pandemic of 1918 led to an increased worldwide demand for public health nurses. In response to this demand, a number of new public health training programs for nurses were started at both national and international levels. At the international level, one of two influential programs in this area included a year-long public health nursing course offered by the League of Red Cross Societies, in conjunction with Bedford College in London, England. In total, 341 nurses from 49 different countries have been documented as participants in this initiative throughout the interwar period, including 20 Canadians. Using archival material from the Canadian Nurses Association and the Royal College of Nursing, as well as articles from the journals Canadian Nurse, American Journal of Nursing and British Journal of Nursing, this paper examines these nurses' commitment to internationalism throughout their careers and explores the effect of this commitment on the development of nursing education and professionalization at the national level.

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.

Science.gov (United States)

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

2018-04-13

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.

UK strategy for radioactive discharges 2001-2020. Consultation document

International Nuclear Information System (INIS)

2000-06-01

This consultation draft of a strategy for radioactive discharges describes how the United Kingdom (UK) will implement the agreements reached at the 1998 Ministerial meeting of the OSPAR Commission, with regard to radioactive substances. It also provides a policy base for future reviews of discharge authorisations by the regulatory bodies and for strategic planning by the nuclear operators. The strategy sets a framework for radioactive discharges from UK installations over the next twenty years. Its aims are: progressive and substantial reductions in radioactive discharges from the UK as a whole and from each of the main sectors responsible for such discharges; progressive reduction of human exposure to ionising radiation resulting from radioactive discharges, so that no member of the general public in the UK will be exposed to a dose of more than 0.02 mSv a year, as a result of authorised radioactive discharges made from 2020 onwards; progressive reductions in concentrations of radionuclides in the marine environment resulting from radioactive discharges, such that by 2020 they add close to zero to historic levels. The scope of the UK strategy encompasses radioactive discharges from nuclear licensed sites, defence activities and other nuclear and non-nuclear sources of radioactive discharges. It covers both liquid and aerial discharges, although it is assumed that in general liquid discharges will have the largest and most measurable effects in the marine environment

An exploration of how positive emotions are expressed by older people and nurse assistants in homecare visits.

Science.gov (United States)

Heyn, Lena; Ellington, Lee; Eide, Hilde

2017-11-01

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.

Consulting Whom? Lessons from the Toronto Urban Aboriginal Strategy

Directory of Open Access Journals (Sweden)

Mai T. Nguyen

2014-04-01

Full Text Available The research conducted here looks at the current Urban Aboriginal Strategy (UAS in Toronto. The purpose of this Strategy is to provide long-term investments to support Aboriginal communities in urban settings by focusing on three priority areas: improving life skills; promoting job training, skills, and entrepreneurship; and supporting Aboriginal women, children, and families. This article seeks to answer the following question: Does the UAS provide Aboriginal participants with the ability to effectively participant in the consultation process? It argues that the UAS process of consulting with the urban Aboriginal community does not allow for the effective participation of Aboriginal peoples because of problematics related to consulting in an urban setting and despite the language of partnership, the federal government still reserves the right to make final decisions. These problems diminish the ability to build renewed Aboriginal-State relations based on mutual respect and trust, which has been absent within the Aboriginal-State apparatus and resulted in the political exclusion of Aboriginals in Canada. Though consultation can be a vehicle for empowering participants with decision-making authority, this is not the case in Toronto. The lack of a common vision, political buy-in, and the aura of secrecy leads to a political relationship built on mistrust. Mistrust between members and government renders the consultation process ineffective. This article combines the literature on public consultations with official government documents to identify critical components that must be evident for consultations to be fruitful and participation effective. These criteria are the benchmarks upon which to measure effectiveness. Based on interviews with the Steering Committee, this article finds that the UAS process of consulting with the Toronto Aboriginal community does not enable Aboriginal participants to effectively participate in the democratic process.

Leadership in nursing education: voices from the past.

Science.gov (United States)

Gosline, Mary Beth

2004-01-01

When education for nurses became a reality, leaders in the emerging profession spoke out early and often for educational improvements to prepare those who would nurse. The writings and speeches of Isabel Hampton Robb, Mary Adelaide Nutting, Lavinia Lloyd Dock, Lillian Wald, and Isabel Maitland Stewart formed the basis for a qualitative study that documents the voices of early nursing leaders who contributed to the development of nursing education as it moved from "training" toward professional education in a university setting. What is documented in the literature is the desire of these women to enhance the professional status of nursing through improvements in its educational system.

Profile of medical and injury consultations of Team South Africa ...

African Journals Online (AJOL)

Objective. This descriptive study was undertaken to document the nature of medical and injury consultations of the athletes and officials of the South African Team at the 2004 Olympic Games, and to provide data for planning future events. Setting. South African medical facility, 2004 Olympic Games, Athens, Greece.

Practice nurse and health visitor management of acute minor illness in a general practice.

Science.gov (United States)

Pritchard, A; Kendrick, D

2001-11-01

To evaluate practice nurse (PN) and health visitor (HV) management of patients with acute minor illnesses, monitor the effect on general practitioner (GP) workload, and describe the range of conditions seen by nurses. Patients requesting 'urgent' appointments (within 24 hours) were offered consultations with a PN or HV trained in the management of acute minor illness. Comparative data were collected before and after the establishment of the acute minor illness service. A general practice in Nottingham, England. Patient satisfaction, consultation rate, prescriptions, investigations, referrals and urgent re-consultations for the same condition within 2 weeks. About 2056 urgent consultations were recorded in the study period, of which 332 (16.1%) were seen by PNs and 46 (2.2%) by a HV. High levels of patient satisfaction were reported for all health professionals. Patients seeing the HV reported higher levels of satisfaction than those consulting GPs (P=0.033) and PNs (P=0.010). There was no difference by health professional for prescription rates (P=0.76), re-consultations (P=0.14), or referrals to secondary care (P=0.07). General practitioners were more likely to initiate further investigations than the PNs or HV (P manage patients with a range of conditions. General practitioner workload can be reduced while maintaining high patient satisfaction levels.

Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit

OpenAIRE

Santos, Ana Paula de Souza; Silva, Maria de Lourdes Costa da; Souza, Nilba Lima de; Mota, Gabriela Miranda; França, Débora Feitosa de

2014-01-01

OBJECTIVES: to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers.METHOD: a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Associati...

The effectiveness of a nurse practitioner-led pain management team in long-term care: A mixed methods study.

Science.gov (United States)

Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa

2016-10-01

Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group

Metrics for Electronic-Nursing-Record-Based Narratives: Cross-sectional Analysis

Science.gov (United States)

Kim, Kidong; Jeong, Suyeon; Lee, Kyogu; Park, Hyeoun-Ae; Min, Yul Ha; Lee, Joo Yun; Kim, Yekyung; Yoo, Sooyoung; Doh, Gippeum

2016-01-01

Summary Objectives We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. Methods We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system. The standardized number of nursing narratives (i.e., the total number of nursing narratives divided by the length of the hospital stay) was suggested to integrate the frequency and quantity of nursing documentation. Results The standardized number of nursing narratives was higher for patients aged 70 years (median = 30.2 narratives/day, interquartile range [IQR] = 24.0–39.4 narratives/day), long (8 days) hospital stays (median = 34.6 narratives/day, IQR = 27.2–43.5 narratives/day), and hospital deaths (median = 59.1 narratives/day, IQR = 47.0–74.8 narratives/day). The standardized number of narratives was higher in “pregnancy, childbirth, and puerperium” (median = 46.5, IQR = 39.0–54.7) and “diseases of the circulatory system” admissions (median = 35.7, IQR = 29.0–43.4). Conclusions Diverse hospital admissions can be consistently described with nursing-document-derived metrics for similar hospital admissions and diagnoses. Some areas of hospital admissions may have consistently increasing volumes of nursing documentation across years. Usability of electronic nursing document metrics for evaluating healthcare requires multiple aspects of hospital admissions to be considered. PMID:27901174

Nursing philosophy: A review of current pre registration curricula in the UK.

Science.gov (United States)

Mackintosh-Franklin, Carolyn

2016-02-01

Nursing in the UK has been subject to criticism for failing to provide care and compassion in practice, with a series of reports highlighting inadequacies in care. This scrutiny provides nursing with an ideal opportunity to evaluate the underpinning philosophy of nursing practice, and for nurse educators to use this philosophy as the basis for programmes which can inculcate neophyte student nurses with a fundamental understanding of the profession, whilst providing other health care professionals and service users with a clear representation of professional nursing practice. The key word philosophy was used in a systematic stepwise descriptive content analysis of the programme specifications of 33 current undergraduate programme documents, leading to an undergraduate award and professional registration as a nurse. The word philosophy featured minimally in programme specification documents, with 12 (36%) documents including it. Its use was superficial in 3 documents and focused on educational philosophy in a further 3 documents. 2 programme specifications identified their philosophy as the NMC (2010) standards for pre-registration nurse education. 2 programme specifications articulated a philosophy specific to that programme and HEI, focusing on caring, and 2 made reference to underpinning philosophies present in nursing literature; the Relationship Centred Care Approach, and The Humanising Care Philosophy. The philosophy of nursing practice is not clearly articulated in pre-registration curricula. This failure to identify the fundamental nature of nursing is detrimental to the development of the profession, and given this lack of direction it is not surprising that some commentators feel nursing has lost its way. Nurse educators must review their current curricula to ensure that there is clear articulation of nursing's professional philosophical stance, and use this as the framework for pre-registration curricula to support the development of neophyte nursing

Campus Partnerships Improve Impact Documentation of Nutrition Programs

Science.gov (United States)

Brinkman, Patricia

2015-01-01

Partnerships with other campus college units can provide ways of improving Extension's impact documentation. Nutrition programs have relied upon knowledge gained and people's self report of behavior change. Partnering with the College of Nursing, student nurses provided blood screenings during the pre and 6 month follow-up of a pilot heart risk…

Standardized nomenclatures: keys to continuity of care, nursing accountability and nursing effectiveness.

Science.gov (United States)

Keenan, G; Aquilino, M L

1998-01-01

Standardized nursing nomenclatures must be included in clinical documentation systems to generate data that more accurately represent nursing practice than outcomes-related measures currently used to support important policy decisions. NANDA, NIC, and NOC--comprehensive nomenclatures for the needed variables of nursing diagnoses, interventions, and outcomes--are described. Added benefits of using NANDA, NIC, and NOC in everyday practice are outlined, including facilitation of the continuity of care of patients in integrated health systems.

Association of the nurse work environment with nurse incivility in hospitals.

Science.gov (United States)

Smith, Jessica G; Morin, Karen H; Lake, Eileen T

2018-03-01

To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.

The structure of contraceptive education and instruction within nurse led family planning clinics: a grounded theory study.

Science.gov (United States)

Hayter, Mark

2009-09-01

This study aimed to explore and analyse how nurses instruct women in contraceptive use during consultations in family planning clinics to produce a grounded theory of contraceptive education. Nurses play a key role in instructing women how to use contraception in family planning clinic consultations. These one-to-one situations are encounters where women are taught how to use contraceptive methods effectively. However, very little is known about the nature of these consultations. A qualitative study using a grounded theory approach was used. Three linked 'core categories' emerged from the data analysis. Firstly, women are educated about their body and how it responds to contraception: 'reproductive education'. This core category is closely linked to 'surveillance' where women are taught to monitor their reproductive health and to 'contraceptive regimen' where women are instructed in techniques to successfully use a contraceptive method. Together these three core categories present a grounded theory of 'contraceptive education'. Nursing practice in this important area of women's health care is complex and requires skilled practitioners. This study presents unique empirical data into how nurses conduct one-to-one consultations with women - providing a novel insight into how contraception is explained in clinical situations. Key issues for practice from the data were the lack of a balance when discussing side effects, the rigidity of some instructions and the lack of recognition of risk from sexually transmitted infection. Nurses working in sexual health need to ensure that women understand the often complex instructions they provide and that rigid instruction be occasionally amended to enable some flexibility. The manner in which side-effects are discussed should also be balanced. Nurses need to address the risk of sexually transmitted infections more substantially in contraceptive discussions.

Nurses' reported thinking during medication administration.

Science.gov (United States)

Eisenhauer, Laurel A; Hurley, Ann C; Dolan, Nancy

2007-01-01

To document nurses' reported thinking processes during medication administration before and after implementation of point-of-care technology. Semistructured interviews and real-time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US. Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose-time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications. Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the "5 rights."

Benign Episodic Unilateral Mydriasis in a Flight Nurse.

Science.gov (United States)

Schiemer, Anthony

2017-05-01

Benign episodic unilateral mydriasis is one cause of anisocoria. This phenomenon is thought to be related to an imbalance between the sympathetic and parasympathetic nervous systems. There is a documented association with migraines, but asymptomatic cases have also been reported. A challenge with all cases is the level of investigation required to exclude more sinister causes of nervous system dysfunction. In a dynamic flight environment, additional considerations need to be made, such as varying light levels and use of night vision devices. A 27-yr-old woman on deployment to Afghanistan as a flight nurse presented to the role one clinic with right-sided mydriasis. The patient denied headache or any history of migraines. A dilated right pupil that was reactive to light was found on exam. Symptoms and exam findings resolved shortly after initial presentation. We consulted an ophthalmologist who requested patient transfer for review. He made a diagnosis of benign episodic unilateral mydriasis. There are a variety of causes for anisocoria. A thorough history and examination are required to avoid unnecessary investigations that may not be locally available in the more austere deployed military settings. From an operational perspective, the decision needs to be made regarding the maintenance of flight status. Consideration needs to be given to patient care capability when treating a flight nurse. In cases of rapid resolution such as this, removal from operational status is not reasonable should a clinician be confident of the diagnosis.Schiemer A. Benign episodic unilateral mydriasis in a flight nurse. Aerosp Med Hum Perform. 2017; 88(5):500-502.

The Impact of the Expanded Nursing Practice on Professional Identity in Denmark

DEFF Research Database (Denmark)

Piil, Karin; Kolbæk, Raymond; Ottmann, Goetz

2012-01-01

. The aim of this case study was to explore the impact of “nurse consultations,” representing an expanded nursing role, of 5 nurses focusing on their perception of autonomy, self-esteem, and confidence. Methods: The case study used semistructured interviews with 5 participants triangulated and validated...... gained a higher sense of autonomy, self-esteem, and confidence in their practice. These elements have a positive impact on their professional identity. Conclusion: The research demonstrates that for the nurses involved in expanded professional practice, the boundaries of professional practice have...

Why Are There So Few Ethics Consults in Children's Hospitals?

Science.gov (United States)

Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John

2017-10-03

In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set

Nursing leadership and management effects work environments.

Science.gov (United States)

Tomey, Ann Marriner

2009-01-01

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

Protótipo de sistema de documentação em enfermagem no puerpério Documentation system prototype for postpartum nursing

Directory of Open Access Journals (Sweden)

Regina Célia Sales Santos Veríssimo

2013-01-01

Full Text Available OBJETIVO: Desenvolver protótipo de sistema de documentação em enfermagem no puerpério. MÉTODOS: Planejamento de software utilizou modelo baseado em orientação a objetos, que englobou: compreensão e definição do contexto e dos modos de utilização projeto de arquitetura do sistema, identificação dos principais objetos do sistema, desenvolvimento dos modelos do projeto, especificação das interfaces dos objetos. Foram utilizadas as linguagem Structured Query Language (SQL, MySQL e Hypertext Preprocessor (php. RESULTADOS: O protótipo apresenta os requisitos planejados, entre eles: uso da Classificação Internacional para a Prática de Enfermagem (CIPE® versão 1.0 como código de apoio para execução do processo de enfermagem; apresentação dos eixos da CIPE® versão 1.0 em ordem de uso; geração de relatórios sobre a prática de uso dos processos de enfermagem. CONCLUSÃO: O protótipo de sistema de documentação proposto foi desenvolvido com sucesso com possibilidade de registros de enfermagem por meio de linguagem padronizada.OBJECTIVE: To develop a documentation system prototype for postpartum nursing. METHODS: For the software planning, a model based on object orientation was used, which included: understanding and definition of the context and usage modes of the system design project, identification of the main objects of the system, development of project models, specification of object interfaces. The languages Structured Query Language (SQL, MySQL and Hypertext Preprocessor (php were used. RESULTS: The prototype shows the planned requirements, among them: use of the International Classification For Nursing Practice (ICNP® version 1.0 as support code to perform the nursing process; presentation of the axes of ICNP® version 1.0 in order of use; elaboration of reports about the usage practice of nursing processes. CONCLUSION: The proposed documentation system prototype was successfully developed, allowing professional

READS: the rapid electronic assessment documentation system.

LENUS (Irish Health Repository)

Hickey, Ann

2012-12-13

Patient documentation is time consuming and can detract from care. The authors report a novel computer programme that manipulates routinely collected information to quantify nursing workload, along with the reason for admission, functional status, estimates of in-hospital mortality and life expectancy. The programme stores information in a database, and produces a print-out in a situation\\/background\\/assessment\\/recommendation (SBAR) format. The average time taken to enter 629 patient encounters was 6.6 minutes. Pain was the most common presentation for low workload patients, while high workload patients often presented with altered mental status and reduced mobility. There was only a modest correlation between the risk of death and nursing workload. The programme measures nursing workload without further paperwork, and improves routine documentation with a legible brief report that is automatically generated. This report can be shared and provides data that is immediately available for day-to-day care, audit, quality control and service planning.

[Nursing care to the client with hypertension: a bibliographic review].

Science.gov (United States)

Moura, Denizielle de Jesus Moreira; Bezerra, Sara Taciana Firmino; Moreira, Thereza Maria Magalhães; Fialho, Ana Virgínia de Melo

2011-01-01

This study aimed to identify the nursing care practices to the client with hypertension in the scientific production in the last ten years. It was carried out a bibliographic study, using in the BIREME, the LILACS, SciELO and BDENF's data basis, selecting thirty articles. The results were exposed in charts, tables and graphics, where prevails, in the literature analyzed, the nursing consultation as the more used practice, through the nursing attendance systematization and the Health Education with individual approaches, besides the realization of home visits with family approach. One believes that the systematization of nursing care will contribute in an expressive manner to the adhesion to the antihypertensive treatment.

Sharing the load: parents and carers talk to consumer consultants at a child and youth mental health inpatient unit.

Science.gov (United States)

Geraghty, Kerry; McCann, Karen; King, Robert; Eichmann, Kathryn

2011-08-01

Caring for a child or adolescent affected by mental illness has been identified as imposing stresses and burdens in excess of those usually associated with child rearing. Peer support has been identified as one means by which these stresses and burdens can be reduced. This study investigated the work of a peer support service provided by Mater Child and Youth Mental Health Service in Brisbane, Australia. The study took the form of a content analysis of records of consultations between consumer consultants and 50 families/carers of children admitted into the acute inpatient unit during the period May 2006-April 2008. The content analysis identified four key themes or domains: experience of service provision, emotions and feelings associated with the admission, need for information, and coping with challenges. The findings from the study affirm the role of consumer consultants in child and adolescent inpatient services. Some families value a peer perspective and the opportunity to seek advice and information around a wide variety of topics from people not directly involved in the treatment of their child. © 2011 Mater Health Services. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Development and evaluation of nursing user interface screens using multiple methods.

Science.gov (United States)

Hyun, Sookyung; Johnson, Stephen B; Stetson, Peter D; Bakken, Suzanne

2009-12-01

Building upon the foundation of the Structured Narrative Electronic Health Record (EHR) model, we applied theory-based (combined Technology Acceptance Model and Task-Technology Fit Model) and user-centered methods to explore nurses' perceptions of functional requirements for an electronic nursing documentation system, design user interface screens reflective of the nurses' perspectives, and assess nurses' perceptions of the usability of the prototype user interface screens. The methods resulted in user interface screens that were perceived to be easy to use, potentially useful, and well-matched to nursing documentation tasks associated with Nursing Admission Assessment, Blood Administration, and Nursing Discharge Summary. The methods applied in this research may serve as a guide for others wishing to implement user-centered processes to develop or extend EHR systems. In addition, some of the insights obtained in this study may be informative to the development of safe and efficient user interface screens for nursing document templates in EHRs.

40 CFR 26.1117 - Documentation of informed consent.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Documentation of informed consent. 26.1117 Section 26.1117 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL PROTECTION OF... Intentional Exposure of Non-pregnant, Non-nursing Adults § 26.1117 Documentation of informed consent. (a...

Implementation of nursing process in clinical settings: the case of three governmental hospitals in Ethiopia, 2017.

Science.gov (United States)

Semachew, Ayele

2018-03-13

The purpose of this survey was to evaluate the implementation of the nursing process at three randomly selected governmental hospitals found in Amhara Region North West Ethiopia. From the total 338 reviewed documents, 264 (78.1%) have a nursing process format attached with the patient's profile/file, 107 (31.7%) had no nursing diagnosis, 185 (54.7%) of nurses stated their plan of care based on priority, 173 (51.2%) of nurses did not document their interventions based on plan and 179 (53.0%) of nurses did not evaluate their interventions. The overall implementation of nursing process among Felege Hiwot Referal hospital, Debretabor general hospital and Finoteselam general hospitals were 49.12, 68.18, and 69.42% respectively. Nursing professionals shall improve documentation required in implementing the nursing process. Nursing managers (matron, ward heads) shall supervise the overall implementation of nursing process. Hospital nursing services managers (matrons) shall arrange and facilitate case presentations by the nursing staffs which focus on documentation and updates on nursing process. Hospitals need to establish and support nursing process coordinating staff in their institution.

A Model of Electronic Document Management System for Limited Partnership

OpenAIRE

Faiqunisa, Faiqunisa; Nugroho, Eko; Santosa, Paulus Insap

2013-01-01

Both types of documents, electronic and non-electronic are a major component supporting activities. In addition to the documents, communications capabilities to employees and managers effectively with other stakeholders are one of the important key achievements of organizational goals. LP. XYZ is one of the Consultants in the field of Information Technology, but the storage and management of electronic documents and archives themselves carried on a server without a management information sy...

[Exploring nurse, usage effectiveness of mobile nursing station].

Science.gov (United States)

Chang, Fang-Mei; Lee, Ting-Ting

2013-04-01

A mobile nursing station is an innovative cart that integrates a wireless network, information technology devices, and online charts. In addition to improving clinical work and workflow efficiencies, data is integrated among different information systems and hardware devices to promote patient safety. This study investigated the effectiveness of mobile nursing cart use. We compared different distributions of nursing activity working samples to evaluate the nursing information systems in terms of interface usability and usage outcomes. There were two parts of this study. Part one used work sampling to collect nursing activity data necessary to compare a unit that used a mobile nursing cart (mobile group, n = 18) with another that did not (traditional group, n = 14). Part two applied a nursing information system interface usability questionnaire to survey the mobile unit with nurses who had used a mobile nursing station (including those who had worked in this unit as floating nurses) (n = 30) in order to explore interface usability and effectiveness. We found that using the mobile nursing station information system increased time spent on direct patient care and decreased time spent on indirect patient care and documentation. Results further indicated that participants rated interface usability as high and evaluated usage effectiveness positively. Comments made in the open-ended question section raised several points of concern, including problems / inadequacies related to hardware devices, Internet speed, and printing. This study indicates that using mobile nursing station can improve nursing activity distributions and that nurses hold generally positive attitudes toward mobile nursing station interface usability and usage effectiveness. The authors thus encourage the continued implementation of mobile nursing stations and related studies to further enhance clinical nursing care.

Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

Science.gov (United States)

Fox, Amanda; Gardner, Glenn; Osborne, Sonya

2018-02-01

This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

Back to the future: A practice led transition program from Assistant in Nursing to Enrolled Nurse.

Science.gov (United States)

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

2017-01-01

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.

Small Business & Consultancy: Exploration of an Experiment with Student Consultants

NARCIS (Netherlands)

I. Hollaender

2007-01-01

In this paper I’ll discuss the first outcomes of an explorative research concerning the consultancy projects of a consultancy-based learning programme (Minor Consultancy 2006 - 2007, half-year bachelor programme University of Applied Sciences, Hogeschool Utrecht, The Netherlands). In order to

Resolving the ethical dilemma of nurse managers over chemically-dependent colleagues.

Science.gov (United States)

Chiu, W; Wilson, D

1996-12-01

This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers.

La Matriz BCG (Boston Consulting Group para la Gestión de Publicaciones Periádicas The BCG (Boston Consulting Group matrix for management of periodic publications

Directory of Open Access Journals (Sweden)

Mª del Pilar Serrano Gallardo

2005-11-01

Full Text Available El marketing documental se ha de encargar de satisfacer las necesidades informativas de los usuarios de forma rentable para ellos y para el centro; para ello se ha de partir de un conjunto de herramientas técnicas que se conocen como el Marketing - Mix, y que abarcan el Producto, el Precio, la Distribución y la Comunicación. Dentro de las herramientas destinadas al producto se encuentra la matriz BCG (Boston Consulting Group, que está orientada a gestión, sobre la base de la situación del producto en el mercado. El objetivo del presente artículo es proponer una matriz BCG para la gestión de una publicación periódica enfermera en nuestro mercado.La matriz BCG se construye con dos variables: el Crecimiento del Mercado y la Tasa Relativa del Mercado, las cuales se han operacionalizado como Media de Crecimiento Anual en el número de suscripciones de tres revistas enfermeras (Rol de Enfermería, Metas de Enfermería y Nursing durante el último quinquenio y Media de Tirada Actual de las tres publicaciones. Se han utilizado datos ofrecidos por la Oficina para el Control de la Difusión (OJD. La matriz BCG puede constituirse como herramienta básica en la gestión de publicaciones, dado que tras determinar la situación del producto, se pueden establecer estrategias que ayuden o favorezcan el mejor posicionamiento posible del producto en el mercado.Documentary marketing has to address the information needs of the users in a manner that is cost-effective not only for them but also for the institution. To do this, a set of technical tools, known as Marketing- Mix, need to be used. These tools include the Product, Price, Distribution and Communication. Within the set of tools used for the Product, we find the BCG matrix (Boston Consulting Group, a tool aimed at the management of the product on the basis of where it is positioned in the market. The objective of this paper is to propose a BCG matrix for the management of a nursing periodic

The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences.

Science.gov (United States)

Murdoch, Jamie; Barnes, Rebecca; Pooler, Jillian; Lattimer, Valerie; Fletcher, Emily; Campbell, John L

2015-02-01

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Situation awareness and documentation of changes that affect patient outcomes in progress notes.

Science.gov (United States)

Tower, Marion; Chaboyer, Wendy

2014-05-01

To report on registered nurses' situation awareness as a precursor to decision-making when recording changes in patients' conditions. Progress notes are important to communicate patients' progress and detail changes in patients' conditions. However, documentation is often poorly completed. There is little work that examines nurses' decision-making during documentation. This study focused on describing situation awareness as a precursor to decision-making during documentation. This study used Endsley's (Situation Awareness Analysis and Measurement, 2000, Lawrence Erlbaum Associates, NJ) work on situation awareness to guide and conceptualise information. The study was situated in a naturalistic paradigm to provide an interpretation of nurses' decision-making. Think-aloud research methods and semi-structured interviews were employed to illuminate decision-making processes. Audio recordings and interview texts were individually examined for evidence of cues, informed by Endsley's (Situation Awareness Analysis and Measurement, 2000, Lawrence Erlbaum Associates, NJ) descriptions of situation awareness. As patients' conditions changed, nurses used complex mental models and pattern-matching of information, drawing on all 3 levels of situation awareness during documentation. Level 1 situation awareness provided context, level 2 situation awareness signified a change in condition and its significance for the patient, and level 3 situation awareness was evident when nurses thought aloud about what this information indicated. Three themes associated with changes in patients' conditions emerged: deterioration in condition, not responding to prescribed treatments as expected and issues related to professional practice that impacted on patients' conditions. Nurses used a complex mental model for decision-making, drawing on 3 levels of situation awareness. Hamm's cognitive continuum theory, when related to situation awareness, is a useful decision-making theory to provide a

75 FR 54064 - Consultation Agreements: Proposed Changes to Consultation Procedures

Science.gov (United States)

2010-09-03

... State consultants performing worksite visits. Following the successful completion of an on-site... all types of complaints in a similar fashion. As a result, OSHA does not need to distinguish between...) * * * (2) The Consultant shall terminate an onsite consultative visit already in progress where one of the...

Registered Nurse (Associate Degree).

Science.gov (United States)

Ohio State Univ., Columbus. Center on Education and Training for Employment.

This document, which is designed for use in developing a tech prep competency profile for the occupation of registered nurse (with an associate degree), lists technical competencies and competency builders for 19 units pertinent to the health technologies cluster in general and 5 units specific to the occupation of registered nurse. The following…

Patient education about cough: effect on the consulting behaviour of general practice patients.

Science.gov (United States)

Rutten, G; Van Eijk, J; Beek, M; Van der Velden, H

1991-07-01

The aim of this general practice study was to examine how the consulting behaviour of patients with a cough was affected when the tasks and responsibilities of patients, practice nurses and general practitioners were reorganized. In four 'average' single-handed general practices the effects on the consulting behaviour of patients of a rational practice policy on cough and the provision of systematic patient education on cough were compared with patient behaviour in four matched control practices. Changes of behaviour were measured in 548 patients who consulted for cough at least twice, in two successive autumn-winter periods. Significantly more patients in the experimental practice changed their behaviour to follow the practice guidelines than did patients in the control practices (56% versus 30%, P less than 0.001). The proportion of patients who continued to consult in the approved manner was greater among patients receiving intervention (66% versus 29%, P less than 0.001). This was equally true for patients who had suffered less than four episodes of cough or more than four episodes. The more often the patients received the education, the more effective it was. All patients who consulted the general practitioner for cough during the first autumn-winter period filled in a cough diary during the second period. From this it appeared that the intervention did not result in patients delaying consultation when they had a cough lasting longer than three weeks or one with 'serious' symptoms. It would appear that a rational practice policy and the provision of patient education can stimulate patients to modify their consulting behaviour. This could result in a reduction in the costs of health care.

CARES: AACN's New Competencies and Recommendations for Educating Undergraduate Nursing Students to Improve Palliative Care.

Science.gov (United States)

Ferrell, Betty; Malloy, Pam; Mazanec, Polly; Virani, Rose

2016-01-01

Nurses spend the most time of any health care professional caring for patients and families dealing with the challenges of serious illness. The demand for nursing expertise in palliative care is growing as more people are living with chronic, life-limiting illnesses. Nursing faculty must prepare future nurses to meet this demand. The new American Association of Colleges of Nursing Palliative Competencies And Recommendations for Educating undergraduate nursing Students document, released February 2016, identifies the 17 competencies that all undergraduate nursing students should achieve by the time of graduation. This historic document is a revision of the 1998 American Association of Colleges of Nursing Peaceful Death document and is now the guiding framework for undergraduate nursing education. In an effort to support nursing faculty and prepare nursing students to deliver quality palliative care, an innovative, interactive on-line undergraduate End-of-Life Nursing Education Consortium (ELNEC) curriculum is under development and will be released in January 2017. This new curriculum will meet the competencies and recommendations for achieving those competencies outlined in the Competencies And Recommendations for Educating undergraduate nursing Students document. Copyright © 2016 Elsevier Inc. All rights reserved.

Dutch nurses' attitudes towards euthanasia and physician-assisted suicide.

Science.gov (United States)

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

2008-03-01

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.

Interventions before consultations for helping patients address their information needs.

Science.gov (United States)

Kinnersley, P; Edwards, A; Hood, K; Cadbury, N; Ryan, R; Prout, H; Owen, D; Macbeth, F; Butow, P; Butler, C

2007-07-18

Patients often do not get the information they require from doctors and nurses. To address this problem, interventions directed at patients to help them gather information in their healthcare consultations have been proposed and tested. To assess the effects on patients, clinicians and the healthcare system of interventions which are delivered before consultations, and which have been designed to help patients (and/or their representatives) address their information needs within consultations. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library (issue 3 2006); MEDLINE (1966 to September 2006); EMBASE (1980 to September 2006); PsycINFO (1985 to September 2006); and other databases, with no language restriction. We also searched reference lists of articles and related reviews, and handsearched Patient Education and Counseling (1986 to September 2006). Randomised controlled trials of interventions before consultations designed to encourage question asking and information gathering by the patient. Two researchers assessed the search output independently to identify potentially-relevant studies, selected studies for inclusion, and extracted data. We conducted a narrative synthesis of the included trials, and meta-analyses of five outcomes. We identified 33 randomised controlled trials, from 6 countries and in a range of settings. A total of 8244 patients was randomised and entered into studies. The most common interventions were question checklists and patient coaching. Most interventions were delivered immediately before the consultations.Commonly-occurring outcomes were: question asking, patient participation, patient anxiety, knowledge, satisfaction and consultation length. A minority of studies showed positive effects for these outcomes. Meta-analyses, however, showed small and statistically significant increases for question asking (standardised mean difference (SMD) 0.27 (95% confidence interval (CI) 0.19 to 0.36)) and

The need for academic electronic health record systems in nurse education.

Science.gov (United States)

Chung, Joohyun; Cho, Insook

2017-07-01

The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems. Copyright © 2017. Published by Elsevier Ltd.

Doctor-patient communication: a comparison between telemedicine consultation and face-to-face consultation.

Science.gov (United States)

Liu, Xiao; Sawada, Yoshie; Takizawa, Takako; Sato, Hiroko; Sato, Mahito; Sakamoto, Hironosuke; Utsugi, Toshihiro; Sato, Kunio; Sumino, Hiroyuki; Okamura, Shinichi; Sakamaki, Tetsuo

2007-01-01

The objective of this study was to compare doctor-patient communications in clinical consultations via telemedicine technology to doctor-patient communications in face-to-face clinical consultations. Five doctors who had been practicing internal medicine for 8 to 18 years, and twenty patients were enrolled in this study; neither doctors nor patients had previous experience of telemedicine. The patients received both a telemedicine consultation and a face-to-face consultation. Three measures--video observation, medical record volume, and participants' satisfaction--were used for the assessment. It was found that the time spent on the telemedicine consultation was substantially longer than the time spent on the face-to-face consultation. No statistically significant differences were found in the number of either closed or open-ended questions asked by doctors between both types of consultation. Empathy-utterances, praise-utterances, and facilitation-utterances were, however, seen less in the telemedicine consultations than in the face-to-face consultations. The volume of the medical records was statistically smaller in the telemedicine consultations than in the face-to-face consultations. Patients were satisfied with the telemedicine consultation, but doctors were dissatisfied with it and felt hampered by the communication barriers. This study suggests that new training programs are needed for doctors to develop improved communication skills and the ability to express empathy in telemedicine consultations.

Prison nursing: legal framework and care reality

Directory of Open Access Journals (Sweden)

H. Carrasco-Baún

Full Text Available Introduction: Penitentiary Nursing has experienced during the last decades a deep transformation similar to that experienced by the rest of the Nursing. However, there is a great distance from the protective legislation. Objective: To analyze the main legal documents which regulate the functions of Penitentiary Nursing and to compare it with the health care reality of nurses in Spanish prisons. Methodology: Narrative bibliographic review based on various sources such as Medline, Cuiden, Scielo, Dialnet, etc. Results: Is selected 43 documents, due to its relevance with the theme object of study. Is rejected 4 articles for lack of the same. Analyzed documents regarding legal framework and functions of nursing in prisons in its different sections (health care, teaching, research and management. Conclusion: The functions currently carried out in prisons are the ones provided for by health care legislation outside the prison context, along with the internal administrative regulations established by prisons. The possibility should be reconsidered of integrating Prison Healthcare into the Public Healthcare System so as to guarantee equality of healthcare for persons deprived of liberty and to provide the same rights and obligations to health professionals working in this sector.

Prison nursing: legal framework and care reality.

Science.gov (United States)

Carrasco-Baún, H

2017-06-01

Penitentiary Nursing has experienced during the last decades a deep transformation similar to that experienced by the rest of the Nursing. However, there is a great distance from the protective legislation. To analyze the main legal documents which regulate the functions of Penitentiary Nursing and to compare it with the health care reality of nurses in Spanish prisons. Narrative bibliographic review based on various sources such as Medline, Cuiden, Scielo, Dialnet, etc. Is selected 43 documents, due to its relevance with the theme object of study. Is rejected 4 articles for lack of the same. Analyzed documents regarding legal framework and functions of nursing in prisons in its different sections (health care, teaching, research and management). The functions currently carried out in prisons are the ones provided for by health care legislation outside the prison context, along with the internal administrative regulations established by prisons. The possibility should be reconsidered of integrating Prison Healthcare into the Public Healthcare System so as to guarantee equality of healthcare for persons deprived of liberty and to provide the same rights and obligations to health professionals working in this sector.

Patients' Care Needs: Documentation Analysis in General Hospitals.

Science.gov (United States)

Paans, Wolter; Müller-Staub, Maria

2015-10-01

The purpose of the study is (a) to describe care needs derived from records of patients in Dutch hospitals, and (b) to evaluate whether nurses employed the NANDA-I classification to formulate patients' care needs. A stratified cross-sectional random-sampling nursing documentation audit was conducted employing the D-Catch instrument in 10 hospitals comprising 37 wards. The most prevalent nursing diagnoses were acute pain, nausea, fatigue, and risk for impaired skin integrity. Most care needs were determined in physiological health patterns and few in psychosocial patterns. To perform effective interventions leading to high-quality nursing-sensitive outcomes, nurses should also diagnose patients' care needs in the health management, value-belief, and coping stress patterns. © 2014 NANDA International, Inc.

Feeling like a nurse: re-calling the spirit of nursing.

Science.gov (United States)

Spence, Deborah; Smythe, Elizabeth

2008-12-01

To explore the essential meaning of being a nurse. Nine registered nurses were each asked to write a story of a time when they felt like a nurse. Analysis was informed by Heideggerian hermeneutic philosophy, seeking to reveal the phenomenon of "feeling like a nurse." As part of a workshop on phenomenological methodology, participants were invited to reflect on a personal experience of feeling like a nurse. These documents were analyzed according to the method of van Manen. Participants were kept informed throughout each phase. Feelings announce primordial meaning of feeling like a nurse. Nurses experience the call as mood attuned by an anxiety that creates possibilities for authentic caring. It is a way of being that encompasses watching and acting, doing to and caring for, and taking over and giving back. Moreover, it is after the encounter that the essential meaning is more clearly revealed. We argue that there is value in continuing to question the meaning of "being a nurse." Amid a complex and increasingly technological world, this calls the profession to remember the human encounter at the heart of all nursing.

Defining, Delivering, and Documenting the Outcomes of Case Management by School Nurses

Science.gov (United States)

Engelke, Martha Keehner; Guttu, Martha; Warren, Michelle B.

2009-01-01

Case management is a component of school nurse practice that provides an opportunity to demonstrate the contribution that school nurses make to the health and academic success of children, particularly children with chronic health conditions. However, case management programs vary in their mission and scope, leading to confusion about what it…

Entry into Nursing: An Ethnographic Study of Newly Qualified Nurses Taking on the Nursing Role in a Hospital Setting

Directory of Open Access Journals (Sweden)

Mari Skancke Bjerknes

2012-01-01

Full Text Available The transition from student to working nurse has long been recognized as challenging. This paper presents the findings of research into the opportunities and limitations encountered by newly qualified nurses when taking on the nursing role. The study had an ethnographic design. Observation, interviews, and document analysis were used to gain insight into nurses' daily work from the perspective of recently graduated nurses. Thirteen nurses were monitored closely during their first year in a hospital setting in Norway. These new nurses generally entered the field with empathy for their patients, enthusiasm for the profession, and readiness to learn more about being a good nurse. However, their more experienced colleagues seemed to neither respect nor nurture this attitude. The new nurses experienced heavier responsibilities than expected, fragmentation of patient care, and stressful interactions with colleagues. The lack of a supportive work environment and role models increased the new nurses' experience of overwhelming responsibility in their daily work situations. The nurses learned to cope the hard way, despite the organizational culture, not because of it. Adjusting the profession's expectations of new nurses, and offering good role models and more comprehensive support programmes, would markedly ease the transition for new nurses.

Writing ourselves into a web of obedience: a nursing policy analysis.

Science.gov (United States)

Bail, Kasia; Cook, Robert; Gardner, Anne; Grealish, Laurie

2009-11-01

Nursing work is governed by a web of overarching documents from professional bodies, registration bodies, and individual health care organisations. The focus for these documents is to maintain high standards and protect patients and organisations from unnecessary risk. The presentation of the nurse within these documents has important implications for the ability of nurses to function as autonomous professionals. How the role of the nurse is situated in hospital procedural policy, and more specifically how these presentations of the nurse define, limit, and enable nursing practice is the focus of this paper. A combination of random and purposive sampling of the nursing policies of one tertiary level hospital was utilised to collect policy documents for thematic content analysis. The study was completed in a tertiary level health institution, in one Australian jurisdiction with a population of approximately 500,000 people. This health institution employs over 4000 people and admitted 49,000 patients in the 2004-2005 financial year. An inductive approach, which utilised theoretical and contextual comprehension of the nursing policies, informed the collation of coded data which determined the themes of the study. Analysis consisted of coding of particular words, textual structure and theory content. Practice was presented in the nursing procedural policies in two themes, called 'lingering tradition' and 'bureaucratic template'. The discourse of hospital procedural policy situates the nurse as obedient to organisational requirements by limiting practice to a performance of actions without explicit recognition of professional autonomy. This sets up a puzzling contradiction between performance expectations from the employing organisation and the nursing profession. Writing hospital policy in the discourse of procedural directives reduces nurses' ability to act as autonomous, critically thinking professionals, with implications for patient safety, nurse autonomy and the

Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities.

Science.gov (United States)

Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet

2016-10-01

To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. Exploratory, qualitative pilot study. Two community based SNFs. Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators. Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self-reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety. Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Consultation Models Revisited

International Nuclear Information System (INIS)

Fawaz, S.; Khan, Zulfiquar A.; Mossa, Samir Y.

2006-01-01

A new definition is proposed for analyzing the consultation in the primary health care, integrating other models of consultation and provides a framework by which general practitioners can apply the principles of consultation using communication skills to reconcile the respective agenda and autonomy of both doctor and patient into a negotiated agreed plan, which includes both management of health problems and health promotion. Achieving success of consultations depends on time and mutual cooperation between patient and doctor showed by doctor-patient relationship. (author)

20 CFR 668.710 - What planning documents must an INA grantee submit?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What planning documents must an INA grantee... Planning/Funding Process § 668.710 What planning documents must an INA grantee submit? Each grantee... participant services and expenditures covering the two-year planning cycle. We will, in consultation with the...

Scheme of collective services for the energy. Document under consultation; Schema de services collectifs de l'energie. Document soumis a la consultation

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

The energy policy is a major question of a government, for the economy and also for the environmental impact. This document aims at defining objectives in the context of the energy and the environment and its future in the next twenty years. It gives information and assistance to decision makers to manage the energy valorization and conservation. It includes five parts. The first part deals with the context, the stakes and forecast. The second and the third parts presents respectively the means for new actions and their control. The fourth part is an analysis of the regional contributions and the last part provides charts and maps. (A.L.B.)

Continuing competence assessment and maintenance in occupational therapy: Scoping review with stakeholder consultation.

Science.gov (United States)

Myers, Christine T; Schaefer, Nancy; Coudron, Ashley

2017-12-01

Continuing competence activities hold the promise of improving health-care service quality, especially given concerns about system inefficiencies and fragmentation. The aim of this scoping review was to describe the assessment and maintenance of occupational therapists' continuing competence and identify knowledge gaps for future research. A secondary aim was comparing scoping review findings with those from other health-care fields and considering possible impact of varying international regulations. A series of database searches retrieved peer-reviewed and grey literature on assessment and maintenance of occupational therapy continuing competence from 1995 to 2015. Themes were developed and findings shared with stakeholders, whose comments drove a second phase: searching for reviews related to continuing competence from allied health, medicine, and nursing, and reviewing websites and documents concerning regulatory requirements for occupational therapy continuing competence in seven English-speaking nations. Twenty-seven sources from the scoping review search met inclusion criteria. Stakeholder consultation validated the themes and preliminary knowledge gaps. Research into other health-care specialties corresponded to findings from the scoping review. The website/document review of occupational therapy regulatory requirements revealed wide variation on both the state/province and national levels. This scoping review highlights gaps in research on effective methods and assessment of occupational therapy continuing competence. Findings suggest a need for research on approaches to continuing competence that incorporate the translation of evidence to practice and address the influence of external factors. Regulatory agencies may address the quality of occupational therapy services by incorporating a variety of professional development options into requirements. © 2017 Occupational Therapy Australia.

Risk assessment of forensic patients: nurses' role.

Science.gov (United States)

Encinares, Maxima; McMaster, Jeff James; McNamee, Jim

2005-03-01

One of the unique roles of forensic nurses is to conduct risk assessments. Establishing a therapeutic nurse-patient relationship helps forensic nurses perform accurate and useful risk assessments. Accurate risk assessments can facilitate formulation of individualized risk management plans, designed to meet patients' needs and ensure public safety. The importance of forensic nurses' knowledge and application of appropriate communication and proper documentation cannot be overemphasized.

Automatic generation of nursing narratives from entity-attribute-value triplet for electronic nursing records system.

Science.gov (United States)

Min, Yul Ha; Park, Hyeoun-Ae; Lee, Joo Yun; Jo, Soo Jung; Jeon, Eunjoo; Byeon, Namsoo; Choi, Seung Yong; Chung, Eunja

2014-01-01

The aim of this study is to develop and evaluate a natural language generation system to populate nursing narratives using detailed clinical models. Semantic, contextual, and syntactical knowledges were extracted. A natural language generation system linking these knowledges was developed. The quality of generated nursing narratives was evaluated by the three nurse experts using a five-point rating scale. With 82 detailed clinical models, in total 66,888 nursing narratives in four different types of statement were generated. The mean scores for overall quality was 4.66, for content 4.60, for grammaticality 4.40, for writing style 4.13, and for correctness 4.60. The system developed in this study generated nursing narratives with different levels of granularity. The generated nursing narratives can improve semantic interoperability of nursing data documented in nursing records.

Family systems ideas in the 10-minute consultation: using a reflecting partner or observing team in a surgery.

Science.gov (United States)

Mayer, R; Graham, H; Schuberth, C; Launer, J; Tomson, D; Czauderna, J

1996-04-01

Family therapy and the ideas that underlie it have not had much impact on general practice, although there is good reason to think this could be a useful approach. As a group of general practitioners (and a practice nurse) with experience of family therapy, we were interested in demonstrating whether family therapy methods could usefully inform general practice consultations. Two surgeries were observed by the general practitioner's colleagues. Selected cases are discussed to illustrate the impact of the use of family therapy ideas and a reflecting colleague or team. Family therapy ideas can be a helpful framework within which to think about both demanding and ordinary consultations. Inviting a colleague to contribute respectfully could be useful both as a method of teaching, and in resolving difficult or faltering consultations.

Telemedicine diabetes consultations are cost-effective, and effects on essential diabetes treatment parameters are similar to conventional treatment

DEFF Research Database (Denmark)

Levin, Klaus; Madsen, Jette R; Petersen, Inge

2013-01-01

been offered expert diabetes care using teleconsultations. This article describes the impact of the telemedicine solution on essential diabetes treatment parameters, patient satisfaction, and cost-effectiveness. METHODS: Telemedicine consultations were conducted with the patient and nurse specialist...... in transportation time (7 h). Reductions in traveling costs and saved working days were the most important factors in making the telemedicine set-up economically efficient. CONCLUSION: Telemedicine consultation for remote outpatient diabetes control is feasible, and the interdisciplinary interventions achieved high...... treatment quality results in essential diabetes treatment parameters. In addition, the telemedicine set-up was associated with improved cost-effectiveness and patient satisfaction....

Audit of Orthopaedic Surgical Documentation

Directory of Open Access Journals (Sweden)

Fionn Coughlan

2015-01-01

Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

The Effect of the Strictness of Consultation Requirements on Fraud Consultation

NARCIS (Netherlands)

Gold, A.H.; Knechel, W.R.; Wallage, P.

2012-01-01

We investigate how the strictness of a requirement to consult on potential client fraud affects auditors' propensity to consult with firm experts. We consider two specific forms of guidance about fraud consultations: (1) strict, i.e., mandatory and binding; and (2) lenient, i.e., advisory and

Integration of clinical research documentation in electronic health records.

Science.gov (United States)

Broach, Debra

2015-04-01

Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

Inpatient Consultative Dermatology.

Science.gov (United States)

Biesbroeck, Lauren K; Shinohara, Michi M

2015-11-01

Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses,infectious processes, adverse medication reactions, and neoplastic disorders, many of which can be diagnosed based on dermatologic examination alone, but when necessary, bedside skin biopsies can contribute important diagnostic information. Copyright © 2015 Elsevier Inc. All rights reserved.

Population Consultation: A Powerful Means to Ensure that Health Strategies are Oriented Towards Universal Health Coverage.

Science.gov (United States)

Rohrer, Katja; Rajan, Dheepa; Schmets, Gerard

2017-01-01

We seek to highlight why population consultations need to be promoted more strongly as a powerful means to move health reforms towards Universal Health Coverage (UHC). However, despite this increasing recognition that the "population" is the key factor of successful health planning and high-quality service delivery, there has been very little systematic reflection and only limited (international) attention brought to the idea of specifically consulting the population to improve the quality and soundness of health policies and strategies and to strengthen the national health planning process and implementation. So far, research has done little to assess the significance of population consultations for the health sector and its importance for strategic planning and implementation processes; in addition, there has been insufficient evaluation of population consultations in the health sector or health-related areas. We drew on ongoing programmatic work of World Health Organization (WHO) offices worldwide, as most population consultations are not well-documented. In addition, we analyzed any existing documentation available on population consultations in health. We then elaborate on the potential benefits of bringing the population's voice into national health planning. We briefly mention the key methods used for population consultations, and we put forward recent country examples showing that population consultation is an effective way of assessing the population's needs and expectations, and should be more widely used in strategizing health. Giving the voice to the population is a means to strengthen accountability, to reinforce the commitment of policy makers, decision-makers and influencers (media, political parties, academics, etc.) to the health policy objectives of UHC, and, in the specific case of donor-dependent countries, to sensitize donors' engagement and alignment with national health strategies. The consequence of the current low international interest for

Medication discussion between nurse prescribers and people with diabetes

DEFF Research Database (Denmark)

Sibley, Andrew; Latter, Sue; Richard, Claude

2011-01-01

Aim. This paper is a report of a study to identify the content of, and participation in, medicine discussion between nurse prescribers and people with diabetes in England. Background. Diabetes affects 246 million people worldwide and effective management of medicines is an essential component...... of successful disease control. There are now over 20,000 nurse independent prescribers in the UK, many of whom frequently prescribe for people with diabetes. With this responsibility comes a challenge to effectively communicate with patients about medicines. National guidelines on medicines communication have...... recently been issued, but the extent to which nurse prescribers are facilitating effective medicine-taking in diabetes remains unknown. Methods. A purposive sample of 20 nurse prescribers working with diabetes patients audio-recorded 59 of their routine consultations and a descriptive analysis...

Effects of video-feedback on the communication, clinical competence and motivational interviewing skills of practice nurses: a pre-test posttest control group study.

Science.gov (United States)

Noordman, Janneke; van der Weijden, Trudy; van Dulmen, Sandra

2014-10-01

To examine the effects of individual video-feedback on the generic communication skills, clinical competence (i.e. adherence to practice guidelines) and motivational interviewing skills of experienced practice nurses working in primary care. Continuing professional education may be necessary to refresh and reflect on the communication and motivational interviewing skills of experienced primary care practice nurses. A video-feedback method was designed to improve these skills. Pre-test/posttest control group design. Seventeen Dutch practice nurses and 325 patients participated between June 2010-June 2011. Nurse-patient consultations were videotaped at two moments (T0 and T1), with an interval of 3-6 months. The videotaped consultations were rated using two protocols: the Maastrichtse Anamnese en Advies Scorelijst met globale items (MAAS-global) and the Behaviour Change Counselling Index. Before the recordings, nurses were allocated to a control or video-feedback group. Nurses allocated to the video-feedback group received video-feedback between T0 and T1. Data were analysed using multilevel linear or logistic regression. Nurses who received video-feedback appeared to pay significantly more attention to patients' request for help, their physical examination and gave significantly more understandable information. With respect to motivational interviewing, nurses who received video-feedback appeared to pay more attention to 'agenda setting and permission seeking' during their consultations. Video-feedback is a potentially effective method to improve practice nurses' generic communication skills. Although a single video-feedback session does not seem sufficient to increase all motivational interviewing skills, significant improvement in some specific skills was found. Nurses' clinical competences were not altered after feedback due to already high standards. © 2014 John Wiley & Sons Ltd.

Danish National Framework for collecting information about patients’ nutritional status. Nursing Minimum dataset (N-MDS)

DEFF Research Database (Denmark)

Håkonsen, Sasja Jul; Madsen, Inge; Bjerrum, Merete

2012-01-01

In Denmark the national guidelines for nursing documentation outlines twelve areas in which nurses have to systematically document daily care. Nutrition is one of these areas. However, the guidelines are frameworks that do not specify exactly what data nurses have to collect and which areas nurses...... need to document about nutrition in order to make a nursing specific documentation. This present study set out to identify a Nursing Minimum Data set for nutrition in a clinical setting. As data was used validated and available tools to screen or assess patients’ nutritional risk. A systematic...... literature search was undertaken identifying x eligible instruments. An inductive qualitative content analysis identified eighteen subcategories that were divided into five main categories: 1 Anthropometry such as weight, height, biochemistry, muscle mass and fat etc., 2 Ability to eat, 3 Intake, 4 Factors...

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions.

Science.gov (United States)

Marchi-Alves, Leila Maria; Ventura, Carla A Arena; Trevizan, Maria Auxiliadora; Mazzo, Alessandra; de Godoy, Simone; Mendes, Isabel Amélia Costa

2013-07-17

Angola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola. After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis. Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources,bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes. Public health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country.

CRE answer to the European Commission public consultation on the new electricity market design

International Nuclear Information System (INIS)

Ladoucette, Philippe de

2015-01-01

On July 15, 2015, the European Commission launched a public consultation on the new Electricity Market Design. All National Regulatory Authorities (NRAs), and CRE in particular, contributed to the joint ACER-CEER response to the consultation. CRE supports this joint response, and further develops some topics in this document, building on its particular experience in the implementation of the internal energy market: implementation of the network codes, in particular those regarding the markets, development of demand-side flexibility, development of interconnections, and alignment of fragmented balancing markets

Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study.

Science.gov (United States)

Achrekar, Meera S; Murthy, Vedang; Kanan, Sadhana; Shetty, Rani; Nair, Mini; Khattry, Navin

2016-01-01

The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR) form. Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM). Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR) form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1 st week (A1) and 16 th week (A2), post introduction of SIM. Nurse's opinion about the SBAR form was also captured. Majority of nurses were females (65%) in the age group 21-30 years (80%). There was a significant association ( P = 0.019) between overall audit scores and graduate nurses. Significant improvement ( P = 0.043) seen in overall scores between A1 (mean: 23.20) and A2 (mean: 24.26) and also in "Situation" domain ( P = 0.045) as compared to other domains. There was only a marginal improvement in documentation related to patient's allergies and relevant past history (7%) while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76%) of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53%) to document while recommendation was the difficult (53%) part. SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.

Documentation of psychotropic PRN medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

Science.gov (United States)

Martin, Krystle; Ham, Elke; Hilton, Zoe

2018-05-12

To describe the documentation of pro re nata (PRN) medication for anxiety, and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., De Marinis, Piredda, Pascarella et al., 2009) and considerable information missing (e.g., Marinis et al., 2010). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker, Lovell, & Harris, 2008). The project was a mixed method, two-phase study that collected data from two sites. In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be done through training, using structured report templates, and switching to electronic databases. This article is protected by copyright. All rights reserved. This article is

Nursing education development in China (1887-1949): influences on contemporary nursing.

Science.gov (United States)

Yan, Z; Li, J An; McDonald, T

2014-09-01

On 8 May 2013, the Chinese Nursing Association joined the International Council of Nurses. It is hoped that by sharing the history of nursing in China, scholars globally can incorporate into current thinking the challenges that Chinese nurses have faced in pursuing educational development and professional acknowledgement. To review the history of nurse education in China between 1887 and 1949 and summarize events marking its development; and to provide historical references for considering contemporary nurse education and discipline development in China. Content analysis using bibliometric and historical research methods on available documentation sources. Milestone events were listed and their historical significance analysed. Nurse education development during this period was affected by three major influences: (1) international nursing collaboration and involvement with Chinese nursing in China and abroad, (2) the determination of leaders to develop nursing as a unique and ethical profession, and (3) the pressure of war and civilian need on the focus of nursing development in China. The development of nurse education in China occurred within an environment of social change, war and international collaboration. Throughout the Modern China period (1887-1949), nursing leadership has guided the growth of nurse education to be responsive to individual and community needs as well as ensuring nurse accountability for conduct and nursing practice. Contemporary Chinese nursing and education owes much to those throughout the Modern China period, who laid the foundations that support the current position and status of nursing. The study displays the benefits and challenges of participation in policy and forums that help nurse scholars and practitioners understand the development of nurse education in China. © 2014 International Council of Nurses.

Stakeholder consultations on community-based rehabilitation guidelines in Ghana and Uganda

Directory of Open Access Journals (Sweden)

Mary Wickenden

2012-10-01

Objectives: To consult with key stakeholders in the disability arena in Uganda and Ghana, in order to gain their opinions and suggestions for improvements to the then draft CBR guidelines, as part of a wider global participatory process of consultation on the document. Methods: The INGO Sightsavers gathered qualitative data through focus group discussions and questionnaires in both countries. Results: The participants’ critiques of the draft guidelines carried out in multiagency participatory processes were analysed thematically and fed back to the CBR guidelines editorial team. Conclusion: The paper concludes that stakeholders in diverse communities can actively contribute to shaping policy and practice through participatory consultations. Local and national government and non-government organisations and other key informants can inform the development of national and international guidelines and policies. This participatory approach can be successfully facilitated by INGOs. In turn, these processes have prompted organisations to adapt their own policies and programmes in order to be more responsive to the local needs and concerns of PWDs.

Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial.

Science.gov (United States)

Taft, Angela J; Hooker, Leesa; Humphreys, Cathy; Hegarty, Kelsey; Walter, Ruby; Adams, Catina; Agius, Paul; Small, Rhonda

2015-06-25

Mothers are at risk of domestic violence (DV) and its harmful consequences postpartum. There is no evidence to date for sustainability of DV screening in primary care settings. We aimed to test whether a theory-informed, maternal and child health (MCH) nurse-designed model increased and sustained DV screening, disclosure, safety planning and referrals compared with usual care. Cluster randomised controlled trial of 12 month MCH DV screening and care intervention with 24 month follow-up. The study was set in community-based MCH nurse teams (91 centres, 163 nurses) in north-west Melbourne, Australia. Eight eligible teams were recruited. Team randomisation occurred at a public meeting using opaque envelopes. Teams were unable to be blinded. The intervention was informed by Normalisation Process Theory, the nurse-designed good practice model incorporated nurse mentors, strengthened relationships with DV services, nurse safety, a self-completion maternal health screening checklist at three or four month consultations and DV clinical guidelines. Usual care involved government mandated face-to-face DV screening at four weeks postpartum and follow-up as required. Primary outcomes were MCH team screening, disclosure, safety planning and referral rates from routine government data and a postal survey sent to 10,472 women with babies ≤ 12 months in study areas. Secondary outcomes included DV prevalence (Composite Abuse Scale, CAS) and harm measures (postal survey). No significant differences were found in routine screening at four months (IG 2,330/6,381 consultations (36.5 %) versus CG 1,792/7,638 consultations (23.5 %), RR = 1.56 CI 0.96-2.52) but data from maternal health checklists (n = 2,771) at three month IG consultations showed average screening rates of 63.1 %. Two years post-intervention, IG safety planning rates had increased from three (RR 2.95, CI 1.11-7.82) to four times those of CG (RR 4.22 CI 1.64-10.9). Referrals remained low in both intervention groups (IGs

75 FR 78198 - Proposed Final Policy on Consultation and Coordination With Indian Tribes

Science.gov (United States)

2010-12-15

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Chapter I [EPA-HQ-OA-2010-0992 FRL-9239-4] Proposed Final Policy on Consultation and Coordination With Indian Tribes AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of document for public comment. SUMMARY: The Environmental Protection Agency (EPA) is...

What Data Do States Collect Related to School Nurses, School Health, and the Health Care Provided?

Science.gov (United States)

Selekman, Janice; Wolfe, Linda C.; Cole, Marjorie

2016-01-01

School nurses collect data to report to their school district and state agencies. However, there is no national requirement or standard to collect specific data, and each state determines its own set of questions. This study resulted from a joint resolution between the National Association of State School Nurse Consultants and the National…

The content and meaning of administrative work: a qualitative study of nursing practices.

Science.gov (United States)

Michel, Lucie; Waelli, Mathias; Allen, Davina; Minvielle, Etienne

2017-09-01

To investigate the content and meaning of nurses' administrative work. Nurses often report that administrative work keeps them away from bedside care. The content and meaning of this work remains insufficiently explored. Comparative case studies. The investigation took place in 2014. It was based on 254 hours of observations and 27 interviews with nurses and staff in two contrasting units: intensive care and long-term care. A time and motion study was also performed over a period of 96 hours. Documentation and Organizational Activities is composed of six categories; documenting the patient record, coordination, management of patient flow, transmission of information, reporting quality indicators, ordering supplies- stock management Equal amounts of time were spent on these activities in each case. Nurses did not express complaints about documentation in intensive care, whereas they reported feeling frustrated by it in long-term care. These differences reflected the extent to which these activities could be integrated into nurses' clinical work and this is in turn was related to several factors: staff ratios, informatics, and relevance to nursing work. Documentation and Organizational Activities are a main component of care. The meaning nurses attribute to them is dependent on organizational context. These activities are often perceived as competing with bedside care, but this does not have to be the case. The challenge for managers is to fully integrate them into nursing practice. Results also suggest that nurses' Documentation and Organizational Activities should be incorporated into informatics strategies. © 2017 John Wiley & Sons Ltd.

Invisible inventors. A historical overview of creative midwives and nurses.

Science.gov (United States)

Hiestand, W C

1999-01-01

This historical overview documents women's inventions for providing nursing care dating from 1608 to 1928. The word invention is broadly defined and includes ideas that created therapeutic activities, caregiving environments, and specific devices for care. It focuses on the creative contributions of early outstanding midwives and other practicing nurses around the late 19th and early 20th centuries. Sources include illustrations of patented items, practical hints published in early issues of the American Journal of Nursing (AJN), published translations of original documents from Europe, original historical research on women in Europe and America, and records from the U.S. Government Patent Office. The role of nurses in creating and developing tools and methods for providing nursing care has gone unrecognized. It is important to clarify the record of women's and nurses' inventiveness.

Updating the definition and role of public health nursing to advance and guide the specialty.

Science.gov (United States)

Bekemeier, Betty; Walker Linderman, Tessa; Kneipp, Shawn; Zahner, Susan J

2015-01-01

National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. © 2014 Wiley Periodicals, Inc.

Co-creative development of an eHealth nursing intervention: Self-management support for outpatients with cancer pain.

Science.gov (United States)

Hochstenbach, Laura M J; Courtens, Annemie M; Zwakhalen, Sandra M G; Vermeulen, Joan; van Kleef, Maarten; de Witte, Luc P

2017-08-01

Co-creative methods, having an iterative character and including different perspectives, allow for the development of complex nursing interventions. Information about the development process is essential in providing justification for the ultimate intervention and crucial in interpreting the outcomes of subsequent evaluations. This paper describes a co-creative method directed towards the development of an eHealth intervention delivered by registered nurses to support self-management in outpatients with cancer pain. Intervention development was divided into three consecutive phases (exploration of context, specification of content, organisation of care). In each phase, researchers and technicians addressed five iterative steps: research, ideas, prototyping, evaluation, and documentation. Health professionals and patients were consulted during research and evaluation steps. Collaboration of researchers, health professionals, patients and technicians was positive and valuable in optimising outcomes. The intervention includes a mobile application for patients and a web application for nurses. Patients are requested to monitor pain, adverse effects and medication intake, while being provided with graphical feedback, education and contact possibilities. Nurses monitor data, advise patients, and collaborate with the treating physician. Integration of patient self-management and professional care by means of eHealth key into well-known barriers and seem promising in improving cancer pain follow-up. Nurses are able to make substantial contributions because of their expertise, focus on daily living, and their bridging function between patients and health professionals in different care settings. Insights from the intervention development as well as the intervention content give thought for applications in different patients and care settings. Copyright © 2017 Elsevier Inc. All rights reserved.

Exploring the research domain of consultant practice: Experiences of consultant radiographers

International Nuclear Information System (INIS)

Harris, R.; Paterson, A.

2016-01-01

Aim: This paper reports on one part of a larger study. The aim of the overall study was to explore what the core domain of research means to consultant radiographers in clinical practice and to identify the key factors that facilitate or hinder research activity by this staff group. Design and method: Grounded theory research methodology was employed. This second part of the study involved telephone interviews with twenty five consultant radiographers. Results: Results indicate there are variations across clinical specialties as to the amount and level of research undertaken by consultant radiographers. The principal barriers revealed were: lack of time; excessive clinical workload; lack of skills and confidence to undertake research; poor research culture; and lack of support. The main facilitators noted were: dedicated time, research training and up-skilling; mutually beneficial collaborations; managerial understanding of the research domain of the role; and research focussed on clinical demand. Conclusion: Fulfilling the clinical role is imperative and integral to the profession at consultant level; however, if it is undertaken to the detriment of the other domains then these practitioners may not be operating at ‘consultant’ level. Overall improvements must be made to ensure that the consultant radiographer role is delivering on current expectations and is safeguarded for the future of the next generation of radiographers. - Highlights: • Consultant radiographers undertake research but have concerns about their research skills. • Research aims to improve practice and patients' experiences. • Relatively few consultant radiographers publish their work regularly. • Consultant radiographers allocate little protected time for research due to clinical demands.

An ontology model for nursing narratives with natural language generation technology.

Science.gov (United States)

Min, Yul Ha; Park, Hyeoun-Ae; Jeon, Eunjoo; Lee, Joo Yun; Jo, Soo Jung

2013-01-01

The purpose of this study was to develop an ontology model to generate nursing narratives as natural as human language from the entity-attribute-value triplets of a detailed clinical model using natural language generation technology. The model was based on the types of information and documentation time of the information along the nursing process. The typesof information are data characterizing the patient status, inferences made by the nurse from the patient data, and nursing actions selected by the nurse to change the patient status. This information was linked to the nursing process based on the time of documentation. We describe a case study illustrating the application of this model in an acute-care setting. The proposed model provides a strategy for designing an electronic nursing record system.

Accompanied consultations in occupational health.

Science.gov (United States)

Hobson, J; Hobson, H; Sharp, R

2016-04-01

Accompanied consultations are often reported as difficult by occupational physicians but have not been studied in the occupational health setting. To collect information about accompanied consultations and the impact of the companion on the consultation. We collected data on all accompanied consultations by two occupational physicians working in a private sector occupational health service over the course of 16 months. Accompanied consultations were matched to non-accompanied consultations for comparison. We collected data on 108 accompanied consultations. Accompanied consultations were more likely to be connected with ill health retirement (P Occupational health practitioners may benefit from better understanding of accompanied consultations and guidance on their management. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[The concept of nursing. A systematic analysis].

Science.gov (United States)

Camaño, R; Piqué, J

1999-01-01

Nursing is a field which employs numerous people whose formation and professional roles are regulated by a wide set of rules and norms, and one which benefits innumerable patients. A paradox exists when, upon consulting various dictionaries, one of these the Royal Academy Dictionary (Diccionario de la Real Academia), the term nursing is defined as a physical space/set of nurses without any reference whatsoever to nurses' role in the health and educational systems. The definition we find in a dictionary should correspond to the concept the general public holds and reflect the true meaning of the profession. During a three year period, academic years 1994-96, on the first day of class, we asked each student to define or describe what he/she understood nursing to be. We consider that their responses, in a large sense, should correspond to the idea which the general public holds about nursing. An analysis of the content of these definitions allowed us to establish that there is a clear confrontation between what dictionaries state and what students, as a sample of society as a whole, think. Our results permit us to offer a definition for nursing which may be incorporated into new dictionary editions for the purpose of completing the already existing ones.

Multiple sclerosis documentation system (MSDS): moving from documentation to management of MS patients.

Science.gov (United States)

Ziemssen, Tjalf; Kempcke, Raimar; Eulitz, Marco; Großmann, Lars; Suhrbier, Alexander; Thomas, Katja; Schultheiss, Thorsten

2013-09-01

The long disease duration of multiple sclerosis and the increasing therapeutic options require a individualized therapeutic approach which should be carefully documented over years of observation. To switch from MS documentation to an innovative MS management, new computer- and internet-based tools could be implemented as we could demonstrate with the novel computer-based patient management system "multiple sclerosis management system 3D" (MSDS 3D). MSDS 3D allows documentation and management of visit schedules and mandatory examinations via defined study modules by integration of data input from various sources (patients, attending physicians and MS nurses). It provides forms for the documentation of patient visits as well as clinical and diagnostic findings. Information can be collected via interactive touch screens. Specific modules allow the management of highly efficacious treatments as natalizumab or fingolimod. MSDS can be used to transfer the documented data to databases as, e.g. the registry of the German MS society or REGIMS. MSDS has already been implemented successfully in clinical practice and is currently being evaluated in a multicenter setting. High-quality management and documentation are crucial for improvements in clinical practice and research work.

Consultant management estimating tool.

Science.gov (United States)

2012-04-01

The New York State Department of Transportation (NYSDOT) Consultant Management Bureaus primary responsibilities are to negotiate staffing hours/resources with : engineering design consultants, and to monitor the consultant's costs. Currently the C...

[The registered nurse and the battle against tuberculosis in Brazil: 1961-1966].

Science.gov (United States)

Montenegro, Hercília Regina do Amaral; de Almeida Filho, Antonio José; Santos, Tânia Cristina Franco; Lourenço, Lucia Helena Silva Corrêa

2009-12-01

The objective of this study was to describe the circumstances that promoted the implementation of the new Program for Action Against Tuberculosis in Brazil (Programa de Ação na Luta contra a Tuberculose no Brasil) and discuss the strategies used by registered nurses from the Santa Maria State Hospital, Guanabara State, to adjust nursing care to the new program against tuberculosis. This was performed through document research, interviews, and statements from nurses working at the time of the reorganization. Documents were analyzed based on the concepts of habitus, field, and symbolic power by Pierre Bourdieu, and included written and oral documents as well as secondary sources. The reorganization of the nursing service was performed under the leadership of a nurse whose symbolic capital assigned power and prestige to implement the necessary changes. It is concluded that the work of that nurse made it possible to implement the new program and contributed to establishing the position and importance of the registered nurse in providing care to individuals with tuberculosis, for prevention and cure.

Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study

Directory of Open Access Journals (Sweden)

Meera S Achrekar

2016-01-01

Full Text Available Objective: The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR form. Methods: Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM. Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1 st week (A1 and 16 th week (A2, post introduction of SIM. Nurse′s opinion about the SBAR form was also captured. Results : Majority of nurses were females (65% in the age group 21-30 years (80%. There was a significant association (P = 0.019 between overall audit scores and graduate nurses. Significant improvement (P = 0.043 seen in overall scores between A1 (mean: 23.20 and A2 (mean: 24.26 and also in "Situation" domain (P = 0.045 as compared to other domains. There was only a marginal improvement in documentation related to patient′s allergies and relevant past history (7% while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76% of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53% to document while recommendation was the difficult (53% part. Conclusions: SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.

Timing of psychiatric consultations - The impact of social vulnerability and level of psychiatric dysfunction

NARCIS (Netherlands)

de Jonge, P; Huyse, FJ; Ruinemans, GMF; Stiefel, FC; Lyons, JS; Slaets, JPJ

2000-01-01

The authors examined the timing of patient referrals to a psychiatric consultation-liaison service in relation to the patient's social vulnerability and level of psychiatric dysfunction. One hundred consecutive patients were assessed with the INTERMED, a method to document biopsychosocial and health

The Application of Standards and Recommendations to Clinical Ethics Consultation in Practice: An Evaluation at German Hospitals.

Science.gov (United States)

Schochow, Maximilian; Rubeis, Giovanni; Steger, Florian

2017-06-01

The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation (including ethics consultation, ethics training and the establishment of policy guidelines) are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly.

Rescheduling nursing shifts: scoping the challenge and examining the potential of mathematical model based tools.

Science.gov (United States)

Clark, Alistair; Moule, Pam; Topping, Annie; Serpell, Martin

2015-05-01

To review research in the literature on nursing shift scheduling / rescheduling, and to report key issues identified in a consultation exercise with managers in four English National Health Service trusts to inform the development of mathematical tools for rescheduling decision-making. Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives from scheduling. Poor rescheduling decisions can have quality, cost and morale implications. A systematic critical literature review identified rescheduling issues and existing mathematic modelling tools. A consultation exercise with nursing managers examined the complex challenges associated with rescheduling. Minimal research exists on rescheduling compared with scheduling. Poor rescheduling can result in greater disruption to planned nursing shifts and may impact negatively on the quality and cost of patient care, and nurse morale and retention. Very little research examines management challenges or mathematical modelling for rescheduling. Shift rescheduling is a complex and frequent management activity that is more challenging than scheduling. Mathematical modelling may have potential as a tool to support managers to minimise rescheduling disruption. The lack of specific methodological support for rescheduling that takes into account its complexity, increases the likelihood of harm for patients and stress for nursing staff and managers. © 2013 John Wiley & Sons Ltd.

Child consultation patterns in general practice comparing "high" and "low" consulting families.

OpenAIRE

Campion, P D; Gabriel, J

1984-01-01

All children's consultations with their general practitioner over a 12 month period in a small urban practice were analysed. Overall consultation rates ranged from 2.2 per child a year for 8 to 11 year olds, to 6.8 for those under 2. Families were grouped according to their average rate of new consultation for children, standardised for age. Families with higher consulting rates scored higher on an index of economic disadvantage, with mothers who scored higher on a test of "tendency to consul...

The Effect of an Electronic SBAR Communication Tool on Documentation of Acute Events in the Pediatric Intensive Care Unit.

Science.gov (United States)

Panesar, Rahul S; Albert, Ben; Messina, Catherine; Parker, Margaret

2016-01-01

The Situation, Background, Assessment, Recommendation (SBAR) handoff tool is designed to improve communication. The effects of integrating an electronic medical record (EMR) with a SBAR template are unclear. The research team hypothesizes that an electronic SBAR template improves documentation and communication between nurses and physicians. In all, 84 patient events were recorded from 542 admissions to the pediatric intensive care unit. Three time periods were studied: (a) paper documentation only, (b) electronic documentation, and (c) electronic documentation with an SBAR template. Documentation quality was assessed using a 4-point scoring system. The frequency of event notes increased progressively during the 3 study periods. Mean quality scores improved significantly from paper documentation to EMR free-text notes and to electronic SBAR-template notes, as did nurse and attending physician notification. The implementation of an electronic SBAR note is associated with more complete documentation and increased frequency of documentation of communication among nurses and physicians. © The Author(s) 2014.

Skills for Effective Consultation.

Science.gov (United States)

Dustin, Dick; Ehly, Stewart

1984-01-01

Discusses counselor skills that promote effective consultation. Reviews research on effective school consultation and presents a five-stage model which involves phasing in, problem identification, implementation, evaluation, and termination. Provides recommendations for the process and products of consultation. (JAC)

Consulta de enfermagem ambulatorial e diagnósticos de enfermagem relacionados a características demográficas e clínicas Consulta en ambulatorio y diagnóstico de enfermería relacionados con las características demográficas y clínicas Outpatient nursing consultation and nursing diagnoses related to demographic and clinical characteristics

Directory of Open Access Journals (Sweden)

Elenara Franzen

2012-09-01

óreas. Se encontró una asociación significativa entre los diagnósticos más frecuentes con algunas características demográficas y clínicas. Este estudio confirma que la definición de los diagnósticos de enfermería durante la consulta puede proporcionar exactitud en el foco de la atención en el ambulatorio.This study was aimed at verifying the relationship between demographic and clinical features and nursing diagnoses established during a nurse consultation in a general hospital. This is a cross-sectional study that assessed 237 nursing consultations of patients in two different programs: Women's Health (46 in obstetrical nursing and 24 in mastology nursing and 167 in Diabetes Mellitus Education. A total of 49 nursing diagnoses were identified. The most frequent in the women's health program were: Knowledge Deficit, Impaired Comfort, Impaired Tissue Integrity and Anxiety; in the program of diabetes education were: Ineffective Therapeutic Regimen Management, and Imbalanced Nutrition: more than body requirements. There was a significant association between the most common diagnoses with certain demographic and clinical features. The results confirmed that the identification of the nursing diagnoses during the consultation may provide accuracy in the focus of outpatient care.

Classificatory multiplicity: intimate partner violence diagnosis in emergency department consultations.

Science.gov (United States)

Olive, Philippa

2017-08-01

To explore the naming, or classification, of physical assaults by a partner as 'intimate partner violence' during emergency department consultations. Research continues to evidence instances when intimate partner physical violence is 'missed' or unacknowledged during emergency department consultations. Theoretically, this research was approached through complexity theory and the sociology of diagnosis. Research design was an applied, descriptive and explanatory, multiple-method approach that combined qualitative semistructured interviews with service-users (n = 8) and emergency department practitioners (n = 9), and qualitative and quantitative document analysis of emergency department health records (n = 28). This study found that multiple classifications of intimate partner violence were mobilised during emergency department consultations and that these different versions of intimate partner violence held different diagnostic categories, processes and consequences. The construction of different versions of intimate partner violence in emergency department consultations could explain variance in people's experiences and outcomes of consultations. The research found that the classificatory threshold for 'intimate partner violence' was too high. Strengthening systems of diagnosis (identification and intervention) so that all incidents of partner violence are named as 'intimate partner violence' would reduce the incidence of missed cases and afford earlier specialist intervention to reduce violence and limit its harms. This research found that identification of and response to intimate partner violence, even in contexts of severe physical violence, was contingent. By lowering the classificatory threshold so that all incidents of partner violence are named as 'intimate partner violence', practitioners could make a significant contribution to reducing missed intimate partner violence during consultations and improving health outcomes for this population. This

Do the majority of South Africans regularly consult traditional healers?

Directory of Open Access Journals (Sweden)

Gabriel Louw

2016-12-01

Full Text Available Background The statutory recognition of traditional healers as healthcare practitioners in South Africa in terms of the Traditional Health Practitioners Act 22 of 2007 is based on various assumptions, opinions and generalizations. One of the prominent views is that the majority of South Africans regularly consult traditional healers. It even has been alleged that this number can be as high as 80 per cent of the South African population. For medical doctors and other health practitioners registered with the Health Professions Council of South Africa (HPCSA, this new statutory status of traditional health practitioners, means the required presence of not only a healthcare competitor that can overstock the healthcare market with service lending, medical claims and healthcare costs, but also a competitor prone to malpractice. Aims The study aimed to determine if the majority of South Africans regularly consult traditional healers. Methods This is an exploratory and descriptive study following the modern historical approach of investigation and literature review. The emphasis is on using current documentation like articles, books and newspapers, as primary sources to determine if the majority of South Africans regularly consult traditional healers. The findings are offered in narrative form. Results It is clear that there is no trustworthy statistics on the percentages of South Africans using traditional healers. A scientific survey is needed to determine the extent to which traditional healers are consulted. This will only be possible after the Traditional Health Practitioners Act No 22 has been fully enacted and traditional health practitioners have become fully active in the healthcare sector. Conclusion In poorer, rural areas no more than 11.2 per cent of the South African population regularly consult traditional healers, while the figure for the total population seems to be no more than 1.4 per cent. The argument that the majority of South

Wipro Consulting Services: Building an Effective Global Configuration in Business and IT Consulting Industry

OpenAIRE

Joseph Lampel; Ajay Bhalla; Kaivalya Vishnu

2010-01-01

The Wipro Consulting Services (WCS) case charts the evolution of the consulting initiative within Wipro Technologies; the strategic choices the management made during this evolution and the challenges facing the firm once it consolidated the various consulting initiatives to set up Wipro Consulting Services in 2008. The case deals with several questions facing the leadership team, such as the competencies to develop to move up the value chain in delivering consulting services and the extent t...

Cap and trade offsets regulation - consultation paper

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-07-01

Due to increasing concerns about the environment, British Columbia has committed to reducing its 2007 greenhouse gas emissions levels by 33% in 2020 and 80% in 2050. To reach those objectives, emissions trading and offset regulations are being developed by the Climate Action Secretariat. The aim of this document is to present a first draft of the regulations to the various stakeholders, including First Nations and the general public, together with the proposed offset eligibility criteria and related process, and to get their feedback. This document is itself part of the 5-phase process of developing the regulations. Following the 45 days during which comments on the proposed regulation were sought, the climate action secretariat will complete legal drafting of the regulations, drawing on help from this stakeholder input, and the regulation will subsequently be implemented. An accompanying response form was attached to this consultation paper.

Consultation paper : Nova Scotia's renewed energy strategy and climate change action plan

International Nuclear Information System (INIS)

2007-10-01

The Nova Scotia Department of Energy is seeking to create a sustainable and prosperous Nova Scotia that is responsive to climate change. The purpose of this report was to inform public discussion around two upcoming documents, namely the renewed energy strategy focusing on broad energy policy and a climate change action plan for Nova Scotia to reduce greenhouse gas emissions. The report discussed mitigation measures, as it is closely tied with energy use. The consultation process to inform the two documents was to include public forums and direct stakeholder consultation. The report discussed Nova Scotia's strategy for dealing with climate change and the world of energy. Recent changes in energy prices, exploration, awareness, and emerging but uncertain technologies were presented. Long term planning and a review of policy changes were also addressed. The report also presented options for a renewed energy strategy and discussed air quality; energy conservation and efficiency; electricity; natural gas; energy opportunities; government action; and government intervention. Submissions were also sought as input to the discussion paper. refs., tabs., figs., appendices

European Consulting Survey 2012 : The Future of European Management Consulting Firms' Business Models

OpenAIRE

Kreutzer, Markus; Menz, Markus

2012-01-01

This study report provides European management consulting firms' assessment of trends and currently prevailing business models in the industry. It depicts the different threats and opportunities that consulting firms with different business models, consulting foci, sizes, leverage ratios, international orientations, and geographical footprints face; it also reveals these firms' adaptation strategies. Based on an analysis of a survey of 311 consulting firms from 26 European countries, the repo...

78 FR 18585 - FIFRA Pesticide Registration Review and ESA Consultation Processes; Stakeholder Input; Notice of...

Science.gov (United States)

2013-03-27

... Review and ESA Consultation Processes; Stakeholder Input; Notice of Availability AGENCY: Environmental... describing enhanced opportunities for stakeholder input during its review of pesticide registrations under... announcing the availability of a document titled, ``Enhancing Stakeholder Input in the Pesticide Registration...