Sample records for nursing executive replacement
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CEO- CNE Relationships: Building an Evidence-Base of Chief Nursing Executive Replacement Costs
Sredl, Darlene; Peng, Niang-Huei
2010-01-01
OBJECTIVE: Explore professional relationships between Chief Nurse Executives (CNEs) and Chief Executive Officers (CEOs); CNE ethnic diversity; and CNE replacement costs. BACKGROUND: Theoretical frameworks - Marilyn Ray's Theory of Bureaucratic Caring, and Turkel's Theory of Relational Complexity espousing economic as well as caring variables. METHODS: Exploratory mixed-method descriptive design using CNE mailed survey. RESULTS: CNE- cited opportunities for maintaining a positive relationship ...
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CEO- CNE relationships: building an evidence-base of chief nursing executive replacement costs.
Sredl, Darlene; Peng, Niang-Huei
2010-06-03
Explore professional relationships between Chief Nurse Executives (CNEs) and Chief Executive Officers (CEOs); CNE ethnic diversity; and CNE replacement costs. Theoretical frameworks - Marilyn Ray's Theory of Bureaucratic Caring, and Turkel's Theory of Relational Complexity espousing economic as well as caring variables. Exploratory mixed-method descriptive design using CNE mailed survey. CNE- cited opportunities for maintaining a positive relationship with the CEO: respect for CEO; goal- sharing (r=.782, prelationship (r= .718, pmaintaining specific roles (r= .261, prelationship with CEO (r=.254, prelationships have identified cohesive factors that may contribute to CNE longevity in position; an ethically diverse CNE deficit exists; and, CNE turnover and vacancy rates impact an organization's financial health and quality of care.
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National Research Council Canada - National Science Library
Sutto, Natalie B
2006-01-01
...). Using the Delphi method for executive decision-making, 144 current nurse executives, as well as 168 nurses identified for potential selection to this position, judged the relative importance of SKAs...
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Nurse executive transformational leadership found in participative organizations.
Dunham-Taylor, J
2000-05-01
The study examined a national sample of 396 randomly selected hospital nurse executives to explore transformational leadership, stage of power, and organizational climate. Results from a few nurse executive studies have found nurse executives were transformational leaders. As executives were more transformational, they achieved better staff satisfaction and higher work group effectiveness. This study integrates Bass' transformational leadership model with Hagberg's power stage theory and Likert's organizational climate theory. Nurse executives (396) and staff reporting to them (1,115) rated the nurse executives' leadership style, staff extra effort, staff satisfaction, and work group effectiveness using Bass and Avolio's Multifactor Leadership Questionnaire. Executives' bosses (360) rated executive work group effectiveness. Executives completed Hagberg's Personal Power Profile and ranked their organizational climate using Likert's Profile of Organizational Characteristics. Nurse executives used transformational leadership fairly often; achieved fairly satisfied staff levels; were very effective according to bosses; were most likely at stage 3 (power by achievement) or stage 4 (power by reflection); and rated their hospital as a Likert System 3 Consultative Organization. Staff satisfaction and work group effectiveness decreased as nurse executives were more transactional. Higher transformational scores tended to occur with higher educational degrees and within more participative organizations. Transformational qualities can be enhanced by further education, by achieving higher power stages, and by being within more participative organizations.
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Innovative behavior in nurse executives.
Adams, C E
1994-05-01
This study addresses the problem-solving styles of hospital nurse executives and explores the relationship between problem-solving style and leader effectiveness. The Kirton Adaption-Innovation Inventory (KAI) and the Leader Effectiveness and Adaptability Description-Self (LEAD-S) were the instruments used to survey nurse executives from 66 medium-sized urban California hospitals. The majority of respondents used innovative approaches, but no correlation was found between problem-solving style and leader effectiveness.
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Strategic management: a new dimension of the nurse executive's role.
Johnson, L J
1990-09-01
The growth of corporate orientation for health care structures, with a focus on bottom-line management, has radically altered the role of nurse executives. With the organization's emphasis on performance, productivity, and results, successful nurse executives are now integrating the management of the delivery of nursing care with the management of complex corporate structures and relationships. The editor of Executive Development discusses the rapidly changing expectations and demands of the contemporary nurse executive's work. The nurse executive's role can be viewed from many perspectives: its scope, its value, its structure, its content. Content--"What does the nurse executive do that makes a real difference?"--is the focus here.
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Quality circles: the nurse executive as mentor.
Flarey, D L
1991-12-01
Changes within and around the health care environment are forcing health care executives to reexamine their managerial and leadership styles to confront the resulting turbulence. The nurse executive is charged with the profound responsibility of directing the delivery of nursing care throughout the organization. Care delivered today must be of high quality. Declining financial resources as well as personnel shortages cause the executive to be an effective innovator in meeting the increasing demands. Quality circles offer the nurse executive an avenue of recourse. Circles have been effectively implemented in the health care setting, as has been consistently documented over time. By way of a participative management approach, quality circles may lead to increased employee morale and productivity, cost savings, and decreased employee turnover rates, as well as realization of socialization and self-actualization needs. A most effective approach to their introduction would be implementation at the first-line manager level. This promotes an acceptance of the concept at the management level as well as a training course for managers to implement the process at the unit level. The nurse executive facilitates the process at the first-line manager level. This facilitation will cause a positive outcome to diffuse throughout the entire organization. Quality circles offer the nurse executive the opportunity to challenge the existing environmental turmoil and effect a positive and lasting change.
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Nurse executives: new roles, new opportunities.
Kleinman, C S
1999-01-01
As women have been nursing since the earliest days of recorded civilization, so nurses have been associated with health care since the earliest days of recorded medical history. Gender and function have been inextricably woven in ways that created a struggle for success within a male-dominated industry. Nurses, as women, have been undervalued as, until recently, their role in health care has been similarly undervalued. Changing realities in the health care environment have created an opportunity for women's unique skills and talents to be revalued in a way that offers new opportunities for nurses. Teamwork, global thinking, multitasking, creativity, and flexibility are characteristics that have assumed new importance in the marketplace. Nursing leaders possess these attributes, along with a strong clinical foundation that is integrated with knowledge of sound business principles. This combination now positions nurse executives to reach the highest levels of heath care administration. Critical to this achievement is the professional credibility obtained through education at the master's degree level in health care and nursing administration programs that provide the essential tools for professional success. New opportunities for nurse executives afford educators in health care and nursing administration similar opportunities to develop and market programs to this large group of health care professionals who are seeking graduate education in increasing numbers.
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Succession planning: a call to action for nurse executives.
Trepanier, Sylvain; Crenshaw, Jeannette T
2013-10-01
To discuss the organisational benefits of strategic succession planning in acute care hospital settings as a responsibility of chief nurse executives. A formal succession planning process is crucial to the financial and operational viability and sustainability of acute care hospitals. A succession plan is an essential business strategy that promotes effective leadership transition and continuity while maintaining productivity. Nursing and business literature were reviewed; reports contrasting institutions with and without succession plans were examined; and, operational implications were considered. It is imperative that chief nurse executives respond to the business benefits of an effective succession planning programme, identify common barriers and solutions, and implement best practices for a successful strategic succession planning programme. A strategic succession planning programme may offer many benefits to an acute care hospital, including improved retention rates, increased staff engagement and enhanced financial performance. Considering the ageing nursing workforce and the potential increase in demand for nursing services in the near future, nurse executives and other nurse leaders must actively engage in a formal succession planning process. A formal succession planning programme will help to provide strategic leadership continuity, operational effectiveness and improved quality of care. © 2013 John Wiley & Sons Ltd.
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Voices of chief nursing executives informing a doctor of nursing practice program.
Embree, Jennifer L; Meek, Julie; Ebright, Patricia
The purpose of this article is to describe the business case framework used to guide doctor of nursing practice (DNP) program enhancements and to discuss methods used to gain chief nurse executives' (CNEs) perspectives for desired curricular and experiential content for doctor of nursing practice nurses in health care system executive roles. Principal results of CNE interview responses were closely aligned to the knowledge, skills and/or attitudes identified by the national leadership organizations. Major conclusions of this article are that curriculum change should include increased emphasis on leadership, implementation science, and translation of evidence into practice methods. Business, information and technology management, policy, and health care law content would also need to be re-balanced to facilitate DNP graduates' health care system level practice. Copyright © 2017 Elsevier Inc. All rights reserved.
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Assessing the professional development needs of experienced nurse executive leaders.
Leach, Linda Searle; McFarland, Patricia
2014-01-01
The objective of this study was to identify the professional development topics that senior nurse leaders believe are important to their advancement and success. Senior/experienced nurse leaders at the executive level are able to influence the work environment of nurses and institutional and health policy. Their development needs are likely to reflect this and other contemporary healthcare issues and may be different from middle and frontline managers. A systematic way of assessing professional development needs for these nurse leaders is needed. A descriptive study using an online survey was distributed to a convenience sample of nurse leaders who were members of the Association of California Nurse Leaders (ACNL) or have participated in an ACNL program. Visionary leadership, leading complexity, and effective teams were the highest ranked leadership topics. Leading change, advancing health: The future of nursing, healthy work environments, and healthcare reform were also highly ranked topics. Executive-level nurse leaders are important to nurse retention, effective work environments, and leading change. Regular assessment and attention to the distinct professional development needs of executive-level nurse leaders are a valuable human capital investment.
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Management development: a needs analysis for nurse executives and managers.
Kirk, R
1987-04-01
Clearly, both the nurse executive and nurse manager roles are becoming more complex. I feel an enthusiasm by the professionals in those positions to pursue development activities that will help them do their jobs better and with less discomfort. Nurse executives obviously know the power of combining knowledge with experience. How do the different leadership and management development needs identified by these NE fit with your organization's needs? What is the content in your leadership and management development programs? Are your programs meeting the real needs of your executive and management-level staff? One way to find out is to do a simple survey. Today, nurse executives are responsible and accountable for challenges we never considered possible, even a few years ago. But along with the new challenges came the flexibility and positive attitudes of NEs to respond to changes and acquire new skills such as cost accounting, computers, or marketing. It's this type of proactive thinking that helps nurse leaders turn problems into opportunities and their situations into success stories.
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Nursing procedures during continuous renal replacement therapies: a national survey.
Ricci, Zaccaria; Benelli, Sonia; Barbarigo, Fabio; Cocozza, Giulia; Pettinelli, Noemi; Di Luca, Emanuela; Mettifogo, Mariangela; Toniolo, Andrea; Ronco, Claudio
2015-01-01
The current role of nurses in the management of critically ill patients needing continuous renal replacement therapies is clearly fundamental. The care of these complex patients is typically shared by critical care and dialysis nurses: their precise duties may vary from country to country. To clarify this issue we conducted a national-level survey at a recent Italian course on nursing practices during continuous renal replacement therapies. A total of 119 questionnaires were analysed. The participants, who were equally divided between critical care and dialysis nurses, came from 44 different hospitals and 35 Italian cities. Overall, 23% of participants answered that "the dialysis staff" were responsible for continuous renal replacement therapies in the Intensive Care Unit, while 39% answered "the critical care nurse", and 38% "a shared organization". Interestingly, less than the half of participants claimed specific continuous renal replacement therapies training was provided to employees before handling an acute dialysis machine. Finally, about 60% of participants had experience of extra-corporeal membrane oxygenation machines used in conjunction with continuous renal replacement therapies. Workload coordination and management of critically ill patients undergoing continuous renal replacement therapies in Italy is not standardized. At present, the duties of critical care and dialysis nurses vary significantly across the country. They frequently overlap or leave gaps in the assistance received by patients. The role of nurses involved in the care of continuous renal replacement therapies patients in Italy currently requires better organization, possibly starting with intensive standardized training and educational programs.
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The system chief nurse executive role: sign of the changing times?
Clark, Joan Shinkus
2012-01-01
As the health care system landscape continues to evolve toward more integrated care, a trend toward consolidation of hospitals into larger systems continues. The systems are more than the traditional hospital-centric structures, as acute care becomes just one component to a larger system that includes ambulatory care, acute and post-acute care, chronic disease and end-of-life management, and all structures in between. To provide leadership in these new models, there have been an increasing number of system chief nurse executives hired both to facilitate the integration of care and to align and standardize nursing practice across the continuum. By definition, the role of the system chief nurse executive differs from that of the entity chief nursing officer. A crosswalk is presented that describes the differences between the roles and reflects on the implication for system chief nurse executives during our changing times.
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The role of the nurse executive in fostering and empowering the advanced practice registered nurse.
Talbert, Tukea L
2012-06-01
The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders. Copyright © 2012 Elsevier Inc. All rights reserved.
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The chief nurse executive role in large healthcare systems.
Englebright, Jane; Perlin, Jonathan
2008-01-01
Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a council of facility CNEs. The increasingly competitive healthcare environment in which value-based purchasing of healthcare and pay-for-performance programs demand improved clinical performance for financial success has led to reconsideration of whether a council model can provide either the leadership or adequate attention to clinical (and operational) improvement. In turn, community hospitals and health systems look to CNE or chief nursing officer roles at the highest level of the organization as resources that are able to segue between the clinical and operational domains, translating clinical performance demands into operating strategies and tactics. This article explores CNE characteristics required for success in these increasingly responsible and visible roles.
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Porter-O'grady, Tim
2009-01-01
Chief nurse executives create a context for leadership, innovation, and practice in hospitals. It is valuable to get a sense of nurse executives' perceptions regarding their leadership practices and how they value them. Furthermore, it is of interest to see if there is significant differentiation in these perceptions between chief nurse executives in Magnet hospitals and those in non-Magnet hospitals. This article discusses a study of the leadership practices of these 2 groups of nurse executive's leadership practices and reports the results. Concluding is a brief discussion regarding impact and importance of the nurse executive related to excellence and innovation.
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Alexander, Catherine; Lopez, Ruth Palan
2018-01-01
The aim of this study is to understand the behaviors experienced nurse executives use to create healthy work environments (HWEs). The constructs of authentic leadership formed the conceptual framework for the study. The American Association of Critical-Care Nurses recommends authentic leadership as the preferred style of leadership for creating and sustaining HWEs. Behaviors associated with authentic leadership in nursing are not well understood. A purposive sample of 17 experienced nurse executives were recruited from across the United States for this qualitative study. Thematic analysis was used to analyze the in-depth, semistructured interviews. Four constructs of authentic leaders were supported and suggest unique applications of each including self-awareness (a private and professional self), balanced processing (open hearted), transparency (limiting exposure), and moral leadership (nursing compass). Authentic leadership may provide a sound foundation to support nursing leadership practices; however, its application to the discipline requires additional investigation.
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The Big Data Revolution: Opportunities for Chief Nurse Executives.
Remus, Sally
2016-01-01
Informatics competency adoption is a recognized issue across nursing roles in digital health practice settings. Further, it has been suggested that the health system's inability to reap the promised benefits of electronic health/patient records is, in part, a manifestation of inadequate development of informatics competency by chief nurse executives (CNEs) and other clinicians (Amendola 2008; Simpson 2013). This paper will focus on CNE informatics competency and nursing knowledge development as it pertains to the Big Data revolution. With the paper's aim of showing how CNEs armed with informatics competency can harness the full potential of Big Data offering new opportunities for nursing knowledge development in their clinical transformation roles as eHealth project sponsors. It is proposed that informatics-savvy CNEs are the new transformational leaders of the digital age who will have the advantage to successfully advocate for nurses in leading 21st-century health systems. Also, transformational CNEs armed with informatics competency will position nurses and the nursing profession to achieve its future vision, where nurses are perceived by patients and professionals alike as knowledge workers, providing the leadership essential for safe, quality care and demonstrating nursing's unique contributions to fiscal health through clinically relevant, evidence-based practices (McBride 2005b). Copyright © 2016 Longwoods Publishing.
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Hahn, Joyce A
2010-01-01
The opportunity exists for academia and the nursing executive community to collaboratively create cultures of excellence. One university formed relationships of collaborative synergy with nurse executives to provide practicum experiences of value for both the graduate nursing administration students and the health care facilities. The strategic preceptor partnerships offer graduate students the invaluable opportunity to experience the in-depth, real world perspective of nursing administration resulting in the enrichment of their academic scholarship. A final practicum work project is designed collaboratively with the preceptor and completed by the end of the second practicum semester. The resulting practicum project is an example of a mutually rewarding experience for the graduate nursing administration student and the preceptor. The collaborative synergistic model is a win-win situation for the university and the health care facility.
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Ameigh, A Y
1996-01-01
The nurse executive at the corporate level is in a pivotal position to provide balance between the provision of integrated patient care and success of the corporate mission. In this role, the nurse executive shifts the spotlight from a solely nursing perspective to the systems approach in support of patient care. The response that follows is often a redoubling of the efforts of health care providers to render more efficient and cohesive care to patients. In the end, success is an outgrowth of strong teamwork combined with the ability of the executive to connect the corporate business strategy with the provision of patient care wherever it is delivered.
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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.
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Innovation in transformative nursing leadership: nursing informatics competencies and roles.
Remus, Sally; Kennedy, Margaret Ann
2012-12-01
In a recent brief to the Canadian Nurses Association's National Expert Commission on the Health of Our Nation, the Academy of Canadian Executive Nurses (ACEN) discussed leadership needs in the Canadian healthcare system, and promoted the pivotal role of nursing executives in transforming Canada's healthcare system into an integrated patient-centric system. Included among several recommendations was the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. This paper focuses on an emerging "avant-garde executive leadership competency" recommended for today's health leaders to guide health system transformation. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive. The authors of this paper propose that distinct nursing informatics competencies are required to augment traditional executive skills to support transformational outcomes of safe, integrated, high-quality care delivery through knowledge-driven care. International trends involving nursing informatics competencies and the evolution of new corporate informatics roles, such as chief nursing informatics officers (CNIOs), are demonstrating value and advanced transformational leadership as nursing executive roles that are informed by clinical data. Copyright © 2013 Longwoods Publishing.
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Chief nurse executives' balance of their work and personal lives.
Borman, J S
1993-01-01
Stress among chief nurse executives (CNEs) can result from the desire to meet work-related responsibilities and maintain a satisfying personal life. The purpose of this research was to determine if the stress level that results from balancing work-related and personal-life time pressures differs among CNEs by gender. CNEs experienced moderate levels of strain; gender differences were apparent. The research findings demonstrate that the influence of gender within a female-dominated profession is consistent not with the gender norms of females, but with the gender norms seen within the larger society.
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DEFF Research Database (Denmark)
Soffer, Ann Katrine Bønnelykke
2015-01-01
This article examines the intimate profession of nursing and the affective practices that bind bodies together into engagements that appear stable. However, once the bodies of patients are replaced with ‘plastic replicas’ for the purpose of clinical training within an educational setting, new...
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Newell, Mary E
2013-01-01
School nursing in the United States has been in existence for many decades but has become increasingly more complex, as student health needs have escalated and the role itself has expanded in scope of practice. Given the changes in health care delivery mandated by the Patient Safety and Affordable Care Reform Act, and the increasing complexity of school nursing practice, it is important to determine whether nurses who enter this area of practice are educationally prepared to do so. The objective of this study was to determine the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and whether they felt adequately prepared to effectively practice as a school nurse. The survey The Perceptions of School Nurses' Educational Preparation: Survey of Washington State School Nurses was sent to school nurses in Washington State. This was a descriptive, quantitative online survey that asked school nurses to assess their initial nursing education and whether their baccalaureate preparation adequately prepared them for this specialty role. There are a total of 17 school nurse standards, and 8 of the standards (47%) were identified as minimally achieved upon graduation. In addition, school nurses self-assessed gaps in their ongoing continuing educational needs, such as needing additional education regarding special education laws (81%), 504 accommodations (90.5%), diabetic care (76%), and delegation skills (68.6%). The findings from this study have illustrated the need for additional didactic and clinical practicum components that could be incorporated into baccalaureate nursing programs to better prepare graduates for school nursing practice in Washington State. Participants were able to identify areas in need of further education within their baccalaureate program, and also during their orientation to the role and responsibilities of a school nurse. Nurse executives must be able to use this knowledge to support staff nurses with an
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Chief nursing officers' perceptions of the Doctorate of Nursing Practice degree.
Swanson, Michelle L; Stanton, Marietta P
2013-01-01
Nurse executives practice in a business environment, which requires a skill set that has traditionally not been included in advanced nursing curriculum. The Doctorate of Nursing Practice (DNP) essentials are designed to address this gap in education while maintaining the focus on advanced nursing practice and executive management competency. Current literature supports the appropriateness of the DNP with practice focus areas of advanced practice specialties and nursing leadership. Although certification and educational bodies, and some professional nursing organizations, have embraced the DNP as the terminal degree for non-research-focused nurses, there remains a gap in the literature in regards to the perceptions of validity of the DNP for nurse executives. The purpose of this capstone project was to investigate the perceptions of practicing chief nursing officers (CNOs) in the acute care setting regarding the application of the DNP degree for nurse leaders. Utilizing an online survey, specific perceptions investigated included application and appropriateness of the DNP in a business-based practice model and managing daily nursing operations. CNOs practicing in the acute care setting differed on their responses regarding whether the DNP should be the recommended or the required degree in CNO development programs. CNOs with tenure responded more positively to the perception that the DNP curricula contains advanced nursing knowledge content appropriate to nurse executive practice. Practicing CNOs in the acute care setting do perceive the DNP as an appropriate degree option for nurse executive roles at aggregate, system, and organizational levels. © 2013 Wiley Periodicals, Inc.
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A model for the future. Certified nurse-midwives replace residents and house staff in hospitals.
Ament, L A; Hanson, L
1998-01-01
In one model of the future, certified nurse-midwives (CNMs) replace most obstetric residents and house staff in hospitals. This model offers numerous benefits, such as cost containment and quality outcomes. Furthermore, its application could open opportunities for educating CNMs and residents in a truly collaborative model in an educational setting and begin to balance the ratio of physicians to CNMs in the care of low-risk populations. This model was used with some success in the late 1980s to early 1990s at an inner-city Midwestern medical center. By definition, CNMs are educated in the two disciplines of nursing and midwifery and possess evidence of certification according to the requirements of the American College of Nurse Midwives (ACNM, 1978). Nurse-midwifery practice is the independent management of care of normal newborns and women, antepartally, intrapartally, postpartally, and/or gynecologically. Certified Nurse Midwifery practice occurs within a health care system that provides for medical consultation, collaborative management, and referral (ACNM, 1978). Physician and CNM roles differ. Certified nurse-midwives focus on supporting the process of normal birth, whereas physicians focus more on the management of complications. There are data that suggest that CNM outcomes are equivalent to those of physicians (American Nurses Association, 1992; Thompson, 1986; Wilson, 1989); that CNM costs are less than those of physicians (Bell & Mills, 1989; Cherry & Foster, 1982; Gravely & Littlefield, 1992; Rooks, 1986); and that the cost of educating CNMs is much less than the cost of educating physicians (Safriet, 1992). Within an environment of health care reform and cost containment, CNMs can replace residents and house staff in hospitals in the care of low-risk clients and work in consultation with physicians for the care of high-risk clients. This article compares medical education and nurse-midwifery education, reviews nurse-midwifery outcome data, and discusses
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DEFF Research Database (Denmark)
Jakobsen, Dorrit; Bager, Palle; Hentze, Runa
Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both for the patie......Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both...... for the patients and for the outpatient clinic. The purpose of this study was to identify potential barriers and pitfalls in the planning and implementation phase of a nurse-led telephone service. Methods: Preparations prior to introducing the annual telephone calls were done in 2010. From January 2011 all...... eligible IBD patients were shifted from regularly visits to annual telephone calls performed by an IBD nurse. As the intervention contained of several sub-elements and the elements were subject to adjustment during implementation, the intervention was regarded as a Complex Intervention. All the elements...
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2018-04-25
Wound, ostomy, and continence (WOC) nursing was recognized as a nursing specialty by the American Nurses Association in February 2010, and the Society published the original scope and standards of WOC nursing practice in May 2010. The Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition is the definitive resource promoting excellence in professional practice, quality care, and improved patient outcomes in WOC specialty practice. It can be used to articulate the value of WOC nurses to administrators, legislators, payers, patients, and others. The second edition also provides an overview of the scope of WOC nursing practice including a description of the specialty, the history and evolution of WOC nursing, characteristics of WOC nursing practice, and description of the trispecialty. The document describes various WOC nurse roles, populations served, practice settings, care coordination, and collaboration. Educational preparation, levels of practice within WOC specialty nursing, certification, mandate for continuous professional development, ethics, current trends, future considerations and challenges, and standards of WOC nursing practice and professional performance with competencies for each standard are provided. The purpose of this Executive Summary is to describe the process for developing the scope and standards document, provide an overview of the scope of WOC nursing practice, and list the standards of practice and professional performance along with the competencies for each level of WOC nurse provider. The original document is available from the WOCN Society's online book store (www.wocn.org).
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Recognition of clinical deterioration: a clinical leadership opportunity for nurse executive.
Swartz, Colleen
2013-01-01
Recognition and avoidance of further clinical deterioration can be termed a critical success factor in every care delivery model. As care resources become more constrained and allocated to the most critical of patients, some patients are being shifted to less intense and costly care settings where continuous physiologic monitoring may not be an option. Nurse executives are facing these complex issues as they work with clinical experts to develop systems of safety in the patient care arena. A systematic review of the literature related to the recognition of clinical deterioration is needed to identify areas for further leadership, research, and practice advancements.
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Huang, Yi-Chen; Hsu, Li-Ling
2011-02-01
Many nurses have difficulty learning to use the complex, non-traditional, and regularly-updated critical care equipment. Failure to use such equipment properly can seriously compromise treatment and endanger patient health and lives. New self-learning materials for novice nurses are necessary to provide essential and effective guidance as a part of formal nursing training. Such materials can enhance the capabilities of critical care nurses and, thus, improve the general quality of critical care. The purpose of this research was to develop a continuous renal replacement therapy (CRRT)-themed self-learning manual that would provide easily absorbed and understood knowledge in an easy-to-carry format for ICU nursing staff. This study also investigated CCRT skill learning efficacy. This study adopted a quasi-experimental design with pretests and posttests. Purposive sampling generated a sample of 66 critical care nurses currently working at one hospital in Taipei City. Participants submitted a completed self-assessment survey that rated their command of continuous renal replacement therapy before and after the self-learning manual intervention. Survey data were analyzed using SPSS Version 17.0 for Windows. The two major findings derived from the study included: (1) The mean response score from the self-assessment survey filled out after the intervention was 91.06 and 79.75 (SD = 9.49 and 11.65), respectively, for experimental and control groups. Such demonstrated significant difference. (2) The mean posttest score after the intervention for the experimental group was 91.06 ± 9.49. This represents a significant increase of 10.35 ± 10.35 over their mean pretest score (80.71 ± 11.82). The experimental group showed other significant differences in terms of the CRRT self-assessment survey posttest. Self-learning manuals may be introduced in nursing education as useful aids and catalysts to achieve more effective and satisfying learning experiences.
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Wray, Karen
2018-04-01
Violence affecting healthcare workers and healthcare organizations continues to be a serious safety issue. In this Leadership Perspectives column, Karen Wray, an American Organization of Nurse Executives (AONE) member who has experienced a mass causality incident 1st hand, outlines AONE's continuing work to promote safety and combat violence. She discusses recent work on violence issues by the American Hospital Association, AONE's parent organization.
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Do we really understand how to retain nurses?
O'Brien-Pallas, Linda; Duffield, Christine; Hayes, Laureen
2006-05-01
To compare views of nurse executives with those of nurses who have left the profession on the importance of retention strategies. Although much has been written about nursing turnover, there continues to be dissonance among decision makers as to why nurses leave the profession and what the most crucial issues are for retention. Factor analysis was undertaken to compare responses of nurse executives with those of nurses employed outside of nursing. Contract requirements represented the greatest discrepancy, 1.07, followed by legal and employer issues, 1.02; worklife/homelife balance, 0.91; external values and beliefs about nursing, 0.75; and professional practice, 0.29. A disparity exists between perceptions of nurse executives and those of nurses who have left the profession as to which issues are most critical in retention. We suggest that nurse executives ensure sufficient organizational support for nursing unit managers who are more likely to understand methods of retaining nurses at the clinical interface.
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DEFF Research Database (Denmark)
Soffer, Ann Katrine Bønnelykke
2015-01-01
This article examines the intimate profession of nursing and the affective practices that bind bodies together into engagements that appear stable. However, once the bodies of patients are replaced with ‘plastic replicas’ for the purpose of clinical training within an educational setting, new...... affective relations emerge and underexplored aspects of professional engagements appear. Through theories of affectivity, I propose the notion of touchability as a theoretical device which focuses attention on the body and the sensory, affective and embodied vicissitudes that traverse it, while nonetheless...... attending to the difference between feeling patients and plastic. Sensuous ethnography is the method used for exploring these professional engagements. By engaging through bodily senses, I actively use bodies as tools of inquiry and sources of knowledge within nursing. I argue that the notion...
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Future directions for nursing administration.
Poulin, M A
1984-03-01
As the age of centralization wanes, nurse executives must look ahead. The author, noting a terrain obscured by the increasing complexity of nursing practice, points out the advantages of decentralizing decision making and of providing a distinctive nursing stamp to research and administration theory. Nurse executives, trained in management from early in their professional formation, can provide enlightened direction and flexible support for tomorrow's opportunities.
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Leadership skills and attributes of women and nurse executives: challenges for the 21st century.
Carroll, Theresa L
2005-01-01
This study used a descriptive comparative design in which the skills/attributes identified by women leaders were compared to the skills/attributes identified by the nurse executives (NEs). For the women leaders and NEs, 6 factors were identified through principal components analysis: (1) personal integrity, (2) strategic vision/action orientation, (3) team building/communication skills, (4) management and technical competencies, (5) people skills (eg, empowering others, networking, valuing diversity, working collaboratively), and (6) personal survival skills/attributes (eg, political sensitivity, self-direction, self-reliance, courage, and candor). The items that received the highest level of agreement regarding importance for both groups were contained in the personal integrity factor, which included ethical standards, trustworthiness, and credibility. These factors are discussed and implications for leadership development and nursing administration graduate programs are identified.
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Advancing the nursing profession begins with leadership.
O'Neill, Jennifer A
2013-04-01
This bimonthly department, sponsored by the American Organization of Nurse Executives (AONE), presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients.
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Kang, Chun-Mei; Chiu, Hsiao-Ting; Hu, Yi-Chun; Chen, Hsiao-Lien; Lee, Pi-Hsia; Chang, Wen-Yin
2012-10-01
To assess the level of and the differences in managerial competencies, research capability, time management, executive power, workload and work-stress ratings among nurse administrators (NAs), and to determine the best predictors of managerial competencies for NAs. Although NAs require multifaceted managerial competencies, research related to NAs' managerial competencies is limited. A cross-sectional survey was conducted with 330 NAs from 16 acute care hospitals. Managerial competencies were determined through a self-developed questionnaire. Data were collected in 2011. All NAs gave themselves the highest rating on integrity and the lowest on both financial/budgeting and business acumen. All scores for managerial competencies, research capability, time management and executive power showed a statistically significant correlation. The stepwise regression analysis revealed that age; having received NA training; having completed a nursing project independently; and scores for research capability, executive power and workload could explain 63.2% of the total variance in managerial competencies. The present study provides recommendations for future administrative training programmes to increase NAs' managerial competency in fulfilling their management roles and functions. The findings inform leaders of hospitals where NAs need to develop additional competencies concerning the type of training NAs need to function proficiently. © 2012 Blackwell Publishing Ltd.
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Breaking through the glass ceiling: women in executive leadership positions--Part I.
Parsons, Lynn C; Reiss, Patricia L
2004-01-01
Women have had their share of difficulties climbing the corporate ladder in their chosen professional roles. Excellent role models exist for nurses to look up to as role models for leadership and executive level positions. Nurses and women must strive to achieve their goals of attaining executive/management level positions in their respective organizations. The glass ceiling still exists; however, women are slowly eroding that glass barrier and reaching their professional goals. In reviewing the struggles that men in nursing have encountered in a predominantly female profession, one realizes that stereotypical attitudes do cross gender lines. The authors conclude that executive level positions need to be opened more to women, just as the nursing profession must be more welcoming to men. The profession of nursing will only become stronger with gender diversity. Women encounter barriers when aspiring to executive level positions. In the next issue of SCI Nursing, the authors will report on what the evidence says about women in leadership roles, and the challenges they have and will continue to face.
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Nurse Executive Leadership During Organizational Mergers.
Piper, Letty Roth; Schneider, Maureen
2015-12-01
The recent growth in hospital mergers and the resultant mergers of nursing service departments (NSDs) have produced a need for chief nursing officers (CNOs) to be aware of implications and anticipated dynamic changes. This article addresses the major issues raised by mergers for NSDs and presents an operational step-by-step checklist for CNOs.
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Directory of Open Access Journals (Sweden)
Mofleh S. Awawdeh
2010-09-01
Full Text Available Two experiments were conducted to evaluate the effect of replacing soybean meal with xylose-treated soybean meal (soypass meal; SPM on performance of nursing Awassi ewes and fattening lambs. In Experiment 1, lasting for eight weeks, 39 Awassi ewes and their lambs were randomly assigned to three diets. Diets were formulated by replacing soybean meal from the basal diet (CON-SBM; n=13 with 50% (50% SPM; n=13 and 100% (100% SPM; n=13 SPM. Initial and final weights of the ewes were not different (P>0.55 among diets. Total gain and average daily gain (ADG of lambs were similar (P=0.44 among diets. Ewes fed the CON-SBM diet tended (P0.38 in milk component percentages among diets were observed. In Experiment 2, lasting for 63 days, twenty weaned lambs were used to determine the effects of replacing soybean meal with SPM on growth performance. Diets were either soybean meal (SBM; n=10 or SPM (SPM; n=10. Nutrient intake and digestibility were not different between diets. However, rumen undegradable protein intake was greater (P0.05 between the diets. Results suggest that replacement of soybean meal with soypass meal is not likely to produce any production benefits in nursing Awassi ewes and fattening lambs except for the slight improvement of milk yield.
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Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D
2010-07-01
To characterize rehabilitation services in two types of postacute facilities in patients who underwent hip replacement following a hip fracture. Multisite prospective observational cohort from 6 freestanding skilled nursing facilities and 11 inpatient rehabilitation facilities. Patients (n = 218) with hip fracture who had either hemiarthroplasty or total hip arthroplasty followed by rehabilitation at skilled nursing facilities or inpatient rehabilitation facilities were enrolled. Using a point-of-care methodology, we recorded data from actual physical therapy and occupational therapy sessions completed including functional outcomes during the postacute admission. Onset time from surgical repair to rehabilitation admission was not significantly different between sites. Average skilled nursing facilities length of stay was 24.7 +/- 13.6 days, whereas inpatient rehabilitation facilities was 13.0 +/- 5.7 days (P inpatient rehabilitation facilities. For weekdays only, these data changed to 1.6 in skilled nursing facilities and 2.6 hrs per patient in inpatient rehabilitation facilities (P inpatient rehabilitation facilities accrued more time for gait training and exercise in physical therapy, which was found to be 48% and 40% greater, respectively, through day 8. In occupational therapy, patients of inpatient rehabilitation facilities had more time allocated to lower body dressing and transfers. Significant differences in rehabilitation activities were observed, and intensity was notably different within the first 8 therapy days even though baseline demographics and medical complexity were comparable across facility types. Our data suggest that after more complex hip replacement surgery, hip fracture patients can tolerate more intensive therapy earlier within the rehabilitation program.
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Skilled nursing facilities after joint replacement
... care providers in the weeks before your joint replacement. They can advise you about whether going directly ... of many people who have had a joint replacement? Can they tell you how many? A good ...
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Cultivating future nurse leaders with student nurses associations.
Akans, Merlana; Harrington, Maura; McCash, John; Childs, Ashlyn; Gripentrog, Jessica; Cole, Sharon; Fitzgerald, Kevin; Searing, Kimberly; Fuehr, Patricia
2013-01-01
Student nurses associations (SNAs) assist in developing tomorrow's nurse leaders. In this article, executive board members of an SNA in a traditional baccalaureate nursing program at a public regional university recounted common themes in their participation in an SNA. These broad themes included leadership, mentorship and communication, all which foster professional development through the acquisition of specific knowledge, skills and experiences. © 2013 AWHONN.
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[Update in continuous renal replacement techniques].
Romero-García, M; de la Cueva-Ariza, L; Delgado-Hito, P
2013-01-01
Acute renal failure affects 25% of patients hospitalized in intensive care units. Despite technological advances, the mortality of these patients is still high due to its associated complications. Continuous renal replacement techniques are one of the treatments for acute renal failure because they make it possible to treat the complications and decrease mortality. The nurse's knowledge and skills regarding these techniques will be decisive for the success of the therapy. Consequently, the nurse's experience and training are key components. The objective of this article is to update the knowledge on continuous renal replacement techniques. Keeping this in mind, a review has been made of the physical and chemical principles such as diffusion and convection, among others. A description of the different continuous renal replacement techniques, a presentation of the main vascular access, and a description of the nursing cares and complications related to techniques used have also been provided. Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.
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Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E
2012-01-01
There has been lengthy debate as to which setting, skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF), is more efficient in treating joint replacement patients. This study aims to determine the efficiency of rehabilitation care provided by SNF and IRF to joint replacement patients with respect to both payment and length of stay (LOS). This study used a prospective multisite observational cohort design. Tobit models were used to examine the association between setting of care and efficiency. The study enrolled 948 knee replacement patients and 618 hip replacement patients from 11 IRFs and 7 SNFs between February 2006 and February 2007. Output was measured by motor functional independence measure (FIM) score at discharge. Efficiency was measured in 3 ways: payment efficiency, LOS efficiency, and stochastic frontier analysis efficiency. IRF patients incurred higher expenditures per case but also achieved larger motor FIM gains in shorter LOS than did SNF patients. Setting of care was not a strong predictor of overall efficiency of rehabilitation care. Great variation in characteristics existed within IRFs or SNFs and severity groups. Medium-volume facilities among both SNFs and IRFs were most efficient. Early rehabilitation was consistently predictive of efficient treatment. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate.
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Cantu, Kathy; Batcheller, Joyce A
2016-01-01
The chief nursing officer (CNO) is a critical senior executive in a hospital and serves as the architect of patient care. Recruiting, hiring, and on-boarding a new CNO present a challenge for any facility. Stakes are higher when the facility is replacing a CNO in the midst of its Magnet redesignation. How does a facility ensure success under these circumstances? This case study demonstrates how one organization was successful in meeting this challenge.
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Bliss, Julie
2016-08-03
Queen's Nursing Institute chief executive Crystal Oldman has welcomed the RCN congress resolution urging RCN council to lobby for all district nurses to have a specialist practice qualification. This provides the ideal route for future talent and must be supported.
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Opportunities and strategies in contemporary health system executive leadership.
McCausland, Maureen P
2012-01-01
The contemporary health care environment presents opportunities for nurse executive leadership that is patient and family centered, satisfying to professional nurses and their colleagues, and results in safe quality care that is fiscally responsible and evidence based. This article focuses on the strategic areas of systemness, people, performance, and innovation and offers strategies and tactics to help move nursing in integrated delivery systems from important entity-based services to a system approach where the nursing leadership team and entity chief nursing officers are recognized as major contributors to system success.
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Fevre, Marie-Cécile; Vincent, Caroline; Picard, Julien; Vighetti, Arnaud; Chapuis, Claire; Detavernier, Maxime; Allenet, Benoît; Payen, Jean-François; Bosson, Jean-Luc; Albaladejo, Pierre
2018-02-01
Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand-eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle guidance positioning systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety. Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS. We measured execution times to perform the tasks, hand-eye coordination and the number of repositioning occurrences or errors in handling the needle or the probe. Without the GPS system, we observed a significant inter-individual difference for execution time (Pgaming were found to be independent factors associated with a shorter execution time. Use of GPS attenuated the inter-individual and group variability. We observed a reduced execution time and improved hand-eye coordination in all groups as compared to US without GPS. Neither US training, video gaming nor demographic personal or professional factors were found to be significantly associated with reduced execution time when GPS was used. US associated with GPS systems may improve safety and decrease execution time by reducing inter-individual variability between professionals for needle-handling procedures. Copyright © 2016 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
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Executive Summary: Transforming Moral Distress into Moral Resilience in Nursing.
Rushton, Cynda Hylton; Schoonover-Shoffner, Kathy; Kennedy, Maureen Shawn
To examine practices for addressing moral distress, a collaborative project was developed by the Johns Hopkins Berman Institute of Bioethics, the Johns Hopkins School of Nursing, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical-Care Nurses and the American Nurses Association. Its purpose was to identify strategies that individuals and systems can use to mitigate the detrimental effects of moral distress and foster moral resilience. On August 11 and 12, 2016, an invitational symposium, State of the Science: Transforming Moral Distress into Moral Resilience in Nursing, was held at the Johns Hopkins School of Nursing in Baltimore, Maryland. Forty-five nurse clinicians, researchers, ethicists, organization representatives, and other stakeholders took part. The result of the symposium was group consensus on recommendations for addressing moral distress and building moral resilience in four areas: practice, education, research, and policy. Participants and the organizations represented were energized and committed to moving this agenda forward. The full report is available online at http://journals.lww.com/ajnonline/Pages/Moral-Distress-Supplement.aspx.
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The nursing human resource budget: design for success.
Winkler, J B; Cameron, M L; Flarey, D L
1995-06-01
As vital as the nursing human resource budget is to the successful achievement of institutional goals, it is very important to present a well-developed budget. Using current automated spreadsheet technology, the nursing human resource budget can be laid out in a format that is easy to understand and easy to present. Using the methods discussed in this article, the nurse executive will be able to perform infinite iterations of the proposed budget with a few simple key strokes, thus allowing for things like zero-based budgeting or addition of programs during the budgeting process or at a later date. Implications for nurse executives are discussed.
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Replacing the projected retiring baby boomer nursing cohort 2001 – 2026
Directory of Open Access Journals (Sweden)
Schofield Deborah J
2007-06-01
Full Text Available Abstract Background The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement. Methods Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future age structure of the population and the growth and age distribution of the pool of labour from which future nurses will be drawn. Results Attrition rates for nurses aged 45 and over are projected to be significantly higher between the base year of 2006 and 2026, than they were between 1986 and 2001 (p Between 2006 and 2026 the growth in the labour force aged 20 to 64 is projected to slow from 7.5 per cent every five years to about 2 per cent, and over half of that growth will be in the 50 to 64 year age group. Over this period Australia is projected to lose almost 60 per cent of the current nursing workforce to retirement, an average of 14 per cent of the nursing workforce every five years and a total of about 90,000 nurses. Conclusion The next 20 years will see a large number of nursing vacancies due to retirement, with ageing already impacting on the structure of the nursing workforce. Retirement income policies are likely to be a key driver in the retirement rate of nurses, with some recent changes in Australia having some potential to slow retirement of nurses before the age of 60 years. However, if current trends continue, Australia can expect to have substantially fewer nurses than it needs in 2026.
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Financial literacy as an essential element in nursing management practice.
Talley, Linda B; Thorgrimson, Diane H; Robinson, Nellie C
2013-01-01
Grooming nurses at all levels of the organization to master health care executive skills is critical to the organization's success and the individual's growth. Selecting and executing next steps for nursing leadership team development is critical to success. Leaders must make it their responsibility to provide nurses with increased exposure to quality, safety, and financial data, thereby allowing nurses to translate data while achieving and sustaining successful outcomes. The work of the CNO Dashboard to measure, report, trend, and translate clinical and non-clinical outcomes must be integrated throughout all levels of nursing staff so that nursing practice is positioned to continually strive for best practice. The education and evolution of nurses as business managers is critical to building a strong RN workforce.
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Replacing the projected retiring baby boomer nursing cohort 2001 – 2026
Schofield Deborah J
2007-01-01
Abstract Background The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement. Methods Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS) censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future a...
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Executive function, episodic memory, and Medicare expenditures.
Bender, Alex C; Austin, Andrea M; Grodstein, Francine; Bynum, Julie P W
2017-07-01
We examined the relationship between health care expenditures and cognition, focusing on differences across cognitive systems defined by global cognition, executive function, or episodic memory. We used linear regression models to compare annual health expenditures by cognitive status in 8125 Nurses' Health Study participants who completed a cognitive battery and were enrolled in Medicare parts A and B. Adjusting for demographics and comorbidity, executive impairment was associated with higher total annual expenditures of $1488 per person (P episodic memory impairment was found. Expenditures exhibited a linear relationship with executive function, but not episodic memory ($584 higher for every 1 standard deviation decrement in executive function; P < .01). Impairment in executive function is specifically and linearly associated with higher health care expenditures. Focusing on management strategies that address early losses in executive function may be effective in reducing costly services. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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Alleyne, Jo; Jumaa, Mansour Olawale
2007-03-01
The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and
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DEFF Research Database (Denmark)
Hørdam, Britta
2010-01-01
and over by using telephone support and counselling 2 and 10 weeks after surgery compared with a control group receiving conventional care and treatment. Design: A randomised clinical trial focusing on patients' health status by using short-form 36 at 4 weeks preoperatively and 3 and 9 months...... postoperatively was carried out. Sample: 180 patients aged 65 years and over were randomised 4 weeks preoperatively to either control or intervention groups. Measurements: both groups received conventional surgical treatment, but the intervention group was interviewed by telephone 2 and 10 weeks after surgery......Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Objective: We hypothesised that all areas of health status after total hip replacement could be improved in patients aged over 65 years...
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A national study of nurse leadership and supports for quality improvement in rural hospitals.
Paez, Kathryn; Schur, Claudia; Zhao, Lan; Lucado, Jennifer
2013-01-01
This study assessed the perceptions and actions of rural hospital nurse executives with regard to patient safety and quality improvement (QI). A national sample of rural hospital nurse executives (n = 300) completed a survey measuring 4 domains related to patient safety and QI: (a) patient "Safety Culture," (b) adequacy of QI "Resources," (c) "Barriers" related to QI, and (d) "Nurse Leader Engagement" in activities supporting QI. Perceptions of Safety Culture were strong but 47% of the Resources needed to carry out QI were inadequate, 29% of Barriers were moderate to major, and 25% of Nurse Leader Engagement activities were performed infrequently. Nurse Leader Engagement in quality-related activities was less frequent among nurses in isolated and small rural town hospitals compared with large rural city hospitals. To further QI, rural nurse executives may need to use their communications and actions to raise the visibility of QI.
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Niesen, Cynthia R; Kraft, Sarah J; Meiers, Sonja J
Motivational interviewing (MI) is a mentoring style used in various health care settings to guide patients toward health promotion and disease management. The aims of this project were (1) to identify evidence supporting the application of MI strategies and principles by nurse leaders to promote healthful leadership development among direct-report staff and (2) to report outcomes of an educational pilot project regarding MI use for new nurse leaders. Correlations between MI and the American Organization of Nurse Executives nurse executive competencies are reviewed and summarized. These competencies shape the roles, responsibilities, and skills required for nurse executives to function proficiently and successfully within health care organizations. Survey responses were gathered from new nurse supervisors and nurse managers following the MI educational session for nurse leaders. The results show acceptability for MI use in professional development of direct-report staff and in other aspects of nursing leadership roles.
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Enrolled Nurses: A Study for the UKCC.
Seccombe, I.; Smith, G.; Buchan, J.; Ball, J.
Selected issues of concern to second-level enrolled (registered) nurses in the United Kingdom were examined through national surveys of two groups: (1) a random sample of 21,762 of the 115,459 nurses holding second-level registration in the United Kingdom, and (2) 700 employers who, included nurse executive directors in all National Health Service…
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Factors involved in nurses' responses to burnout: a grounded theory study
Directory of Open Access Journals (Sweden)
Nikravesh Mansoure
2004-11-01
Full Text Available Abstract Background Intense and long-standing problems in burn centers in Tehran have led nurses to burnout. This phenomenon has provoked serious responses and has put the nurses, patients and the organization under pressure. The challenge for managers and nurse executives is to understand the factors which would reduce or increase the nurses' responses to burnout and develop delivery systems that promote positive adaptation and facilitate quality care. This study, as a part of more extensive research, aims to explore and describe the nurses' perceptions of the factors affecting their responses to burnout. Methods Grounded theory was used as the method. Thirty- eight participants were recruited. Data were generated by unstructured interviews and 21 sessions of participant observations. Constant comparison was used for data analysis. Results Nurses' and patients' personal characteristics and social support influenced nurses' responses to burnout. Personal characteristics of the nurses and patients, especially when interacting, had a more powerful effect. They altered emotional, attitudinal, behavioral and organizational responses to burnout and determined the kind of caring behavior. Social support had a palliative effect and altered emotional responses and some aspects of attitudinal responses. Conclusions The powerful effect of positive personal characteristics and its sensitivity to long standing and intense organizational pressures suggests approaches to executing stress reduction programs and refreshing the nurses' morale by giving more importance to ethical aspects of caring. Moreover, regarding palliative effect of social support and its importance for the nurses' wellbeing, nurse executives are responsible for promoting a work environment that supports nurses and motivates them.
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Nursing Aides' Attitudes to Elder Abuse in Nursing Homes: The Effect of Work Stressors and Burnout
Shinan-Altman, Shiri; Cohen, Miri
2009-01-01
Background: Nursing aides' attitudes condoning elder abuse are a possible risk factor for executing abusive behaviors against elder residents of long-term care facilities but have been studied infrequently. Purpose: The purpose of the study was to assess nursing aides' attitudes that condone abusive behaviors toward elderly people, as well as the…
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Nurses' perceptions of the challenges related to the Omanization policy.
Al-Riyami, M; Fischer, I; Lopez, V
2015-12-01
Human resource development has become a major concern in Oman since the inception of the 'Omanization' policy in 1988. The main goal of this policy was to replace the expatriate nursing workforce with similarly qualified local nurses to develop a sustainable workforce and achieve self-reliance. The aim of this study is to explore the nurses' perceptions of Omanization policy. A qualitative research design was used and 16 Omani registered nurses and 26 student nurses were interviewed in depth. Transcribed data were analysed using content analysis. Two main themes emerged from the data: 'Challenges of sustaining the local nursing workforce' and 'Challenges of educational preparation for local nurses'. The participants agreed that Omanization benefited national development, social stability and ensuring local workforce. The challenges faced were cultural and work life balance, preparation of nurses and pace of replacement. The participants were concerned that the pace of replacement could leave behind a marked experience gap. A slow-phased approach to Omanization of the nursing workforce was recommended by the participants. Results obtained from this study reflect the perceptions and voices of student nurses and registered nurses only from the Institute of Nursing and Oman Ministry of Health. A policy of this magnitude requires gradual establishment. The upgrading of the nursing education to degree level, continuous professional development, mentoring and role modeling of expert nurses should be established to prepare local nurses for the localization of the nursing workforce. © 2015 International Council of Nurses.
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International examples of steam generator replacement
International Nuclear Information System (INIS)
Wiechmann, K.
1993-01-01
Since 1979-1980 a total of twelve nuclear power plants world-wide have had their steam generators replaced. The replacement of the Combustion steam generators in the Millstone-2 plant in the United States was completed very recently. Steam generator replacement activities are going on at present in four plants. In North Anna, the steam generators have been under replacement since January 1990. In Japan, preparations have been started for Genkai-1. Since January 1992, the two projects in Beznau-1, Switzerland, and Doel-3, Belgium, have bee planned and executed in parallel. Why steam generator replacement? There are a number of defect mechanisms which give rise to the need for early steam generator replacement. One of the main reasons is the use of Inconel-600 as material for the heating tubes. Steam generator heating tubes made of Inconel-600 have been known to exhibit their first defects due to stress corrosion cracking after less than one year of operation. (orig.) [de
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2016-06-10
Democratic Society White House Leadership Development Program (WHLD) Harvard Kennedy School (HKS)–Senior Executive Fellows Program George......Nurse Leaders: An Exploration of Current Nurse Leadership Development in the Veterans Health Administration 5a. CONTRACT NUMBER 5b. GRANT NUMBER
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Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015
Jimvert I Camarillo
2016-01-01
Another significant milestone from the Executive Board and the Organizing Committee of the Asian Oncology Nursing Society (AONS) transpired last November 20-21, 2015. The 2 nd AONS Conference was held in Seoul, South Korea under the theme of "Flying the Spirits of Asian Oncology Nursing." A total of 687 delegates from USA, Canada, Australia, Romania, and Asian Region supported this groundbreaking event. The objective of this 2-day conference was to facilitate sharing of expertise in the field...
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Prolonged Intermittent Renal Replacement Therapy.
Edrees, Fahad; Li, Tingting; Vijayan, Anitha
2016-05-01
Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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Affordance estimation for vision-based object replacement on a humanoid robot
DEFF Research Database (Denmark)
Mustafa, Wail; Wächter, Mirko; Szedmak, Sandor
2016-01-01
In this paper, we address the problem of finding replacements of missing objects, involved in the execution of manipulation tasks. Our approach is based on estimating functional affordances for the unknown objects in order to propose replacements. We use a vision-based affordance estimation syste...
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Kang, Seung-Wan; Lee, Soojin; Choi, Suk Bong
2017-05-01
This study tested a multilevel model examining the effect of nursing leader's behavioral integrity and intragroup relationship conflict on staff nurses' intent to remain. In the challenging situation of nursing shortage, nurse executives are required to focus on the retention of nurses. No previous studies have examined the impact of nursing leader's behavioral integrity and intragroup relationship conflict on nurses' intention to remain. A cross-sectional survey of 480 RNs in 34 nursing units of a large public hospital in South Korea was conducted to test the hypothesized multilevel model. Nursing leader's behavioral integrity was positively related to nurses' intention to remain (b = 0.34, P relationship was enhanced when the level of intragroup relationship conflict was high (b = 0.21, P relationship conflict should endeavor to maintain their behavioral integrity to promote nurses' intention to remain.
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1996-01-01
The American Nurses Association (ANA) is committed to safeguarding the public, protecting and advancing the careers of professional nurses, supporting individual and collective efforts by registered nurses to protect their clients and enhancing the professional development and job security of registered nurses. As the nation's health care system is restructured, ANA is actively engaged in initiatives to strengthen the economic and general welfare of registered nurses, the safety and care for the public, and, in partnership with the state nurses associations (SNAs), oppose efforts to replace registered nurses with inappropriate substitutes.
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Nursing leadership in professional organizations.
Hill, Karen S
2011-04-01
This department highlights nursing leaders who have demonstrated the ability to inspire and lead change. This competency is seen in the ability to create, structure, and implement organizational change through strategic vision, risk taking, and effective communication. Each article showcases a project of a nurse leader who demonstrates change in a variety of environments, ranging from acute care hospitals to home care and alternative practice settings. Included are several "lessons learned" applicable to multiple settings that provide insight for other nurses in executive practice.
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The glass ceiling in nursing management.
Crawford, D I
1993-01-01
Women managers in business and health care have experienced discrimination related to advancement in management. Nurse executives must understand the strategies to overcome the barriers, the "glass ceiling," as well as implications for future practice. Women executives need an organized blueprint and the tools to dismantle the glass ceiling and overcome the political and discriminatory barriers to success.
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Promoting a Strategic Approach to Clinical Nurse Leader Practice Integration.
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.
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Nurse managers: the ties that bind.
Simons, Sherri Lee
2003-01-01
The staff nurses' immediate manager directly influences an NICU's ability to attract and retain professional nurses. This makes it especially important that nurse executives and administrators identify opportunities to better meet the needs of their nurse managers and measure the impacts of their decisions. Data about front-line manager turnover need to be measured, reported, and examined. No longer can organizations afford to view managers as another expense; they are an asset on the balance sheet. Strategic planning for the recruitment and retention of nurse managers will be vital both to an organization's healthy bottom line and to the quality of its patient care.
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Delirium After Transcatheter Aortic Valve Replacement.
Giuseffi, Jennifer L; Borges, Nyal E; Boehm, Leanne M; Wang, Li; McPherson, John A; Fredi, Joseph L; Ahmad, Rashid M; Ely, E Wesley; Pandharipande, Pratik P
2017-07-01
Postoperative delirium is associated with increased mortality. Patients undergoing transcatheter aortic valve replacement are at risk for delirium because of comorbid conditions. To compare the incidence, odds, and mortality implications of delirium between patients undergoing transcatheter replacement and patients undergoing surgical replacement. The Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit were used to assess arousal level and delirium prospectively in all patients with severe aortic stenosis who had transcatheter or surgical aortic valve replacement at an academic medical center. Multivariable logistic regression was used to determine the relationship between procedure type and occurrence of delirium. Cox regression was used to assess the association between postoperative delirium and 6-month mortality. A total of 105 patients had transcatheter replacement and 121 had surgical replacement. Patients in the transcatheter group were older (median age, 81 vs 68 years; P replacement. Delirium is less likely to develop in the transcatheter group but is associated with higher mortality in both groups. ©2017 American Association of Critical-Care Nurses.
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12-hour shifts: an ethical dilemma for the nurse executive.
Lorenz, Susan G
2008-06-01
Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue.
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Transformative leadership based on nursing science.
Clarke, Pamela N; Cody, William; Cowling, Richard
2014-04-01
The dialogue for this column is a summary of a dialogue among two preeminent nursing scholars and myself that took place "live" at the 40th Meeting of the American Academy of Nursing, focused on transforming healthcare. The dialogue was recorded and transcribed verbatim. In editing the dialogue I tried to leave it conversational which was the nature of the interaction. The paper that follows reflects the thinking of two executive nurse leaders who use different nursing frameworks as the basis for their practice. Translation of their practice models to leadership is presented as a natural transition to transformation.
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Person-centred care in nursing documentation.
LENUS (Irish Health Repository)
Broderick, Margaret C
2012-12-07
BACKGROUND: Documentation is an essential part of nursing. It provides evidence that care has been carried out and contains important information to enhance the quality and continuity of care. Person-centred care (PCC) is an approach to care that is underpinned by mutual respect and the development of a therapeutic relationship between the patient and nurse. It is a core principle in standards for residential care settings for older people and is beneficial for both patients and staff (International Practice Development in Nursing and Healthcare, Chichester, Blackwell, 2008 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). However, the literature suggests a lack of person-centredness within nursing documentation (International Journal of Older People Nursing 2, 2007, 263 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). AIMS AND OBJECTIVES: To explore nursing documentation in long-term care, to determine whether it reflected a person-centred approach to care and to describe aspects of PCC as they appeared in nursing records. METHOD: A qualitative descriptive study using the PCN framework (Person-centred Nursing; Theory and Practice, Oxford, Wiley-Blackwell, 2010) as the context through which nursing assessments and care plans were explored. RESULTS: Findings indicated that many nursing records were incomplete, and information regarding psychosocial aspects of care was infrequent. There was evidence that nurses engaged with residents and worked with their beliefs and values. However, nursing documentation was not completed in consultation with the patient, and there was little to suggest that patients were involved in decisions relating to their care. IMPLICATIONS FOR PRACTICE: The structure of nursing documentation can be a major obstacle to the recording of PCC and appropriate care planning. Documentation
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Directory of Open Access Journals (Sweden)
Mahmood Keyvanara
2015-09-01
Full Text Available Introduction and Purpose: Due to vast and varied nature of their work, managers need to operate in a wide range of emotions. In addition, managers must be able to determine when to show certain emotions. This shows the important role of emotional labor in management positions which can in turn affect the managers' job satisfaction. Therefore the current study aims to investigate the relationship between emotional labor and job satisfaction among executives and nursing managers of educational hospitals of Isfahan University of Medical Sciences. Methods: This is a descriptive, correlation study using field survey method. The study population consisted of executives and nursing managers of educational hospitals of Isfahan University of Medical Sciences. The sample size of 250 people was selected using census method. Data collection was carried out using a translated version of a questionnaire whose validity and reliability were approved (&alpha=0/81. The questionnaires were distributed among the study population and the resulting data was analyzed using descriptive and analytical statistics with the help of SPSS18 software. Results: The rate of emotional labor among the executive and nursing management of the selected hospitals was average while the job satisfaction, deep interaction and genuine emotions were reported to be above average and the rate of surface interaction was lower than average. The results showed that there is a direct and significant statistical relationship between the genuine emotions dimension of emotional labor and job satisfaction (P<0/05. However there was no statistically significant relationship between the other dimensions of emotional labor (surface interaction and deep interaction and job satisfaction of the managers. Conclusions: It can be concluded that, like in general population, the closer the emotional labor of the managers is to what they really feel (genuine emotions the greater their job satisfaction.
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Beyond the classroom: nurse leader preparation and practices.
O'Connor, Mary
2011-01-01
Formal academic education and experience as a nurse are established preparation for the chief nurse executive (CNE) or upcoming nurse leaders. This article proposes that the nurse leader must build on these fundamentals through self-discipline, lifelong learning, and practice. Three critical ingredients are discussed to guide the nurse leader on a life/career for the CNE and the nurse leader at every level. These include fostering relationships, feeding intellectual curiosity, and engaging in self-care practices. These indispensable ingredients of the successful nurse leader serve as an augmentation to formal education and experience for the nurse aspiring to reach the CNE level and beyond as well as for the current CNE mentoring future leaders.
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Feeder replacement tooling and processes
International Nuclear Information System (INIS)
Mallozzi, R.; Goslin, R.; Pink, D.; Askari, A.
2008-01-01
Primary heat transport system feeder integrity has become a concern at some CANDU nuclear plants as a result of thinning caused by flow accelerated corrosion (FAC). Feeder inspections are indicating that life-limiting wall thinning can occur in the region between the Grayloc hub weld and second elbow of some outlet feeders. In some cases it has become necessary to replace thinned sections of affected feeders to restore feeder integrity to planned end of life. Atomic Energy of Canada Limited (AECL) and Babcock and Wilcox Canada Ltd. (B and W) have developed a new capability for replacement of single feeders at any location on the reactor face without impacting or interrupting operation of neighbouring feeders. This new capability consists of deploying trained crews with specialized tools and procedures for feeder replacements during planned outages. As may be expected, performing single feeder replacement in the congested working environment of an operational CANDU reactor face involves overcoming many challenges with respect to access to feeders, available clearances for tooling, and tooling operation and performance. This paper describes some of the challenges encountered during single feeder replacements and actions being taken by AECL and B and W to promote continuous improvement of feeder replacement tooling and processes and ensure well-executed outages. (author)
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To What Extent Can Motor Imagery Replace Motor Execution While Learning a Fine Motor Skill?
Sobierajewicz, Jagna; Szarkiewicz, Sylwia; Prekoracka-Krawczyk, Anna; Jaskowski, Wojciech; van der Lubbe, Robert Henricus Johannes
2016-01-01
Motor imagery is generally thought to share common mechanisms with motor execution. In the present study, we examined to what extent learning a fine motor skill by motor imagery may substitute physical practice. Learning effects were assessed by manipulating the proportion of motor execution and
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Demographic Predictors of Job Satisfaction among Nurses
Masoumeh Hasanlo; Mansour Mohajeri; Razzagh Osfori
2017-01-01
Background: The implementation effect of nurses' efficiency improvement law on their job satisfaction is still not clear. Therefore, the aim of this study was to investigate nurses' job satisfaction after execution of the efficiency improvement law among them. Methods: This analytic study was carried out among 410 clinical nurses selected through a convenient and accessible sampling method and based on the assigned ratio in each of the hospitals. A questionnaire designed in 2 parts of demo...
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Directory of Open Access Journals (Sweden)
Peter Mathieu Van Bogaert
2014-11-01
Full Text Available Key words: burnout,job satisfaction, nurse retention, nurse practice environment,quality of care, acute health care,structural equation modelling. Aim:To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption.Background: Understanding to support and guide the practice community in their daily effort to answer most accurate complex care demands along with a stable nurse workforce are challenging.Design: Cross-sectional survey.Method:Based on previous empirical findings,a structural equation model designed with valid measurement instruments was tested.The study population was registered acute care hospital nurses(N = 1201 in twoindependent hospitals and one hospital group with six hospitals in Belgium.Results: Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care.Analyses were consistent with features of nurses’ work characteristics including perceived workload,decision latitude,and social capital,as well as three dimension of work engagement playing mediating roles between nurse practice environment and outcomes.A revised model adjusted using various fit measures explained 60 % and 47 % of job outcomes and nurse - assessed quality of care,respectively.Conclusion: Study findings show that aspects of nurse work characteristics such as workload,decision latitude and social capital along with nurse work engagement(e.g.vigor, dedication and absorption play a role between how various stakeholders such as executives,nurse managers and physicians will organize care and how nurses perceive job outcomes and quality of care.
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Florence Nightingale: The queen of nurses
Directory of Open Access Journals (Sweden)
Asha P Shetty
2016-01-01
Full Text Available Florence Nightingale, who was called as “the lady with the lamp,” by the sick and injured at Crimean war, has laid down strong foundational principles in nursing. Her multitasked role contributed significantly toward the development of nursing profession into structured institution. As an administrator, educator, researcher Nightingale's contributions moved nursing from disrespectable profession into replacing more of autonomy and evidence-based practice.
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Florence Nightingale: The queen of nurses
Asha P Shetty
2016-01-01
Florence Nightingale, who was called as “the lady with the lamp,” by the sick and injured at Crimean war, has laid down strong foundational principles in nursing. Her multitasked role contributed significantly toward the development of nursing profession into structured institution. As an administrator, educator, researcher Nightingale's contributions moved nursing from disrespectable profession into replacing more of autonomy and evidence-based practice.
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Vision 2020, part I: profile of the future nurse leader.
Scoble, Kathleen B; Russell, Gail
2003-06-01
The demand for knowledgeable and skilled nursing leaders at the first, middle, and executive levels of management in healthcare organizations drove a multi-phased project about the kinds of nurse managers who will be needed in the future and their educational needs. This first article in a two-part series describes seasoned nurse leaders' opinions about the educational preparation, experiences, and competencies desired in nurse managers for the year 2020.
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Teamwork and Clinical Error Reporting among Nurses in Korean Hospitals
Directory of Open Access Journals (Sweden)
Jee-In Hwang, PhD
2015-03-01
Conclusions: Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety.
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Authentic leadership: becoming and remaining an authentic nurse leader.
Murphy, Lin G
2012-11-01
This article explores how chief nurse executives became and remained authentic leaders. Using narrative inquiry, this qualitative study focused on the life stories of participants. Results demonstrate the importance of reframing, reflection in alignment with values, and the courage needed as nurse leaders progress to authenticity.
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Ogbolu, Yolanda; Scrandis, Debra A; Fitzpatrick, Grace
2018-01-01
To examine chief nurse executives' perspectives on: (1) the provision of culturally and linguistically appropriate services in hospitals and (2) to identify barriers and facilitators associated with the implementation of culturally and linguistically appropriate services. Hospitals continue to face challenges providing care to diverse patients. The uptake of standards related to culturally and linguistically appropriate services into clinical practice is sluggish, despite potential benefits, including reducing health disparities, patient errors, readmissions and improving patient experiences. A qualitative study with chief nurse executives from one eastern United States (US). Data were analysed using content analysis. Seven themes emerged: (1) lack of awareness of resources for health care organisations; (2) constrained cultural competency training; (3) suboptimal resources (cost and time); (4) mutual understanding; (5) limited workplace diversity; (6) community outreach programmes; and (7) the management of unvoiced patient expectations. As the American population diversifies, providing culturally and linguistically appropriate services remains a priority for nurse leaders. Being aware and utilizing the resources, policies and best practices available for the implementation of culturally and linguistically appropriate services can assist nursing managers in reaching their goals of providing high quality care to diverse populations. Nurse managers are key in aligning the unit's resources with organisational goals related to the provision of culturally and linguistically appropriate services by providing the operational leadership to eliminate barriers and to enhance the uptake of best practices related to culturally and linguistically appropriate services. © 2017 John Wiley & Sons Ltd.
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Time well spent? Assessing nursing-supply chain activities.
Ferenc, Jeff
2010-02-01
The amount of time nurses spend providing direct patient care seems to be continually eroding. So it's little wonder a survey conducted last year of critical care, OR nurses and nurse executives found that half of the 1600 respondents feel they spend too much time on supply chain duties. Most also said their supply chain duties impact patient safe ty and their ability to provide bedside care. Experts interviewed for this report believe it's time for supply chain leaders and nurses to develop a closer working partnership. Included are their recommendations to improve performance.
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Nursing Staff Perceptions of Fall Risk: The Emergence of Learned Helplessness as a Theme.
Gibson, Terri Lea; Lloyd, Susan L
2018-01-01
Nurses and unlicensed assistive personnel on 2 medical-surgical units were asked about their perceptions regarding patient falls. Their responses reflect learned helplessness and a lack of nurse empowerment that are relevant findings as nurse executives work to decrease patient falls.
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A task force model for statewide change in nursing education: building quality and safety.
Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona
2013-01-01
The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.
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Patient safety and nursing implication: Survey in Catalan hospitals.
Freixas Sala, Núria; Monistrol Ruano, Olga; Espuñes Vendrell, Jordi; Sallés Creus, Montserrat; Gallardo González, Mónica; Ramón Cantón, Carme; Bueno Domínguez, María José; Llinas Vidal, Montserrat; Campo Osaba, María Antonia
This study aims to describe the implementation of the patient safety (PS) programs in catalan hospitals and to analyze the level of nursing involvement. Multicenter cross-sectional study. To obtain the data two questionnaires were developed; one addressed to the hospital direction and another to the nurse executive in PS. The survey was distributed during 2013 to the 65 acute care hospitals in Catalonia. The questionnaire was answered by 43 nursing directors and 40 nurse executive in PS. 93% of the hospitals responded that they had a PS Program and 81.4% used a specific scoreboard with PS indicators. The referent of the hospital in PS was a nurse in 55.8% of the centres. 92.5% had a system of notification of adverse effects with an annual average of 190.3 notifications. In 86% of the centres had a nurse involved in the PS program but only in the 16% of the centres the nurse dedication was at full-time. The nurse respondents evaluate the degree of implementation of the PBS program with a note of approved and they propound as improvement increase the staff dedicated to the PS and specific academic training in PS. The degree of implementation of programs for patient safety is high in Catalan acute hospitals, while the organizational structure is highly diverse. In more than half of the hospitals the PS referent was a nurse, confirming the nurse involvement in the PS programs. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
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Give UK nursing bigger global voice by rejoining ICN, college is urged.
Longhurst, Chris
2015-08-26
The next chief executive of the International Council of Nurses should encourage the RCN to rejoin the organisation and ensure the UK has a greater say on nursing at a global level, a former college president believes.
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Evaluation of a nurse leadership development programme.
West, Margaret; Smithgall, Lisa; Rosler, Greta; Winn, Erin
2016-03-01
The challenge for nursing leaders responsible for workforce planning is to predict the knowledge, skills and abilities required to lead future healthcare delivery systems effectively. Succession planning requires a constant, competitive pool of qualified nursing leader candidates, and retention of those interested in career growth. Formal nursing leadership education in the United States is available through graduate education and professional nursing organisation programmes, such as the Emerging Nurse Leader Institute of the American Organization of Nurse Executives. However, there is also a need for local development programmes tailored to the needs of individual organisations. Leaders at Geisinger Health System, one of the largest rural health systems in the US, identified the need for an internal professional development scheme for nurses. In 2013 the Nurses Emerging as Leaders programme was developed to prepare nurse leaders for effective leadership and successful role transition. This article describes the programme and an evaluation of its effectiveness.
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Elliott, Naomi
2017-01-01
To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives. Advanced nurse practitioners are ideally positioned to act as leaders both within and beyond the health care organisation. From the available research evidence, several support structures and mechanisms are identified as enablers for advanced nurse practitioners to enact their leadership role. Health care organisations need to include building leadership capacity as a priority in their strategic plan and take action to build-up the level of advanced nurse practitioner leadership. Nurse executives have a vital role in influencing the organisation's strategic plan and making a business case for prioritising leadership capacity building within advanced nurse practitioners. A challenge for nurse executives faced with competing service and leadership development demands, involves strategic decision-making regarding whether the advanced nurse practitioner's role is limited to service delivery or its potential in leading health care reforms is realised. © 2016 John Wiley & Sons Ltd.
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FitzPatrick, Kate; Doucette, Jeffrey N; Cotton, Amy; Arnow, Debra; Pipe, Teri
2016-10-01
In this second installment of a three-part series on mindfulness, we describe the process of producing video vignettes to illustrate how clinical nurses draw on the power of mindfulness to build their own resiliency while delivering compassionate care.
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Hocker, Susan M; Trofino, Joan
2003-01-01
Management philosophy and culture of any organization must match the nursing professions' core value of caring. Organizational conflict symptomology includes communication barriers and widely differing values. Employment of accountability based systems and bringing nurses into governance prevents conflict and improves job satisfaction. This article identifies the barriers to case management program development and discusses strategies for its successful implementation. Today's most successful organizations will implement an institution-wide commitment to a culture within which excellence flourishes. Creative staffing models and professional practice partnerships such as nursing case management will be supported and encouraged by executive leadership; they work as a team and will be jointly accountable for positive outcomes The United States Army Nurse Corps has the framework necessary to develop a premiere nursing organization. Case management departments may adopt these techniques to improve working relationships and leadership capacity within their organizations.
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Directory of Open Access Journals (Sweden)
Luciane Patrícia Andreani Cabral
2015-10-01
Full Text Available AbstractOBJECTIVETo report the nurse's experience of inclusion in interdisciplinary clinical study about technological innovation, involving people with spinal cord injury.METHODDescriptive experience report. The empirical support was based on notes about perspectives and practice of clinical research, with a multi-professional nursing, physical education, physiotherapy and engineering staff.RESULTThe qualification includes the elaboration of the document for the Ethics Committee, familiarization among the members of staff and with the studied topic, and also an immersion into English. The nurse's knowledge gave support to the uptake of participants and time adequacy for data collection, preparation and assistance of the participants during the intervention and after collection. Nursing theories and processes have contributed to reveal risky diagnoses and the plan of care. It was the nurse's role to monitor the risk of overlapping methodological strictness to the human aspect. The skills for the clinical research must be the object of learning, including students in multidisciplinary researches.CONCLUSIONTo qualify the nurse for clinical research and to potentialize its caregiver essence, some changes are needed in the educational system, professional behavior, attitude and educational assistance.
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Nurses perceptions about the nurse's social role in Greece
Directory of Open Access Journals (Sweden)
Lavdaniti M.
2008-01-01
Full Text Available B A C K G R O U N D : There is great evidence in nursing literature about the nurses’ perceptions on their role. Moststudies are focused on nursing practice and the actual role in hospitals, and other skills on basic-, intermediate- andadvanced- level patient care. In Greece, there are no studies examining the social role of nurses and nurses’ perceptionsabout it.A I M : Τo assess how nurses in Greece perceive their social role and investigate the factors influencing their social role.M A T E R I A L - M E T H O D : 342 nurses working in hospitals in the wider area of Thessaloniki were recruited inthis study. Data collection was carried out through one self-completed questionnaire developed by the researchers.R E S U L T S : 47.5% (n=162 agreed that society expects from nurses a particular behaviour, and almost half of theparticipants [51.8% (n=176] totally agreed that nurses are practicing a ‘litourgima’. 49.1% (n=165 agreed that nursesare health educators in society and another 46.3% (n=157 totally agreed that nurses undertake actions in order toeliminate patient discrimination. 47.6% (n=160 of the participants totally agreed that nurses should be dedicated toquality improvement and 40.9% of the sample (n=138 agreed that nurses should provide care during an epidemicwhile 41.3% totally agreed that nurses execute duties of other professionals. 45.7% (n=155 totally agreed that nursesshouldn’t deny care for patients with infectious diseases. A high percentage of nurses (60.1%, n=197 agreed that apart of the nursing role is patient advocacy.C O N C L U S I O N S : The findings of the present study indicate the importance of nurses’ social role, which mayallow them to empower patients to further recognize the role of nursing during hospitalization.
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The Judaic-Christian origin of nursing homes.
Brandeis, Gary H; Oates, Daniel J
2007-06-01
Many nursing homes today have a religious heritage. While governmental regulations control how much of the care is delivered, the foundations and goals of many homes predate governmental rules and payment policies. This paper explores the basis of Jewish and Christian thought in providing groundwork for religiously based nursing homes. Although the underlying principles are similar, differences in approach and execution for the formation of these homes exist.
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Pittman, Patricia; Bass, Emily; Hargraves, John; Herrera, Carolina; Thompson, Pamela
2015-02-01
The objective of this study was to assess the implementation of recommendations of the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. In 2010, the IOM made a series of recommendations aimed at transforming the role of nurses in healthcare delivery. We conducted a multiyear survey, in 2011 and 2013, with nurse leaders who were members of the American Organization of Nurse Executives, the National Nursing Centers Consortium, or the Visiting Nurses Association of America. When comparing 2013 to 2011, we find progress in instituting the IOM's recommendations in 3 areas: (1) raising the proportion of employed RNs with at least a bachelor's degree; (2) expanding the proportion of healthcare institutions with nurse residency programs; and (3) offering opportunities for continuing nurse education Our findings suggest that healthcare organizations are transforming to support the recommendations of the IOM.
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DEFF Research Database (Denmark)
Bøttcher Berthelsen, Connie; Frederiksen, Kirsten
2017-01-01
The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised...... fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim...... and Lundman. The main theme of the overall interpretation was Orchestrating care through the fast-track perspective, accompanied by three sub-themes: Identifying and legitimising relevant individual care in the fast-track programme, Struggling to fit all patients in the fast-track programme and Justifying...
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Longitudinal charge nurse leadership development and evaluation.
Krugman, Mary; Heggem, Laura; Kinney, Lisa Judd; Frueh, Margaret
2013-09-01
The study's aim was to examine longitudinal outcomes of a leadership program for permanent and relief charge nurse from 1996 to 2012 using action research and Kouzes and Posner's The Leadership Challenge conceptual frameworks. Charge nurses hold significant oversight of patient safety, quality, and team functioning. This study contributes knowledge regarding charge nurse leadership and organization outcomes associated with these essential roles over time. Data were collected over 6 time periods using Kouzes and Posner's The Leadership Practices Inventory (LPI) and internally developed action research tools. Surveys were aligned with leadership and work environment changes to examine outcomes. Charge nurse leadership LPI mean ratings improved. Relief charge nurses reached similar LPI outcomes by 2012, with no statistical differences in mean or domain scores. Action research methods facilitated executive decision making during change processes. Demographics shifted with younger charge nurses with less practice experience serving as charge nurses in the most recent years. Charge nurse leadership reported significant gains despite institutional changes and uneven delivery of educational interventions.
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Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik
2014-08-01
. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Comparable cortisol, heart rate and milk let-down in nurse sows and non-nurse sows
DEFF Research Database (Denmark)
Amdi, C.; Moustsen, V. A.; Oxholm, L. C.
2017-01-01
Increasing litter size in hyperprolific sows has led to the need for management systems for surplus piglets, one of which is the use of nurse sows. The aim of this study was to investigate physiological changes in salivary cortisol, heart rate and number of milk let-downs in nurse sows compared...... to non-nurse sows. Sows were divided into three treatments: 1) control (non-nurse) sows nursed their own piglets until weaning at 26 days of age; 2) nurse1 sows had their own piglets removed and replaced with newborn piglets (between 6−24 h old) at Day 7, these were weaned at Day 33 of the sow......'s lactation period and 3) nurse2 sows weaned their own piglets at Day 21 and received a litter of 7 day old piglets from a nurse1 sow. These new piglets were weaned at Day 40 of the nurse2 sow's lactation period. Saliva samples were collected for cortisol analyses and the sows were fitted with pulse belts...
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Mallinson, Trudy R; Bateman, Jillian; Tseng, Hsiang-Yi; Manheim, Larry; Almagor, Orit; Deutsch, Anne; Heinemann, Allen W
2011-05-01
To examine differences in outcomes of patients after lower-extremity joint replacement across 3 post-acute care (PAC) rehabilitation settings. Prospective observational cohort study. Skilled nursing facilities (SNFs; n=5), inpatient rehabilitation facilities (IRFs; n=4), and home health agencies (HHAs; n=6) from 11 states. Patients with total knee (n=146) or total hip replacement (n=84) not related to traumatic injury. None. Self-care and mobility status at PAC discharge measured by using the Inpatient Rehabilitation Facility Patient Assessment Instrument. Based on our study sample, HHA patients were significantly less dependent than SNF and IRF patients at admission and discharge in self-care and mobility. IRF and SNF patients had similar mobility levels at admission and discharge and similar self-care at admission, but SNF patients were more independent in self-care at discharge. After controlling for differences in patient severity and length of stay in multivariate analyses, HHA setting was not a significant predictor of self-care discharge status, suggesting that HHA patients were less medically complex than SNF and IRF patients. IRF patients were more dependent in discharge self-care even after controlling for severity. For the full discharge mobility regression model, urinary incontinence was the only significant covariate. For the patients in our U.S.-based study, direct discharge to home with home care was the optimal strategy for patients after total joint replacement surgery who were healthy and had social support. For sicker patients, availability of 24-hour medical and nursing care may be needed, but intensive therapy services did not seem to provide additional improvement in functional recovery in these patients. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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The Nurse Leader Role in Crisis Management.
Edmonson, Cole; Sumagaysay, Dio; Cueman, Marie; Chappell, Stacey
2016-09-01
Leaders from the American Organization of Nurse Executives describe the dynamic state of today's healthcare system related to crisis management. Adaptive leadership, driven by strong values and morality, can guide leaders and organizations through the most difficult times.
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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...
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Qualified nurses' rate new nursing graduates as lacking skills in key clinical areas.
Missen, Karen; McKenna, Lisa; Beauchamp, Alison; Larkins, Jo-Ann
2016-08-01
The aim of this study was to explore perceptions of qualified nurses on the abilities of newly registered nursing graduates to perform a variety of clinical skills. Evidence from the literature suggests that undergraduate nursing programmes do not adequately prepare nursing students to be practice-ready on completion of their nursing courses. A descriptive quantitative design was used. Participants were recruited through the Australian Nursing and Midwifery Federation, Victorian branch. A brief explanation of the study and a link to the survey were promoted in their monthly e-newsletter. A total of 245 qualified nurses in the state of Victoria, Australia participated in this study. A survey tool of 51 clinical skills and open-ended questions was used, whereby participants were asked to rate new nursing graduates' abilities using a 5-point Likert scale. Overall participants rated new nursing graduates' abilities for undertaking clinical skills as good or very good in 35·3% of skills, 33·3% were rated as adequate and 31·4% rated as being performed poorly or very poorly. Of concern, essential clinical skills, such as critical thinking and problem solving, working independently and assessment procedures, were found to be poorly executed and affecting new registered nurses graduates' competence. The findings from this study can further serve as a reference for nursing education providers to enhance nursing curricula and work collaboratively with healthcare settings in preparing nurses to be competent, safe practitioners on completion of their studies. Identifying key areas in which new nursing graduates are not yet competent means that educational providers and educators from healthcare settings can focus on these skills in better preparing our nurses to be work ready. © 2016 John Wiley & Sons Ltd.
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Staff nurse perceptions of nurse manager leadership styles and outcomes.
Casida, Jesus; Parker, Jessica
2011-05-01
To explore the correlations of leadership styles of nurse managers (NMs) and outcomes. Little is known about the linkages among leadership styles [transformational (TFL), transactional (TRL)] of NMs and outcomes [a leader's extra effort (LEE), leadership satisfaction (LS) and effectiveness (LE)] using the full-range leadership theory. Methods An exploratory correlational design was employed using data from a 2007 study in which staff nurses (n = 278) from four hospitals in the Northeastern US were asked to rate the leadership styles of NMs (n = 37) and outcomes using the Multifactor Leadership Questionnaire Form 5x-Short. Data were analysed using descriptive and inferential statistical methods. TFL leadership has strong correlations to LEE, LS and LE, and was a predictor for leadership outcomes. Conversely, TRL leadership has week correlations to LEE, LS and LE and did not predict leadership outcomes. NMs who frequently display TFL leadership styles will probably achieve goals in a satisfying manner, warranting further research. TFL leadership training should be a basic competency requirement of NMs. Placing successful and effective TFL leaders in nursing units are the professional and moral obligations of nurse executives. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
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Bilingualism as a potential strategy to improve executive function in preterm infants: a review.
Head, Lauren M; Baralt, Melissa; Darcy Mahoney, Ashley E
2015-01-01
Preterm birth is associated with long-term deficits in executive functioning and cognitive performance. Using the model of brain plasticity as a theoretical framework, it is possible that preterm infants' neurodevelopmental sequelae can be altered. Evidence suggests that bilingualism confers cognitive advantages on executive functioning, so it is possible that bilingualism may improve preterm infants' neurodevelopment. However, bilingualism has only been studied in term children. This review examined literature that compared the performance of preterm-born children to term children and bilingual children to monolingual children on executive function tasks. To address cognitive disparities in preterm-born children, studies investigating the effect of bilingualism on preterm infants' executive functioning is warranted. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
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Nurses of African descent and career advancement.
Wesley, Yvonne; Dobal, May T
2009-01-01
The purpose of this article is to evaluate a leadership institute designed to promote career advancement and leadership in administration, education, and research among nurses of African descent. Government reports indicate that Black Americans receive lower quality health care than other racial groups even when insurance and income are equal. Moreover, the literature suggests that less than 10% of practicing professional nurses in America are Black-and of these, less than 1% are in senior executive leadership positions. However, the literature lacks detailed discussion of the effectiveness of leadership programs. This article provides an in-depth look at a leadership institute for Black nurses and outlines the impact of the program.
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[The role of university hospital executive board members].
Debatin, J F; Rehr, J
2009-09-01
Demographic changes and medical progress in combination with vastly altered regulatory and economic environments have forced considerable change in the structure of German university hospitals in recent years. These changes have affected medical care as well as research and medical school training. To allow for more flexibility and a higher level of reactivity to the changing environment German university hospitals were transferred from state agencies to independent corporate structures. All but one remains wholly owned by the respective state governments. The governing structure of these independent medical hospitals consists of an executive board, generally made up of a medical director, a financial director, a director for nursing, and the dean of the medical faculty. In most hospitals, the medical director serves as chief executive officer. The regulations governing the composition and responsibility of the members of the executive board differ from state to state. These differences do affect to some degree the interactive effectiveness of the members of the executive boards. Modalities that stress the overall responsibility for all board members seem to work better than those that define clear portfolio limits. Even more than organizational and regulatory differences, the effectiveness of the work of the executive boards is influenced by the personality of the board members themselves. Success appears to be a clear function of the willingness of all members to work together.
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Defining the role of a forensic hospital registered nurse using the Delphi method.
Newman, Claire; Patterson, Karen; Eason, Michelle; Short, Ben
2016-11-01
A Delphi survey was undertaken to refine the position description of a registered nurse working in a forensic hospital, in New South Wales, Australia. Prior to commencing operation in 2008, position descriptions were developed from a review of legislation, as well as policies and procedures used by existing forensic mental health services in Australia. With an established workforce and an evolving model of care, a review of the initial registered nurse position description was required. An online Delphi survey was undertaken. Eight executive (88.9%) and 12 (58.3%) senior nursing staff participated in the first survey round. A total of four survey rounds were completed. At the final round, there was consensus (70%) that the revised position description was either very or somewhat suitable. There were a total of nine statements, from 31 originally produced in round 1, that did not reach consensus. The Delphi survey enabled a process for refining the Forensic Hospital registered nurse position description. Methods that facilitate executive and senior nursing staff consensus in the development and review of position descriptions should be considered in nursing management. © 2016 John Wiley & Sons Ltd.
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Exploring nurse leader fatigue: a mixed methods study.
Steege, Linsey M; Pinekenstein, Barbara J; Arsenault Knudsen, Élise; Rainbow, Jessica G
2017-05-01
To describe hospital nurse leaders' experiences of fatigue. Fatigue is a critical challenge in nursing. Existing literature focuses on staff nurse fatigue, yet nurse leaders are exposed to high demands that may contribute to fatigue and associated risks to patient, nurse and organisational outcomes. A mixed method approach comprising semi-structured interviews and the Occupational Fatigue Exhaustion Recovery scale with 21 nurse administrators (10 nurse managers and 11 nurse executives) from hospitals in a Midwestern state. Most nurse leaders experience fatigue; nurse managers reported higher levels of chronic fatigue. Participants identified multiple sources of fatigue including 24 h accountability and intensity of role expectations, and used a combination of wellness, restorative, social support and boundary setting strategies to cope with fatigue. The consequences of nurse leader fatigue include an impact on decision-making, work-life balance and turnover intent. The high prevalence of nurse leader fatigue could impact the turnover intent of nurse administrators and quality of care. This study highlights the significance and consequences of nurse leader fatigue. As health care organisations continue to raise awareness and establish systems to reduce nurse fatigue, policies and programmes must be adapted to address nurse leader fatigue. © 2017 John Wiley & Sons Ltd.
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[Nursing leadership styles at a public institution of Fortaleza].
Vale, E G; Caetano, F H; Carneiro, M M; Sampaio, M G
2000-01-01
In modern organizations leadership has been emphasized, since it is considered fundamental to the execution of the objectives of a company. It is through leadership that the ability of influencing the behavior of others is developed, facilitating the accomplishment of activities. The study has as its objective the investigation of the head nurse's leadership, considering the opinion of assistant nurses in four units of a public hospital. The study has shown that nurses who are in managerial position, present a leadership profile centered on the service and on individuals.
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Nilsson, Carina; Skär, Lisa; Söderberg, Siv
2008-01-01
The use of information and communication technology has increased in the society, and can be useful in nursing care. The aim of this study was to describe district nurses' attitudes regarding the implementation of information and communication technology in home nursing. The first and third authors performed five focus group discussions with 19 district nurses' from five primary healthcare centres in northern Sweden. During the focus group discussions, the following topics were discussed: the current and future use of information and communication technology in home nursing; expectations, advantages, disadvantages and hindrances in the use of information and communication technology in home nursing; and the use of information and communication technology from an ethical perspective. The transcribed focus group discussions were analysed using qualitative content analysis. The results showed that district nurses' attitudes were positive regarding the use of information and communication technology in their work. They also asked for possibilities to influence the design and its introduction. However, the use of information and communication technology in home nursing can be described as a complement to communication that could not replace human physical encounters. Improvements and risks, as well as the importance of physical presence in home nursing were considered vital. The results revealed that the use of information and communication technology requires changes in the district nurses' work situation.
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Framework for 21st Century School Nursing Practice: National Association of School Nurses.
2016-01-01
The National Association of School Nurses (NASN) developed the Framework for 21st Century School Nursing Practice to reflect current school nurse practice. The Framework of practice was introduced in June 2015, and feedback was requested and obtained from practicing school nurses in a variety of ways. The final version of the Framework is introduced in this article. This article updates (and replaces) the articles in the July 2015 NASN School Nurse related to the Framework. Central to the Framework is student-centered nursing care that occurs within the context of the students' family and school community. Surrounding the student, family, and school community are the nonhierarchical, overlapping key principles of Care Coordination, Leadership, Quality Improvement, and Community/Public Health.These principles are surrounded by the fifth principle, Standards of Practice, which is foundational for evidence-based and clinically competent quality care. Each of these principles is further defined by practice components. Suggestions are provided regarding how the Framework can be used in a variety of settings to articulate and prioritize school nursing practice. The ultimate goal is to provide a resource to guide school nurses in their practice to help students be healthy, safe, and ready to learn. © 2015 The Author(s).
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Replacement model of city bus: A dynamic programming approach
Arifin, Dadang; Yusuf, Edhi
2017-06-01
This paper aims to develop a replacement model of city bus vehicles operated in Bandung City. This study is driven from real cases encountered by the Damri Company in the efforts to improve services to the public. The replacement model propounds two policy alternatives: First, to maintain or keep the vehicles, and second is to replace them with new ones taking into account operating costs, revenue, salvage value, and acquisition cost of a new vehicle. A deterministic dynamic programming approach is used to solve the model. The optimization process was heuristically executed using empirical data of Perum Damri. The output of the model is to determine the replacement schedule and the best policy if the vehicle has passed the economic life. Based on the results, the technical life of the bus is approximately 20 years old, while the economic life is an average of 9 (nine) years. It means that after the bus is operated for 9 (nine) years, managers should consider the policy of rejuvenation.
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Steam generator replacement at Bruce A: approach, results, and lessons learned
International Nuclear Information System (INIS)
Tomkiewicz, W.; Savage, B.; Smith, J.
2008-01-01
Steam Generator Replacement is now complete in Bruce A Units 1 and 2. In each reactor, eight steam generators were replaced; these were the first CANDU steam generator replacements performed anywhere in the world. The plans for replacement were developed in 2004 and 2005, and were summarized in an earlier paper for the CNS Conference held in November, 2006. The present paper briefly summarizes the methodologies and special processes used such as metrology, cutting and welding and heavy lifting. The paper provides an update since the earlier report and focuses on the project achievements to date, such as: - A combination of engineered methodology, laser metrology and precise remote machining led to accurate first time fit-ups of each new replacement steam generator and steam drums - Lessons learned in the first unit led to schedule improvements in the second unit - Dose received was lowest recorded for any steam generator replacement project. The experience gained and lessons learned from Units 1 and 2 will be valuable in planning and executing future replacement steam generator projects. A video was presented
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Energy Technology Data Exchange (ETDEWEB)
Reed, Gary
2010-09-30
This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University's aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.
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Energy Technology Data Exchange (ETDEWEB)
Reed, Gary
2010-09-30
This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.
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Unluturk, Mehmet S
2012-06-01
Nurse call system is an electrically functioning system by which patients can call upon from a bedside station or from a duty station. An intermittent tone shall be heard and a corridor lamp located outside the room starts blinking with a slow or a faster rate depending on the call origination. It is essential to alert nurses on time so that they can offer care and comfort without any delay. There are currently many devices available for a nurse call system to improve communication between nurses and patients such as pagers, RFID (radio frequency identification) badges, wireless phones and so on. To integrate all these devices into an existing nurse call system and make they communicate with each other, we propose software client applications called bridges in this paper. We also propose a window server application called SEE (Supervised Event Executive) that delivers messages among these devices. A single hardware dongle is utilized for authentication and copy protection for SEE. Protecting SEE with securities provided by dongle only is a weak defense against hackers. In this paper, we develop some defense patterns for hackers such as calculating checksums in runtime, making calls to dongle from multiple places in code and handling errors properly by logging them into database.
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Leadership style and patient safety: implications for nurse managers.
Merrill, Katreena Collette
2015-06-01
The purpose of this study was to explore the relationship between nurse manager (NM) leadership style and safety climate. Nursing leaders are needed who will change the environment and increase patient safety. Hospital NMs are positioned to impact day-to-day operations. Therefore, it is essential to inform nurse executives regarding the impact of leadership style on patient safety. A descriptive correlational study was conducted in 41 nursing departments across 9 hospitals. The hospital unit safety climate survey and multifactorial leadership questionnaire were completed by 466 staff nurses. Bivariate and regression analyses were conducted to determine how well leadership style predicted safety climate. Transformational leadership style was demonstrated as a positive contributor to safety climate, whereas laissez-faire leadership style was shown to negatively contribute to unit socialization and a culture of blame. Nursing leaders must concentrate on developing transformational leadership skills while also diminishing negative leadership styles.
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Bridge to shared governance: developing leadership of frontline nurses.
Dearmon, Valorie A; Riley, Bettina H; Mestas, Lisa G; Buckner, Ellen B
2015-01-01
Transforming health care systems to improve quality is the responsibility of nurse executives and frontline nurses alike, yet frontline nurses are often ill-prepared to share leadership and accountability needed for transformation. The aim of this qualitative study was to describe the process used to build leadership capacity of frontline nurses engaged in resolving operational failures interrupting nursing care. The leadership development process served to bridge staff transition to shared governance. This institutional review board-approved qualitative research was designed to identify the effects of mentoring by the chief nursing officer and faculty partners on leadership development of frontline nurses working to find solutions to operational failures. Twelve nurses from 4 medical surgical units participated in a Frontline Innovations' nurse-led interdisciplinary group, which met over 18 months. Transcriptions of audiotaped meetings were analyzed for emerging process and outcome themes. The transcripts revealed a robust leadership development journey of frontline nurses engaged in process improvement. Themes that emerged from the mentoring process included engagement, collaboration, empowerment, confidence, and lifelong learning. The mentoring process provided frontline nurses the leadership foundation necessary to initiate shared governance.
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Iranian nurses' constraint for research utilization
Directory of Open Access Journals (Sweden)
Mehrdad Neda
2009-09-01
Full Text Available Abstract Background This paper identifies the views of Iranian clinical nurses regarding the utilization of nursing research in practice. There is a need to understand what restricts Iranian clinical nurses to use research findings. The aim of this study was to identify practicing nurses' view of aspects which they perceived constrain them from research utilization that summarizes and uses research findings to address a nursing practice problem. Methods Data were collected during 6 months by means of face-to face interviews follow by one focus group. Analysis was undertaken using a qualitative content analysis. Results Findings disclosed some key themes perceived by nurses to restrict them to use research findings: level of support require to be research active, to be research minded, the extent of nurses knowledge and skills about research and research utilization, level of educational preparation relating to using research, administration and executive challenges in clinical setting, and theory-practice gap. Conclusion This study identifies constraints that require to be overcome for clinical nurses to actively get involved in research utilization. In this study nurses were generally interested to use research findings. However they felt restricted because of lack of time, lack of peer and manager support and limited knowledge and skills of the research process. This study also confirms that research utilization and the change to research nursing practice are complex issues which require both organizational and educational efforts.
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Big Data, Big Challenges: Implications for Chief Nurse Executives.
Clancy, Thomas R; Reed, Laura
2016-03-01
As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on the application of management strategies in health systems. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. In this edition, I begin a series of articles on the growing challenge faced by nurse administrators of finding value in the vast amounts of information collected by health systems today.
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Rehabilitation of patients aged 65 and over after total hip replacement
DEFF Research Database (Denmark)
Hørdam, Britta
by a randomised clinical trial by using telephone interviews and counseling postoperatively, and testing improvement in patients´health status after THR. The last study involved testing the effect of nursing intervention by providing a measurement of patients´healthrelated quality of life.......The overall aim of this thesis was to investigate improvement in health status of patients aged 65 and over after total hip replacement (THR) as a result of nursing rehabilitation. The projects conssits of three studies, first a description of patients´health status after THR, followed...
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The mindful nurse leader: Key take-away: Go slow before you go fast.
Doucette, Jeffrey N; Cotton, Amy; Arnow, Debra; Pipe, Teri; FitzPatrick, Kate
2016-11-01
The first and second articles in this three-part series on mindfulness described the production of the video "In the Moment: Stories of Mindfulness in Nursing" as part of the authors' Robert Wood Johnson Foundation Executive Nurse Fellowship program. In this final installment, we discuss our leadership approaches and lessons learned, both as a team and individuals.
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Florida State Postsecondary Education Planning Commission, Tallahassee.
As directed by the Florida State Legislature, the Postsecondary Education Commission examined Florida's needs in the area of nursing education. Following the executive summary, the introduction reviews the commission charge and activities. Major topics addressed include: the nursing profession (introduction, history, licensure, careers, and…
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Influence of Shift Work on Manual Dexterity and Reaction Time in Tunisian Nurses.
Merchaoui, Irtyah; Chaari, Neila; Bouhlel, Mohamed; Bouzgarrou, Lamia; Malchaire, Jacques; Akrout, Mohamed
2017-01-01
Major effects of shift schedule are related to sleep alertness and performance, but also to long term health outcomes. For nurses, these negative effects have consequences not only on the individual, but also on the workplace, as decreased alertness and reduced job performance could endanger human lives. The specific aim of our study is to assess the influence of shift schedule on nurses´ cognitive ability and rapidity of execution. Our survey is a cross sectional study which had been conducted for 15 months; it involved a sample of 293 participants representative of 1118 nurses working in two Tunisian university hospitals. It included an evaluation of the rapidity of execution performance through the manual dexterity test and the reaction time test. The study was completed by an assessment of the workability Index through a 7- item survey. No association was found between the groups of work schedules and the cognitive ability of execution speed. However, we found a significant decrease in cognitive performance in the nurses exceeding 10 years of job seniority for both schedules. We concluded to an impaired cognitive performance speed in the over 10-year seniority groups in both schedules. Recommendations should be focused on implementing periodic assessment of cognitive performance based on O'Connor finger dexterity test and time reaction test and on implementing effective preventive measures in hospitals after ten years of seniority at work. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
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The Experience of Intense Pain: Nursing Management and Interventions.
Kiser-Larson, Norma
Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.
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Reinstating district nursing: A UK perspective.
Morris, Hannah
2017-09-01
As policy directives gather pace for service provision to be delivered in primary care, district nursing has not been recognised as a valuable asset to facilitate this agenda. Investment in district nursing and specialist district nursing education has fallen. This is concurrent with an ageing district nursing workforce, a lack of recruitment and growing caseloads, as district nursing adapts to meet the challenges of the complexities of contemporary healthcare in the community. The district nurse role is complex and multifaceted and includes working collaboratively and creatively to coordinate care. Redressing the shortages of specialist district nurse practitioners with increased numbers of health care support workers will not replace the skill, knowledge, experience required to meet the complex care needs of today's society. District nursing needs to be reinstated as the valuable asset it is, through renewed investment in the service, research development and in specialist practice education. To prevent extinction district nurses need to be able to demonstrate and articulate the complexities and dynamisms of the role to reinstate themselves to their commissioners as a valuable asset for contemporary practice that can meet current health and social care needs effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
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Oyeleye, Olubunmi; Hanson, Patricia; O'Connor, Nancy; Dunn, Deborah
2013-10-01
This study explored the relationships among perceived workplace incivility, stress, burnout, perceived turnover intentions, and perceived level of psychological empowerment among acute care nurses (medical-surgical and critical care) in community and tertiary hospitals through the lens of complexity science. An exploratory study was conducted, and findings demonstrate significant relationships among workplace incivility, stress, burnout, turnover intentions, total years of nursing experience, and RN education levels. Creating targeted retention strategies and policies that will be sensitive to the needs and interests of nurses at high risk for leaving their organizations is imperative for nurse executives.
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Patient-Controlled Oral Analgesia for Postoperative Pain Management Following Total Knee Replacement
Directory of Open Access Journals (Sweden)
Patti Kastanias
2010-01-01
Full Text Available PURPOSE: To investigate whether patient-controlled oral analgesia (PCOA used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN-administered oral analgesia.
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The New Jersey Nursing Initiative: building sustainable collaboration.
Bakewell-Sachs, Susan; Mertz, Lynn M; Egreczky, Dana; Ladden, Maryjoan
2011-01-01
The New Jersey Nursing Initiative was publically launched in 2009 as a 5-year, $22 million program of the Robert Wood Johnson Foundation based at the New Jersey Chamber of Commerce Foundation. It was reauthorized in 2011 through 2016 for an additional $8.5 million. The initiative includes a faculty preparation program and strategic tracks of work focusing on building education capacity, increasing current faculty capacity, making nurse faculty a preferred career, leading policy initiatives, creating sustainable funding in support of nursing education, and ultimately, building local, regional, and statewide collaborative networks. The tagline, "So a Nurse will be there for You," emphasizes both the reality of an aging nursing workforce needing replacement and the expected health care transformation that will result in the need for new knowledge and skills in the future nursing workforce. The purpose of this article was to describe the New Jersey Nursing Initiative, emphasizing the partnerships that have resulted from the project to date. Copyright © 2011 Elsevier Inc. All rights reserved.
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Medicare and Medicaid: Stronger Enforcement of Nursing Home Requirements Needed.
1987-07-22
General Unanr . ’, n- ri ...................4" D .. . .. .. ... 1,- . .~ l ’ ’ t ! ! * ’ Executive Summary Pur,,pse One of every four elderly will enter...7 (AO HRD-87-113 Nursing Home Enforeement %% Chapter 1 Introduction One of every four elderly will enter a nursing home during his or her lifetime...during one or more of the five inspections were " treatments to decubitus ulcers that were not done and/or consistently recorded; " essentially bedridden
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It takes chutzpah: oncology nurse leaders.
Green, E
1999-01-01
Chutzpah, according to the Oxford Dictionary of Current English (1996) is a slang term from the Yiddish language which means shameless audacity. Chutzpah has been used to identify people with courage who take on situations that others avoid and somehow achieve the impossible. Tim Porter-O'Grady (1997) recently wrote that management is dead, and has been replaced by process leadership. Health care organizations have made shifts from hierarchical structures to process or program models where people have dual/multiple reporting/communication relationship. In this new orientation, management functions of controlling, directing, organizing and disciplining are replaced by process leadership functions of coordinating, facilitating, linking and sustaining (Porter O'Grady, 1997). Herein lies the challenge for oncology nurse leaders: "what lies behind us and what lies before us are tiny matters compared to what lies within us" (Ralph Waldo Emerson). Leadership is not a function of job title. The evidence for this is clear in current practice.... There are no/few positions of nurse leaders. Titles have changed to eliminate the professional discipline, and reflect a non-descript orientation. The new titles are process leaders, program leaders, professional practice leaders. Nurse leaders need new points of reference to take in the challenges of influencing, facilitating and linking. Those points of reference are: principle-centered leadership, integrity and chutzpah. This presentation will focus on examining current thinking, defining key characteristics and attributes, and using scenarios to illustrate the impact of leadership. We, as leaders in oncology nursing, must use chutzpah to make positive change and long-term gains for patient care and the profession of nursing.
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Managing work-related stress in the district nursing workplace.
Burke, Michelle
2013-11-01
This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive's (HSE's) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture.
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Goetz, Kristopher; Janney, Michelle; Ramsey, Kristin
2011-01-01
With nurses and unlicensed supportive personnel composing the greatest percentage of the workforce at any hospital, it is not surprising nursing leadership plays an increasing role in the attainment of financial goals. The nursing leadership team at one academic medical center reduced costs by more than $10 million over 4 years while outperforming national benchmarks on nurse-sensitive quality indicators. The most critical success factor in attaining exceptional financial performance is a personal and collective accountability to achieving outcomes. Whether it is financial improvement, advancing patient safety, or ensuring a highly engaged workforce, success will not be attained without thoughtful, focused leadership. The accountability model ensures there is a culture built around financial performance where nurses and leaders think and act, on a daily basis, in a manner necessary to understand opportunities, find answers, and overcome obstacles. While structures, processes, and tools may serve as the means to achieve a target, it is leadership's responsibility to set the right goal and motivate others.
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Happell, Brenda; McAllister, Margaret
2014-12-01
Preparation of nursing students for practice in mental health settings in Australia has been criticized since comprehensive education replaced preregistration specialist education. Current and projected workforce shortages have given rise to considering the reintroduction of specialization at preregistration level as a potential solution. Support of heads of schools of nursing would be essential for such an initiative to be considered. A qualitative exploratory study was undertaken involving in-depth telephone interviews with heads of schools of nursing in Queensland. Participants generally favoured the concept of specialization in mental health nursing at undergraduate level. Data analysis revealed the following themes: meeting workforce needs, improving quality of care, employability of graduates, an attractive option for students, and what would have to go. Participants identified many benefits to mental health service delivery and consumer outcomes. How the initiative could be developed within an already overcrowded curriculum was identified as the major barrier. This level of support is encouraging if necessary changes to the educational preparation for mental health nursing practice are to be considered. © 2014 Australian College of Mental Health Nurses Inc.
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Pinakiewicz, Diane; Smetzer, Judy; Thompson, Pamela; Navarra, Mary Beth; Lambert, Monique
2009-06-01
In September 2008, nurse executives from around the country met in Scottsdale, Ariz, to develop practical tools and recommendations for "Driving Patient Safety Through Transformation," the theme of the fourth annual Nursing Leadership Congress. The Congress was made possible through an educational grant from McKesson and Intel in collaboration with sponsorship from the American Organization of Nurse Executives, Institute for Safe Medication Practices and National Patient Safety Foundation. This paper summarizes the Congress plenary sessions and roundtable discussions. Plenaries included the following: *Transformational Leadership: The Role of Leaders in Managing Complex Problems *Using the Baldrige Business Model as the Infrastructure for Creating a Culture of Patient Safety *Prospects for Structural Reform in Health Care Roundtables included the following: *Joy and Meaning in Work *Managing Chronic Care Across the Continuum *The Future of Acute Care Delivery in Light of Changing Reimbursement* Leveraging Transparency to Drive Patient Safety *Collaborative Partnerships for Driving a Patient Safety Agenda *Innovative Solutions for Patient Safety *Implementing the Fundamentals of the Toyota Production Model forHealthcare
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The changing nature of nursing work in rural and small community hospitals.
Montour, Amy; Baumann, Andrea; Blythe, Jennifer; Hunsberger, Mabel
2009-01-01
The nursing literature includes descriptions of rural nursing workforces in Canada, the United States of America and Australia. However, inconsistent definitions of rural demography, diverse employment conditions and health care system reorganization make comparisons of these data difficult. In 2007, the Ministry of Health and Long-term Care in Ontario, Canada, transferred responsibility for decision-making and funding to 14 regional governing bodies known as Local Health Integration Networks (LHINs). Little is known about rural-urban variations in the nursing workforces in the LHINs because existing data repositories do not describe them. This study investigated the influence of demographic characteristics, provincial policies, organizational changes and emerging practice challenges on nursing work in a geographically unique rural region. The purpose was to describe the nature of nursing work from the perspective of rural nurse executives and frontline nurses. The study was conducted in 7 small rural and community hospitals in the Hamilton Niagara Haldimand Brant LHIN. Data collection occurred between August and November 2007. A qualitative descriptive study design was chosen to facilitate exploration of nursing in the rural setting. Study participants were identified through purposive snowball sampling. All nurses, nurse managers and nurse executives currently employed in the 7 study hospitals were eligible to participate. Data collection included the use of questionnaires and semi-structured interviews. Memos were also created to describe the relevance and applicability of concepts, categories and properties emerging from the data. Themes were compared across interviews to determine relevance and value. Twenty-one nurses from 7 different hospitals participated. The nurses reflect the aging trend in the provincial and regional workforces of Ontario. All study participants anticipate a substantial increase in retirements during the next decade, which will alter
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How to appoint a new chief nurse, win friends and influence people.
Butterworth, Tony
2004-07-01
OUR CHIEF nurse for England, Sarah Mullally, has announced her intention to leave the NHS and the search is on for her replacement. Speculation on who it will be is rife; this is an opportune moment therefore to reflect on the ideal qualities of the new chief nursing officer (CNO) for England.
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Nurses' maths: researching a practical approach.
Wilson, Ann
To compare a new practical maths test with a written maths test. The tests were undertaken by qualified nurses training for intravenous drug administration, a skill dependent on maths accuracy. The literature showed that the higher education institutes (HEIs) that provide nurse training use traditional maths tests, a practical way of testing maths had not been described. Fifty five nurses undertook two maths tests based on intravenous drug calculations. One was a traditional written test. The second was a new type of test using a simulated clinical environment. All participants were also interviewed one week later to ascertain their thoughts and feelings about the tests. There was a significant improvement in maths test scores for those nurses who took the practical maths test first. It is suggested that this is because it improved their conceptualisation skills and thus helped them to achieve accuracy in their calculations. Written maths tests are not the best way to help and support nurses in acquiring and improving their maths skills and should be replaced by a more practical approach.
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Job satisfaction among multiple sclerosis certified nurses.
Gulick, Elsie E; Halper, June; Costello, Kathleen
2007-08-01
Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.
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Leadership behaviours, organizational culture and intention to stay amongst Jordanian nurses.
AbuAlRub, R F; Nasrallah, M A
2017-12-01
To investigate the impact of leadership behaviours of nurse managers and organizational culture on Jordanian nurses' intention to stay at work in public, private and university hospitals. Leadership behaviours of nurses and organizational culture are considered important factors in enhancing retention of nurses. A correlational design was used in the study. A sample of 285 Jordanian nurses was conveniently selected to complete a self-administered questionnaire that consisted of three measures; Kouzes and Posner's Leadership Practise Inventory, Professional Organizational Culture questionnaire and McCain's Intent to Stay Scale. Nurse managers' leadership behaviours and organizational culture were positively associated with the level of intention to stay at work. The study variables explained almost 43% of the variance in nurses' intention to stay at work. The limitation of the study was the use of convenience sampling method. The results asserted that transformational leadership styles of nurse managers enhance positive hospitals' culture as well as the intention of nurses to stay at work. Nurse executives should promote leadership behaviours of nurse managers through training. The regulatory bodies of nursing profession in collaboration with nurse educators and administrators should help in developing competencies for nurse managers that are based on transformational leadership and incorporate such competencies in nursing education programs as well as continuous education programs. © 2017 International Council of Nurses.
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Scorpiniti, A; Lorusso, A; L'Abbate, N
2007-01-01
Here we describe a workplace intervention aimed at reducing the risk of low back pain in nursing personnel. The intervention we carried out included a specific ergonomic training and an exercise program according to the Feldenkrais Method. After the intervention, we evaluated its effect on the execution of manual handling activities in nurses. We found an increased rate of correct manual handling in the post-intervention period.
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Hart, Patricia L; Spiva, LeeAnna; Baio, Pamela; Huff, Barbara; Whitfield, Denice; Law, Tammy; Wells, Tiffany; Mendoza, Inocenica G
2014-10-01
To explore and understand medical-surgical nurses' perceived self-confidence and leadership abilities as first responders in recognising and responding to clinical deterioration prior to the arrival of an emergency response team. Patients are admitted to hospitals with multiple, complex health issues who are more likely to experience clinical deterioration. The majority of clinical deterioration events occur on medical-surgical units, and medical-surgical nurses are frequently the first healthcare professionals to identify signs and symptoms of clinical deterioration and initiate life-saving interventions. A prospective, cross-sectional, descriptive quantitative design using a survey method was used. Nurses were recruited from an integrated healthcare system located in the south-east United States. Nurses completed a demographic, a self-confidence and a leadership ability questionnaire. One hundred and forty-eight nurses participated in the study. Nurses felt moderately self-confident in recognising, assessing and intervening during clinical deterioration events. In addition, nurses felt moderately comfortable performing leadership skills prior to the arrival of an emergency response team. A significant, positive relationship was found between perceived self-confidence and leadership abilities. Age and certification status were significant predictors of nurses' leadership ability. Although nurses felt moderately self-confident and comfortable with executing leadership abilities, improvement is needed to ensure nurses are competent in recognising patients' deterioration cues and making sound decisions in taking appropriate, timely actions to rescue patients. Further strategies need to be developed to increase nurses' self-confidence and execution of leadership abilities in handling deterioration events for positive patient outcomes. Educational provisions should focus on various clinical deterioration events to build nurses' self-confidence and leadership abilities
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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.
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Nurse manager succession planning: synthesis of the evidence.
Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria
2013-10-01
The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.
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Social justice considerations in neonatal care for nurse managers and executives.
Yoder, Linda; Walden, Marlene; Verklan, M Terese
2010-01-01
This article presents the struggle between social justice and market justice within the current health care system, specifically issues affecting neonatal care. Community benefit is described and discussed as an aspect of social justice demonstrated by hospitals. The federal and state Children's Health Insurance Program also is discussed in relation to social justice and health care costs. Implications for managers and executives overseeing neonatal care are presented in relation to the economic and social issues.
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Assertiveness process of Iranian nurse leaders: a grounded theory study.
Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim
2009-06-01
The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.
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The challenges of primary health care nurse leaders in the wake of New Health Care Reform in Norway.
Tingvoll, Wivi-Ann; Sæterstrand, Torill; McClusky, Leon Mendel
2016-01-01
The local municipality, whose management style is largely inspired by the New Public Management (NPM) model, has administrative responsibilities for primary health care in Norway. Those responsible for health care at the local level often find themselves torn between their professional responsibilities and the municipality's market-oriented funding system. The introduction of the new health care reform process known as the Coordination Reform in January 2012 prioritises primary health care while simultaneously promoting a more collaborative and multidisciplinary approach to health care. Nurse leaders experience constant cross-pressure in their roles as members of the municipal executive team, the execution of their professional and administrative duties, and the overall political aims of the new reform. The aim of this article is to illuminate some of the major challenges facing nurse leaders in charge of nursing homes and to draw attention to their professional concerns about the quality of nursing care with the introduction of the new reform and its implementation under NPM-inspired municipal executive leadership. This study employs a qualitative design. In-depth interviews were conducted with 10 nurse leaders in 10 municipalities, with a phenomenological-hermeneutic approach used for data analysis and interpretation. Findings highlighted the increasingly complex challenges facing nurse leaders operating in the context of the municipality's hierarchical NPM management structure, while they are required to exercise collaborative professional interactions as per the guidelines of the new Coordination Reform. The interview findings were interpreted out of three sub-themes 1) importance of support for the nurse leader, 2) concerns about overall service quality, and 3) increased tasks unrelated to nursing leadership. The priorities of municipal senior management and the focus of the municipality's care service need clarification in the light of this reform. The voices
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The community nurse and the use of social media.
Peate, Ian
2013-04-01
The role and function of the community nurse has changed in a number of ways over the years; however, central to that role is the direct hands-on care that expert nurses provide to a variety of client groups. Social media can never replace that unique role yet it can help the community nurse provide safer and more effective care. The use of social media is growing and is having a significant influence on society. Social media can dictate tomorrow's news today, provide individuals with a public voice and help to form new social connections regardless of geography. Social media has become embedded within our daily lives. For community nurses social media networks offer alternative ways in which they can share knowledge and expertise and keep up to date. This article intends to stimulate thoughts about how social media could be used positively by the community nurse and his or her organisation to help meet the future demands on the NHS and community nursing services.
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Process and device for replacing heater in PWR pressurizer
International Nuclear Information System (INIS)
Gente, D.; Giron, M.
1990-01-01
To assure the tight fixation of replacing heater on a pressurizer penetration sleeve, a gas metal-arc welding single pass is executed. A tubular shaft is fixed over end of heater projecting from penetration sleeve. Over shaft is fixed tubular support for the torch which can rotate about axis of support axis heater. Welding torch and welding wire feeder roll are rotated in synchronisation by appropriate motors. Weld is made in single pass round periphery of heater and penetration sleeve [fr
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Management of the execution the bridge between the aspirations and the results
International Nuclear Information System (INIS)
Rodriguez, M.
2008-01-01
The nuclear power plants of Almaraz, Trillo and Cofrentes (Iberdrola) have decoded tp change the way to manage their engineering activities. They have replaced their old project management model, with a new methodology called Critical Chain, developed by Doctor Goldratt. They have achieved outstanding results in the improvement of productivity and quality. In other words, with the same people they are making project in a 20% shorter period of time. As a direct consequence, the Engineer departments are able to complete more projects with the same resources by keeping the quality of the final product. After working in many different project scenarios where the symptoms were similar to the ones described in this article, the conclusion is that technical time of execution is around 30% of the total time of project. The other 70% are interruptions and Parkinson's Law. This is shows that technical solutions are just a little part of the solution. We believe that tis necessary to replace the current project management rules with other rules that will foster the action minimizing the interruptions and Parkinson's Law. the key for improvement comes from the Execution Management. CMG Consultores is one of the leaders companies in Europe in the implementation of Critical Chain methodology. In order to achieve this goal CMG signed a strategic alliance with Realization Technologies, Inc eight years ago. Realization, located in California, USA is the leading implementer of Critical Chain Execution Management in the world, along with execution management system called Concerto that is based on Critical Chain principles and is deployed in the Nuclear Power Plants of Almaraz, Trillo and Cofrentes. In addition to Energy Industry, Critical Chain has been implemented in a wide range of organizations. (Author)
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Key components of financial-analysis education for clinical nurses.
Lim, Ji Young; Noh, Wonjung
2015-09-01
In this study, we identified key components of financial-analysis education for clinical nurses. We used a literature review, focus group discussions, and a content validity index survey to develop key components of financial-analysis education. First, a wide range of references were reviewed, and 55 financial-analysis education components were gathered. Second, two focus group discussions were performed; the participants were 11 nurses who had worked for more than 3 years in a hospital, and nine components were agreed upon. Third, 12 professionals, including professors, nurse executive, nurse managers, and an accountant, participated in the content validity index. Finally, six key components of financial-analysis education were selected. These key components were as follows: understanding the need for financial analysis, introduction to financial analysis, reading and implementing balance sheets, reading and implementing income statements, understanding the concepts of financial ratios, and interpretation and practice of financial ratio analysis. The results of this study will be used to develop an education program to increase financial-management competency among clinical nurses. © 2015 Wiley Publishing Asia Pty Ltd.
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Boyle, Martin; Baldwin, Ian
2010-01-01
Delivery of renal replacement therapy is now a core competency of intensive care nursing. The safe and effective delivery of this form of therapy is a quality issue for intensive care, requiring an understanding of the principles underlying therapy and the functioning of machines used. Continuous hemofiltration, first described in 1977, used a system where blood flowed from arterial to venous cannulas through a small-volume, low-resistance, and high-flux filter. Monitoring of these early systems was limited, and without a machine interface, less nursing expertise was required. Current continuous renal replacement therapy machines offer user-friendly interfaces, cassette-style circuits, and comprehensive circuit diagnostics and monitoring. Although these machines conceal complexity behind a user-friendly interface, it remains important that nurses have sufficient knowledge for their use and the ability to compare and contrast circuit setups and functions for optimal and efficient treatment.
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Falling from the top: the fired physician executive.
Coile, R C; Tyler, J L
2000-01-01
Today's health care market is volatile, and the job of a physician executive is becoming more risky. Recognizing signs of trouble and taking immediate action is essential. Ten early warning signs that you could be fired are: (1) Net profits dip unexpectedly; (2) investment income can't cover operating losses; (3) bond rating is downgraded; (4) revenues are not rising as fast as costs; (5) senior executives leave the team; (6) wage increases don't improve nursing vacancy rate; (7) unions begin whisper campaign; (8) medical staff elect an SOB; (9) hospital is slapped with a costly lawsuit; and (10) recruiters call to check on your status. Physician executives are quickly learning what it takes to overcome tough challenges and prevent premature job termination: Communication; no-surprise performance; continuous monitoring of key indicators; openness and plain talk; and no-more-business-as-usual attitude. What can you do to make your job loss as painless as possible? (1) Negotiate a contract upfront; (2) don't lose your temper; (3) ask for your wish list quickly; (4) be reluctant to sue your former employer; (5) tell your family as soon as possible; (6) take only a brief vacation; (7) consider a temporary assignment; (8) be prepared to be re-employed by your former employer; and (9) keep a positive attitude.
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Bring Your Own Device and Nurse Managers' Decision Making.
Martinez, Karen; Borycki, Elizabeth; Courtney, Karen L
2017-02-01
The Bring Your Own Device phenomenon is important in the healthcare environment because this trend is changing the workplace in healthcare organizations, such as British Columbia. At present, there is little research that exists in Canada to provide a distinct understanding of the complexities and difficulties unique to this phenomenon within the nursing practice. This study focused on the experiences and perceptions of nurse managers regarding how they make decisions on the use of personal handheld devices in the workplace. Telephone interviews (N = 10) and qualitative descriptive analysis were used. Four major themes emerged: (1) management perspective, (2) opportunities, (3) disadvantages, and (4) solutions. Nurse managers and other executives in healthcare organizations and health information technology departments need to be aware of the practice and organizational implications of the Bring Your Own Device movement.
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Chang, Li-Yin; Chen, Yu-Chih; Huang, Kuang-Chi; Huang, Jui-Lan; Lee, Tso-Ying
2015-04-01
"literature review and reference", "analysis of current situation", "problem result and process", "evaluation of results", and "validation of questions". This study analyzed the types of nursing projects, the trends in submission, and the comments of project reviewers. The results indicate that the validation of problems in project writing and current situation analysis and the evaluation of results should be improved. These findings may be referenced by nursing personnel for executing projects in the future and for developing improved criteria / methodologies for the clinical ladder system for nursing personnel.
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Nurses' bodywork: is there a body of work?
Shakespeare, Pam
2003-03-01
The work that many nurses do involves the use of their own body as one of the tools of their occupation. Being a nurse, in many cases, means controlled, purposeful use of her or his own body oriented to the patient. This paper discusses some of the ways in which nurses' bodies and the work that those bodies do are represented in professional and academic research accounts and made relevant in literature. Using instances of bodies and bodily activity mentioned in a variety of literature, the paper discusses three categories of accounts of nursing bodywork: those which are problematised and where the nurse's body is seen as a topic for investigation, and those which are unproblematised either explicitly discussing bodily activity (for example, touch) or implicitly dealing with bodywork (for example, taking blood pressure). Four ways in which nurses' bodies are made relevant in accounts are proposed: relational, corporate, instrumental and human. The paper discusses the prominence (or not) nurses' bodies are given in professional and academic accounts, as a contribution to preliminary work of generating a topic for investigation and concludes with some suggestions as to how this investigative project might be taken forward, focusing primarily on an examination of methodic practices, or how bodywork is brought off and executed as a skilled but taken-for-granted activity.
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Profile of an excellent nurse manager: identifying and developing health care team leaders.
Kallas, Kathryn D
2014-01-01
The purpose of this research was to identify the profile of an excellent nurse manager who can lead effective health care teams. Leadership attributes and competencies that characterize an excellent nurse manager and tools to identify them are lacking in the literature but are required to efficiently and effectively address the growing shortage of registered nurses (RNs) in health care team leadership roles and the critical linkage of these roles to patient outcomes. A profile of an excellent nurse manager was developed on the basis of the responses of nurse managers across the United States who had been identified as excellent or competent by chief nurse executive assessment or/and the Nurse Manager Ability, Leadership, and Support of Nurses staff survey to the Kouzes and Posner Leadership Practices Inventory: Self Instrument. Statistically significant distinctions exist between nurse managers who are excellent and those who are competent as assessed by the Five Practices of Exemplary Leadership, which together comprise the profile of an excellent nurse manager. The Kouzes and Posner Leadership Practices Inventory: Self Instrument can be used to identify, recruit, and develop RNs in the nurse manager role as excellent leaders of effective health care teams.
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Leadership styles in ethical dilemmas when head nurses make decisions.
Zydziunaite, V; Lepaite, D; Suominen, T
2013-06-01
The overlooked aspect in Lithuania is the dearth of leaders among head nurses, who bear the responsibility for decisions in ethical dilemmas. Understanding the application of leadership styles is fundamental to ensuring head nurses' abilities to influence outcomes for healthcare providers and patients. To identify the leadership styles applied by head nurses in decision making in ethical dilemmas on hospital wards. The data were collected by questionnaires completed by head nurses (n = 278) working in five major state-funded hospitals in each of the five regions of Lithuania. The data were analysed using SPSS 16.0, calculating descriptive statistics and analysis of variance. Head nurses apply democratic, affiliative, transformational and sustainable leadership styles when resolving ethical dilemmas. The application of leadership styles is associated not only with specific situations, but also with certain background factors, such as years of experience in a head nurse's position, ward specialization and the incidence of ethical dilemmas. Nurses having been in a head nurse's position over 10 years use primitive leadership styles, notably bureaucratic leadership, more often than do those head nurses with only a few years of experience in such a position. The results highlight the need for head nurses to reflect on their practices and to find new ways of learning from practice, colleagues and patients. Head nurses' managerial decisions due to their 'executive power' can turn into a new state-of-the-art leadership in nursing. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.
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Total quality management and nursing: a shared vision.
Morey, W
1996-09-01
The application of the Total Quality Management (TQM) philosophy within the health care sector would enhance the development of nursing power, leadership and knowledge. TQM challenges conventional management techniques as it requires a participative management style in order to be effective. There are many potential benefits for nurses, when quality assurance monitoring within a hierarchical management structure, is replaced with a focus on continuous quality improvement by every member of staff. These benefits are described within the context of both organisational and personal commitment to Total Quality Management.
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Risk factor for phlebitis: a questionnaire study of nurses' perception.
Milutinović, Dragana; Simin, Dragana; Zec, Davor
2015-01-01
to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions. a cross-sectional questionnaire study, which included a sample of 102 nurses. Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis. predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived.
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Strategies to address the nursing shortage in Saudi Arabia.
Aboshaiqah, A
2016-09-01
To investigate the nursing shortage in Saudi Arabia and specifically the shortage of Saudi nurses in the healthcare workforce and to propose solutions. Literature published from 1993 to 2013 providing relevant information on the nursing shortage, cultural traditions and beliefs, and nursing education and policies in Saudi was accessed from multiple sources including Medline, CINAHL Plus and Google Scholar and from official Saudi government document and was reviewed. Saudi Arabia depends largely on an expatriate workforce, and this applies to nursing. Saudi Arabia is experiencing a nursing shortage in common with most countries in the world and a shortage of Saudi nationals, especially women, in the healthcare workforce. The world shortage of nursing is extrinsic to Saudi, but intrinsic factors include a poor image of the nursing profession in the country that is exacerbated by cultural factors. With the call for the Saudization of the workforce to replace the imported workforce by Saudi nationals, including nurses, through the 1992 Royal Decree, Saudi Arabia faces a problem in attracting and retaining Saudi nationals in the nursing workforce. Solutions are suggested that are aimed at improving the public image of nursing through education and the use of the media and improvements in the workplace by addressing working processes such as teamwork, ensuring adequate staffing levels and addressing some aspects of culture which may make working in nursing more compatible with being a Saudi national. © 2016 International Council of Nurses.
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Social networks in nursing work processes: an integrative literature review
Directory of Open Access Journals (Sweden)
Ana Cláudia Mesquita
Full Text Available Abstract OBJECTIVE To identify and analyze the available evidence in the literature on the use of social networks in nursing work processes. METHOD An integrative review of the literature conducted in PubMed, CINAHL, EMBASE and LILACS databases in January 2016, using the descriptors social media, social networking, nursing, enfermagem, redes sociais, mídias sociais, and the keyword nursing practice, without year restriction. RESULTS The sample consisted of 27 international articles which were published between 2011 and 2016. The social networks used were Facebook (66.5%, Twitter (30% and WhatsApp (3.5%. In 70.5% of the studies, social networks were used for research purposes, in 18.5% they were used as a tool aimed to assist students in academic activities, and in 11% for executing interventions via the internet. CONCLUSION Nurses have used social networks in their work processes such as Facebook, Twitter and WhatsApp to research, teach and watch. The articles show several benefits in using such tools in the nursing profession; however, ethical considerations regarding the use of social networks deserve further discussion.
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The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals
Directory of Open Access Journals (Sweden)
Laetitia C. Rispel
2015-05-01
Full Text Available Background: Globally, flexible work arrangements – through the use of temporary nursing staff – are an important strategy for dealing with nursing shortages in hospitals. Objective: The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Methods: Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices. Results: In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million. The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467 and at Hospital 2 the value was R300,121 (US$42,874, thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Conclusion
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The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals.
Rispel, Laetitia C; Moorman, Julia
2015-01-01
Globally, flexible work arrangements - through the use of temporary nursing staff - are an important strategy for dealing with nursing shortages in hospitals. The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices). In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Hospital managers and policy-makers need to address the effective
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Innovations in occupational health nursing education, including a distance learning approach.
Lowis, A; Ellington, H
1991-07-01
The results of a survey in the United Kingdom in the late 1980s indicated that many occupational health nurses were not being sent for formal training because of the length of time nurses needed to be away from their employment and the difficulty employers had in finding nurse replacements during training. To meet the needs of occupational health nurses and their employers, the Robert Gordon Institute of Technology (RGIT) instituted a modular training course that offers full time attendance or distance learning options. RGIT's course consists of six modules over a 1 to 3 year period, which students can take in any order after completing a short Return to Study course. Using the innovative distance learning option, occupational health nurses can earn a Diploma in Occupational Health Nursing while completing most of their courses at the workplace, thus avoiding conflicts between training and work schedules.
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CH-53K Heavy Lift Replacement Helicopter (CH-53K)
2015-12-01
Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-390 CH-53K Heavy Lift Replacement Helicopter (CH-53K) As of FY 2017 President’s Budget...December 2015 SAR March 4, 2016 10:04:18 UNCLASSIFIED 4 Col Henry Vanderborght PMA-261 Heavy Lift Helicopters Program Executive Office - Air, Anti...757-5780 Fax: 301-757-5109 DSN Phone: 757-5780 DSN Fax: 757-5109 Date Assigned: May 29, 2014 Program Information Program Name CH-53K Heavy Lift
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Primary separator replacement for Bruce Unit 8 steam generators
International Nuclear Information System (INIS)
Roy, S.B.; Mewdell, C.G.; Schneider, W.G.
2000-01-01
During a scheduled maintenance outage of Bruce Unit 8 in 1998, it was discovered that the majority of the original primary steam separators were damaged in two steam generators. The Bruce B steam generators are equipped with GXP type primary cyclone separators of B and W supply. There were localized perforations in the upper part of the separators and large areas of generalized wall thinning. The degradation was indicative of a flow related erosion corrosion mechanism. Although the unit- restart was justified, it was obvious that corrective actions would be necessary because of the number of separators affected and the extent of the degradation. Repair was not considered to be a practical option and it was decided to replace the separators, as required, in Unit 8 steam generators during an advanced scheduled outage. GXP separators were selected for replacement to minimize the impact on steam generator operating characteristics and analysis. The material of construction was upgraded from the original carbon steel to stainless steel to maximize the assurance of full life. The replacement of the separators was a first of a kind operation not only for Ontario Power Generation and B and W but also for all CANDU plants. The paper describes the degradations observed and the assessments, the operating experience, manufacture and installation of the replacement separators. During routine inspection in 1998, many of the primary steam separators in two of steam generators at Bruce Nuclear Division B Unit 8 were observed to have through wall perforations. This paper describes assessment of this condition. It also discusses the manufacture and testing of replacement primary steam separators and the development and execution of the replacement separator installation program. (author)
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The organizational transformative power of nurse residency programs.
Kramer, Marlene; Maguire, Pat; Halfer, Diana; Budin, Wendy C; Hall, Debra S; Goodloe, Lauren; Klaristenfeld, Jessica; Teasley, Susan; Forsey, Lynn; Lemke, Johanna
2012-01-01
Residency programs for newly licensed registered nurses (NLRNs) have been strongly advocated by the Institute of Medicine, American Organization of Nurse Executives, and other professional organizations. Their cost-effectiveness as well as their impact on NLRN retention, job and practice satisfaction, improved performance, and reduction in environmental reality shock has been demonstrated. This qualitative study sought answers to the question: what people, components, processes and activities of Nurse Residency Programs (NRPs), and the work environment are instrumental in the transition and integration of NLRNs into the professional practice role and into professional communities? In the course of interviewing 907 nurses-NLRNs, experienced nurses, managers, and educators-practicing on clinical units with confirmed "very healthy work environments" in 20 Magnet hospitals, it became evident that not only did NRPs positively impact the professional socialization of NLRNs, they led to transformative changes in the organization and in the practice of other health care professionals. The organizational transformative changes described by the interviewees are presented for each of the 7 major challenges identified by NLRNs-delegation, prioritization, managing patient care delivery, autonomous decision-making, collaboration with other disciplines, constructive conflict resolution, and utilizing feedback to restore self-confidence. If it can be demonstrated that these transformative changes stimulated by NRPs also lead to improved patient outcomes, NRPs may be the most significant organization transformation instituted by nurse leaders in recent years.
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Attrition of undergraduate nursing students at selected South African universities
Directory of Open Access Journals (Sweden)
Erna Roos
2016-08-01
Full Text Available Background: The nursing profession forms the backbone of many healthcare systems. It therefore needs a consistent supply of registered nurses to deliver continuous and safe quality healthcare, and to replace the nurses leaving or retiring from the profession. Attrition actively occurs among nursing students in South Africa and threatens the future supply of registered nurses. Aim: The aim of the study was to describe the attrition rate at selected South African universities and the factors influencing undergraduate nursing students to discontinue their nursing studies at these universities. Method: A quantitative descriptive design was followed. Heads of the nursing departments at the selected universities captured data with a specifically designed questionnaire. Thereafter their former nursing students provided information via a structured telephonic interview on the reasons why they discontinued the nursing programme. Results: The study revealed that attrition of undergraduate nursing students for three intake years (2007, 2008 and 2009 at the participating universities was between 39.3% and 58.7%. Academic and financial reasons as well as poor wellness and health were the main causes for attrition. Another factor was failure to cope with the demands of the clinical environment. Conclusion: Attrition might not occur immediately when a nursing student is challenged, as the student might exploit the various types of support offered. Although some nursing students do benefit from the offered support, a large number of nursing students still discontinue the undergraduate nursing programme.
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Directory of Open Access Journals (Sweden)
Ladan Naseh
2015-04-01
Conclusion Poor quality of life in elder people who live in elderly nursing homes is an important finding that needs special attention. Because of the significant correlation between general self-efficacy and different subscales of elder’s quality of life in this study, it is suggested that nurses can design and execute appropriate interventions to promote these peoples’ self-efficacy and quality of life.
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Technology-Based Healthcare for Nursing Education Within The Netherlands: Past, Present and Future.
Koster, Ybranda; van Houwelingen, Cornelis T M
2017-01-01
At the present time, nearly all Dutch nursing schools are searching for suitable ways to implement technology-based healthcare in their curriculum. Some Universities chose elective education, others a mandatory solution. Several studies were executed to determine competencies needed by nurses in order to work with technology-based healthcare. In 2016 a nationwide new curriculum for nurses has been published. Providing technology-based healthcare is included under the core competencies of this new curriculum. All baccalaureate nursing educational institutes must implement this new curriculum at the start of 2016 which will have a huge impact on the implementation of technology-based healthcare in the education programs. In the future, technology centers from Universities will collaborate and specialize, partner with technology companies and crossovers between information and communication technology and healthcare education will be expanded.
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DEFF Research Database (Denmark)
Stahlberg, Claudia; Pedersen, Anette Tønnes; Lynge, Elsebeth
2004-01-01
was established in 1993, where all female nurses aged 45 years and above received a mailed questionnaire (n = 23,178). A total of 19,898 women returned the questionnaire (86%). The questionnaire included information on HRT types and regimens, reproductive history and lifestyle-related factors. Breast cancer cases......Epidemiologic studies have shown an increased risk of breast cancer following hormone replacement therapy (HRT). The aim of this study was to investigate whether different treatment regimens or the androgenecity of progestins influence the risk of breast cancer differently. The Danish Nurse Cohort...
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Validity of the Italian Code of Ethics for everyday nursing practice.
Gobbi, Paola; Castoldi, Maria Grazia; Alagna, Rosa Anna; Brunoldi, Anna; Pari, Chiara; Gallo, Annamaria; Magri, Miriam; Marioni, Lorena; Muttillo, Giovanni; Passoni, Claudia; Torre, Anna La; Rosa, Debora; Carnevale, Franco A
2016-12-07
The research question for this study was as follows: Is the Code of Ethics for Nurses in Italy (Code) a valid or useful decision-making instrument for nurses faced with ethical problems in their daily clinical practice? Focus groups were conducted to analyze specific ethical problems through 11 case studies. The analysis was conducted using sections of the Code as well as other relevant documents. Each focus group had a specific theme and nurses participated freely in the discussions according to their respective clinical competencies. The executive administrative committee of the local nursing licensing council provided approval for conducting this project. Measures were taken to protect the confidentiality of consenting participants. The answer to the research question posed for this investigation was predominantly positive. Many sections of the Code were useful for discussion and identifying possible solutions for the ethical problems presented in the 11 cases. We concluded that the Code of Ethics for Nurses in Italy can be a valuable aid in daily practice in most clinical situations that can give rise to ethical problems. © The Author(s) 2016.
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The making of a nurse manager: the role of experiential learning in leadership development.
Cathcart, Eloise Balasco; Greenspan, Miriam; Quin, Matthew
2010-05-01
To articulate the experientially acquired knowledge, skill and ethics embedded in nurse manager practice and describe the ways in which they were developed. The role of the nurse manager is usually described in lists of competencies, talents and traits which fail to capture the experience-based judgment and practical knowledge in this pivotal organizational role. Using Benner's methodology of practice articulation, 32 nurse managers wrote and interpreted first person narratives of their practice. The experience level of the group ranged from new nurse managers to those with more than 10 years' role tenure. The seminars were facilitated by a seasoned nurse executive and nurse manager with expertise in narrative interpretation. Interpretation of the paradigm case of one nurse manager suggests that complex leadership challenges can be a source of significant experiential learning for the individual and for the group. CONCLUSIONS; Articulating and reflecting on experiential learning elucidates the skilled knowledge and judgment embedded in nurse manager practice which cannot be accessed in any other way. Articulating the practical knowledge which is necessary for effective nurse manager practice can hasten the development of role incumbents.
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Risk factor for phlebitis: a questionnaire study of nurses' perception
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Dragana Milutinović
2015-08-01
Full Text Available AbstractObjectives: to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions.Method: a cross-sectional questionnaire study, which included a sample of 102 nurses.Results: Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis.Conclusion: predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived.
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[Ethical dilemma for nurses who manage marital violence in clinical setting].
Hou, Wen-Li; Kuo, Ya-Wen; Huang, Mei-Chih
2008-06-01
Marital violence or intimate partner violence is a serious and recurring public health issue. In the clinical setting, battered women often seek medical advice, because of the health problems that result from marital violence. Thus, nursing staff are the first persons to come into contact with the battered women. Can nurses execute their notify responsibility to prevent continued injury before obtained the woman's agreement? Will this action violate the principle of autonomy or not? Nurses would face an ethical dilemma when they care for battered women. The purpose of this article is to use Aroskar's ethical decision making model to analyze and clarify the ethical dilemmas involved in managing marital violence, including: under the value systems of the person, the profession, and time to illustrate the basic information, decision theory dimensions, and ethical theories or positions. It is hoped that this article provides an ethical decision making model for the ethical dilemmas facing nurses who manage marital violence in the clinical setting.
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Can New Zealand achieve self-sufficiency in its nursing workforce?
North, Nicola
2011-01-01
This paper reviews impacts on the nursing workforce of health policy and reforms of the past two decades and suggests reasons for both current difficulties in retaining nurses in the workforce and measures to achieve short-term improvements. Difficulties in retaining nurses in the New Zealand workforce have contributed to nursing shortages, leading to a dependence on overseas recruitment. In a context of global shortages and having to compete in a global nursing labour market, an alternative to dependence on overseas nurses is self-sufficiency. Discursive paper. Analysis of nursing workforce data highlighted threats to self-sufficiency, including age structure, high rates of emigration of New Zealand nurses with reliance on overseas nurses and an annual output of nurses that is insufficient to replace both expected retiring nurses and emigrating nurses. A review of recent policy and other documents indicates that two decades of health reform and lack of a strategic focus on nursing has contributed to shortages. Recent strategic approaches to the nursing workforce have included workforce stocktakes, integrated health workforce development and nursing workforce projections, with a single authority now responsible for planning, education, training and development for all health professions and sectors. Current health and nursing workforce development strategies offer wide-ranging and ambitious approaches. An alternative approach is advocated: based on workforce data analysis, pressing threats to self-sufficiency and measures available are identified to achieve, in the short term, the maximum impact on retaining nurses. A human resources in health approach is recommended that focuses on employment conditions and professional nursing as well as recruitment and retention strategies. Nursing is identified as 'crucial' to meeting demands for health care. A shortage of nurses threatens delivery of health services and supports the case for self-sufficiency in the nursing
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Estimating the costs associated with malnutrition in Dutch nursing homes.
Meijers, Judith M M; Halfens, Ruud J G; Wilson, Lisa; Schols, Jos M G A
2012-02-01
Malnutrition in western health care involves a tremendous burden of illness. In this study the economic implications of malnutrition in Dutch nursing homes are investigated as part of the Health and Economic Impact of Malnutrition in Europe Study from the European Nutrition for Health Alliance. A questionnaire was developed, focussing on the additional time and resources spent to execute all relevant nutritional activities in nursing home patients with at risk of malnutrition or malnourished. Results were extrapolated on national level, based on the prevalence rates gathered within the national Prevalence Measurement of Care Problems 2009. The normal nutritional costs are 319 million Euro per year. The total additional costs of managing the problem of malnutrition in Dutch nursing homes involve 279 million Euro per year and are related to extra efforts in nutritional screening, monitoring and treatment. The extra costs for managing nursing home residents at risk of malnutrition are 8000 euro per patient and 10000 euro for malnourished patients. The extra costs related to malnutrition are a considerable burden for the nursing home sector and urge for preventive measures. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
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Upenieks, Valda
2003-01-01
The purpose of this study was to gain an understanding of nurse leaders' perceptions of both the value of their roles in today's health care setting and their beliefs about how power and gender interface with role worth. Support for the theoretical significance of this research stemmed from Kanter's Structural Theory of Organizational Behavior. Four leaders were recruited at the executive level and 12 at the director/managerial level. The results of the deductive analysis supported Kanter's theory. Eighty-three percent of the nurse leaders validated that access to power, opportunity, information, and resources created an empowered environment, producing a climate that fostered leadership success and enhanced levels of job satisfaction among nurses. This study provided groundwork on the kinds of leadership traits that foster nursing satisfaction and on whether or not gender influences leadership effectiveness. The findings of this study are both timely and relevant for nurse leaders faced with the effects of the current supply-and-demand nursing shortage and with fiscal restraints mandated by managed care and regulatory agencies.
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Nurse manager succession planning: A cost-benefit analysis.
Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R
2018-03-01
This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.
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Moreland, Jack E.
2011-01-01
There is a nursing faculty shortage in the United States today and projections are that over the next decade nurses will retire at a rate faster than they are being replaced. The projected shortage at a time when the largest part of the population will begin to retire and enter the ranks of the elderly could potentially cause serious problems…
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Cognitive changes in nurses working in intensive care units
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Daniel Aragão Machado
Full Text Available ABSTRACT Objective: To measure the levels of stress, anxiety, and depression of nurses working in ICUs, relating them to levels of attention before and after 24 hours. Method: An observational, quantitative, analytical study with 18 nurses undergoing an inventory of stress, anxiety, and depression, as well as assessment of attention levels and psychomotor functioning. Results: Sixty-one percent showed positive for stress. Depression was observed in 33%; and anxiety in 99.9%. A strong correlation between stress and depression (ρ = 0.564 with p <0.05 and anxiety (ρ = 1 with p <0.05 was observed. There was a weak correlation between stress and task execution time in M2 (ρ = 0.055 for TMT A, a fact that did not occur in M0 (ρ = -0.249. Conclusion: The study shows that the workload of the nurses working in 24-hour shifts in the ICU is correlated with high levels of stress, decreases in the attention process, and psychomotor decline.
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Rabinovici, Gil D.; Stephens, Melanie L.; Possin, Katherine L.
2015-01-01
Purpose of Review: Executive functions represent a constellation of cognitive abilities that drive goal-oriented behavior and are critical to the ability to adapt to an ever-changing world. This article provides a clinically oriented approach to classifying, localizing, diagnosing, and treating disorders of executive function, which are pervasive in clinical practice. Recent Findings: Executive functions can be split into four distinct components: working memory, inhibition, set shifting, and fluency. These components may be differentially affected in individual patients and act together to guide higher-order cognitive constructs such as planning and organization. Specific bedside and neuropsychological tests can be applied to evaluate components of executive function. While dysexecutive syndromes were first described in patients with frontal lesions, intact executive functioning relies on distributed neural networks that include not only the prefrontal cortex, but also the parietal cortex, basal ganglia, thalamus, and cerebellum. Executive dysfunction arises from injury to any of these regions, their white matter connections, or neurotransmitter systems. Dysexecutive symptoms therefore occur in most neurodegenerative diseases and in many other neurologic, psychiatric, and systemic illnesses. Management approaches are patient specific and should focus on treatment of the underlying cause in parallel with maximizing patient function and safety via occupational therapy and rehabilitation. Summary: Executive dysfunction is extremely common in patients with neurologic disorders. Diagnosis and treatment hinge on familiarity with the clinical components and neuroanatomic correlates of these complex, high-order cognitive processes. PMID:26039846
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This article provides an executive summary of recommendations from the 2016 Guideline for Prevention and Management of Pressure Ulcers (Injuries) published by the Wound, Ostomy and Continence Nurses Society (WOCN). It presents an overview of the process used to update and develop the guideline, and lists the specific recommendations from the guideline for assessment, prevention, and treatment of pressure injuries. The guideline is a resource for physicians, nurses, therapists, and other healthcare professionals who work with adults who have/or are at risk for pressure injuries. The full text of the published guideline, which includes the available evidence supporting the recommendations and a complete reference list, is available from the Wound, Ostomy and Continence Nurses Society, 1120 Rt 73, Ste 200, Mount Laurel, NJ 08054; Web site: www.wocn.org. Refer to the Supplemental Digital Content (http://links.lww.com/JWOCN/A38) associated with this article for a complete reference list for the guideline. The guideline has been accepted for inclusion in the National Guideline Clearinghouse (www.guideline.gov/).
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Gärtner, F R; Nieuwenhuijsen, K; van Dijk, F J H; Sluiter, J K
2012-02-01
Common mental disorders (CMD) negatively affect work functioning. In the health service sector not only the prevalence of CMDs is high, but work functioning problems are associated with a risk of serious consequences for patients and healthcare providers. If work functioning problems due to CMDs are detected early, timely help can be provided. Therefore, the aim of this study is to develop a detection questionnaire for impaired work functioning due to CMDs in nurses and allied health professionals working in hospitals. First, an item pool was developed by a systematic literature study and five focus group interviews with employees and experts. To evaluate the content validity, additional interviews were held. Second, a cross-sectional assessment of the item pool in 314 nurses and allied health professionals was used for item selection and for identification and corroboration of subscales by explorative and confirmatory factor analysis. The study results in the Nurses Work Functioning Questionnaire (NWFQ), a 50-item self-report questionnaire consisting of seven subscales: cognitive aspects of task execution, impaired decision making, causing incidents at work, avoidance behavior, conflicts and irritations with colleagues, impaired contact with patients and their family, and lack of energy and motivation. The questionnaire has a proven high content validity. All subscales have good or acceptable internal consistency. The Nurses Work Functioning Questionnaire gives insight into precise and concrete aspects of impaired work functioning of nurses and allied health professionals. The scores can be used as a starting point for purposeful interventions.
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Nurse turnover in New Zealand: costs and relationships with staffing practises and patient outcomes.
North, Nicola; Leung, William; Ashton, Toni; Rasmussen, Erling; Hughes, Frances; Finlayson, Mary
2013-04-01
To determine the rates and costs of nurse turnover, the relationships with staffing practises, and the impacts on outcomes for nurses and patients. In the context of nursing shortages, information on the rates and costs of nursing turnover can improve nursing staff management and quality of care. Quantitative and qualitative data were collected prospectively for 12 months. A re-analysis of these data used descriptive statistics and correlational analysis techniques. The cost per registered nurse turnover represents half an average salary. The highest costs were related to temporary cover, followed by productivity loss. Both are associated with adverse patient events. Flexible management of nursing resources (staffing below budgeted levels and reliance on temporary cover), and a reliance on new graduates and international recruitment to replace nurses who left, contributed to turnover and costs. Nurse turnover is embedded in staffing levels and practises, with costs attributable to both. A culture of turnover was found that is inconsistent with nursing as a knowledge workforce. Nurse managers did not challenge flexible staffing practices and high turnover rates. Information on turnover and costs is needed to develop strategies that retain nurses as knowledge-based workers. © 2012 Blackwell Publishing Ltd.
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Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis.
Park, Claire Su-Yeon
2017-08-01
To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.
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Gender-Based Discrimination In Nursing: A Ghanaian
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DF Ofori
2007-12-01
Full Text Available Purpose and objectives: The 'glass escalator' phenomenon holds that men in female dominated professions like nursing can rise quickly to the top. However, they can also suffer discrimination. This phenomenon is widely recognised in advanced countries. Trained, mostly female nurses have been leaving Ghana in droves for greener pastures abroad, particularly the US and UK, with serious consequences on the health delivery service in Ghana. Conversely, increasing numbers of males are joining the nursing profession. It examines whether male nurses in Ghana enjoy any hidden advantages, and if so, what makes the men successful (even with their limited numbers in a women-dominated field and what the implications are for both male and female nurses. Problem investigated: The article explores gender-based discrimination and the phenomenon of the glass escalator in a developing country context. It examines the position of male nurses in Ghana; the type, nature and extent of advantages they enjoy and any discrimination they face in a female-dominated field. Methodology: An in-depth cross-sectional questionnaire was employed. A thematic and cluster analysis of findings was executed, with data captured using Statistical Package for Social Sciences (SPSS. A combination of descriptive accounts as well as summary statistics using chi-square and correlations was used to examine the findings. Findings and implications: This paper reports the findings of an empirical study that show that male nurses neither suffer gender-based discrimination nor occupy the top positions in the nursing field. It also found that a majority of males do not want to leave the profession even though they feel they are assigned more responsibilities and are sometimes passed over for promotion. Originality: Whilst representing a modest contribution to research in gender-based discrimination in nursing, this paper is a first attempt to investigate the phenomenon in a Ghanaian context, with
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Losing Items in the Psychogeriatric Nursing Home
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J. van Hoof PhD
2016-09-01
Full Text Available Introduction: Losing items is a time-consuming occurrence in nursing homes that is ill described. An explorative study was conducted to investigate which items got lost by nursing home residents, and how this affects the residents and family caregivers. Method: Semi-structured interviews and card sorting tasks were conducted with 12 residents with early-stage dementia and 12 family caregivers. Thematic analysis was applied to the outcomes of the sessions. Results: The participants stated that numerous personal items and assistive devices get lost in the nursing home environment, which had various emotional, practical, and financial implications. Significant amounts of time are spent on trying to find items, varying from 1 hr up to a couple of weeks. Numerous potential solutions were identified by the interviewees. Discussion: Losing items often goes together with limitations to the participation of residents. Many family caregivers are reluctant to replace lost items, as these items may get lost again.
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DEFF Research Database (Denmark)
Bignoux, Stephane; Sund, Kristian J.
2018-01-01
Studies of learning and student satisfaction in the context of online university programmes have largely neglected programmes catering specifically to business executives. Such executives have typically been away from higher education for a number of years, and have collected substantial practical...... experience in the subject matters they are taught. Their expectations in terms of both content and delivery may therefore be different from non-executive students. We explore perceptions of the quality of tutoring in the context of an online executive MBA programme through participant interviews. We find...... that in addition to some of the tutor behaviours already discussed in the literature, executive students look specifically for practical industry knowledge and experience in tutors, when judging how effective a tutor is. This has implications for both the recruitment and training of online executive MBA tutors....
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DEFF Research Database (Denmark)
Bignoux, Stephane; Sund, Kristian J.
2016-01-01
Studies of learning and student satisfaction in the context of online university programs have largely neglected programs catering specifically to business executives. Such executives have typically been away from higher education for a number of years, and have collected substantial practical...... experience in the subject matters they are taught. Their expectations in terms of both content and delivery may therefore be different from non-executive students. We explore perceptions of the quality of tutoring in the context of an online executive MBA program through participant interviews. We find...... that in addition to some of the tutor behaviors already discussed in the literature, executive students look specifically for practical industry knowledge and experience in tutors, when judging how effective a tutor is. This has implications for both the recruitment and training of online executive MBA tutors....
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Zanon, David C; Gralher, Dieter; Müller-Staub, Maria
2017-01-01
Background: Pain affects patients' rehabilitation after hip replacement surgery. Aim: The study aim was to compare patients' responses, on their received pain relieving nursing interventions after hip replacement surgery, with the documented interventions in their nursing records. Method: A mixed methods design was applied. In order to evaluate quantitative data the instrument „Quality of Diagnoses, Interventions and Outcomes“ (Q-DIO) was further developed to measure pain interventions in nursing records (Q-DIO-Pain). Patients (n = 37) answered a survey on the third postoperative day. The patients' survey findings were then compared with the Q-DIO-Pain results and cross-validated by qualitative interviews. Results: The most reported pain level was „no pain“ (NRS 0 – 10 Points). However, 17 – 50 % of patients reported pain levels of three or higher and 11 – 22 % of five or higher in situations of motion / ambulation. A significant match between patients' findings and Q-DIO-Pain results was found for the intervention „helping to adapt medications“ (n = 32, ICC = 0.111, p = 0.042, CI 95 % 2-sided). Otherwise no significant matches were found. Interviews with patients and nurses confirmed that far more pain-relieving interventions affecting „Acute Pain“ were carried out, than were documented. Conclusions: Based on the results, pain assessments and effective pain-relieving interventions, especially before or after motion / ambulation should be improved and documented. It is recommended to implement a nursing standard for pain control.
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Nurses' perspectives on the intersection of safety and informed decision making in maternity care.
Jacobson, Carrie H; Zlatnik, Marya G; Kennedy, Holly Powell; Lyndon, Audrey
2013-01-01
To explore maternity nurses' perceptions of women's informed decision making during labor and birth to better understand how interdisciplinary communication challenges might affect patient safety. Constructivist grounded theory. Four hospitals in the western United States. Forty-six (46) nurses and physicians practicing in maternity units. Data collection strategies included individual interviews and participant observation. Data were analyzed using the constant comparative method, dimensional analysis, and situational analysis (Charmaz, 2006; Clarke, 2005; Schatzman, 1991). The nurses' central action of holding off harm encompassed three communication strategies: persuading agreement, managing information, and coaching of mothers and physicians. These strategies were executed in a complex, hierarchical context characterized by varied practice patterns and relationships. Nurses' priorities and patient safety goals were sometimes misaligned with those of physicians, resulting in potentially unsafe communication. The communication strategies nurses employed resulted in intended and unintended consequences with safety implications for mothers and providers and had the potential to trap women in the middle of interprofessional conflicts and differences of opinion. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
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Impact of Advocacy Initiatives on Nurses' Motivation to Sustain Momentum in Public Policy Advocacy.
Taylor, Melissa R S
2016-01-01
The purpose of this study is to elicit insight from the public policy leaders of 2 regional professional nursing organizations on key qualities of their current advocacy initiatives that motivate nurses to sustain momentum in public policy advocacy beyond a single episode. The goal is to inform quality improvement in the development of future advocacy initiatives to increase sustained engagement of nurses. Social cognitive theory was used as the rationale for this qualitative, descriptive study. A purposive convenience sample of executive leadership and board committee members from 2 regional professional nursing organizations were recruited to complete an initial Web-based electronic survey, followed by separate semistructured interview focus groups. One organization was composed primarily of advanced practice registered nurses, and the other group composed of diverse, multispecialty nursing members with varied educational levels. Nine themes emerged, categorized as facilitators or challenges to the positive impact of advocacy initiatives on nurses' motivation. Highlighting and marketing facilitators to the positive impact of advocacy initiatives on nurses' motivation to sustain momentum in public policy advocacy, while designing and testing new initiatives that address the challenges, may increase the number of nurses who sustain engagement in the policy advocacy process. Copyright © 2016 Elsevier Inc. All rights reserved.
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Applying lean principles to continuous renal replacement therapy processes.
Benfield, C Brett; Brummond, Philip; Lucarotti, Andrew; Villarreal, Maria; Goodwin, Adam; Wonnacott, Rob; Talley, Cheryl; Heung, Michael
2015-02-01
The application of lean principles to continuous renal replacement therapy (CRRT) processes in an academic medical center is described. A manual audit over six consecutive weeks revealed that 133 5-L bags of CRRT solution were discarded after being dispensed from pharmacy but before clinical use. Lean principles were used to examine the workflow for CRRT preparation and develop and implement an intervention. An educational program was developed to encourage and enhance direct communication between nursing and pharmacy about changes in a patient's condition or CRRT order. It was through this education program that the reordering workflow shifted from nurses to pharmacy technicians. The primary outcome was the number of CRRT solution bags delivered in the preintervention and postintervention periods. Nurses and pharmacy technicians were surveyed to determine their satisfaction with the workflow change. After implementation of lean principles, the mean number of CRRT solution bags dispensed per day of CRRT decreased substantially. Respondents' overall satisfaction with the CRRT solution preparation process increased during the postintervention period, and the satisfaction scores for each individual component of the workflow after implementation of lean principles. The decreased solution waste resulted in projected annual cost savings exceeding $70,000 in product alone. The use of lean principles to identify medication waste in the CRRT workflow and implementation of an intervention to shift the workload from intensive care unit nurses to pharmacy technicians led to reduced CRRT solution waste, improved efficiency of CRRT workflow, and increased satisfaction among staff. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
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Leadership profile: HealthAchieve 2013 Nursing Leadership Award Winner, Tiziana Rivera.
Rivera, Tiziana
2014-03-01
Tiziana Rivera, the winner of the 2013 Nursing Leadership Award at the November HealthAchieve conference, is chief nursing executive and chief practice officer at Mackenzie Health. As such, she provides strategic leadership for the development and implementation of a shared vision for professional practice, nursing and all disciplines to promote innovative care and the development of care delivery models that will improve quality of care and population health.Prior to assuming her position at Mackenzie Health, Rivera provided strategic leadership for the Seniors' Health Program at Trillium Health Centre, where her role focused on the development of seniors' health services across the continuum of care. She has published numerous articles in refereed journals, conducted several research studies and presented her papers provincially, nationally and internationally. Rivera has a clinical appointment at the University of Toronto Faculty of Nursing, a faculty adviser position at Ryerson and an adjunct faculty position at the School of Health Sciences, York University and at the School of Health Sciences, Humber Institute of Technology and Advanced Learning.In the following Q and A, Rivera shares her thoughts on leadership in nursing and perspectives on several critical issues.
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The impact of corporate memory loss: What happens when a senior executive leaves?
Lahaie, Denis
2005-01-01
The author is a nursing management practitioner, whose purpose in writing this paper is twofold: to examine the impact of corporate memory loss on a health care institution, caused by increasing retirement rates of senior executives; and to use this research as an opportunity for action learning where both the author and the institution can benefit from the learning outcomes. Using qualitative research methods based on ethnographic interviewing techniques and grounded theory, the author interviews 12 senior executives from four diverse health care facilities. The purpose is to determine the point at which corporate memory loss, in the form of tacit knowledge in the heads of departing executives, becomes a problem for the institution. The research determined that the requisite managerial competencies normally assumed for senior management positions are insufficient to minimize the negative impacts of corporate memory loss caused by departing senior executives. Effective knowledge management and knowledge transfer within the organization are fundamental for ongoing organizational effectiveness. The research is limited to 12 senior executives. The grounded theory nature of the research provides a framework for more research in other institutions to test and further explore some of the findings. One of the most significant threats facing the majority of health care organizations related to the aging workforce is the greater number of staff who are retiring from all levels within the organization. The development of techniques to reducing the impact of corporate memory loss on the culture of an organization will increase its effectiveness, help build continuity, and provide a more secure footing for the workforce of the future. The exit of knowledge workers is causing a major problem for Canada's health care organizations. This study throws more light on to this problem from the point of view of senior executives who have been specifically impacted by the problem of
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Surfactant replacement therapy--economic impact.
Pejaver, R K; al Hifzi, I; Aldussari, S
2001-06-01
Surfactant replacement is an effective treatment for neonatal respiratory distress syndrome. (RDS). As widespread use of surfactant is becoming a reality, it is important to assess the economic implications of this new form of therapy. A comparison study was carried out at the Neonatal Intensive Care Unit (NICU) of Northwest Armed Forces Hospital, Saudi Arabia. Among 75 infants who received surfactant for RDS and similar number who were managed during time period just before the surfactant was available, but by set criteria would have made them eligible for surfactant. All other management modalities except surfactant were the same for all these babies. Based on the intensity of monitoring and nursing care required by the baby, the level of care was divided as: Level IIIA, IIIB, Level II, Level I. The cost per day per bed for each level was calculated, taking into account the use of hospital immovable equipment, personal salaries of nursing, medical, ancillary staff, overheads and maintenance, depreciation and replacement costs. Medications used, procedures done, TPN, oxygen, were all added to individual patient's total expenditure. 75 infants in the Surfactant group had 62 survivors. They spent a total of 4300 days in hospital. (av 69.35) Out of which 970 d (av 15.65 per patient) were ventilated days. There were 56 survivors in the non-surfactant group of 75. They had spent a total of 5023 days in the hospital (av 89.69/patient) out of which 1490 were ventilated days (av 26.60 d). Including the cost of surfactant (two doses), cost of hospital stay for each infant taking the average figures of stay would be SR 118, 009.75 per surfactant treated baby and SR 164, 070.70 per non-surfactant treated baby. The difference of 46,061 SR is 39.03% more in non-surfactant group. One Saudi rial = 8 Rs (approx at the time study was carried out.) Medical care cost varies from place to place. However, it is definitely cost-effective where surfactant is concerned. Quality adjusted
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Dobrowolska, Barbara; Hoch, Stefania; Jabkowska-Sochanska, Aniela; Benedict, Susan; Shields, Linda
2011-11-01
Poland was invaded by Nazi Germany on 1 September 1939 and World War II began on 3 September. Polish nurses have their place in this difficult history. In the first months of occupation, nurses focused on caring for wounded soldiers. In order to protect them from prisoner-of-war camps and execution, nurses sought safe havens for the wounded in private homes and transported them there. After their regular jobs, the nurses visited them, changed their dressings and provided them with civilian clothes so that soldiers could eventually escape. This paper describes the work of two of these nurses, Wanda Ossowska and Stanisława Leszczyńska. The first three authors (BD, SH, AJS) were nurses in Poland at that time and they present some of the information in this paper as primary source data.
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The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing
Hassmiller, Susan; Bilazarian, Ani
2018-01-01
OBJECTIVE The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. METHODS A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. RESULTS Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. CONCLUSION Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement. PMID:29470381
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The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing.
Hassmiller, Susan; Bilazarian, Ani
2018-04-01
The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement.
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Resisting gender-bias: insights from Western Australian middle-level women nurses.
Pannowitz, Helen K; Glass, Nel; Davis, Kierrynn
2009-10-01
An integrated feminist postmodernist ethnography was applied to explore the experiences of eight women nurses working in the corporate sector and/or management in public hospitals in Western Australia. Data were collected through participant observation, the researcher's field notes and journal and through semi-structured critical conversations. Data were analysed by the application of a trifocal analytic method (Glass & Davis, 2004; Savage, 2000b). This approach, consistent with the methodology, examined the data at multiple levels by applying realist, feminist and feminist postmodern lens which allowed the data to remain relevant to each participant, avoided objectifying the participants and uncovered knowledge relevant to the nursing profession. The findings revealed what it meant to be a nurse functioning within a corporate setting. Three culturally-constructed discourses emerged: values attributed to nursing, bureaucratic managerialism and medical science. The first was found to be empowering but the other two revealed evidence of patriarchal and oppressive behaviours by both medical staff and senior nurses. The findings also revealed that the nurses were sometimes unaware of the oppression they were subject to. The nurses avoided confronting their oppressors preferring strategies revealed as creep up/creep in. Discussion focuses upon the implications of the research project findings for senior and executive nurse leaders and managers and which may evoke a sense of commonality for women in general. The implications are that nurses could apply self-managing strategies in order to resist gendered oppression in senior-level workplace relationships. The authors recommend that more research and publications are needed that reveal and celebrate women's every-day exemplar empowering leadership practices.
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Nursing cooperation in endovascular aneurysm repair treatment for aortic dissection
International Nuclear Information System (INIS)
Xing Li; Yuan Chanjuan; Chen Rumei; Xiao Zhanqiang; Qi Youfei
2014-01-01
Objective: To summarize the main points of nursing cooperation in endovascular aneurysm repair treatment for aortic dissection. Methods: Preoperative psychological care and the other preparations were carefully conducted. During the operation, the patient's body was correctly placed. Active cooperation with the performance of angiography and close observation during heparinization were carried out. The proper delivery of catheter and stent to the operator was carefully done. Close observation for the patient's vital signs, the renal function and the changes of limb blood supply were made. Results: Under close cooperation of' the operators, nurses, anesthesiologists and technicians, the surgery was successfully accomplished in 35 patients. The monitoring of vital signs during the entire performance of operation was well executed. No surgical instruments delivery error's or surgery failure due to unsuitable cooperation occurred. Conclusion: Perfect preoperative preparation, strict nursing cooperation and team cooperation are the key points to ensure a successful endovascular aneurysm repair for aortic dissection. (authors)
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Trends in nursing and midwifery research and the need for change in complementary therapy research
Biley, Francis; Freshwater, Dawn
1999-01-01
In recent years there has been a change in nursing and midwifery research. Whilst many of the subjects being studied remain the same, nurses and midwives have started to employ a range of data collection methods that are relatively new to the profession. Predominantly quantitative research, which concentrates on reduction, objectivity, manipulation, categorization, passivity, control, prediction, causality and generalizability (Munhall & Oiler 1986), is starting to be replaced by other approa...
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Do primary health care nurses address cardiovascular risk in diabetes patients?
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.
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Moules, Nancy J; Bell, Janice M; Paton, Brenda I; Morck, Angela C
2012-05-01
Teaching graduate family nursing students the important and delicate practice of entering into and mitigating families' illness suffering signifies an educational practice that is rigorous, intense, and contextual, yet not articulated as expounded knowledge. This study examined the pedagogical practices of the advanced practice of Family Systems Nursing (FSN) as taught to master's and doctoral nursing students at the Family Nursing Unit, University of Calgary, using observation of expert and novice clinical practice, live supervision, videotape review, presession hypothesizing, clinical documentation, and the writing of therapeutic letters to families. A triangulation of research methods and data collection strategies, interpretive ethnography, autoethnography, and hermeneutics, were used. Students reported an intensity of learning that had both useful and limiting consequences as they developed skills in therapeutic conversations with families experiencing illness. Faculty used an intentional pedagogical process to encourage growth in perceptual, conceptual, and executive knowledge and skills of working with families.
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Accelerating execution of the integrated TIGER series Monte Carlo radiation transport codes
Smith, L. M.; Hochstedler, R. D.
1997-02-01
Execution of the integrated TIGER series (ITS) of coupled electron/photon Monte Carlo radiation transport codes has been accelerated by modifying the FORTRAN source code for more efficient computation. Each member code of ITS was benchmarked and profiled with a specific test case that directed the acceleration effort toward the most computationally intensive subroutines. Techniques for accelerating these subroutines included replacing linear search algorithms with binary versions, replacing the pseudo-random number generator, reducing program memory allocation, and proofing the input files for geometrical redundancies. All techniques produced identical or statistically similar results to the original code. Final benchmark timing of the accelerated code resulted in speed-up factors of 2.00 for TIGER (the one-dimensional slab geometry code), 1.74 for CYLTRAN (the two-dimensional cylindrical geometry code), and 1.90 for ACCEPT (the arbitrary three-dimensional geometry code).
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Accelerating execution of the integrated TIGER series Monte Carlo radiation transport codes
International Nuclear Information System (INIS)
Smith, L.M.; Hochstedler, R.D.
1997-01-01
Execution of the integrated TIGER series (ITS) of coupled electron/photon Monte Carlo radiation transport codes has been accelerated by modifying the FORTRAN source code for more efficient computation. Each member code of ITS was benchmarked and profiled with a specific test case that directed the acceleration effort toward the most computationally intensive subroutines. Techniques for accelerating these subroutines included replacing linear search algorithms with binary versions, replacing the pseudo-random number generator, reducing program memory allocation, and proofing the input files for geometrical redundancies. All techniques produced identical or statistically similar results to the original code. Final benchmark timing of the accelerated code resulted in speed-up factors of 2.00 for TIGER (the one-dimensional slab geometry code), 1.74 for CYLTRAN (the two-dimensional cylindrical geometry code), and 1.90 for ACCEPT (the arbitrary three-dimensional geometry code)
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Myers, Jamie S.; Grigsby, Jim; Teel, Cynthia S.; Kramer, Andrew M.
2009-01-01
The goals of this study were to evaluate the accuracy of nurses' predictions of rehabilitation potential in older adults admitted to inpatient rehabilitation facilities and to ascertain whether the addition of a measure of executive cognitive function would enhance predictive accuracy. Secondary analysis was performed on prospective data collected…
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Global nursing management. Avoiding conflicts of interest.
Willers, Lisa
2004-01-01
Traditionally, the healthcare industry has been no stranger to some conflicts of interest. However, as healthcare responds to demands to contain costs and adapts business models that resemble those of the corporate world, new conflicts of interest arise. Nurse executives operating in healthcare systems today must have an understanding of conflicts of interest in order to promptly identify actual as well as potential conflicts. It is imperative that strategies are set in place to prevent or handle conflicts of interest as they occur in order to build trusting relationships with patients, suppliers, and communities.
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The influence of personal and workplace resources on new graduate nurses' job satisfaction.
Pineau Stam, Lisa M; Spence Laschinger, Heather K; Regan, Sandra; Wong, Carol A
2015-03-01
This study examined the influence of new graduate nurses' personal resources (psychological capital) and access to structural resources (empowerment and staffing) on their job satisfaction. Reports suggest that new graduate nurses are experiencing stressful work environments, low job satisfaction, and high turnover intentions. These nurses are a health human resource that must be retained for the replacement of retiring nurses, and to address impending shortages. Supportive workplaces that promote new graduate nurses' job satisfaction may play an important role in the retention of new nurses. A secondary analysis of data from a larger study of new graduate nurses was conducted. Data collection was completed using self-reported questionnaires. Hierarchical multiple regression was used to test the hypothesised model. Psychological capital, structural empowerment and perceived staffing adequacy were significant independent predictors of job satisfaction. The final model explained 38% of the variance in job satisfaction. Both personal and structural workplace factors are important to new graduate nurses' job satisfaction. Managers should ensure empowerment structures are in place to support new graduate nurses' job satisfaction. Orientation processes and ongoing management support to build psychological capital in new graduate nurses will help create positive perceptions of the workplace, enhancing job satisfaction. © 2013 John Wiley & Sons Ltd.
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Beck, Mary S; Doscher, Mindy
2018-04-01
The current study described RN and patient care technician (PCT) communication in centralized and hybrid decentralized workstation designs using hands-free communication technology and infrared locator badge technology to facilitate communication. New construction of an oncology unit provided the opportunity to compare staff communication in two different workstation designs. Observations and questionnaires compared nurse and PCT communication in the two-unit designs. Descriptive statistics were used to analyze the differences. The hybrid decentralized unit had increased use of hands-free communication technology and hallway communication by nurses and PCTs, and increased patient room communication by nurses. Perceptions of communication between nurses and PCTs and congruency of priorities for care were similar for both units. The locator badge technology had limited adoption. Replacement of nurse workstations with new construction or remodeling impact staff communication patterns, necessitating that nurse leaders understand the impact of design and technology on communication. [Journal of Gerontological Nursing, 44(4), 17-22.]. Copyright 2018, SLACK Incorporated.
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Sau-Man Conny, Chan; Wan-Yim, Ip
2016-12-01
Nurse-led preoperative assessment clinics (POAC) have been introduced in different specialty areas to assess and prepare patients preoperatively in order to avoid last-minute surgery cancellations. Not all patients are referred to POACs before surgery, and the benefits of nurse-led POACs are not well documented in Hong Kong. The purpose of this systemic review was to identify the best available research evidence to inform current clinical practice, guide health care decision making and promote better care. The Joanna Briggs Institute (JBI) approach for conducting systematic review of quantitative research was used. Data bases searched included all published and unpublished studies in Chinese and English. All studies with adult patients who required elective orthopaedic surgery e.g. total knee replacement, total hip replacement, reduction of fracture or reconstruction surgery etc. in a hospital or day surgery center and attended a nurse-led POAC before surgery were included. Ten studies were critically appraised. Results showed that nurse-led POACs can reduce surgery cancellation rates. These studies suggested a reduction in the rate of postoperative mortality and length of hospital stay. In addition, the level of satisfaction towards services provided was significantly high. Although POACs are being increasingly implemented worldwide, the development of clinical guidelines, pathways and protocols was advocated. The best available evidence asserted that nurses in the POAC could serve as effective coordinators, assessors and educators. The nurse-led practice optimized patients' condition before surgery and hence minimized elective surgery cancellations. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
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A journey of leadership: from bedside nurse to chief executive officer.
Comack, Margret Tannis
2012-01-01
Understanding leadership from the inside out was a journey that spanned a 40-year career in health care. This article describes an individual's journey of becoming an effective executive leader using the LEADS in a caring environment--capabilities framework. This framework was recently developed in Canada and is now used broadly to understand the complexity and depth of health care leadership skills and challenges. The author utilizes the framework to explore leadership skill development from a personal perspective to a broader system transformation level. Challenges and successes along this journey are included to highlight the manner in which leadership evolves with experience, time, and determination. A retrospective view of a successful career in health care provides the model for others to consider a similar career path using a theoretical base and a thoughtful process of personal development.
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Energy Technology Data Exchange (ETDEWEB)
Willcock, J J; Lumsdaine, A; Quinlan, D J
2008-08-19
Tabled execution is a generalization of memorization developed by the logic programming community. It not only saves results from tabled predicates, but also stores the set of currently active calls to them; tabled execution can thus provide meaningful semantics for programs that seemingly contain infinite recursions with the same arguments. In logic programming, tabled execution is used for many purposes, both for improving the efficiency of programs, and making tasks simpler and more direct to express than with normal logic programs. However, tabled execution is only infrequently applied in mainstream functional languages such as Scheme. We demonstrate an elegant implementation of tabled execution in Scheme, using a mix of continuation-passing style and mutable data. We also show the use of tabled execution in Scheme for a problem in formal language and automata theory, demonstrating that tabled execution can be a valuable tool for Scheme users.
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de Andrade, Selma Regina; Boehs, Astrid Eggert; Coelho, Bruna; Schmitt, Isabel Maria; Boehs, Carlos Gabriel Eggert
2014-01-01
This study aimed to characterize the stages of the inter-organizational relationships between educational and caring aspects of Nursing, operating in the context of primary health care in a municipality of Santa Catarina, Brazil. The qualitative approach of the case study was used by deliberately selecting the cooperation between two organizations. Eight teaching nurses and eight assistant nurses were interviewed. The data were submitted to content analysis, and the results demonstrated a number of elements in the phases of interaction (negotiation, commitment and execution of activities), as well as the variability of their content over time. It was concluded that the interaction, at an operational level, is characterized by dynamics that happen during relationship cycles, usually spanning through the school-semester, producing new negotiations and commitments for the following semester.
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Outcomes of single-stage total arch replacement via clamshell incision
Directory of Open Access Journals (Sweden)
Ishizaka Toru
2011-09-01
Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.
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Nursing Informatics Certification Worldwide: History, Pathway, Roles, and Motivation
Cummins, M. R.; Gundlapalli, A. V.; Murray, P.; Park, H.-A.; Lehmann, C. U.
2016-01-01
numbers of informatics nurses are pursuing certification. Conclusions The pathway to certification is clear and well-established for U.S. based informatics nurses. The motivation for obtaining and maintaining nursing informatics certification appears to be stronger for nurses who do not have an advanced informatics degree. The primary difference between nursing and physician certification pathways relates to the requirement of formal training and level of informatics practice. Nurse informatics certification requires no formal education or training and verifies knowledge and skill at a more basic level. Physician informatics certification validates informatics knowledge and skill at a more advanced level; currently this requires documentation of practice and experience in clinical informatics and in the future will require successful completion of an accredited two-year fellowship in clinical informatics. For the profession of nursing, a graduate degree in nursing or biomedical informatics validates specialty knowledge at a level more comparable to the physician certification. As the field of informatics and its professional organization structures mature, a common certification pathway may be appropriate. Nurses, physicians, and other healthcare professionals with informatics training and certification are needed to contribute their expertise in clinical operations, teaching, research, and executive leadership. PMID:27830261
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Bayramzadeh, Sara; Alkazemi, Mariam F
2014-01-01
This study aims to explore the relationship between the nursing station design and use of communication technologies by comparing centralized and decentralized nursing stations. The rapid changes in communication technologies in healthcare are inevitable. Communication methods can change the way occupants use a space. In the meantime, decentralized nursing stations are emerging as a replacement for the traditional centralized nursing stations; however, not much research has been done on how the design of nursing stations can impact the use of communication technologies. A cross sectional study was conducted using an Internet-based survey among registered nurses in a Southeastern hospital in the United States. Two units with centralized nursing stations and two units with decentralized nursing stations were compared in terms of the application of communication technologies. A total of 70 registered nurses completed the survey in a 2-week period. The results revealed no significant differences between centralized and decentralized nursing stations in terms of frequency of communication technologies used. However, a difference was found between perception of nurses toward communication technologies and perceptions of the use of communication technologies in decentralized nursing stations. Although the study was limited to one hospital, the results indicate that nurses hold positive attitudes toward communication technologies. The results also reveal the strengths and weaknesses of each nursing station design with regard to communication technologies. Hospital, interdisciplinary, nursing, technology, work environment.
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W. Edwards Deming and total quality management: an interpretation for nursing practice.
Williams, T; Howe, R
1992-01-01
The purpose of this article is to introduce nurses to W. Edwards Deming and the 14 points of his management philosophy, the basis of total quality management (TQM) (Deming, 1986). Each of Deming's points has been subject to in-depth analysis from business executives for the past 40 years. Quality improvement is at the very center of TQM. To adopt TQM will require a major thought transformation for many nursing leaders, but the benefits that nurses and the profession as a whole can reap from this revolutionary style of management make the effort to change worthwhile. If you are not satisfied with the status quo and are looking for a better way to conduct business, the information in this article will begin to define quality improvement and will help you strive for the highest possible level of service to your ultimate customer--the patient.
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[Nursing process in advanced cardiopulmonary resuscitation].
Lucio Peña, Gerardo; Fuentes Leonardo, Ana María
2002-01-01
The process male nurse is a systematic and organized method to offer effective and efficient cares guided to the achievement of solving real problems of health, reducing the incidence and the duration. It is organized and systematic for that consists of five sequential and interrelated steps: Valuation, diagnostic, planning, execution and evaluation, in which are carried out interrelated actions, thought to maximize the long term results. The nurse process is based on the notion that the success of the cares is measured by the degree of effectiveness and the degree of satisfaction and the patient's progress. Applying this method in the Advanced Cardiac Live Support (ACLS) the identification of a cardiovascular or cardiopulmonary urgency was achieved that implies advanced treatment of the air road, defibrillation and appropriate medications to the circumstances. The ACLS challenges the nurses in charge from the patient's attention to make decisions quick low pressure and in dramatic scenes. Reason why it develops the flowing process male nurse in the advanced cardiopulmonary reanimation due to the incidence of these events in the National Institute of Cardiology Ignacio Chávez, which should guarantee the benefit of services in basic and advanced cardiopulmonary reanimation for personal with a high formation level in all the units of intensive cares and services of hospitalization in integrated form and stratified this way to avoid that it progresses to situations that cause the death or leave irreversible sequels since in the central nervous system the time it is a factor critical for the treatment of this events.
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Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S.; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael
2014-01-01
Aims: With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. Background: DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. Methods/Design: A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting
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Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael
2014-01-01
With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting quantitative and qualitative findings
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Nurses' perceptions of patient safety culture in Jordanian hospitals.
Khater, W A; Akhu-Zaheya, L M; Al-Mahasneh, S I; Khater, R
2015-03-01
Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers. The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective. A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture. Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority. Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases. The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture. Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between
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Nurses who work outside nursing.
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.
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Reducing surgical nurses' aseptic practice-related stress.
Aholaakko, Teija-Kaisa
2011-12-01
This paper aims to explore aseptic practice-related stress in surgery. The objectives are to define stress-related factors and the means to reduce the stress. Occupational stress is related to personal characteristics: job satisfaction and physiological and psychological well-being. The stress symptoms are often classified as part of a negative mood. Nurses have expressed stress when deadening their conscience to external demands with co-workers or internal working role-related demands. Surgery nurses expect fair division of work and compliance with rules. The hospital management, technology and the medical profession, instead of the needs of the patient, are recognised as a danger in the development of surgery nurses' role. A qualitative stimulated recall interview was performed in the surgery of the university hospital. Thirty-one operations were videotaped, and 31 nurses interviewed during videotape stimulation. The 1306 text pages were transcripted and analysed by a qualitative membership categorisation device analysis. The analysis revealed aseptic practice-related stress which constructed a sixteen level category. The membership categorisation identified connections between qualitatively attributed personnel and seven stress factors: working experience; time; equipment; person; patient; working morals and power. Final analysis revealed nurses reducing aseptic practice-related stress by safe, peaceful, competent and relative means. The aseptic practice-related stress varied from positive motivating feelings to exhaustion. The stress was experienced by medical and nursing co-workers and reduced by means which varied according to expertise and co-workers. This study showed needs for both the shared multiprofessional documentation of aseptic practice and better adherence to recommendations. Constructive means are useful when solving conflicts and replacing person-related aseptic practice with evidence-based. They may support nurses' professional growth, reduce
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Training Needs Assessment for Leaders in Nursing Based on Comparison of Competency Models
Directory of Open Access Journals (Sweden)
Kvas Andreja
2014-02-01
Full Text Available Background and Purpose: The main purpose behind the formation of leadership competency models must be the improvement of leadership. A competency model should serve as one of the tools for selecting the most suitable leaders, appraising their work, assessing training needs and preparing programmes of functional and formal education. The objective of this research is to assess the training needs of leaders in health care. A comparison of leadership competency models between different professional groups should serve as one of the tools with which to assess the training needs of various levels of leaders. Design/Methodology/Approach: A descriptive study using a survey design was conducted on 141 nurse leaders in Slovenia. Respondents indicated to what extent each of 95 different behaviours was characteristic of a person at their leadership level. Results: The most important competence dimensions (groups of behaviours for leaders in health care are (1 at the first - top leadership level: strategic thinking, openness to change and responsibility; (2 for leaders at the second - middle leadership level: relations with co-workers, animation, resistance to stress; and (3 for leaders at the third leadership level: realisation skills, execution of procedures, communication. Training needs assessments were done for three leadership levels in nursing care. Conclusions: The greatest need for training of nurse leaders can be observed at the third leadership level. Special training programmes should be organised in the competency areas of realisation skills, execution of procedures, communication, education and ethics
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[Evaluation of the handwashing technique held by students from the nursing graduation course].
Felix, Carla Cristiane Paz; Miyadahira, Ana Maria Kazue
2009-03-01
The purpose of this study was to compare the execution and verify the compliance with the handwashing techniques by students in an undergraduate Nursing course. The study was performed with 113 students enrolled in internship programs in healthcare institutions in the city of São Paulo. Data collection occurred through direct observation, using a check-list instrument with the steps of the technique. Students in their 2nd and 3rd year had better results in most steps of the technique, with a statistically significant difference when compared to the 4th year. Compliance with the steps of the technique by the students was very low, since their compliance with half the handwashing steps was lower than 50%. The average amount of students who executed all the steps of the technique correctly was very low, 8.8%. The observed students did not execute the handwashing techniques according to the recommendations.
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Competencies required for nursing telehealth activities: A Delphi-study.
van Houwelingen, Cornelis T M; Moerman, Anna H; Ettema, Roelof G A; Kort, Helianthe S M; Ten Cate, Olle
2016-04-01
Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to use these technologies effectively. Therefore, the potential of telehealth fails to reach full utilization. A better understanding of nursing telehealth entrustable professional activities (NT-EPAs) and the required competencies can contribute to the development of nursing telehealth education. In a four-round Delphi-study, a panel of experts discussed which NT-EPAs are relevant for nurses and which competencies nurses need to possess to execute these activities effectively. The 51 experts, including nurses, nursing faculty, clients and technicians all familiar with telehealth, were asked to select items from a list of 52 competencies based on the literature and on a previous study. Additionally, the panelists could add competencies based on their experience in practice. The threshold used for consensus was set at 80%. Consensus was achieved on the importance of fourteen NT-EPAs, requiring one or more of the following core competencies; coaching skills, the ability to combine clinical experience with telehealth, communication skills, clinical knowledge, ethical awareness, and a supportive attitude. Each NT-EPA requires a specific set of competencies (at least ten). In total, 52 competencies were identified as essential in telehealth. Many competencies for telehealth, including clinical knowledge and communication skills, are not novel competencies. They are fundamental to nursing care as a whole and therefore are also indispensable for telehealth. Additionally, the fourteen NT-EPAs appeared to require additional subject specific competencies, such as the ability to put patients at ease when they feel insecure about using technology. The NT-EPAs and related competencies presented in this study can be used by nursing schools that are considering including or expanding
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Development of a conceptual policy framework for advanced practice nursing: an ethnographic study.
Schober, Madrean M; Gerrish, Kate; McDonnell, Ann
2016-06-01
To report on a study examining policy development for advanced practice nursing from intent of policy to realization in practice. Inclusion of advanced practice nursing roles in the healthcare workforce is a worldwide trend. Optimal advanced nursing practice requires supportive policies. Little is known about how policy is developed and implemented. Ethnography using an instrumental case study approach was selected to give an in-depth understanding of the experiences of one country (Singapore) to contribute to insight into development elsewhere. The four-phase study was conducted from 2008-2012 and included document analysis (n = 47), interviews with key policy decision makers (n = 12), interviews with nursing managers and medical directors (n = 11), interviews and participant observation with advanced practice nurses (n = 15). Key policymakers in positions of authority were able to promote policy development. However, this was characterized by lack of strategic planning for implementation. A vague understanding by nursing managers and medical directors of policies, the role and its position in the healthcare workforce led to indecision and uncertainty in execution. Advanced practice nurses developed their role based on theory acquired in their academic programme but were unsure what role to assume in practice. Lack of clear guidelines led to unanticipated difficulties for institutions and healthcare systems. Strategic planning could facilitate integration of advanced practice nurses into the healthcare workforce. A Conceptual Policy Framework is proposed as a guide for a coordinated approach to policy development and implementation for advanced practice nursing. © 2016 John Wiley & Sons Ltd.
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Quality improvement: the nurse's role.
Moran, M J; Johnson, J E
1992-06-01
Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers
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Multisite Assessment of Nursing Continuing Education Learning Needs Using an Electronic Tool.
Winslow, Susan; Jackson, Stephanie; Cook, Lesley; Reed, Joanne Williams; Blakeney, Keshia; Zimbro, Kathie; Parker, Cindy
2016-02-01
A continued education needs assessment and associated education plan are required for organizations on the journey for American Nurses Credentialing Center Magnet® designation. Leveraging technology to support the assessment and analysis of continuing education needs was a new venture for a 12-hospital regional health system. The purpose of this performance improvement project was to design and conduct an enhanced process to increase the efficiency and effectiveness of gathering data on nurses' preferences and increase nurse satisfaction with the learner assessment portion of the process. Educators trialed the use of a standardized approach via an electronic survey tool to replace the highly variable processes previously used. Educators were able to view graphical summary of responses by category and setting, which substantially decreased analysis and action planning time for education implementation plans at the system, site, or setting level. Based on these findings, specific continuing education action plans were drafted for each category and classification of nurses. Copyright 2016, SLACK Incorporated.
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Teamwork and clinical error reporting among nurses in Korean hospitals.
Hwang, Jee-In; Ahn, Jeonghoon
2015-03-01
To examine levels of teamwork and its relationships with clinical error reporting among Korean hospital nurses. The study employed a cross-sectional survey design. We distributed a questionnaire to 674 nurses in two teaching hospitals in Korea. The questionnaire included items on teamwork and the reporting of clinical errors. We measured teamwork using the Teamwork Perceptions Questionnaire, which has five subscales including team structure, leadership, situation monitoring, mutual support, and communication. Using logistic regression analysis, we determined the relationships between teamwork and error reporting. The response rate was 85.5%. The mean score of teamwork was 3.5 out of 5. At the subscale level, mutual support was rated highest, while leadership was rated lowest. Of the participating nurses, 522 responded that they had experienced at least one clinical error in the last 6 months. Among those, only 53.0% responded that they always or usually reported clinical errors to their managers and/or the patient safety department. Teamwork was significantly associated with better error reporting. Specifically, nurses with a higher team communication score were more likely to report clinical errors to their managers and the patient safety department (odds ratio = 1.82, 95% confidence intervals [1.05, 3.14]). Teamwork was rated as moderate and was positively associated with nurses' error reporting performance. Hospital executives and nurse managers should make substantial efforts to enhance teamwork, which will contribute to encouraging the reporting of errors and improving patient safety. Copyright © 2015. Published by Elsevier B.V.
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Redesigning a joint replacement program using Lean Six Sigma in a Veterans Affairs hospital.
Gayed, Benjamin; Black, Stephen; Daggy, Joanne; Munshi, Imtiaz A
2013-11-01
In April 2009, an analysis of joint replacement surgical procedures at the Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, revealed that total hip and knee replacements incurred $1.4 million in non-Veterans Affairs (VA) care costs with an average length of stay of 6.1 days during fiscal year 2008. The Joint Replacement Program system redesign project was initiated following the Vision-Analysis-Team-Aim-Map-Measure-Change-Sustain (VA-TAMMCS) model to increase efficiency, decrease length of stay, and reduce non-VA care costs. To determine the effectiveness of Lean Six Sigma process improvement methods applied in a VA hospital. Perioperative processes for patients undergoing total joint replacement were redesigned following the VA-TAMMCS model--the VA's official, branded method of Lean Six Sigma process improvement. A multidisciplinary team including the orthopedic surgeons, frontline staff, and executive management identified waste in the current processes and initiated changes to reduce waste and increase efficiency. Data collection included a 1-year baseline period and a 20-month sustainment period. The primary endpoint was length of stay; a secondary analysis considered non-VA care cost reductions. Length of stay decreased 36% overall, decreasing from 5.3 days during the preproject period to 3.4 days during the 20-month sustainment period (P Lean and Six Sigma process improvement initiatives in a surgical practice, producing a 36% sustained reduction in length of stay and completely eliminating non-VA care for total hip and knee replacements while increasing total joint replacement volume at this medical center.
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2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Senior Executive Service, Defense Intelligence Senior Executive Service, and Senior Cryptologic Executive Service. 842.211 Section 842.211... EMPLOYEES RETIREMENT SYSTEM-BASIC ANNUITY Eligibility § 842.211 Senior Executive Service, Defense...
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Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... Your hip joint is made up of 2 major parts. One or both parts may be replaced during surgery: ...
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Nursing, Nursing Education, and Anxiety.
Biggers, Thompson; And Others
In response to the current crisis in the field of nursing, a study examined nursing students' perceived work-related stress and differences among associate degree, diploma, and baccalaureate nursing programs in their preparation of nursing students. The 171 subjects, representing the three different nursing programs, completed a questionnaire…
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Complications of the natural childbirth: assistance of nurses obstetras
Directory of Open Access Journals (Sweden)
Zulmerinda Meira Oliveira
2009-01-01
Full Text Available The moment of the natural childbirth is a complex and dynamic event that demands assistance from the health professional that joins the humanized execution of procedures and actions respecting the singularity of the woman. In this way, the objectives of this study were: to know the main occurred complications at the moment of the natural childbirth and the assistance given by the nurse. It’s an exploratory research, in which the scene was a public hospital in the city of Jequié-Ba. The sampling consisted of five persons with specialization in obstetric nursing, and the used instrument for the data collection was the half-structuralized interview. After the data collection, the gotten information were submitted to the content analysis Bardin. Therefore, it’s possible to infer that the obstetric nurse faces in a positive way the complications lived deeply during the natural childbirth, through the exercise of a humanized and distinguished assistance as techniques/procedures endorsed by the literature. Thus, this can make us reflect the importance of this professional in the childbirth room as an executor and promoter of a worthy and welcoming assistance
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Policies for replacing long-term indwelling urinary catheters in adults.
Cooper, Fergus P M; Alexander, Cameron Edwin; Sinha, Sanjay; Omar, Muhammad Imran
2016-07-26
Long-term indwelling catheters are used commonly in people with lower urinary tract problems in home, hospital and specialised health-care settings. There are many potential complications and adverse effects associated with long-term catheter use. The effect of health-care policies related to the replacement of long-term urinary catheters on patient outcomes is unclear. To determine the effectiveness of different policies for replacing long-term indwelling urinary catheters in adults. We searched the Cochrane Incontinence Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, CINAHL, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 19 May 2016), and the reference lists of relevant articles. All randomised controlled trials investigating policies for replacing long-term indwelling urinary catheters in adults were included. At least two review authors independently performed data extraction and assessed risk of bias of all the included trials. Quality of evidence was assessed by adopting the GRADE approach. Any discrepancies were resolved by discussion between the review authors or an independent arbitrator. We contacted the authors of included trials to seek clarification where required. Three trials met the inclusion criteria, with a total of 107 participants in three different health-care settings: A USA veterans administration nursing home; a geriatric centre in Israel; and a community nursing service in Hong Kong. Data were available for three of the pre-stated comparisons. Priefer and colleagues evaluated different time intervals between catheter replacement (n = 17); Firestein and colleagues evaluated the use of antibiotic prophylaxis at the time of replacement (n = 70); and Cheung and colleagues compared two different types of cleaning solutions (n = 20).All the included trials were
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Lin, Hui-Chen; Lin, Chi-Yi; Chien, Tsui-Wei; Liu, Kuei-Fen; Chen, Miao-Yen; Lin, Wen-Chuan
2013-02-01
A constellation of factors accounts for teaching efficacy in the fundamental nursing practicum. Teachers play a critical role in terms of designing and executing an appropriate teaching plan, choosing effective methods, and holding appropriate teaching attitudes. It is thus extremely important that clinical teachers master the core characteristics of basic nursing practice. This study aimed to illuminate the core characteristics of basic nursing practice for students for reference by clinical practicum teachers. Qualitative research was used to identify the fundamentals of nursing practice by clinical teacher. Five focus group meetings were convened during the practice period. The researchers presided over group discussions held during the normal weekly teaching schedule and lasting approximately 2-4 hours each. The content analysis was adopted to analyze the data. Three major themes were proposed, including (1) student status: "novices were stymied by problems and thus improved slowly"; (2) teacher awareness: "teachers need to be aware of student capabilities, mood, and discomfort"; and (3) teaching style: "a good choice of methods should support and encourage students. To cultivate professional nursing knowledge and self-confidence for future professional commitment, clinical teachers must first understand the characteristics and motivations of learning of their students and then select the, skills, and attitudes appropriate to provide step-by-step guidance. Communication with staffs and the preparation of atmosphere prior to nursing practice are also essential for students. Results provide insights into the technical college environment with regard to basic-level clinical nursing practice.
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Nurses' workarounds in acute healthcare settings: a scoping review.
Debono, Deborah S; Greenfield, David; Travaglia, Joanne F; Long, Janet C; Black, Deborah; Johnson, Julie; Braithwaite, Jeffrey
2013-05-11
Workarounds circumvent or temporarily 'fix' perceived workflow hindrances to meet a goal or to achieve it more readily. Behaviours fitting the definition of workarounds often include violations, deviations, problem solving, improvisations, procedural failures and shortcuts. Clinicians implement workarounds in response to the complexity of delivering patient care. One imperative to understand workarounds lies in their influence on patient safety. This paper assesses the peer reviewed empirical evidence available on the use, proliferation, conceptualisation, rationalisation and perceived impact of nurses' use of workarounds in acute care settings. A literature assessment was undertaken in 2011-2012. Snowballing technique, reference tracking, and a systematic search of twelve academic databases were conducted to identify peer reviewed published studies in acute care settings examining nurses' workarounds. Selection criteria were applied across three phases. 58 studies were included in the final analysis and synthesis. Using an analytic frame, these studies were interrogated for: workarounds implemented in acute care settings by nurses; factors contributing to the development and proliferation of workarounds; the perceived impact of workarounds; and empirical evidence of nurses' conceptualisation and rationalisation of workarounds. The majority of studies examining nurses' workarounds have been published since 2008, predominantly in the United States. Studies conducted across a variety of acute care settings use diverse data collection methods. Nurses' workarounds, primarily perceived negatively, are both individually and collectively enacted. Organisational, work process, patient-related, individual, social and professional factors contribute to the proliferation of workarounds. Group norms, local and organisational culture, 'being competent', and collegiality influence the implementation of workarounds. Workarounds enable, yet potentially compromise, the execution of
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Communication in autism spectrum disorder: a guide for pediatric nurses.
Brown, Amanda B; Elder, Jennifer H
2014-01-01
In the United States, one in every 68 children has autism spectrum disorder (ASD) (Centers for Disease Control and Prevention, 2014). ASD is a developmental disorder of the brain that is characterized by impairments in social interaction, communication, and repetitive patterns of behavior (American Psychiatric Association [APA], 2013). Nurses have a duty to provide high quality care to children with ASD. Effective communication is essential to providing quality care. Three main theories attempt to explain how the ASD brain functions and the implications on communication: lack of theory of mind, weak central coherence, and lack of executive function. Children with ASD have difficulties in vocalic, kinesthetic, and proxemic aspects of communication (Notbhom, 2006). Simple adaptations to environment and style can make the communication between nurses and children with ASD easier and more effective (Aylott, 2000; Green et al., 2010).
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Nurse manager engagement: what it means to nurse managers and staff nurses.
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.
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Job embeddedness factors and retention of nurses with 1 to 3 years of experience.
Halfer, Diana
2011-10-01
An aging work force, predictions of job growth in health care, and an eventual economic recovery suggest that the current reprieve from the national nursing shortage is temporary. New graduate nurses are an important part of the work force and are needed to replace nurses who will retire in the next decade. Organizational leaders can address the forecasted work force demand by proactively investing in programs for workplace development and retention. Recent literature reports an increased focus on understanding the work experience and career support needed for new graduate nurses. Several studies report improvements in job satisfaction and retention after implementation of structured mentoring programs for new graduate nurses. However, despite successful transition programs, turnover for these same nurses after 1 to 3 years of organizational tenure remains high. Studying factors that contribute to retention and supporting careers beyond the first year of practice may have a significant effect on improving retention and will contribute new knowledge to the nursing literature. This study, undertaken at a Midwestern pediatric academic medical center, examined job factors and career development support that lead to retention of nurses with 1 to 3 years of experience. Understanding these issues may guide nursing leaders and staff development educators in investing in focused retention and career development plans during an economic recession. Copyright 2011, SLACK Incorporated.
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Commentary: Mentoring the mentor: executive coaching for clinical departmental executive officers.
Geist, Lois J; Cohen, Michael B
2010-01-01
Departmental executive officers (DEOs), department chairs, and department heads in medical schools are often hired on the basis of their accomplishments in research as well as their skills in administration, management, and leadership. These individuals are also expected to be expert in multiple areas, including negotiation, finance and budgeting, mentoring, and personnel management. At the same time, they are expected to maintain and perhaps even enhance their personal academic standing for the purposes of raising the level of departmental and institutional prestige and for recruiting the next generation of physicians and scientists. In the corporate world, employers understand the importance of training new leaders in requisite skill enhancement that will lead to success in their new positions. These individuals are often provided with extensive executive training to develop the necessary competencies to make them successful leaders. Among the tools employed for this purpose are the use of personal coaches or executive training courses. The authors propose that the use of executive coaching in academic medicine may be of benefit for new DEOs. Experience using an executive coach suggests that this was a valuable growth experience for new leaders in the institution.
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Single-instruction multiple-data execution
Hughes, Christopher J
2015-01-01
Having hit power limitations to even more aggressive out-of-order execution in processor cores, many architects in the past decade have turned to single-instruction-multiple-data (SIMD) execution to increase single-threaded performance. SIMD execution, or having a single instruction drive execution of an identical operation on multiple data items, was already well established as a technique to efficiently exploit data parallelism. Furthermore, support for it was already included in many commodity processors. However, in the past decade, SIMD execution has seen a dramatic increase in the set of
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The nexus of nursing leadership and a culture of safer patient care.
Murray, Melanie; Sundin, Deborah; Cope, Vicki
2018-03-01
To explore the connection between +6 nursing leadership and enhanced patient safety. Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes. © 2017 John Wiley & Sons Ltd.
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Fostering nursing ethics for practical nursing
森田, 敏子; モリタ, トシコ; Morita, Toshiko
2014-01-01
Higher nursing ethics can raise nursing quality. The author attempts to define theproblem from the seedling of sensibility in practical nursing and focuses on the clinical environment surrounding nursing ethics from its pedagogical and historicalaspects. On the basis of these standpoints, the author discusses issues on the practical nursing as a practitioner of nursing ethics.
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Executive Orders from 1994-2013
National Archives and Records Administration — The President of the United States manages the operations of the Executive branch of Government through Executive orders. After the President signs an Executive...
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Assuming the mantle of leadership: issues and challenges for directors of nursing.
Fleming, Mary Louise; Kayser-Jones, Jeanie
2008-11-01
This ethnographic study investigated leadership from the perspective of directors of nursing (DONs) in proprietary nursing homes. Data from interviews and extensive participant observation with 10 DONs were analyzed using open coding and content analysis. The study drew on a priori concepts from transformational leadership theory to describe the role, DON approaches to leadership, and factors that facilitate or impede leadership in nursing homes. This article reports findings from a larger study related to conditions existing when participants entered the DON position. Antecedent conditions influenced organizational expectations of incoming DONs and shaped participants' leadership experiences. DONs filling long-standing vacancies had to reestablish the influence and authority of the role. Those replacing unsuccessful DONs confronted serious regulatory, care, and morale issues. In contrast, DONs with successful predecessors experienced organizational support and had confidence in their abilities to lead.
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Radiation control report on intermediate heat exchanger replacement and related works
International Nuclear Information System (INIS)
Kanou, Y.; Yamanaka, T.; Sasajima, T.; Hoshiba, H.; Emori, S.; Shindou, K.
2002-03-01
The 13th periodical inspection of the experimental fast reactor JOYO is being made from Jun. 2000 to Jan. 2003. While this inspection, from the end of Oct. 2000 to Nov. 2001, the MK-III modification work on heat transport system was made in lower region of the reactor containment vessel in the reactor facility (under floor area). In the MK-III modification work, the works important to radiation control were the replacement of intermediate heat exchangers (IHXs) and fixtures, and the picking out of the surveillance material from primary heat transport piping carried out in the maintenance building. Because the working areas of these works were executed in small space around the complicated primary heat transport piping, workability was bad and dose rate from the corrosion products (CP) in piping or fixtures was high. In such condition, radiation control was performed mainly concerned about external exposure. The planted total external exposure of the IHX replacement and related works was 7135 man-mSv (target of total dose control: less than 5708 man-mSv, 80% of the plan), derived from special radiation work plants for segmental works, concerned about work procedure, number of workers, period of work, dose rate of working area and surface dose rate of equipments. The special radiation control organization was established for such long and large-scale work. The spatial organization held detailed discussion about radiation control of this work with the execution section and contractors appropriately, performance careful external/internal exposure control and surface contamination control and made efforts to reduce te external exposure thoroughly. As a result of these action, the total external exposure was 2386 man·mSv (≅33% of the plan, ≅42% of the target) and the maximum individual exposure were 24.7 mSv for staffs and 21.7mSv for contractors. The dose rate, surface contamination and air contamination while the works were kept under the control level with the
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Shoulder replacement - discharge
Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge
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Directory of Open Access Journals (Sweden)
Vitaly Stepashin
2017-01-01
Full Text Available УДК 343.24The subject. The article deals with the problem of the use of "substitute" penalties.The purpose of the article is to identify criminal and legal criteria for: selecting the replacement punishment; proportionality replacement leave punishment to others (the formalization of replacement; actually increasing the punishment (worsening of legal situation of the convicted.Methodology.The author uses the method of analysis and synthesis, formal legal method.Results. Replacing the punishment more severe as a result of malicious evasion from serving accused designated penalty requires the optimization of the following areas: 1 the selection of a substitute punishment; 2 replacement of proportionality is serving a sentence other (formalization of replacement; 3 ensuring the actual toughening penalties (deterioration of the legal status of the convict. It is important that the first two requirements pro-vide savings of repression in the implementation of the replacement of one form of punishment to others.Replacement of punishment on their own do not have any specifics. However, it is necessary to compare them with the contents of the punishment, which the convict from serving maliciously evaded. First, substitute the punishment should assume a more significant range of restrictions and deprivation of certain rights of the convict. Second, the perfor-mance characteristics of order substitute the punishment should assume guarantee imple-mentation of the new measures.With regard to replacing all forms of punishment are set significant limitations in the application that, in some cases, eliminates the possibility of replacement of the sentence, from serving where there has been willful evasion, a stricter measure of state coercion. It is important in the context of the topic and the possibility of a sentence of imprisonment as a substitute punishment in cases where the original purpose of the strict measures excluded. It is noteworthy that the
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2010-09-13
...; File No. 4-612] Joint Public Roundtable on Swap Execution Facilities and Security-Based Swap Execution Facilities AGENCY: Commodity Futures Trading Commission (``CFTC'') and Securities and Exchange Commission... discuss swap execution facilities and security-based swap execution facilities in the context of certain...
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Nursing students assess nursing education.
Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert
2005-01-01
This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.
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Respiratory and dermal symptoms in Thai nurses using latex products.
Supapvanich, C; Povey, A C; de Vocht, F
2013-09-01
Despite known health risks related to the use of powdered latex gloves (PLGs), they are still widely used in hospitals in developing countries due to the high cost of alternatives. To determine the prevalence of dermal and respiratory symptoms associated with latex glove use in nurses in Thailand and evaluate the influence of previously reported occupational risk factors in this population. A cross-sectional study in female nurses working in three Thai hospitals. Participants completed a questionnaire on demographics, occupational and personal history, use of latex products at work and dermal and respiratory symptoms attributed to occupational use of latex gloves. Of 899 nurses, 18% reported health effects attributed to the use of latex products. After adjustment for confounding, occupational risk factors associated with increased reporting of dermal symptoms included wearing more than 15 pairs of PLG per day (odds ratio (OR): 2.10, 95% confidence interval (CI): [1.32-3.34]), using chlorhexidine (OR: 2.07, 95% CI: [1.22-3.52]) and being an operating theatre nurse (OR: 2.46, 95% CI: [1.47-4.12]). Being a labour ward nurse (OR: 3.52, 95% CI: [1.26-9.85]) was the only factor associated with increased reporting of respiratory symptoms. Continuing use of PLGs in Thai nurses is associated with increased prevalence of dermal symptoms compared with data from developed countries. Measures to reduce such health effects are well established and should be considered. Additionally, replacement of chlorhexidine with an alternative detergent seems advisable.
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Men student nurses: the nursing education experience.
Meadus, Robert J; Twomey, J Creina
2011-01-01
This study explored the phenomenon of being a male in a predominately female-concentrated undergraduate baccalaureate nursing program. Men remain a minority within the nursing profession. Nursing scholars have recommended that the profile of nursing needs to change to meet the diversity of the changing population, and the shortfall of the worldwide nursing shortage. However, efforts by nursing schools and other stakeholders have been conservative toward recruitment of men. Using Giorgi's method, 27 students from a collaborative nursing program took part in this qualitative, phenomenological study. Focus groups were undertaken to gather data and to develop descriptions of the experience. Five themes highlighted men students' experience of being in a university nursing program: choosing nursing, becoming a nurse, caring within the nursing role, gender-based stereotypes, and visible/invisible. The experiences of the students revealed issues related to gender bias in nursing education, practice areas, and societal perceptions that nursing is not a suitable career choice for men. Implications for nurse educators and strategies for the recruitment and retention of men nursing students are discussed. © 2011 Wiley Periodicals, Inc.
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Nursing shortages and international nurse migration.
Ross, S J; Polsky, D; Sochalski, J
2005-12-01
The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.
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Concurrent Models for Object Execution
Diertens, Bob
2012-01-01
In previous work we developed a framework of computational models for the concurrent execution of functions on different levels of abstraction. It shows that the traditional sequential execution of function is just a possible implementation of an abstract computational model that allows for the concurrent execution of functions. We use this framework as base for the development of abstract computational models that allow for the concurrent execution of objects.
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Vance, David E.; Dodson, Joan E.; Watkins, Jason; Kennedy, Bridgett H.; Keltner, Norman L.
2013-01-01
To successfully negotiate and interact with one’s environment, optimal cognitive functioning is needed. Unfortunately, many neurological and psychiatric diseases impede certain cognitive abilities such as executive functioning or speed of processing; this can produce a poor fit between the patient and the cognitive demands of his or her environment. Such non-dementia diseases include bipolar disorder, schizophrenia, post-traumatic stress syndrome, depression, and anxiety disorders, just to name a few. Each of these diseases negatively affects particular areas of the brain, resulting in distinct cognitive profiles (e.g., deficits in executive functioning but normal speed of processing as seen in schizophrenia). In fact, it is from these cognitive deficits in which such behavioral and emotional symptoms may manifest (e.g., delusions, paranoia). This article highlights the distinct cognitive profiles of such common neurological and psychiatric diseases. An understanding of such disease-specific cognitive profiles can assist nurses in providing care to patients by knowing what cognitive deficits are associated with each disease and how these cognitive deficits impact everyday functioning and social interactions. Implications for nursing practice and research are posited within the framework of cognitive reserve and neuroplasticity. PMID:23422693
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Demystifying Nursing Theory: A Christian Nursing Perspective.
Schaffer, Marjorie A; Sandau, Kristin; Missal, Bernita
How does nursing theory apply to nursing practice? Nursing theory can explain the why and how of nursing practice, guide nursing interventions, and provide a framework for measuring outcomes. This article briefly explains nursing theory, provides examples for applying theory to nursing practice, and proposes questions for examining the consistency of nursing theories with Christian perspectives. A helpful table illustrating grand, middle-range, and situation-specific theories and their application to nursing practice and research, along with references, is provided online as supplemental digital content. Three caring theories are analyzed from biblical beliefs.
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山梨, 八重子; ヤマナシ, ヤエコ; Yamanashi, Yaeko
2017-01-01
The purpose of this paper is to clarify the originality of nursing given by nursing teachers. From the results, I concluded that, taking nursing from the viewpoint of Kant education, all teachers including the nursing teachers, and nursing teachers make teachers and others to bring out the important nursing skills in themselves. Further the network formed from these interactions is the origin of the nursing provided by nursing teachers.
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Iranian nurses self-perception -- factors influencing nursing image.
Varaei, Shokoh; Vaismoradi, Mojtaba; Jasper, Melanie; Faghihzadeh, Soghrat
2012-05-01
The purpose of this study was to describe the perspectives of Iranian nurses regarding factors influencing nursing image. Nursing image is closely tied to the nurse's role and identity, influencing clinical performance, job satisfaction and quality of care. Images of nursing and nurses are closely linked to the cultural context in which nursing is practised, hence, this study explores how Iranian nurses perceive the factors that influence their own image. A descriptive study using a survey design was conducted with 220 baccalaureate qualified nurses working in four teaching hospitals in an urban area of Iran. A Nursing Image Questionnaire was used and analysed using descriptive and inferential statistics. In the domains of 'characteristics required for entry to work', 'social role characteristics of nursing' and 'prestige, economic and social status, and self image' the nurses had negative images. 'Reward' and 'opportunity for creativity and originality' were factors that least influenced choosing nursing as a career. The presence of a nurse in the family and working in the hospital had the greatest impact on the establishment of nurses' nursing image. Improving the nursing profession's prestige and social position as well as providing the opportunity for creativity and originality in nursing practice will change the self-image of Iranian nurses, facilitating effective and lasting changes in nursing's image. Nurse managers are well-placed to influence nurses' perceptions of nursing's image. Given the finding that thinking about leaving a job positively correlates with holding a negative nursing image, nurse managers need to consider how they can work effectively with their staff to enhance morale and nurses' experience of their job. © 2012 Blackwell Publishing Ltd.
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Black, Lisa; Spetz, Joanne; Harrington, Charlene
2010-01-01
Registered nurses (RNs) who work outside of nursing have seldom been examined. This aim of this study was to compare the 122,178 (4%) of RNs who are employed outside of nursing to those who work in nursing jobs in terms of sociodemographic, market, and political variables to determine if these groups are substantively different from one another. Using a logit regression model, wages were a significant predictor of working outside of nursing for unmarried nurses but not for married nurses. Married and unmarried male nurses were more likely to work outside of nursing. Baccalaureate education, children under age 6, higher family income, and years since graduation increased the odds of working outside of nursing for married nurses. Ultimately, identifying characteristics on which these groups differ may inform future policy directions that could target nurses who may leave nursing at a time when retention efforts might be effective to alter their trajectory away from the profession.
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Cultural competence among nursing students in Saudi Arabia: a cross-sectional study.
Cruz, J P; Alquwez, N; Cruz, C P; Felicilda-Reynaldo, R F D; Vitorino, L M; Islam, S M S
2017-06-01
This study assessed the cultural competence of nursing students in a Saudi University. With the current situation of immigration in Saudi Arabia, the cultural diversity in healthcare facilities is anticipated to grow. This presents a great challenge to the members of the healthcare team. A cross-sectional study was conducted among 272 nursing students in a Saudi university using a self-administered questionnaire consisting of two parts, namely the respondents' demographics and cultural background information sheet and the Cultural Capacity Scale Arabic version. The respondents showed the highest competence in their ability to demonstrate communication skills with culturally diverse patients and lowest in the familiarity with health- or illness-related cultural knowledge or theory. Gender, academic level, clinical exposure, prior diversity training, the experience of taking care of culturally diverse patients and patients belonging to special population groups were significant factors that could likely to influence cultural competence. The findings suggest that the Saudi nursing students possess the ability to provide culturally appropriate nursing care to patients with a diverse cultural background. Despite the good cultural competence reflected in this study, some aspects in ensuring a culturally competent care rendered by Saudi nursing students need to be improved. With the country's Saudization policy in health care (replacing foreign nurses with Saudi nurses), the findings can be used in designing training and interventions to meet the needs of Saudi nursing students regarding cultural competence development, which is integral in their preparation to assume their future roles as nurses. Policy guidelines, such as including cultural competency training and foreign languages training as mandatory continuing education for nurses, as well as integrating cultural competency and foreign languages in the prelicensure curriculum, should be developed and implemented in
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Executive Energy Leadership Academy | NREL
Executive Energy Leadership Academy Executive Energy Leadership Academy NREL's Executive Energy Leadership Academy is a nationally renowned program that provides non-technical business, governmental, and foreground. Leadership Program The Leadership Program is designed for community and industry leaders with an
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Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Jun, Jin
2015-04-01
The objective of this study was to examine early-career frontline nurse managers' (FLNMs') reported educational preparedness and participation in quality improvement (QI). Frontline nurse managers are vitally important for leading QI. However, it is not well known if they have adequate knowledge and skills to lead this important function. We examined cross-sectional survey data from 42 FLNMs using descriptive statistics. About 30% of FLNMs reported being very prepared across 12 measured QI skills by schools or employers and 35% reported participating in a specific clinical effort to improve patient care on their unit more than once a month. More than 50% reported having good organizational support for QI, but only about 30% reported being rewarded for their contributions to QI. Our study highlights opportunities for development in QI for FLNMs and offers some solutions for nurse executives that can bridge the educational gaps.
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Blair, Clancy
2016-01-01
Executive functions are thinking skills that assist with reasoning, planning, problem solving, and managing one’s life. The brain areas that underlie these skills are interconnected with and influenced by activity in many different brain areas, some of which are associated with emotion and stress. One consequence of the stress-specific connections is that executive functions, which help us to organize our thinking, tend to be disrupted when stimulation is too high and we are stressed out, or too low when we are bored and lethargic. Given their central role in reasoning and also in managing stress and emotion, scientists have conducted studies, primarily with adults, to determine whether executive functions can be improved by training. By and large, results have shown that they can be, in part through computer-based videogame-like activities. Evidence of wider, more general benefits from such computer-based training, however, is mixed. Accordingly, scientists have reasoned that training will have wider benefits if it is implemented early, with very young children as the neural circuitry of executive functions is developing, and that it will be most effective if embedded in children’s everyday activities. Evidence produced by this research, however, is also mixed. In sum, much remains to be learned about executive function training. Without question, however, continued research on this important topic will yield valuable information about cognitive development. PMID:27906522
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Concept analysis: nurse-to-nurse lateral violence.
Embree, Jennifer L; White, Ann H
2010-01-01
The purpose of this paper is to examine the concept of nurse-to-nurse lateral violence (LV). Published literature--LV among nurses is significant and results in social, psychological, and physical consequences, negative patient and nursing outcomes, and damaged relationships. An extensive review of literature through Health Source, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest health, and Medical Complete was used to determine agreement and disagreement across disciplines and emerging trends. This concept analysis demonstrates that nurse-to-nurse LV is nurse-to-nurse aggression with overtly or covertly directing dissatisfaction toward another. Origins include role issues, oppression, strict hierarchy, disenfranchising work practices, low self-esteem, powerlessness perception, anger, and circuits of power. The result of this analysis provides guidance for further conceptual and empirical research as well as for clinical practice. Organizations must learn how to eliminate antecedents and provide nurses with skills and techniques to eradicate LV to improve the nursing work environment, patient care outcomes, and nurse retention.
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Student nurses as school nurse extenders.
Rossman, Carol L; Dood, Florence V; Squires, Darcy A
2012-12-01
The severe underuse of school nurses leaves students with unaddressed health needs that impact their safety and learning ability. An undergraduate pediatric clinical focusing on nursing students and the role of a school nurse in an elementary school setting can be a unique approach to combining the needs of school children and educating student nurses. One school of nursing created such a project to help address these needs and collect data on the activities student nurses performed in school nurse role and their impact on student health. This project serves as both a practice improvement project and an innovation in pediatric clinical education. The purposes of this project were to quantify baccalaureate nursing student activities related to the school nurse role and to evaluate the results that have the potential to impact on student health in an urban elementary school. Copyright © 2012 Elsevier Inc. All rights reserved.
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Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...
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Nursing in Malawi: nursing theory in the movement to professionalize nursing.
Bultemeier, Kaye I
2012-04-01
Nursing in Malawi has been predominately a technical trade and only recently has begun the transition to a profession with autonomy and advanced degree preparation. Nursing theories provide a framework for the evolution of nursing to an independent profession. Theories provide a means for the articulation of the nursing role to other members of the healthcare team including consumers. Healthcare and human needs are basic and the guidance provided by nursing theories, including Nightingale's, gives language and structure to the education of nurses as the profession moves into advanced practice in a developing country.
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Smoking cessation - nicotine replacement; Tobacco - nicotine replacement therapy ... Before you start using a nicotine replacement product, here are some things to know: The more cigarettes you smoke, the higher the dose you may need to ...
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Nurse Bullying: Impact on Nurses' Health.
Sauer, Penny A; McCoy, Thomas P
2017-12-01
Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.
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QUALITY OF NURSING CARE BASED ON ANALYSIS OF NURSING PERFORMANCE AND NURSE AND PATIENT SATISFACTION
Directory of Open Access Journals (Sweden)
Abdul Muhith
2017-04-01
Full Text Available Introduction: Nurses who frequently often contact to patients and most of their time serve patients in 24 hours, have an important role in caring for the patient. Patient satisfaction as quality indicator is the key success for competitiveness of service in hospital. The aim of this research was to develop nursing service quality model based on the nursing performance, nurse and patient satisfaction. Method: The research method used cross sectional study, at 14 wards of Gresik Hospital. Research factors were namely: oganization characteristic (organization culture and leadership, work factors (feedback and variety of nurses work, nurse characteristics (motivation, attitude, commitment and mental model, nursing practice, interpersonal communication, nurse and patient satisfaction. Statistical analysis of study data was analyzed by Partial Least Square (PLS. Results: The results of nursing performance revealed that nurse characteristic were not affected by organization culture and leadership style, nurse characteristics were affected by work factors, nurse characteristics affected nursing quality service (nursing practice, nursing professional, nurse and patient satisfaction, nurse satisfaction did not affect nursing professionals. Discussion: Based on the overall results of the development of nursing care model that was originally only emphasizes the process of nursing care only, should be consider the input factor of organizational characteristics, job characteristics, and characteristics of individual nurses and consider the process factors of nursing care standards and professional performance of nurses and to consider the outcome factors nurse and patient satisfaction. So in general the development model of quality of existing nursing care refers to a comprehensive system of quality.
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... Outreach Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB ... PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or ...
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Nurse-patient communication barriers in Iranian nursing.
Anoosheh, M; Zarkhah, S; Faghihzadeh, S; Vaismoradi, M
2009-06-01
Providing effective communication with patients is an essential aspect of nursing care. Understanding the barriers that inhibit nurse-patient communication can provide an opportunity to eliminate them. To investigate nurse-patient and environment-related communication barriers perceived by patients and nurses in Iranian nursing. A descriptive survey was carried out in three randomly selected educational hospitals in a large urban city in Iran. Data were collected by questionnaire; the study sample consisted of 61 patients and 75 nurses. Participants were asked to rate the importance of each communication barriers item. Finally, data were analysed using descriptive statistics, and to compare the perceived importance of communication barriers between patients and nurses, item means were calculated and the t-test for independent samples was applied. Similarities and differences between the two groups were identified. According to nurses' views, 'heavy nursing workload', 'hard nursing tasks' and 'lack of welfare facilities for nurses' were the main communication barriers. From patients' views, 'unfamiliarity of nurses with dialect', 'having contagious diseases' and 'sex differences between nurses and patients' were determined as the main communication barriers. The shared communication barriers were 'age difference', 'social class difference' and 'having contagious diseases'. It can be concluded that nursing managers and healthcare system planners should focus on eliminating or modifying the barriers stated by the two groups, particularly the shared ones. It is suggested that understanding the cultural aspects of nurse-patient communication barriers in various contexts can help nurses. The study relied on self-report by a limited sample of nurses and patients. The responses should now be tested by a larger sample and then by empirical research into actual practice in order to test whether the nurses' and patients' perceived ideas of communication barriers are
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Kennedy, J. R.; Fitzpatrick, W. S.
1971-01-01
The computer executive functional system design concepts derived from study of the Space Station/Base are presented. Information Management System hardware configuration as directly influencing the executive design is reviewed. The hardware configuration and generic executive design requirements are considered in detail in a previous report (System Configuration and Executive Requirements Specifications for Reusable Shuttle and Space Station/Base, 9/25/70). This report defines basic system primitives and delineates processes and process control. Supervisor states are considered for describing basic multiprogramming and multiprocessing systems. A high-level computer executive including control of scheduling, allocation of resources, system interactions, and real-time supervisory functions is defined. The description is oriented to provide a baseline for a functional simulation of the computer executive system.
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Lašaitė, L; Čeponis, J; Preikša, R T; Žilaitienė, B
2017-04-01
The aim of the study was to examine the effects of two-year testosterone replacement therapy on cognitive functioning, emotional state and quality of life in young and middle-aged men with hypogonadotropic hypogonadism. Nineteen males diagnosed with hypogonadotropic hypogonadism participated in the study. Cognitive functions were assessed by Trail Making Test and Digit Span Test of Wechsler Adult Intelligence Scale. Emotional state was evaluated by Profile of Mood States. Quality of life was evaluated by WHO Brief Quality of Life Questionnaire. Changes after two-year testosterone replacement therapy were detected in Trail Making A (42.9 ± 22.3 vs. 36.2 ± 22.5, p = .050) and B (90.6 ± 55.3 vs. 65.6 ± 21.4, p = .025) tests, showing improvement in attention and visual scanning abilities, executive function and psychomotor speed, as well as in Digit Span Test forward score (5.4 ± 2.0 vs. 6.1 ± 2.6, p = .046), showing improvement in attention capacity and psychomotor speed. No significant differences were observed in emotional state and quality of life. In conclusion, beneficial effect in cognitive functioning (improved attention and visual scanning ability, executive function and psychomotor speed), but not in emotional state and quality of life, was observed in young and middle-aged hypogonadal men after two-year testosterone replacement therapy. © 2016 Blackwell Verlag GmbH.
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Kelly, Teresa; Roper, Cath; Elsom, Stephen; Gaskin, Cadeyrn
2011-10-01
Accurate verification of patient identity during medication administration is an important component of medication administration practice. In medical and surgical inpatient settings, the use of identification aids, such as wristbands, is common. In many psychiatric inpatient units in Victoria, Australia, however, standardized identification aids are not used. The present paper outlines the findings of a qualitative research project that employed focus groups to examine mental health nurse and mental health consumer perspectives on the identification of patients during routine medication administration in psychiatric inpatient units. The study identified a range of different methods currently employed to verify patient identity, including technical methods, such as wristband and photographs, and interpersonal methods, such as patient recognition. There were marked similarities in the perspectives of mental health nurses and mental health consumers regarding their opinions and preferences. Technical aids were seen as important, but not as a replacement for the therapeutic nurse-patient encounter. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
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Nursing informatics and nursing ethics
DEFF Research Database (Denmark)
Kaltoft, Mette Kjer
2013-01-01
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...
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Difficulties encountered by hospitalized Syrian refugees and their expectations from nurses.
Sevinç, S; Kılıç, S P; Ajghif, M; Öztürk, M H; Karadağ, E
2016-09-01
Treating patients with care and respecting their cultural values are key factors necessary to enhance the quality of nursing care. The objective of this study was to explore and describe the difficulties experienced by hospitalized Syrian refugees and their expectations from nurses and hospital administration. We used a descriptive qualitative research approach to engage 30 Syrian refugees undergoing treatment in internal medicine who met the study criteria. Data were collected using a descriptive questionnaire and a semi-structured interview with open-ended interview questions. Interview transcripts were analysed using an inductive coding approach. Descriptive questions were analysed and presented via number and percentage. Other data were assessed using content analysis methods. Three major themes were developed following the analysis of the interviews. We determined that the refugees who participated in the study experienced difficulties in communicating, meeting their personal needs and correctly following treatment instructions. They also had certain expectations from the hospital administration and nurses, and they felt gratitude for both nurses and the nation of Turkey. The results of this study, shared with the executive administration of the hospital, may result in new policies which will help new Syrian refugee patients and patients with similar needs to have better experience related to patient care, communications and meeting personal needs. It is important that nurses and other healthcare provider consider the difficulties and expectations of refugees regarding healthcare services and include same in the development of provider training programmes. Development of public health welfare and employment law and policies help to lay the groundwork for successful integration of refugees in new cultures and countries. © 2016 International Council of Nurses.
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International Nuclear Information System (INIS)
Yang, Li; Ma, Xiaobing; Zhai, Qingqing; Zhao, Yu
2016-01-01
We propose an inspection and replacement policy for a single component system that successively executes missions with random durations. The failure process of the system can be divided into two states, namely, normal and defective, following the delay time concept. Inspections are carried out periodically and immediately after the completion of each mission (random inspections). The failed state is always identified immediately, whereas the defective state can only be revealed by an inspection. If the system fails or is defective at a periodic inspection, then replacement is immediate. If, however, the system is defective at a random inspection, then replacement will be postponed if the time to the subsequent periodic inspection is shorter than a pre-determined threshold, and immediate otherwise. We derive the long run expected cost per unit time and then investigate the optimal periodic inspection interval and postponement threshold. A numerical example is presented to demonstrate the applicability of the proposed maintenance policy. - Highlights: • A delay time model of inspection is introduced for mission-based systems. • Periodic and random inspections are performed to check the state. • Replacement of the defective system at a random inspection can be postponed.
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Competency of Graduate Nurses as Perceived by Nurse Preceptors and Nurse Managers
Wise, Vanessa
2013-01-01
As newly graduated associate degree nurses (ADN) and baccalaureate degree nurses (BSN) enter into the workforce, they must be equipped to care for a complex patient population; therefore, the purpose of this study was to address the practice expectations and clinical competency of new nurses as perceived by nurse preceptors and nurse managers.…
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Nursing students' attitudes about home health nursing.
Prestia, Mindy; Murphy, Susan; Yoder, Marian
2008-09-01
In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.
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Nursing Practice Environment and Outcomes for Oncology Nursing
Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.
2012-01-01
Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101
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The future in the past: Hildegard Peplau and interpersonal relations in nursing.
D'Antonio, Patricia; Beeber, Linda; Sills, Grayce; Naegle, Madeline
2014-12-01
Researchers, educators and clinicians have long recognized the profound influence of the mid-twentieth century focus on interpersonal relations and relationships on nursing. Today, in nursing, as well as in medicine and other social sciences, neuroanatomy, neurobiology and neurophysiology have replaced interpersonal dynamics as keys to understanding human behavior. Yet concerns are being raised that the teaching, research and practice of the critical importance of healing relationships have been overridden by a biological focus on the experiences of health and illness. As a way to move forward, we return to Hildegard Peplau's seminal ideas about the transformative power of relationships in nursing. We propose that Peplau's formulations and, in particular, her seminal Interpersonal Relations in Nursing can provide direction. We do not propose that her formulations or her book be simply transposed from the 1950s to today's classroom and clinic. But we do believe that her ideas and writings are dynamic documents containing concepts and derived operations that can be brought to life in clinical practice. Finally, we explore Peplau's transformative idea that nursing is, at its core, an interpersonal process both to acknowledge an idea that has shaped our past and can guide us into our future. © 2014 John Wiley & Sons Ltd.
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Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf
2014-11-01
To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.
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Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)
Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan
2014-01-01
Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring
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Transcultural nursing practice described by registered nurses and baccalaureate nursing students.
Baldonado, A; Beymer, P L; Barnes, K; Starsiak, D; Nemivant, E B; Anonas-Ternate, A
1998-01-01
Using Leininger's Theory of Culture Care Diversity and Universality as a framework, this research examined transcultural practices of nurses and students. A survey was administered to a convenience sample of registered nurses and senior baccalaureate students with 767 usable questionnaires returned. Neither group expressed confidence in their ability to care for culturally-diverse patients. Registered nurses (RNs) reported assessing cultural factors and modifying practices more frequently than did students. Respondents reported their beliefs about transcultural nursing were influenced by being with people of other cultures, their own personal values, and education. Analysis of the open-ended questions revealed two major themes. First, both nurses and students perceive an overwhelming need for transcultural nursing. Second, nurses and students respond to cultural challenges by modifying their care. Modifications are based on language and communication, pain perception and relief, religious and spiritual dimensions, gender and family roles, and other values. Results suggest that nurses and students are aware of culture, recognize that culture influences the care they provide, and modify their health teaching and nursing care based on culture. The use of a conceptual framework to help make modifications in care was not mentioned.
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Jooste, Karien; Cairns, Lindi
2014-05-01
This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. © 2014 John Wiley & Sons Ltd.
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Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...
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Farr-Wharton, Rod; Brunetto, Yvonne; Shacklock, Kate
2012-06-01
This article reports a generational cohort and leader-member exchange theoretical frameworks-guided study of the influence of the supervisor-subordinate relationship on three generational nurse cohorts' use of intuition, perceptions of empowerment and affective commitment. Within a global context of nurse shortages, knowledge about factors influencing nurse retention is urgently sought. We postulated that nurses' use of intuition is the key to their empowerment and consequent commitment to the organization, and that impact would vary among the three large nurse generations. A self-report survey was used to gather data in 2008, which were then analysed using correlations, regression analysis, manova and path analysis. Data were obtained from 900 Baby Boomer and Generations X and Y nurses, randomly chosen from seven private hospitals across Australia. The findings confirm the important impact of supervisor-nurse relationships upon all three generations' use of intuition. The findings add new knowledge about the differing importance of using intuition for Generation X, Generation Y and Baby Boomer nurses' perceptions of empowerment, suggesting it is more important to Baby Boomers and Generation X than to Generation Y. Further, the impact of using intuition differs significantly among the generational cohorts. The findings suggest the need for a more differentiated tailored style - sensitive to varying needs of the generations. Improving supervisor-nurse relationships is also critical, because of their impact upon nurses' use of intuition, perceptions of empowerment and affective commitment. Poor relationships lead to increased nurse replacement costs. © 2011 Blackwell Publishing Ltd.
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Sibia, Udai S; Grover, Jennifer; Turcotte, Justin J; Seanger, Michelle L; England, Kimberly A; King, Jennifer L; King, Paul J
2018-04-01
We describe a process for studying and improving baseline postanesthesia care unit (PACU)-to-floor transfer times after total joint replacements. Quality improvement project using lean methodology. Phase I of the investigational process involved collection of baseline data. Phase II involved developing targeted solutions to improve throughput. Phase III involved measured project sustainability. Phase I investigations revealed that patients spent an additional 62 minutes waiting in the PACU after being designated ready for transfer. Five to 16 telephone calls were needed between the PACU and the unit to facilitate each patient transfer. The most common reason for delay was unavailability of the unit nurse who was attending to another patient (58%). Phase II interventions resulted in transfer times decreasing to 13 minutes (79% reduction, P care at other institutions. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
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Nurses' Perceptions of Patient Safety Culture in Three Hospitals in Saudi Arabia.
Alquwez, Nahed; Cruz, Jonas Preposi; Almoghairi, Ahmed Mohammed; Al-Otaibi, Raid Salman; Almutairi, Khalid Obaid; Alicante, Jerico G; Colet, Paolo C
2018-05-14
To assess the present patient safety culture of three general hospitals in Saudi Arabia, as perceived by nurses. This study utilized a descriptive, cross-sectional design. A convenience sample of 351 nurses working in three general hospitals in the central region of Saudi Arabia was surveyed in this study using the Hospital Survey of Patients' Safety Culture (HSOPSC) from October 2016 to April 2017. From the 12 composites of the HSOPSC, the nurses perceived only the following two patient safety areas as strengths: teamwork within units and organizational learning-continuous improvement. Six areas of patient safety were identified as weaknesses, namely overall perception of patient safety, handoffs and transitions, communication openness, staffing, frequency of events reported, and nonpunitive response to errors. Nationality, educational attainment, hospital, length of service in the hospital, work area or unit, length of service in the current work area or unit, current position, and direct patient contact or interaction were significant predictors of the nurses' perceived patient safety culture. The findings in this study clarify the current status of patient safety culture in three hospitals in the Kingdom of Saudi Arabia. The present findings should be considered by policymakers, hospital leaders, and nurse executives in creating interventions aimed at improving the patient safety culture in hospitals. A multidimensional network intervention targeting the different dimensions of patient safety culture and involving different organizational levels should be implemented to improve patient safety. © 2018 Sigma Theta Tau International.
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Cai, Qian; Zhou, Yunxian; Yang, Dangan
2018-02-15
In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses' knowledge on phlebotomy to provide reference for improving blood sampling practice in China. A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse's knowledge level on phlebotomy.
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Evaluation of Bluetooth as a replacement for cables in intensive care and surgery.
Wallin, Mats K E B; Wajntraub, Samson
2004-03-01
In today's intensive care and surgery, a great number of cables are attached to patients. These cables can make the care and nursing of the patient difficult. Replacing them with wireless communications technology would facilitate patient care. Bluetooth is a modern radio technology developed specifically to replace cables between different pieces of communications equipment. In this study we sought to determine whether Bluetooth is a suitable replacement for cables in intensive care and during surgery with respect to electromagnetic compatibility. The following questions were addressed: Does Bluetooth interfere with medical equipment? And does the medical equipment decrease the quality of the Bluetooth communication? A Bluetooth link, simulating a patient monitoring system, was constructed with two laptops. The prototype was then used in laboratory and clinical tests according to American standards at the Karolinska Hospital in Stockholm. The tests, which included 44 different pieces of medical equipment, indicated that Bluetooth does not cause any interference. The tests also showed that the hospital environment does not affect the Bluetooth communication negatively. Bluetooth, a new radio technology transmitting at 2.4 GHz, was tested in a clinical setting. The study showed that a single Bluetooth link was robust and electromagnetically compatible with the tested electronic medical devices.
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Nursing Practice Environment and Registered Nurses' Job Satisfaction in Nursing Homes
Choi, JiSun; Flynn, Linda; Aiken, Linda H.
2012-01-01
Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…
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A competence executive coaching model
Directory of Open Access Journals (Sweden)
Pieter Koortzen
2010-07-01
Research purpose: The purpose of this article is to address the training and development needs of these consulting psychologists by presenting a competence executive coaching model for the planning, implementation and evaluation of executive coaching interventions. Research design, approach and method: The study was conducted while one of the authors was involved in teaching doctoral students in consulting psychology and executive coaching, specifically in the USA. The approach involved a literature review of executive coaching models and a qualitative study using focus groups to develop and evaluate the competence executive coaching model. Main findings: The literature review provided scant evidence of competence executive coaching models and there seems to be a specific need for this in the training of coaches in South Africa. Hence the model that was developed is an attempt to provide trainers with a structured model for the training of coaches. Contribution/value-add: The uniqueness of this competence model is not only described in terms of the six distinct coaching intervention phases, but also the competencies required in each.
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The progress of family health nursing in remote and rural Scotland.
Macduff, Colin
2005-12-01
Since 2001 the World Health Organization Europe's family health nurse (FHN) role has been developing in remote and rural areas of Scotland. In 2003, an independent evaluation identified a need for facilitation of the FHN role and family-health orientated approaches with local primary health care teams. The Scottish Executive Health Department appointed three part-time, regionally-based family health practice development facilitators (FHPDFs) in December 2003 to work over an 18-month period. This article presents findings from a small study which sought these FHPDFs' judgements on individual FHN autonomy and supportive colleague action at 24 sites where FHNs were practising. These judgements reveal a picture of mixed progress that is consistent with findings from other related research. This collective overview is presented in the form of a new typology and the resultant implications for future development of family health nursing are discussed.
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An ontology-based nurse call management system (oNCS) with probabilistic priority assessment
2011-01-01
Background The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call. The aim of this research is (1) the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2) the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient. Methods The ontology-based Nurse Call System (oNCS) was developed as an extension of a Context-Aware Service Platform. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient. Results The oNCS system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the oNCS system and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed. Conclusions The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the oNCS system significantly improves the assignment of nurses
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An ontology-based nurse call management system (oNCS with probabilistic priority assessment
Directory of Open Access Journals (Sweden)
Verhoeve Piet
2011-02-01
Full Text Available Abstract Background The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call. The aim of this research is (1 the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2 the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient. Methods The ontology-based Nurse Call System (oNCS was developed as an extension of a Context-Aware Service Platform. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient. Results The oNCS system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the oNCS system and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed. Conclusions The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the oNCS system significantly improves
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Ryu, Jeong-Im; Kim, Kisook
2018-06-20
To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance. Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses. Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units. These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries. © 2018 John Wiley & Sons Ltd.
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Padilha, J M; Sousa, P A F; Pereira, F M S
2018-03-01
To propose nursing clinical practice changes to improve the development of patient self-management. Chronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates. Control of the disease's progression, the preservation of autonomy in self-care and maintenance of quality of life are extremely challenging for patients to execute in their daily living. However, there is still little evidence to support nursing clinical practice changes to improve the development of self-management. A participatory action research study was performed in a medicine inpatient department and the outpatient unit of a Portuguese hospital. The sample comprised 52 nurses and 99 patients. For data collection, we used interviews, participant observation and content analysis. The main elements of nursing clinical practice that were identified as a focus for improvement measures were the healthcare model, the organization of healthcare and the documentation of a support decision-making process. The specific guidelines, the provision of material to support decision-making and the optimization of information sharing between professionals positively influenced the change process. This change improved the development of self-management skills related to the awareness of the need for 'change', hope, involvement, knowledge and abilities. The implemented changes have improved health-related behaviours and clinical outcomes. To support self-management development skills, an effective nursing clinical practice change is needed. This study has demonstrated the relevance of a portfolio of techniques and tools to help patients adopt healthy behaviours. The involvement and participation of nurses and patients in the conceptualization, implementation and evaluation of policy change are fundamental issues to improve the quality of nursing care and clinical outcomes. © 2017 International Council of Nurses.
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Why do student nurses want to be nurses?
Crick, Paula; Perkinton, Louise; Davies, Fiona
Nursing became an all graduate entry profession in September 2013; this move and the publication of the Francis report have brought the debate around nurse education and nurses' capacity to care into sharper focus. There is much debate over what makes a good nurse and whether graduate nurses lack care and compassion. We asked a cohort of pre-registration student nurses on the first day of their course about their motivations to join the profession, what being a nurse meant to them and which aspects of nursing they valued most. The demographics of the degree student group were similar to those of diploma students. Reasons cited for entering the profession and views on the nurse's role showed that students' motivations and perceptions focused on nursing as a caring rather than a technical profession. The characteristics of the degree students, their strong motivation to care and perception of nursing in altruistic terms contradict the media image of student nurses as being primarily academically, technically and career driven.
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Blair, Clancy
2017-01-01
Executive functions are thinking skills that assist with reasoning, planning, problem solving, and managing one's life. The brain areas that underlie these skills are interconnected with and influenced by activity in many different brain areas, some of which are associated with emotion and stress. One consequence of the stress-specific connections is that executive functions, which help us to organize our thinking, tend to be disrupted when stimulation is too high and we are stressed out, or too low when we are bored and lethargic. Given their central role in reasoning and also in managing stress and emotion, scientists have conducted studies, primarily with adults, to determine whether executive functions can be improved by training. By and large, results have shown that they can be, in part through computer-based videogame-like activities. Evidence of wider, more general benefits from such computer-based training, however, is mixed. Accordingly, scientists have reasoned that training will have wider benefits if it is implemented early, with very young children as the neural circuitry of executive functions is developing, and that it will be most effective if embedded in children's everyday activities. Evidence produced by this research, however, is also mixed. In sum, much remains to be learned about executive function training. Without question, however, continued research on this important topic will yield valuable information about cognitive development. WIREs Cogn Sci 2017, 8:e1403. doi: 10.1002/wcs.1403 For further resources related to this article, please visit the WIREs website. © 2016 Wiley Periodicals, Inc.
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Promotion or marketing of the nursing profession by nurses.
Kagan, I; Biran, E; Telem, L; Steinovitz, N; Alboer, D; Ovadia, K L; Melnikov, S
2015-09-01
In recent years, much effort has been invested all over the world in nurse recruitment and retention. Issues arising in this context are low job satisfaction, the poor public image of nursing and the reluctance of nurses to promote or market their profession. This study aimed to examine factors explaining the marketing of the nursing profession by nurses working at a general tertiary medical centre in Israel. One hundred sixty-nine registered nurses and midwives from five clinical care units completed a structured self-administered questionnaire, measuring (a) professional self-image, (b) job satisfaction, (c) nursing promotional and marketing activity questionnaire, and (d) demographic data. The mean scores for the promotion of nursing were low. Nurses working in an intensive cardiac care unit demonstrated higher levels of promotional behaviour than nurses from other nursing wards in our study. Nurse managers reported higher levels of nursing promotion activity compared with first-line staff nurses. There was a strong significant correlation between job satisfaction and marketing behaviour. Multiple regression analysis shows that 15% of the variance of promoting the nursing profession was explained by job satisfaction and job position. Nurses are not inclined to promote or market their profession to the public or to other professions. The policy on the marketing of nursing is inadequate. A three-level (individual, organizational and national) nursing marketing programme is proposed for implementation by nurse leadership and policy makers. Among proposed steps to improve marketing of the nursing profession are promotion of the image of nursing by the individual nurse in the course of her or his daily activities, formulation and implementation of policies and programmes to promote the image of nursing at the organizational level and drawing up of a long-term programme for promoting or marketing the professional status of nursing at the national level. © 2015
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Yost, Jennifer; Thompson, David; Ganann, Rebecca; Aloweni, Fazila; Newman, Kristine; McKibbon, Ann; Dobbins, Maureen; Ciliska, Donna
2014-06-01
Nurses are increasingly expected to engage in evidence-informed decision making (EIDM); the use of research evidence with information about patient preferences, clinical context and resources, and their clinical expertise in decision making. Strategies for enhancing EIDM have been synthesized in high-quality systematic reviews, yet most relate to physicians or mixed disciplines. Existing reviews, specific to nursing, have not captured a broad range of strategies for promoting the knowledge and skills for EIDM, patient outcomes as a result of EIDM, or contextual information for why these strategies "work." To conduct a scoping review to identify and map the literature related to strategies implemented among nurses in tertiary care for promoting EIDM knowledge, skills, and behaviours, as well as patient outcomes and contextual implementation details. A search strategy was developed and executed to identify relevant research evidence. Participants included registered nurses, clinical nurse specialists, nurse practitioners, and advanced practice nurses. Strategies were those enhancing nurses' EIDM knowledge, skills, or behaviours, as well as patient outcomes. Relevant studies included systematic reviews, randomized controlled trials, cluster randomized controlled trials, non-randomized trials (including controlled before and after studies), cluster non-randomized trials, interrupted time series designs, prospective cohort studies, mixed-method studies, and qualitative studies. Two reviewers performed study selection and data extraction using standardized forms. Disagreements were resolved through discussion or third party adjudication. Using a narrative synthesis, the body of research was mapped by design, clinical areas, strategies, and provider and patient outcomes to determine areas appropriate for a systematic review. There are a sufficiently high number of studies to conduct a more focused systematic review by care settings, study design, implementation strategies
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Essays in Executive Compensation
D. Zhang (Dan)
2012-01-01
textabstractThis dissertation focuses on how executive compensation is designed and its implications for corporate finance and government regulations. Chapter 2 analyzes several proposals to restrict CEO compensation and calibrates two models of executive compensation that describe how firms would
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Exploring the relevance of social justice within a relational nursing ethic.
Woods, Martin
2012-01-01
In the last few decades, a growing number of commentators have questioned the appropriateness of the 'justice view' of ethics as a suitable approach in health care ethics, and most certainly in nursing. Essentially, in their ethical deliberations, it is argued that nurses do not readily adopt the high degree of impartiality and objectivity that is associated with a justice view; instead their moral practices are more accurately reflected through the use of alternative approaches such as relational or care-based ethics. Yet, it has also been argued that this viewpoint does not necessarily 'do justice' to the broader moral responsibilities of nurses towards humanity in general, i.e. to the wider socio-cultural and socio-political issues in society, and to the concept of social justice in particular. This criticism has triggered a much closer examination of relational and care-based ethics in nursing at levels beyond individual responsiveness within relationships and brought into the spotlight the need for a more ethically refined nursing response to an increasingly complex set of socio-cultural inequalities. This article explores a relational ethic within nursing practices with contemporary ideas regarding social justice. In particular, it is argued that the synergy between the two actually produces an ethic that is capable of not only challenging the continuing predominance of justice-based ethics within health care, but of replacing it. Subsequently, in the discussion that follows, it is suggested that a combined social justice and relational care-based approach, as a social ethic, should guide the moral deliberations and actions of nurses. It is maintained that such an approach is not only possible, but crucial if nurses are to realize their full potential as ethical agents for individual and social good. © 2011 Blackwell Publishing Ltd.
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The role of ICT in nursing practice: an integrative literature review of the Swedish context.
Fagerström, Cecilia; Tuvesson, Hanna; Axelsson, Lisa; Nilsson, Lina
2017-09-01
The Swedish healthcare system employs information and communication technologies (ICT) in nursing practice to meet quality-, security- and efficiency-related demands. Although ICT is integrated with nursing practices, nurses do not always feel that they are convenient to use it. We need to improve our knowledge of the role of ICT in healthcare environments and so we decided to complement existing experience of how ICT influences nursing practice. This study aimed to review and synthesise the available literature on the role of ICT in nursing practice in Swedish healthcare settings. To consolidate previous studies based on diverse methodologies, an integrative literature review was carried out. Three databases were used to search for literature, 20 articles met the inclusion criteria. The literature review indicates that ICT integration into nursing practice is a complex process that impacts nurses' communication and relationships in patient care, working conditions, and professional identities and development. Nurses are found to express ambiguous views on ICT as a usable service in their everyday practice since it impacts both positively and negatively. Although ICT cannot replace physical presence, it can be considered a complementary service that gives rise to improved patient care. However, nonverbal communication cues may be missed when ICT is used as mediating tool and ICT can be limiting because it is not always designed to meet nurse and patient needs. The meaning of an encounter appears to change when ICT is used in nursing practice, not only for patient relationships but also for interpersonal communication. © 2016 Nordic College of Caring Science.
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Call to Action for Nurses/Nursing
Directory of Open Access Journals (Sweden)
Shahirose S. Premji
2016-01-01
Full Text Available The 13 million nurses worldwide constitute most of the global healthcare workforce and are uniquely positioned to engage with others to address disparities in healthcare to achieve the goal of better health for all. A new vision for nurses involves active participation and collaboration with international colleagues across research practice and policy domains. Nursing can embrace new concepts and a new approach—“One World, One Health”—to animate nursing engagement in global health, as it is uniquely positioned to participate in novel ways to improve healthcare for the well-being of the global community. This opinion paper takes a historical and reflective approach to inform and inspire nurses to engage in global health practice, research, and policy to achieve the Sustainable Development Goals. It can be argued that a colonial perspective currently informs scholarship pertaining to nursing global health engagement. The notion of unidirectional relationships where those with resources support training of those less fortunate has dominated the framing of nursing involvement in low- and middle-income countries. This paper suggests moving beyond this conceptualization to a more collaborative and equitable approach that positions nurses as cocreators and brokers of knowledge. We propose two concepts, reverse innovation and two-way learning, to guide global partnerships where nurses are active participants.
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[Exploring nurse, usage effectiveness of mobile nursing station].
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.
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Leading nurses in dire straits: head nurses' navigation between nursing and leadership roles.
Sørensen, Erik E; Delmar, Charlotte; Pedersen, Birthe D
2011-05-01
The present study reports selected findings from a doctoral study exploring the negotiation between nursing and leadership in hospital head nurses' leadership practice. The importance of bringing a nursing background into leadership is currently under debate. In spite of several studies of nursing and clinical leadership, it is still unclear how nurses' navigate between nursing and leadership roles. An 11-month-long ethnographic study of 12 head nurses' work: five worked at a first line level and seven at a department level. At the first line level, leadership practices were characterized by an inherent conflict between closeness and distance to clinical practice; at the department level practises were characterized by 'recognition games'. On both levels, three interactive roles were identified, that of clinician, manager and a hybrid role. Where clinician or manager roles were assumed, negotiation between roles was absent, leading to reactive, adaptive and isolated practices. The hybrid role was associated with dialectical negotiation of roles leading to stable and proactive practices. Nursing leadership practises depend on leaders' negotiation of the conflicting identities of nurse and leader. Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
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Perception of nursing as a scientific discipline and nurse profession by students of nursing
Directory of Open Access Journals (Sweden)
Anna Lewandowska
2018-02-01
Full Text Available Introduction: The nurse according to the Supreme Chamber of Nurses and Midwives is a person able to recognize the health condition of an individual or group and can create a care plan and realize it. The nurse should be primarily autonomous in making decisions about nursing care and organizing nursing care. Each competent nurse can make a proper assessment of a given situation, makes decisions efficiently and is able to quickly select the right methods of conduct. The awareness that science is always the foundation of practice is extremely important. This is how the profession of a nurse was shaped over the years. These scientific achievements greatly influence the increase of the professional nurse's prestige. Objective: The aim of the work is to gain knowledge about the perception of nursing, as a scientific discipline and nurses, by students of the nursing field. Material and methods: The study covered 100 people who are students of nursing, finishing the three-year education period. The selection of respondents was random. The study group consisted of 100% women aged 20-35, living in urban areas (51% and rural (49%. The research method used in the work is a diagnostic survey. The research tool used is a self-help questionnaire. Results: Nursing understood 16% of respondents as a profession, 3% considered them as a scientific discipline, 1% as a learning system. The vast majority of respondents (92% stated that nursing is both theoretical and practical science. The nurses' forms of activity, which contribute to the development of nursing, 73% of them reported upgrading professional qualifications, 7% writing scientific papers, 2% participation in scientific research, 1% participation in the preparation of apprentices to the profession and 1% activity in organizations unions. The most important features that should be possessed by a good nurse include: diligence and accuracy of performed procedures (25%, possessing rich knowledge in the field
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Defining line replaceable units
Parada Puig, J. E.; Basten, R. J I
2015-01-01
Defective capital assets may be quickly restored to their operational condition by replacing the item that has failed. The item that is replaced is called the Line Replaceable Unit (LRU), and the so-called LRU definition problem is the problem of deciding on which item to replace upon each type of
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Determinants of job satisfaction for novice nurse managers employed in hospitals.
Djukic, Maja; Jun, Jin; Kovner, Christine; Brewer, Carol; Fletcher, Jason
Numbering close to 300,000 nurse managers represent the largest segment of the health care management workforce. Their effectiveness is, in part, influenced by their job satisfaction. We examined factors associated with job satisfaction of novice frontline nurse managers. We used a cross-sectional, correlational survey design. The sample consisted of responders to the fifth wave of a multiyear study of new nurses in 2013 (N = 1,392; response rate of 69%) who reported working as managers (n = 209). The parent study sample consisted of registered nurses who were licensed for the first time by exam 6-18 months prior in 1 of 51 selected metropolitan statistical areas and 9 rural areas across 34 U.S. states and the District of Columbia. We examined bivariate correlations between job satisfaction and 31 personal and structural variables. All variables significantly related to job satisfaction in bivariate analysis were included in a multivariate linear regression model. In addition, we tested the interaction effects of procedural justice and negative affectivity, autonomy, and organizational constraints on job satisfaction. The Cronbach's alphas for all multi-item scales ranged from .74 to .96. In the multivariate analysis, negative affectivity (β = -.169; p = .006) and procedural justice (β = .210; p = .016) were significantly correlated with job satisfaction. The combination of predictors in the model accounted for half of the variability in job satisfaction ratings (R = .51, adjusted R = .47; p <. 001). Health care executives who want to cultivate an effective novice frontline nurse manager workforce can best ensure their satisfaction by creating an organization with strong procedural justice. This could be achieved by involving managers in decision-making processes and ensuring transparency about how decisions that affect nursing are made.
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Linnerud, Ida Cathrine Wang
2014-01-01
Background: Executive function difficulties are prevalent in children with autism spectrum disorders (ASD) and there are several indications of a modifying relationship between executive functions and language in children. However, there is limited research on the relationship between executive functioning and language in young children with ASD. The current study compared real-world executive functioning between groups of children with ASD, language disorders (LD), and typical development (T...
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Theoretical assumptions of Maffesoli's sensitivity and Problem-Based Learning in Nursing Education
Directory of Open Access Journals (Sweden)
María-Aurora Rodríguez-Borrego
2014-06-01
Full Text Available OBJECTIVE: understand the everyday and the imaginary of Nursing students in their knowledge socialization process through the Problem-Based Learning (PBL strategy.METHOD: Action Research, involving 86 students from the second year of an undergraduate Nursing program in Spain. A Critical Incident Questionnaire and Group interview were used. Thematic/categorical analysis, triangulation of researchers, subjects and techniques.RESULTS: the students signal the need to have a view from within, reinforcing the criticism against the schematic dualism; PBL allows one to learn how to be with the other, with his mechanical and organic solidarity; the feeling together, with its emphasis on learning to work in group and wanting to be close to the person taking care.CONCLUSIONS: The great contradictions the protagonists of the process, that is, the students experience seem to express that group learning is not a form of gaining knowledge, as it makes them lose time to study. The daily, the execution time and the imaginary of how learning should be do not seem to have an intersection point in the use of Problem-Based Learning. The importance of focusing on the daily and the imaginary should be reinforced when we consider nursing education.
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Sexual harassment of nurses and nursing students.
Bronner, Gila; Peretz, Chava; Ehrenfeld, Mally
2003-06-01
Nursing has dealt with sexual harassment long before the term was coined during the 1970s. The current study investigated sexual harassment of nurses and nursing students in Israel following new legislation against sexual harassment in the workplace. A self-report questionnaire was administered to 281 nurses and 206 nursing students (80% women) from five medical centres in Israel. Seven types of sexual harassment behaviour patterns were evaluated. Frequency of sexual harassment decreased as the behaviour became more intimate and offensive. Ninety percent of subjects reported experiencing at least one type of sexual harassment and 30% described at least four types. A significant difference was found between nurses and nursing students. Furthermore, "severe" types of behaviour were experienced by 33% of nurses, in comparison with 23% of nursing students. Women were significantly more exposed than men to "mild" and "moderate" types of sexual harassment, while 35% of men vs. 26% of women were exposed to "severe" types of harassment. However, women responded significantly more assertively than men to "severe" sexual harassment. Particular attention is needed when sexual harassment occurs to male students and nurses because they may be subjected to the more offensive sexual conducts and at the same time may lack the ability to respond assertively.
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Television and children's executive function.
Lillard, Angeline S; Li, Hui; Boguszewski, Katie
2015-01-01
Children spend a lot of time watching television on its many platforms: directly, online, and via videos and DVDs. Many researchers are concerned that some types of television content appear to negatively influence children's executive function. Because (1) executive function predicts key developmental outcomes, (2) executive function appears to be influenced by some television content, and (3) American children watch large quantities of television (including the content of concern), the issues discussed here comprise a crucial public health issue. Further research is needed to reveal exactly what television content is implicated, what underlies television's effect on executive function, how long the effect lasts, and who is affected. © 2015 Elsevier Inc. All rights reserved.
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Student nurses' perceived challenges of nursing in India.
Garner, S L; Raj, L; Prater, L S; Putturaj, M
2014-09-01
A profound nursing shortage exists in India. Increasingly nursing students in India are opting to migrate to practise nursing abroad upon graduation. Perceptions and attitudes about nursing are shaped during student experiences. The purpose in conducting this research was to illuminate student nurses' perceived challenges of nursing in India. This study took place at a hospital-based, private mission non-profit school of nursing in Bengaluru, India. Purposive sampling of nursing students yielded 14 participants. Photovoice, a qualitative participatory action research methodology, was used. Data were collected between August 2013 and January 2014. A strong international collaboration between researchers resulted in qualitative thematic interpretation of photographs, critical group dialogue transcripts, individual journal entries and detailed field notes. Two main themes were identified including the perceived challenges of a hierarchal system and challenges related to limited nursing workforce capacity. Subcategories of a hierarchal system included challenges related to image, safety, salary and balance. Subcategories of limited workforce capacity were migration, work overload, physical demand, incongruence between theory and practice, and knowledge. Nursing as a profession in India is still in its infancy when measured against standard criteria. Change in health policy is needed to improve salary, safety for nurses, and nurse to patient ratios to address hierarchal and workforce capacity challenges in India. © 2014 International Council of Nurses.
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Nursing Students Perceptions about Traditional and Innovative Teaching Strategies– A Pilot Study
Directory of Open Access Journals (Sweden)
Sailaxmi Gandhi
2015-01-01
Full Text Available Background: Nursing education is undergoing tremendous changes with the changing needs of the rapidly changing society. A sound education system is the prerequisite for the development of any nation. Aim and Objectives: One way to enhance nursing education was to evaluate the learning perceptions of various teaching strategies in nursing education programs. The study was aimed to evaluate the student learning perception about traditional and modern teaching strategies among under graduate nursing students (N=44. Material and Methods: Post test only design was used to compare the learning perception of students about traditional and innovative teaching strategies (brain storming, concept mapping & problem based learning. One group was exposed to traditional teaching strategy and the other group was exposed to innovative teaching strategy about mental health assessment and therapeutic communication. Results: Findings indicated a statistically significant increase (p<0.006 in the learning perception among students exposed to innovative teaching strategies than those exposed to the lecture method at the end of 4 weeks. Conclusion: The results of this study indicate that students perceive innovative teaching strategies in a better way compared to the traditional teaching method as it enhances their motivation for learning, learner control, and self - directed learning abilities. However further evaluation with larger sample size is needed before it can replace traditional teaching methods in nursing education.
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Goossen, WTF; Epping, PJMM; Abraham, IL
The development of nursing information systems (NIS) is often hampered by the fact that nursing lacks a unified nursing terminology and classification system. Currently there exist various initiatives in this area. We address the question as to how current initiatives in the development of nursing
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Use of digital applications in the medicament calculation education for nursing
Directory of Open Access Journals (Sweden)
Francisco Gilberto Fernandes Pereira
Full Text Available Objective.To evaluate the influence of the use of digital applications in medicament calculation education for nursing students. Methods. An experimental study was developed with a sample of 100 nursing students, who were divided randomly into two groups (use of the Calculation Medicines - CalcMed application - available free on the Internet, n=50 and control (conventional method of the calculator use and pre-math skills, n=50. Both groups were assessed before and after the application of the teaching strategy through a test with ten specific questions of medicament calculations. Results. The study group showed a mean score of 8.14 versus an average of 5.02 in the control group. The average time of test execution was faster in the study group compared to the control group (15.7 versus 38.9 minutes. Conclusion. The strategy of using this application positively influences learning and enables greater security in the implementation of medicament calculations.
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Factors influencing disaster nursing core competencies of emergency nurses.
Park, Hye-Young; Kim, Ji-Soo
2017-10-01
Emergency nurses are expected to provide required nursing services by using their professional expertise to reduce the risk posed by disasters. Thus, emergency nurses' disaster nursing core competencies are essential for coping with disasters. The purpose of the study reported here was to identify factors influencing the disaster nursing core competencies of emergency nurses. A survey was conducted among 231 emergency nurses working in 12 hospitals in South Korea. Data were collected on disaster-related experience, attitude, knowledge, and disaster nursing core competencies by means of a questionnaire. In multiple regression analysis, disaster-related experience exerted the strongest influence on disaster nursing core competencies, followed by disaster-related knowledge. The explanatory power of these factors was 25.6%, which was statistically significant (F=12.189, pcompetencies of emergency nurses could be improved through education and training programs that enhance their disaster preparedness. The nursing profession needs to participate actively in the development of disaster nursing education and training programs. Copyright © 2017 Elsevier Inc. All rights reserved.
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Schwendimann, René; Dhaini, Suzanne; Ausserhofer, Dietmar; Engberg, Sandra; Zúñiga, Franziska
2016-01-01
While the relationship between nurses' job satisfaction and their work in hospital environments is well known, it remains unclear, which factors are most influential in the nursing home setting. The purpose of this study was to describe job satisfaction among care workers in Swiss nursing homes and to examine its associations with work environment factors, work stressors, and health issues. This cross-sectional study used data from a representative national sample of 162 Swiss nursing homes including 4,145 care workers from all educational levels (registered nurses, licensed practical nurses, nursing assistants and aides). Care worker-reported job satisfaction was measured with a single item. Explanatory variables were assessed with established scales, as e.g. the Practice Environment Scale - Nursing Work Index. Generalized Estimating Equation (GEE) models were used to examine factors related to job satisfaction. Overall, 36.2 % of respondents reported high satisfaction with their workplace, while another 50.4 % were rather satisfied. Factors significantly associated with high job satisfaction were supportive leadership (OR = 3.76), better teamwork and resident safety climate (OR = 2.60), a resonant nursing home administrator (OR = 2.30), adequate staffing resources (OR = 1.40), fewer workplace conflicts (OR = .61), less sense of depletion after work (OR = .88), and fewer physical health problems (OR = .91). The quality of nursing home leadership-at both the unit supervisor and the executive administrator level-was strongly associated with care workers' job satisfaction. Therefore, recruitment strategies addressing specific profiles for nursing home leaders are needed, followed by ongoing leadership training. Future studies should examine the effects of interventions designed to improve nursing home leadership and work environments on outcomes both for care staff and for residents.
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[Sixteen years of nursing education with diploma at the Semmelweis University].
Csóka, Mária
2006-06-25
Nowadays it is already known that medical sciences on their own cannot achieve spectacular improvement in the state of health of the population even with high-tech appliances. Health care professionals, who can aid individuals, families, and communities in optimizing their physical, mental and social functions, are also needed in the fields of basic provision and clinical-hospital provision and, to achieve this, they possess wider medical, nursing and social scientific expertise. The training of registered nurses was first launched in Hungary at the Postgraduate Medical Institute's Faculty of Health Care (nowadays Semmelweis University Faculty of Health Care) in 1989 as a correspondence, then in 1990 as a full-time program. This was the first step towards the realization of a better, high-standard, individualized nursing system. The aim is training health care professionals who are able to individually assess the needs of people under their care, define the problems, plan, execute and evaluate the nursing-caring process, and take part in nursing research. Besides the positive results of the follow-up examinations of graduate students, the fact cannot be neglected that since the introduction of the training, in the last 15 years it has not become clear to everyone, why the training of registered nurses is necessary, and what these "new-type" professionals can be used for. It is clear to everyone that for real teamwork the mutual appreciation of each other's work, maximum accord, the acceptance and honor of each other are indispensable. Still, all these cannot be expected from school qualification only, these can only be achieved with the continuous proof of aptitude and expertise. For the realistic judgement of registered nurses it is also needed that their nearest colleague, the physician should know in depths and accept the syllabus of the training. That is why the author of the article feels that the history of the first sixteen years of the accredited training
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Chen, Hsin-Ji; Chen, Tsung-Ying; Huang, Chiung-Yu; Hsieh, Yuan-Mei; Lai, Hui-Ling
2015-10-01
The present authors examined the effects of listening to music on psychophysiological parameters (blood pressure, heart rate, and respiratory rate) during preoperative and postoperative days and determined whether listening to music could lower pain intensity and opioid dosage during postoperative days in patients who underwent total knee replacements. This was a two group repeated measures design for 30 subjects aged 53-85 years who were scheduled for total knee replacement. Subjects were randomly assigned to either a music group or a control group. Psychophysiological parameters were obtained from patients' monitors. A visual analog scale was used to assess postoperative pain. Opioid dosage was recorded and converted to standardized units. Mann-Whitney U-test and generalized estimating equation analysis were used to compare groups. Respiratory rates while in the surgical waiting area were lower for the music group than for the control group (P = 0.02). There was no significant difference between these groups for blood pressure, heart rate, pain intensity, or opioid dosage. However, a within-group comparison showed that systolic blood pressure in the music group was significantly and consistently decreased during postoperative recovery (Wald = 9.21, P = 0.007). These results suggest that listening to music stabilized systolic blood pressure in patients during postoperative recovery. However, the effects of music on psychophysiological parameters, pain intensity, and opioid dosage in a surgical setting require further research. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.
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Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography.
Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud
2016-09-01
Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse's practices and behavior patterns regarding the health economics. In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. ICU nurses' belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital
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Using appreciative inquiry to transform student nurses' image of nursing.
Chauke, Motshedisi E; Van Der Wal, Dirk; Botha, Annalie
2015-08-19
Literature provides adequate evidence of a poor perception of nursing within the profession, resulting in high rates of attrition of student nurses and newly qualified nurses. The nursing profession, in particular nurse educators, has an ethical and professional responsibility to find innovative strategies to promote the positive image of nursing amongst student nurses. The purpose of the study was to explore the potential of appreciative inquiry (AI) as an intervention teaching strategy to transform student nurses' image of nursing. A quantitative, quasi-experimental, explorative-descriptive design comprising the pretest, appreciative inquiry as intervention, and the post-test was used. Convenience sampling was used to select third and fourth year college and university student nurses in the Gauteng province of South Africa for the pre- and the post-test respectively. Data were collected by means of a questionnaire and analysed by SPSS version 20.0. The pretest results revealed a mix of positive and negative perceptions of the image of nursing amongst student nurses. The negative perceptions of the image of nursing that needed intervention included the working conditions of nurses, and the perception of nursing as a profession that was not respected and appreciated. The post-test results showed a significant and positive change in the student nurses' perception of the image of nursing as a respected and appreciated profession. Although AI resulted in a negative to positive change in some aspects of student nurses' image of nursing, the negative perceptions of the working conditions of nurses remained and became more negative. The positive image of gender in nursing was enhanced following the implementation of AI. Appreciative inquiry demonstrated potential as a teaching strategy to produce a positive nursing image change and positive orientation towards nursing amongst student nurses.
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Transcatheter aortic valve replacement
... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...
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Nursing work directions in Australia: does evidence drive the policy?
Roche, Michael; Duffield, Christine; Aisbett, Chris; Diers, Donna; Stasa, Helen
2012-01-01
A significant body of research has shown a relationship between nurse staffing (in particular, skill-mix: the proportion of Registered Nurses [RNs]) and both morbidity and mortality. This relationship is typically investigated by measuring the incidence of Nursing Sensitive Outcomes (NSOs) under different skill-mix levels. Yet whilst the evidence suggests that richer skill-mix is associated with a lower incidence of NSOs, recent Australian policy reforms have proposed the replacement of Registered Nurses with less qualified staff. The present study sought to examine the relationship between staffing, skill-mix, and incidence of NSOs at two hospitals in one Australian state. The study sought to determine the rate of occurrence of several NSOs, the relationship of skill-mix to that rate, and the number of patients affected per annum. It was found that the current rate of NSOs across wards ranged from 0.17% to 1.05%, and that there was an inverse relationship between the proportion of hours worked by RNs and NSO rates: an increase of 10% in the proportion of hours worked by RNs was linked to a decrease in NSO rates by between 11% and 45%. It was estimated that increasing the RN staffing percentage by 10% would mean 160 fewer adverse outcomes for patients per year across these two hospitals. Importantly, increases in nursing hours overall (without increases in skill-mix) had no significant effect on patient outcomes. These findings challenge current policy recommendations, which propose increasing the number of unregistered staff without increasing skill-mix.
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Convergence: How Nursing Unions and Magnet are Advancing Nursing.
Johnson, Joyce E; Billingsley, Molley
2014-01-01
Historically, unions and professional associations such as the American Nurses Association have been adversaries in the fight to represent the best interests of the nursing profession. We reviewed the literature on the evolution of nursing unions, nursing's historical unease about unions, the Magnet designation in nursing, the tensions between the unions and Magnet, the core values and commonalities they share, and the obligations of nursing as a profession. Refocusing on the advancement of our profession provides a positive pathway in which the collective efforts of nursing unions and professional initiatives such as the Magnet designation converge during these turbulent times for our profession. The single, central organizing idea of nursing-where nursing unions and Magnet converge-is the pivotal role of nurses in delivering high-quality patient care. The often-maligned dialectic between unions and Magnet has advanced and not hindered the nursing profession. © 2014 Wiley Periodicals, Inc.
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Workplace culture in psychiatric nursing described by nurses.
Kurjenluoma, K; Rantanen, A; McCormack, B; Slater, P; Hahtela, N; Suominen, T
2017-12-01
This study looks to describe the workplace culture from the viewpoints of stress, job satisfaction and practice environment. Data were collected from nurses (n = 109) using a web-based survey, The Person-Centred Nursing Index, from two purposefully selected hospital districts in Finland. Data were statistically analysed. Nurses described their workplace culture in slightly positive terms. Nurses only occasionally experienced stress (mean = 2.56, SD = 0.55) and were fairly satisfied with their job (mean = 4.75, SD = 0.66) and their practice environment (mean = 4.42, SD = 0.81). Demographic variables such as the nurses' age, length of time in nursing, time at their present hospital, working shifts and their use of patient restriction were more frequently associated with their perceived workplace culture. Older nurses and those with a longer work history in the nursing profession tended to be more satisfied with their workplace culture in psychiatric nursing. Young and/or newly graduated nurses felt more negatively on their workplace culture; this issue should be recognised and addressed with appropriate support and mentoring. Nurses who used restrictive measures were more often less satisfied with their workplace culture. Continuous efforts are needed to reduce the use of coercive measures, which challenge also the managers to support nursing practice to be more person-centred. © 2017 Nordic College of Caring Science.
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Nurse retention and satisfaction in Ecuador: implications for nursing administration.
Palmer, Sheri P
2014-01-01
This study explores the characteristics of professional nursing work environments that may affect nursing turnover and satisfaction within a large Ecuadorian hospital. Nursing turnover is a challenge and may compromise patient care. Work dissatisfaction contributes to high turnover. Improving nurse satisfaction can contribute to better patient outcomes. Eighty-eight nurses participated in a quantitative and qualitative survey focusing on nursing satisfaction, turnover and selected organisation characteristics. Issues that may affect nurse satisfaction and turnover were identified using questions from the Nursing Work Index: pay, insufficient number of nurses, undervaluing of nurses by public and the medical team, limited advancement opportunities, lack of autonomy and inflexibility in schedule. Other themes identified from qualitative data are reported. The top factor of decreased satisfaction was low pay as indicated by the Nursing Work Index. The qualitative results showed that low pay was the factor for nurse turnover. Additional factors related to nursing satisfaction can be addressed to improve nurse retention. Along with increasing nursing pay, strategies to consider in decreasing turnover and increasing satisfaction included: providing opportunities for nursing advancement, promoting the value of nursing, creating clinical protocols and enhancing autonomy. This study adds to knowledge about nursing needs and satisfaction in South America. © 2013 John Wiley & Sons Ltd.
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Using Nursing Languages in School Nursing Practice. Second Edition
Denehy, Janice
2010-01-01
The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…
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Assessing Executive Functioning: A Pragmatic Review
Hass, Michael R.; Patterson, Ashlea; Sukraw, Jocelyn; Sullivan, Brianna M.
2014-01-01
Despite the common usage of the term "executive functioning" in neuropsychology, several aspects of this concept remain unsettled. In this paper, we will address some of the issues surrounding the notion of executive functioning and how an understanding of executive functioning and its components might assist school-based practitioners…
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Guidelines for Automation Project Execution
Takkinen, Heidi
2011-01-01
The purpose of this Master’s thesis was to create instructions for executing an automation project. Sarlin Oy Ab needed directions on how to execute an automation project. Sarlin is starting up a new business area offering total project solutions for customers. Sarlin focuses on small and minor automation projects on domestic markets. The thesis represents issues related to project execution starting from the theory of the project to its kick-off and termination. Site work is one importan...
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Organizational safety culture and medical error reporting by Israeli nurses.
Kagan, Ilya; Barnoy, Sivia
2013-09-01
To investigate the association between patient safety culture (PSC) and the incidence and reporting rate of medical errors by Israeli nurses. Self-administered structured questionnaires were distributed to a convenience sample of 247 registered nurses enrolled in training programs at Tel Aviv University (response rate = 91%). The questionnaire's three sections examined the incidence of medication mistakes in clinical practice, the reporting rate for these errors, and the participants' views and perceptions of the safety culture in their workplace at three levels (organizational, departmental, and individual performance). Pearson correlation coefficients, t tests, and multiple regression analysis were used to analyze the data. Most nurses encountered medical errors from a daily to a weekly basis. Six percent of the sample never reported their own errors, while half reported their own errors "rarely or sometimes." The level of PSC was positively and significantly correlated with the error reporting rate. PSC, place of birth, error incidence, and not having an academic nursing degree were significant predictors of error reporting, together explaining 28% of variance. This study confirms the influence of an organizational safety climate on readiness to report errors. Senior healthcare executives and managers can make a major impact on safety culture development by creating and promoting a vision and strategy for quality and safety and fostering their employees' motivation to implement improvement programs at the departmental and individual level. A positive, carefully designed organizational safety culture can encourage error reporting by staff and so improve patient safety. © 2013 Sigma Theta Tau International.
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Nursing and Nursing Education: Public Policies and Private Actions.
Institute of Medicine (NAS), Washington, DC.
Results are presented of a study of nursing and nursing education that focused on the need for continued federal support of nursing education, ways to attract nurses to medically underserved areas, and approaches to encourage nurses to stay in the profession. Findings are presented on whether the aggregate supply of generalist nurses will be…
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Development of nurses with specialties: the nurse administrators' perspective.
Onishi, Mami; Sasaki, Minako; Nagata, Ayako; Kanda, Katsuya
2008-10-01
This study clarified how Japanese nurse administrators consider the current status and future prospects of development and utilization of nurses with specialties. The demand for specialized nurses is not satisfied throughout the country. Nine nurse administrators participated in three focus-group discussions. Data were analyzed using qualitative content analysis technique. On development of specialized nurses, four categories were abstracted: offering opportunities for career development; establishing an environment of life-term continuous learning; providing well-balanced support for the needs of organizations and individual nurses; and support for career development as a specialist. To develop specialized nurses effectively it is important to focus more attention on qualitative aspects of nurses' professional experience in in-service education and to support appropriate personnel for strategic human resource development. Facilitating frequent contacts between specialized and general nurses should be highly valued as making an environment where nurses can face career goals daily leads to steady preservation of human resources. It is necessary for nurse administrators to keep human resources quantitatively and to clarify the developmental process after nurses obtain special roles to plan for continuous education.
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Changes in nurse education: being a nurse teacher.
Carr, Graham
2007-11-01
The aim of this study is to examine changes in nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty, which took place between August 2003 and March 2004 and totalled 34.4h or 305,736 words. There were thirty female and seven male participants, who between them shared 1015 years of nursing experience, averaging at 27.4 years (min7-max 42). These nursing years included 552 years of teaching practice, the average time being 15 years spent in a formal teaching role (min 0.5-max 29). Each interview was subjected to a process of thematic content analysis as described by Miles and Huberman. This paper identifies how nurse teachers try to combine teaching with a nursing role. The Government, the NHS, the Universities and the Nursing and Midwifery Council all articulate contradictory visions of the nurse teacher role, which raises the question of what additional value (if any) is gained from combining nursing practice and its teaching. This tension has led to a default situation where the longer a nurse works as a teacher the less likely it is that they will maintain any nursing practice.
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Undergraduate nursing students' attitudes toward mental health nursing.
Thongpriwan, Vipavee; Leuck, Susan E; Powell, Rhonda L; Young, Staci; Schuler, Suzanne G; Hughes, Ronda G
2015-08-01
The purpose of this study was to describe undergraduate nursing students' attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing. A descriptive, online survey was utilized to examine students' perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey. Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing as a future career; and (d), and beliefs that psychiatric nurses provide a valuable contribution to consumers and the community. Negative stereotypes were significantly different between students who had mental health nursing preparation either in class (p=0.0147) or in clinical practice (p=0.0018) and students who had not. There were significant differences in anxiety about mental illness between students who had classes on mental health nursing (p=.0005), clinical experience (p=0.0035), and work experience in the mental health field (p=0.0012). Significant differences in an interest in a future career in mental health nursing emerged between students with and without prior mental health experience and between students with and without an interest in an externship program with p-values of 0.0012 and students have to mental health nursing through clinical experiences, theory classes, and previous work in the field, the more prepared they feel about caring for persons with mental health issues. Published by Elsevier Ltd.
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40 CFR 68.155 - Executive summary.
2010-07-01
... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Executive summary. 68.155 Section 68...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.155 Executive summary. The owner or operator shall provide in the RMP an executive summary that includes a brief description of the following...
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Directory of Open Access Journals (Sweden)
Lofquist, William Steele
2010-01-01
Full Text Available The stories of those who have been executed in the Bahamas are heretofore untold. In telling these stories and in linking them to the changing course of Bahamian history, the present research adds an important dimension to our understanding of Bahamian history and politics. The major theme of this effort is that the changing practice of the death penalty is much more than a consequence of changes in crime. The use of the death penalty parallels the changing interests of colonial rulers, the changing practice of slavery, and the changing role of the Bahamas in colonial and regional affairs. Four distinctive eras of death penalty practice can be identified: (1 the slave era, where executions and commutations were used liberally and with a clear racial patterning; (2 a long era of stable colonialism, a period of marginalization and few executions; (3 an era of unstable colonialism characterized by intensive and efficient use of the death penalty; and (4 the current independence era of high murder rates and equally high impediments to the use of executions.
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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...
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Cho, Yonjoo; Park, Jiwon; Han, Soo Jeoung; Ju, Boreum; You, Jieun; Ju, Ahreum; Park, Chan Kyun; Park, Hye Young
2017-01-01
Purpose: The purpose of this study was to compare South Korean female executives' definitions of career success with those of male executives, identify their career development strategies for success and provide implications for research and practice. Two research questions guiding our inquiry included: How do female executives' definitions of…
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Nursing home work practices and nursing assistants' job satisfaction.
Bishop, Christine E; Squillace, Marie R; Meagher, Jennifer; Anderson, Wayne L; Wiener, Joshua M
2009-10-01
To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey, and county-level data from the Area Resource File. Multinomial logistic regression was used to estimate effects of compensation and working conditions on nursing assistants' overall job satisfaction, controlling for personal characteristics and local labor market characteristics. Wages, benefits, and job demands, measured by the ratio of nursing assistant hours per resident day, were associated with job satisfaction. Consistent with previous studies, job satisfaction was greater when nursing assistants felt respected and valued by their employers and had good relationships with supervisors. Nursing assistants were more satisfied when they had enough time to complete their work, when their work was challenging, when they were not subject to mandatory overtime, and where food was not delivered to residents on trays. This is the first investigation of nursing assistant job satisfaction using a nationally representative sample of nursing assistants matched to information about their employing nursing homes. The findings corroborate results of previous studies in showing that compensation and working conditions that provide respect, good relationships with supervisors, and better staffing levels are important to nursing assistant job satisfaction.
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Perspectives used for gaining approval of budgets.
Franks-Joiner, G L
1990-01-01
Nurse executives think about problems using a certain perspective which may influence decisions on budgetary matters. The nurse executives' perspective used in decision-making may influence which budget proposals are developed and approved. A study was performed to determine the perspective used by nurse executives in decision-making on supplementary budget item proposals and whether perspective use influenced approval. Findings showed that use of the system view or dual-domain perspective in a proposal may enhance nurse executives' changes of gaining approval.
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Blomberg, Helena; Stier, Jonas
2016-02-01
The aim of the study is to uncover and reveal how nurses as a profession and their working conditions are dramatized and portrayed in Swedish media narratives about the shortage of nurses. The media is an arena where stakeholders can air their views of the healthcare sector in general and the situation for nurses in particular. The focus in this study is the debate in Sweden on the shortage of nurses. Qualitative discursive study. A discourse analysis of media narratives about nurses and their working conditions published in several Swedish newspapers from 2009-2014. 1779 articles were included in the study. A selection (113 articles) of these articles was further analysed using a qualitative discursive psychological approach. Nurses are portrayed as being good, concerned about and critical of healthcare managers and politicians for not taking action. The accused actors justify their actions by partially accepting or displacing responsibility. The shortage of nurses is framed as a social problem - a threat to patients' safety. Seven different types of metaphorical expression frame the problem as inevitable, beyond control, abstract, an individual and collegial problem and nurses as replaceable. In addition, nurses and patients are dehumanized and no-one is held responsible. This study analyses the role of the media in emphasizing the seriousness or obscurity of the problem and possible solutions to it. Alternative narratives are needed to re-frame the nursing shortage and to find sustainable solutions. © 2015 John Wiley & Sons Ltd.
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Vardaman, James M; Rogers, Bryan L; Marler, Laura E
2018-04-11
Because nurses are on the front lines of care delivery, they are subject to frequent changes to their work practices. This change-laden environment puts nurses at higher risk for turnover. Given the frequent disruption to the way nurses perform their jobs, change-related self-efficacy (CSE), or confidence that one can handle change, may be vital to their retention. The purpose of this article is to examine the roles of CSE and job embeddedness in reducing turnover intentions among nurses. Specifically, this article tests a model in which CSE is the intervening mechanism through which job embeddedness influences turnover intentions. Drawing on a sample of 207 nurses working in the medical/surgical unit of a major metropolitan hospital in the United States, this study employs OLS regression to test for direct effects of job embeddedness and CSE on turnover intentions and bias-corrected bootstrapping to test for the indirect effects of job embeddedness on turnover intentions through CSE. Results show that CSE is directly linked to turnover intentions, and the effects of job embeddedness on turnover intentions become fully manifest through CSE. Improved nurse retention may lead to stable patient care and less disruption in service delivery. Improved retention also benefits health care organizations financially, as costs of replacing a nurse can exceed 100% of the salary for the position. Given the shortage of nurses in some geographic areas, retention remains an important goal.
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The NNP/DNP shortage: transforming neonatal nurse practitioners into DNPs.
Pressler, Jana L; Kenner, Carole A
2009-01-01
Neonatal nurse practitioners (NNPs) represent a high-demand specialty practice that is especially targeted for US secondary and tertiary care neonatal intensive care units (NICUs). NNPs make primary decisions about the caregiving of high-risk newborns at the time of admission, throughout hospitalization, at transfer, and at discharge that require an advanced knowledge base in neonatology as well as NICU clinical experience. NNPs prepared at the master's level are currently in very short supply, with some estimates suggesting that for each NNP who graduates, there are 80 positions open across the country. Even with the present shortage, due to the high cost of NNP education, NNP programs are diminishing and those that are remaining are not graduating a sufficient number of new NNPs each year to keep up with the demand. To add to the basic shortage problem, in 2004 the American Association of Colleges of Nursing decided that by 2015, the terminal degree for all nurse practitioners should move from the master's degree to the doctor of nursing practice (DNP) degree. That decision added a minimum of 12 months of full-time education to the advanced education requirements for nurse practitioners. What impact will the decision to require a DNP degree have on NNP specialty practice? Will even more NNP programs close because of faculty shortages of NNPs prepared at the DNP level? If a worse shortage occurs in the number of NNPs prepared to practice in NICUs, will physician assistants or other nonphysician clinicians who meet the need for advanced neonatal care providers replace NNPs? What steps, if any, can nursing take to ensure that NNP specialty practice is still needed and survives after supplementing the DNP requirement to NNP education?
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Palese, Alvisa; Cassone, Andrea; Kulla, Annamaria; Dorigo, Sabrina; Magee, Jesse; Artico, Marco; Camero, Francesco; Cassin, Catia; Cialdella, Sandra; Floridia, Giuseppe; Nadlišek, Boris; Palcic, Annamaria; Valle, Giulia; Sclauzero, Paola
2011-01-01
The clinical and research debate on the peripheral intravascular (PIV) catheter length of stay in situ is ongoing. The principal aim of this study was to explore the factors behind a nurse's decision to leave a PIV in place for more than 96 hours. The study focused on 7 northern Italian hospitals in 2009. A consequent sample of 269 PIV catheters was included. Direct observation and interviews were adopted. The time of the expected PIV replacement was fixed at 96 hours after its positioning, in accordance with the international guideline. Several factors were taken into account in regard to replacement of the PIV catheters by nurses, ranging from analysis based on their own clinical experience with PIV complications and analysis of the patient's clinical situation to the critical analysis of their own work situation. This clinical decision-making process is valuable: leaving the PIV in place for more than 96 hours is a complex decision and not simply a guideline violation.
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Nurses' responsibilities in postoperative pain management following total hip arthroplasty
Dumolard, Pierre; Gök, Mustafa; Le, Ngoc
2017-01-01
Total hip arthroplasty is the replacement of a hip joint that has been severely damaged. The operation is recommended if other treatments have not responded adequately. As the nurses are the professionals who spend the most time with patients after the surgery, they play an important role in the patient’s pain management. The aim of the thesis is to define the nurse’s responsibilities in the care of total hip arthroplasty. The purpose of the thesis is to analyze existing research, which may s...
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Nurses' beliefs about nursing diagnosis: A study with cluster analysis.
D'Agostino, Fabio; Pancani, Luca; Romero-Sánchez, José Manuel; Lumillo-Gutierrez, Iris; Paloma-Castro, Olga; Vellone, Ercole; Alvaro, Rosaria
2018-06-01
To identify clusters of nurses in relation to their beliefs about nursing diagnosis among two populations (Italian and Spanish); to investigate differences among clusters of nurses in each population considering the nurses' socio-demographic data, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and actual behaviours in making nursing diagnosis. Nurses' beliefs concerning nursing diagnosis can influence its use in practice but this is still unclear. A cross-sectional design. A convenience sample of nurses in Italy and Spain was enrolled. Data were collected between 2014-2015 using tools, that is, a socio-demographic questionnaire and behavioural, normative and control beliefs, attitudes, intentions and behaviours scales. The sample included 499 nurses (272 Italians & 227 Spanish). Of these, 66.5% of the Italian and 90.7% of the Spanish sample were female. The mean age was 36.5 and 45.2 years old in the Italian and Spanish sample respectively. Six clusters of nurses were identified in Spain and four in Italy. Three clusters were similar among the two populations. Similar significant associations between age, years of work, attitudes towards nursing diagnosis, intentions to make nursing diagnosis and behaviours in making nursing diagnosis and cluster membership in each population were identified. Belief profiles identified unique subsets of nurses that have distinct characteristics. Categorizing nurses by belief patterns may help administrators and educators to tailor interventions aimed at improving nursing diagnosis use in practice. © 2018 John Wiley & Sons Ltd.
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Kudo, Yasushi; Kono, Keiko; Kume, Ryuko; Matsuhashi, Ayako; Tsutsumi, Akizumi
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
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Theoretical assumptions of Maffesoli's sensitivity and Problem-Based Learning in Nursing Education1
Rodríguez-Borrego, María-Aurora; Nitschke, Rosane Gonçalves; do Prado, Marta Lenise; Martini, Jussara Gue; Guerra-Martín, María-Dolores; González-Galán, Carmen
2014-01-01
Objective understand the everyday and the imaginary of Nursing students in their knowledge socialization process through the Problem-Based Learning (PBL) strategy. Method Action Research, involving 86 students from the second year of an undergraduate Nursing program in Spain. A Critical Incident Questionnaire and Group interview were used. Thematic/categorical analysis, triangulation of researchers, subjects and techniques. Results the students signal the need to have a view from within, reinforcing the criticism against the schematic dualism; PBL allows one to learn how to be with the other, with his mechanical and organic solidarity; the feeling together, with its emphasis on learning to work in group and wanting to be close to the person taking care. Conclusions The great contradictions the protagonists of the process, that is, the students experience seem to express that group learning is not a form of gaining knowledge, as it makes them lose time to study. The daily, the execution time and the imaginary of how learning should be do not seem to have an intersection point in the use of Problem-Based Learning. The importance of focusing on the daily and the imaginary should be reinforced when we consider nursing education. PMID:25029064
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... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...
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A concept analysis of holistic nursing care in paediatric nursing
A.A. Tjale; J. Bruce
2007-01-01
Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative a...
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Manure derived biochar can successfully replace phosphate rock amendment in peatland restoration.
Pouliot, Rémy; Hugron, Sandrine; Rochefort, Line; Godbout, Stéphane; Palacios, Joahnn H; Groeneveld, Elisabeth; Jarry, Isabelle
2015-07-01
Phosphate rock fertilization is commonly used in peatland restoration to promote the growth of Polytrichum strictum, a nurse plant which aids the establishment of Sphagnum mosses. The present study tested whether 1) phosphorus fertilization facilitates the germination of P. strictum spores and 2) biochar derived from local pig manure can replace imported phosphate rock currently used in peatland restoration. Various doses of biochar were compared to phosphate rock to test its effect directly on P. strictum stem regeneration (in Petri dishes in a growth chamber) and in a simulation of peatland restoration with the moss layer transfer technique (in mesocoms in a greenhouse). Phosphorus fertilization promoted the germination of P. strictum spores as well as vegetative stem development. Biochar can effectively replace phosphate rock in peatland restoration giving a new waste management option for rural regions with phosphorus surpluses. As more available phosphorus was present in biochar, an addition of only 3-9 g m(-2) of pig manure biochar is recommended during the peatland restoration process, which is less than the standard dose of phosphate rock (15 g m(-2)). Copyright © 2015 Elsevier Ltd. All rights reserved.
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Autism Spectrum Disorder and intact executive functioning.
Ferrara, R; Ansermet, F; Massoni, F; Petrone, L; Onofri, E; Ricci, P; Archer, T; Ricci, S
2016-01-01
Earliest notions concerning autism (Autism Spectrum Disorders, ASD) describe the disturbance in executive functioning. Despite altered definition, executive functioning, expressed as higher cognitive skills required complex behaviors linked to the prefrontal cortex, are defective in autism. Specific difficulties in children presenting autism or verbal disabilities at executive functioning levels have been identified. Nevertheless, the developmental deficit of executive functioning in autism is highly diversified with huge individual variation and may even be absent. The aim of the present study to examine the current standing of intact executive functioning intact in ASD. Analysis of ASD populations, whether high-functioning, Asperger's or autism Broad Phenotype, studied over a range of executive functions including response inhibition, planning, cognitive flexibility, cognitive inhibition, and alerting networks indicates an absence of damage/impairment compared to the typically-developed normal control subjects. These findings of intact executive functioning in ASD subjects provide a strong foundation on which to construct applications for growth environments and the rehabilitation of autistic subjects.
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Svavarsdottir, Erla Kolbrun; Sigurdardottir, Anna Olafia; Konradsdottir, Elisabet; Tryggvadottir, Gudny Bergthora
2018-04-25
Implementing family system nursing in clinical settings is on the rise. However, little is known about the impact of graduate school education as well as continuing education in family systems nursing (FSN) on nurses' perceptions of their family nursing practice. To evaluate the level of nursing education, having taken a continuing hospital educational course in family system nursing (FN-ETI programme), and the impact of job characteristics on nurses' perceptions of their family nursing practice skills. Participants were 436 nurses with either a BSc degree or graduate degree in nursing. The Job Demand, Control and Support model guided the study (R. Karasek and T. Theorell, 1992, Healthy Work: Stress, Productivity, and the Reconstruction of Working Life, Basic Books, New York, NY). Scores for the characteristics of job demands and job control were created to categorise participants into four job types: high strain (high demand, low control), passive (low demand, low control), low strain (low demand, high control) and active (high demand, high control). Nurses with a graduate education who had taken the FN-ETI programme scored significantly higher on the Family Nursing Practice Scale than nurses with an undergraduate education. Nurses who were characterised as low strain or active scored significantly higher on the Family Nursing Practice Scale than the nurses who were characterised as high strain. Further, the interaction of education by job type was significant regarding family nursing practice skills. Hierarchical regression revealed 25% of the variance in family nursing practice skills was explained by job control, family policy on the unit, graduate education and employment on the following divisions: Maternal-Child, Emergency, Mental Health or Internal Medicine. Graduate education plus continuing education in FSN can offer nurses increased job opportunities more control over one's work as well as increased skills working with families in clinical settings.
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Patients Unicondylar Knee Replacement vs. Total Knee Replacement
Hedra Eskander
2017-01-01
The aim of this review article is to analyse the clinical effectiveness of total knee replacement (TKR) compared to unicondylar knee replacement (UKR) on patients. In terms of survival rates, revision rates and postoperative complications. The keywords used were: knee arthroplasty. Nearly three thousand articles were found on 25 August 2016. Of those, only twenty-five were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, ...
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... Spondylolisthesis BLOG FIND A SPECIALIST Treatments Artificial Disc Replacement (ADR) Patient Education Committee Jamie Baisden The disc ... Disc An artificial disc (also called a disc replacement, disc prosthesis or spine arthroplasty device) is a ...
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EMI Execution Service (EMI-ES) Specification
Schuller, B
2010-01-01
This document provides the interface specification, including related data models such as state model, activity description, resource and activity information, of an execution service, matching the needs of the EMI production middleware stack composed of ARC, gLite and UNICORE components. This service therefore is referred to as the EMI Execution Service (or “ES” for short). This document is a continuation of the work previously know as the GENEVA, then AGU (“ARC, gLite UNICORE”), then PGI execution service. As a starting point, the v0.42 of the “PGI Execution Service Specification” (doc15839) was used.
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小野, 尚香
2003-01-01
Nursing by Buddhist during Meiji Japan was stimulated by the visiting nursing program conducted by nurses connected with the Kyoto Training School for Nurses. Why were Buddhist priests attracted to the visiting nursing. what did they try to adopt and what kind of nursing activities did they try to organize? As the first step to answer these questions. in this paper I considered the specialty. the sociality. and the nursing spirit of the home nursing and district nursing provided by the ...
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Are nurse-led chemotherapy clinics really nurse-led? An ethnographic study.
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
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DEFF Research Database (Denmark)
Sköld, Martin; Karlsson, Christer
2012-01-01
. To shed light on this unexplored and growing managerial concern, the purpose of this explorative study is to identify operational challenges to management when product platforms are replaced. Design/methodology/approach – The study uses a longitudinal field-study approach. Two companies, Gamma and Omega...... replacement was chosen in each company. Findings – The study shows that platform replacements primarily challenge managers' existing knowledge about platform architectures. A distinction can be made between “width” and “height” in platform replacements, and it is crucial that managers observe this in order...... to challenge their existing knowledge about platform architectures. Issues on technologies, architectures, components and processes as well as on segments, applications and functions are identified. Practical implications – Practical implications are summarized and discussed in relation to a framework...
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Association of the nurse work environment with nurse incivility in hospitals.
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.
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Application of a smartphone nurse call system for nursing care.
Chuang, Shu-Ting; Liu, Yi-Fang; Fu, Zi-Xuan; Liu, Kuang-Chung; Chien, Sou-Hsin; Lin, Chin-Lon; Lin, Pi-Yu
2015-02-01
Traditionally, a patient presses the nurse call button and alerts the central nursing station. This system cannot reach the primary care nurse directly. The aim of this study was to apply a new smartphone system through the cloud system and information technology that linked a smartphone and a mobile nursing station for nursing care service. A smartphone and mobile nursing station were integrated into a smartphone nurse call system through the cloud and information technology for better nursing care. Waiting time for a patient to contact the most responsible nurse was reduced from 3.8 min to 6 s. The average time for pharmacists to locate the nurse for medication problem was reduced from 4.2 min to 1.8 min by the new system. After implementation of the smartphone nurse call system, patients received a more rapid response. This improved patients' satisfaction and reduced the number of complaints about longer waiting time due to the shortage of nurses.
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Directory of Open Access Journals (Sweden)
S. Radhakrishnan
2014-03-01
Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.
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What is the value of Values Based Recruitment for nurse education programmes?
Groothuizen, Johanna E; Callwood, Alison; Gallagher, Ann
2018-05-01
A discussion of issues associated with Values Based Recruitment (VBR) for nurse education programmes. Values Based Recruitment is a mandatory element in selection processes of students for Higher Education healthcare courses in England, including all programmes across nursing. Students are selected on the basis that their individual values align with those presented in the Constitution of the National Health Service. However, there are issues associated with the use of values as selection criteria that have been insufficiently addressed. These are discussed. Discussion paper. This article is based on documents published on the website of the executive body responsible for the implementation of a policy regarding VBR in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of VBR, underpinned by contemporary theory and literature. Values Based Recruitment influences who is accepted onto a nurse education programme, but there has been limited critical evaluation regarding the effectiveness of employing values as selection criteria. Values are subject to interpretation and evidence regarding whether or how VBR will improve practice and care is lacking. The issues discussed in this article show that Higher Education Institutions offering nursing courses, whether in England or in other countries, should be critical and reflective regarding the implementation of VBR methods. We call for a debate regarding the meaning and implications of VBR and further research regarding its validity and effectiveness. © 2017 John Wiley & Sons Ltd.
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Foreign nurse importation and the supply of native nurses.
Cortés, Patricia; Pan, Jessica
2014-09-01
The importation of foreign registered nurses has been used as a strategy to ease nursing shortages in the United States. The effectiveness of this policy depends critically on the long-run response of native nurses. We examine the effects of immigration of foreign-born registered nurses on the long-run employment and occupational choice of native nurses. Using a variety of empirical strategies that exploit the geographical distribution of immigrant nurses across US cities, we find evidence of large displacement effects - over a ten-year period, for every foreign nurse that migrates to a city, between 1 and 2 fewer native nurses are employed in the city. We find similar results using data on nursing board exam-takers at the state level - an increase in the flow of foreign nurses significantly reduces the number of natives sitting for licensure exams in more dependent states relative to less dependent states. Using data on self-reported workplace satisfaction among a sample of California nurses, we find suggestive evidence that part of the displacement effects could be driven by a decline in the perceived quality of the workplace environment. Copyright © 2014 Elsevier B.V. All rights reserved.
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Relationship between nurses' practice environments and nursing outcomes in Turkey.
Topçu, I; Türkmen, E; Badır, A; Göktepe, N; Miral, M; Albayrak, S; Kebapçı, A; Serbest, Ş; Özcan, D
2016-06-01
This study aimed to understand nursing practice environment characteristics in Istanbul-area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work. A well-known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey. This cross-sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection. Almost half of nurses suffered from high-level burnout related to emotional exhaustion and personal accomplishment, and one-third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention. There was a relationship between poor practice environments and nursing outcomes in Turkey. The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments. Poor practice environments, high-level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes. Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes. © 2016 International Council of Nurses.
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Disciplining and Screening Top Executives
S. Dominguez Martinez (Silvia); O.H. Swank (Otto); B. Visser (Bauke)
2006-01-01
textabstractBoards of directors face the twin task of disciplining and screening executives. To perform these tasks directors do not have detailed information about executives' behaviour, and only infrequently have information about the success or failure of initiated strategies, reorganizations,
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Cost analysis of nursing home registered nurse staffing times.
Dorr, David A; Horn, Susan D; Smout, Randall J
2005-05-01
To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.
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Nurses' extended work hours: Patient, nurse and organizational outcomes.
Kunaviktikul, W; Wichaikhum, O; Nantsupawat, A; Nantsupawat, R; Chontawan, R; Klunklin, A; Roongruangsri, S; Nantachaipan, P; Supamanee, T; Chitpakdee, B; Akkadechanunt, T; Sirakamon, S
2015-09-01
Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems
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Newton, Jennifer M; Kelly, Cherene M; Kremser, Anne K; Jolly, Brian; Billett, Stephen
2009-04-01
To identify what motivates individuals to engage in a nursing career. Recruitment and retention of nurses is a worldwide concern that is associated with several compounding factors, primarily the high attrition of its new graduates and an ageing workforce. Given these factors, it is necessary to understand why individuals choose to nurse, what keeps them engaged in nursing, and in what ways healthcare systems can support career development and retention. This paper presents initial interview data from a longitudinal multi method study with 29 undergraduate student nurses, 25 registered nurses (RNs), six Nurse Unit Managers (NUMs) and four Directors of Nursing (DoNs) from four hospitals across a healthcare organization in Australia. Thematic analysis yielded four key themes that were common to all participants: (1) a desire to help, (2) caring, (3) sense of achievement and (4) self-validation. These themes represented individuals' motivation to enter nursing and sustain them in their careers as either nurses or managers. Managers need to be cognisant of nurses underlying values and motivators in addressing recruitment and retention issues. Strategies need to be considered at both unit and organizational levels to ensure that the 'desire to care' does not become lost.
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Surgical nurse: his leadership style with nursing auxiliary personnel
Galvão, Cristina Maria; Trevizan, Maria Auxiliadora; Okino Sawada, Namie
2008-01-01
This investigation as carried out in order to promote follow-up in the studies concerning nurse`s leadership in the hospital context. Emphasys is given to the nurses that works in surgical ward unities. As a theoretical framework, authors utilized the model of leadership proposed by Hersey na Blanchard, named Situational Leadership. The objective was to analyze the correspondence of opinion between nurses and nursing auxiliary personnel about the leadership style of nurse should adopt in acco...
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Succession Planning for Nursing Leaders in a College of Nursing
Tucker, Cheryl A.
2017-01-01
The Institute of Medicine (2011) challenged nursing to ensure the nursing workforce includes a sufficient number of academic nurse leaders, nurse educators, and doctorally prepared nurses for the future healthcare needs of the people of the United States. National data reveals a fragile supply of academic nurse educators and leaders. This tenuous…
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Udod, Sonia; Racine, Louise
2014-12-01
This study considers empowerment in nurse-manager relations by examining how conflict is handled on both sides and how the critical social perspective has influenced these relations. The authors use inductive analysis of empirical data to explain how (1) nursing work is organized, structured, and circumscribed by centrally determined policies and practices that downplay nurses' professional judgement about patient care; (2) power is held over nurses in their relationship with their manager; and (3) nurses' response to power is to engage in strategies of resistance. The authors illustrate how power influences relations between staff nurses and managers and provide a critical analysis of the strategies of resistance that result in personal, relational, and critical empowerment among staff nurses. Through resistance, staff nurses engage in alternative discourses to counteract the prevailing neoliberal organizational and managerial discourses of efficiency and cost-effectiveness. Copyright© by Ingram School of Nursing, McGill University.
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Thompson, Juliana; Cook, Glenda; Duschinsky, Robbie
2018-03-01
To explore nursing home nurses' experiences and views of work identity. Nursing home nurses are in a unique position as they work at the interface of health and social care. Little is known about nursing home nurses' perceptions and experiences of working within this context. Evidence suggests that using the concept of work identity can support understanding of how workers make sense of their work. Hermeneutic phenomenological study. The study was carried out in seven nursing homes in North East England. Findings are based upon literary analysis of multiple episodic interviews with 13 nursing home nurses. Participants' responses suggested that nursing "residents" is different to nursing "patients," and nursing home nurses are required to modify their care activities to account for these differences. Participants also proposed that they are isolated and excluded from the rest of the healthcare workforce group. These issues led participants to feel uncertain about work identity. Many participants attempted to strengthen their work identity by aligning their role with what they perceived the "nurse identity" to be. Nurses' work activities and professional group identity influence their work identity. When work activities and professional group identity do not align with role expectations, as can be the case for nursing home nurses, work identity may be compromised. These nurses may attempt to change work practices to strengthen their work identity. Health- and social care providers need to account for work identity factors in the organisation of care, and planning and implementation of integrated health- and social care initiatives. © 2017 John Wiley & Sons Ltd.
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A simple hypothesis of executive function
Directory of Open Access Journals (Sweden)
Bruno eKopp
2012-06-01
Full Text Available Executive function is traditionally conceptualized as a set of abilities required to guide behavior toward goals. Here, an integrated theoretical framework for executive function is developed which has its roots in the notion of hierarchical mental models. Further following Duncan (2010a,b, executive function is construed as a hierarchical recursive system of test-operation-test-exit units (Miller, Galanter, and Pribram, 1960. Importantly, it is shown that this framework can be used to model the main regional prefrontal syndromes, which are characterized by apathetic, disinhibited and dysexecutive cognition and behavior, respectively. Implications of these considerations for the neuropsychological assessment of executive function are discussed.
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Capital Equipment Replacement Decisions
Batterham, Robert L.; Fraser, K.I.
1995-01-01
This paper reviews the literature on the optimal replacement of capital equipment, especially farm machinery. It also considers the influence of taxation and capital rationing on replacement decisions. It concludes that special taxation provisions such as accelerated depreciation and investment allowances are unlikely to greatly influence farmers' capital equipment replacement decisions in Australia.
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Transformational leadership practices of nurse leaders in professional nursing associations.
Ross, Erin J; Fitzpatrick, Joyce J; Click, Elizabeth R; Krouse, Helene J; Clavelle, Joanne T
2014-04-01
This study describes the transformational leadership (TL) practices of nurse leaders in professional nursing associations (PNAs). Professional nursing associations are vehicles to provide educational opportunities for nurses as well as leadership opportunities for members. Little has been published about the leadership practices of PNA members. E-mail surveys of 448 nurse leaders in PNAs were conducted in 2013 using the Leadership Practices Inventory (LPI). The top 2 TL practices of these nurse leaders were enabling others to act and encouraging the heart. Respondents with more leadership training reported higher TL practices. This is the 1st study to describe TL practices of nurse leaders in PNAs. Results of this study show that nurse leaders of PNAs emulate practices of TL. Transformational leaders can mobilize and direct association members in reaching shared values, objectives, and outcomes. Understanding TL practices of nurse leaders in PNAs are important to the future of nursing in order to enable nurses to lead change and advance health through these organizations.
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General and professional values of student nurses and nurse educators.
Riklikiene, Olga; Karosas, Laima; Kaseliene, Snieguole
2018-03-01
The aim of this study was to explore and compare the self-reported general and professional values in undergraduate student nurses and nurse educators in Lithuania. Contemporary nursing requires strong moral motivation and clear values as nurses confront many ethical dilemas in their practice. Students acquire essential values of the nursing profession through the appropriate role modelling of their educators. Nursing students seek to become capable in providing ethical and professional patient care while their educators attempt to model desired behaviours. A national cross-sectional comparative study was carried out in March 2011. Four-hundred eight respondents participated: 316 undergraduate nursing students and 92 nurse educators. A 57-item questionnaire was delivered to nursing programs at three universities and six colleges. Permission to conduct the study was granted by The Center on Bioethics. Student nurses and their educators rated the general value of altruism equally. Educators, in comparison with students, ranked honesty and intellectualism significantly higher and more often admired truth-telling in any circumstance. Students were more likely to avoid intellectual challenges in reading and placed lower importance on academic qualifications for career advancement. The professional nursing values of honesty, intellectualism and authority were ranked significantly higher by nurse educators than student nurses. The study revealed differences in self-reported general and professional values in undergraduate student nurses and nurse educators. The values of nurse educators were not always stronger than those of students. Positive relationships between particular general and professional values in both students and educators confirmed the link between professional and personal values. © 2017 John Wiley & Sons Ltd.
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Caring behaviour perceptions from nurses of their first-line nurse managers.
Peng, Xiao; Liu, Yilan; Zeng, Qingsong
2015-12-01
Nursing is acknowledged as being the art and science of caring. According to the theory of nursing as caring, all persons are caring but not every behaviour of a person is caring. Caring behaviours in the relationship between first-line nurse managers and Registered Nurses have been studied to a lesser extent than those that exist between patients and nurses. Caring behaviour of first-line nurse managers from the perspective of Registered Nurses is as of yet unknown. Identifying caring behaviours may be useful as a reference for first-line nurse managers caring for nurses in a way that nurses prefer. To explore first-line nurse managers' caring behaviours from the perspective of Registered Nurses in mainland China. Qualitative study, using descriptive phenomenological approach. Fifteen Registered Nurses recruited by purposive sampling method took part in in-depth interviews. Data were analysed according to Colaizzi's technique. Three themes of first-line nurse managers' caring behaviours emerged: promoting professional growth, exhibiting democratic leadership and supporting work-life balance. A better understanding of the first-line nurse managers' caring behaviours is recognised. The three kinds of behaviours have significant meaning to nurse managers. Future research is needed to describe what first-line nurse managers can do to promote nurses' professional growth, increase the influence of democratic leadership, as well as support their work-life balance. © 2015 Nordic College of Caring Science.
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Nursing education development in China (1887-1949): influences on contemporary nursing.
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.
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Nurse prescribing in dermatology: doctors' and non-prescribing nurses' views.
Stenner, Karen; Carey, Nicola; Courtenay, Molly
2009-04-01
This paper is a report of a study conducted to explore doctor and non-prescribing nurse views about nurse prescribing in the light of their experience in dermatology. The cooperation of healthcare professionals and peers is of key importance in enabling and supporting nurse prescribing. Lack of understanding of and opposition to nurse prescribing are known barriers to its implementation. Given the important role they play, it is necessary to consider how the recent expansion of nurse prescribing rights in England impacts on the views of healthcare professionals. Interviews with 12 doctors and six non-prescribing nurses were conducted in 10 case study sites across England between 2006 and 2007. Participants all worked with nurses who prescribed for patients with dermatological conditions in secondary or primary care. Thematic analysis was conducted on the interview data. Participants were positive about their experiences of nurse prescribing having witnessed benefits from it, but had reservations about nurse prescribing in general. Acceptance was conditional upon the nurses' level of experience, awareness of their own limitations and the context in which they prescribed. Fears that nurses would prescribe beyond their level of competence were expected to reduce as understanding and experience of nurse prescribing increased. Indications are that nurse prescribing can be acceptable to doctors and nurses so long as it operates within recommended parameters. Greater promotion and assessment of standards and criteria are recommended to improve understanding and acceptance of nurse prescribing.
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Rationing nurses: Realities, practicalities, and nursing leadership theories.
Fast, Olive; Rankin, Janet
2018-04-01
In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers' responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers' responsibilities are shaped to conform to institutional purposes. © 2017 John Wiley & Sons Ltd.
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Nursing career fulfillment: statistics and statements from registered nurses.
Reineck, Carol; Furino, Antonio
2005-01-01
A state-level survey of registered nurses confirmed national findings and raised new issues. Findings revealed that while nurses love the intrinsic reward of nursing, they report workplace, relationship, and stress issues which contribute to frustration and exhaustion. These issues may prevent registered nurses from giving the nursing care they desire to deliver, hastening preventable retirement and costly turnover decisions.
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Cho, Hyeonmi; Han, Kihye
2018-05-14
This study aimed to determine the relationships among the unit-level nursing work environment and individual-level health-promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. This study used a cross-sectional design. Data were collected using self-reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health-promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile-II, respectively. Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse-physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health-promotion interventions for spiritual growth and health responsibility are needed. Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses' responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes. © 2018 Sigma
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Replacing lactose from calf milk replacers : effects on digestion and post-absorptive metabolism
Gilbert, M.S.
2015-01-01
Summary PhD thesis Myrthe S. Gilbert
Replacing lactose from calf milk replacers – Effects on digestion and post-absorptive metabolism
Veal calves are fed milk replacer (MR) and solid feed. The largest part of the energy provided to veal calves
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Nursing students' attitudes toward science in the nursing curricula
Maroo, Jill Deanne
The nursing profession combines the art of caregiving with scientific concepts. Nursing students need to learn science in order to start in a nursing program. However, previous research showed that students left the nursing program, stating it included too much science (Andrew et al., 2008). Research has shown a correlation between students' attitudes and their performance in a subject (Osborne, Simon, & Collins, 2003). However, little research exists on the overall attitude of nursing students toward science. At the time of my study there existed no large scale quantitative study on my topic. The purpose of my study was to identify potential obstacles nursing students face, specifically, attitude and motivation toward learning science. According to research the nation will soon face a nursing shortage and students cite the science content as a reason for not completing the nursing program. My study explored nursing students' attitudes toward science and reasons these students are motivated to learn science. I ran a nationwide mixed methods approach with 1,402 participants for the quantitative portion and 4 participants for the qualitative portion. I validated a questionnaire in order to explore nursing students' attitudes toward science, discovered five different attitude scales in that questionnaire and determined what demographic factors provided a statistically significant prediction of a student's score. In addition, I discovered no statistical difference in attitude exists between students who have the option of taking nursing specific courses and those who do not have that option. I discovered in the qualitative interviews that students feel science is necessary in nursing but do not feel nurses are scientists. My study gives a baseline of the current attitude of nursing students toward science and why these students feel the need to learn the science.
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Using advanced mobile devices in nursing practice--the views of nurses and nursing students.
Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla
2014-09-01
Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research. © The Author(s) 2013.
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Nursing as concrete philosophy, Part I: Risjord on nursing knowledge.
Theodoridis, Kyriakos
2018-04-01
This essay addresses the problem of the essentiality of nursing knowledge and what kind of theory, if any, is essential to nursing practice. The overarching aim of the essay was to argue for the thesis that nursing may be described as a kind of philosophical activity, and, consequently, that philosophy is the kind of "theory" that is essential to nursing practice and to the nursing discipline at large. The essay consists of two papers. The present paper, Part I, is a critical examination of Mark Risjord's discussion of the problem of the theory-practice gap in his Nursing Knowledge: Practice, Science, Philosophy, from 2010. According to Risjord, the cause of the theory-practice gap originates in an erroneous conception of science (logical positivism) which had a decisive influence upon the way nursing scholars appropriated theoretical frameworks for the nursing discipline. This philosophical influence is considered in effect to have generated the theory-practice gap. In order to bridge the gap, Risjord suggests, the nursing discipline needs to adopt a standpoint epistemology conjoined with a postpositivist conception of scientific theory. In this way, a legitimate brand of nursing science may be developed and the theory-practice gap overcome. I will argue that neither Risjord's diagnosis of the problem, nor his recommended cure, may succeed in rescuing the nursing discipline from the theory-practice gap. Rather, the real cause of the theory-practice gap, I will claim, derives from an erroneous conception of nursing (not of science), namely the conception of nursing as a kind of science (roughly speaking). On my view, to overcome the gap, the nursing discipline needs to make salient the inherently philosophical character of nursing. In the second paper (Part II), I will continue the discussion of nursing knowledge and delineate the thesis of nursing as a kind of concrete philosophy. © 2017 John Wiley & Sons Ltd.
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Developing a prenatal nursing care International Classification for Nursing Practice catalogue.
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.
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Executive Functioning Heterogeneity in Pediatric ADHD.
Kofler, Michael J; Irwin, Lauren N; Soto, Elia F; Groves, Nicole B; Harmon, Sherelle L; Sarver, Dustin E
2018-04-28
Neurocognitive heterogeneity is increasingly recognized as a valid phenomenon in ADHD, with most estimates suggesting that executive dysfunction is present in only about 33%-50% of these children. However, recent critiques question the veracity of these estimates because our understanding of executive functioning in ADHD is based, in large part, on data from single tasks developed to detect gross neurological impairment rather than the specific executive processes hypothesized to underlie the ADHD phenotype. The current study is the first to comprehensively assess heterogeneity in all three primary executive functions in ADHD using a criterion battery that includes multiple tests per construct (working memory, inhibitory control, set shifting). Children ages 8-13 (M = 10.37, SD = 1.39) with and without ADHD (N = 136; 64 girls; 62% Caucasian/Non-Hispanic) completed a counterbalanced series of executive function tests. Accounting for task unreliability, results indicated significantly improved sensitivity and specificity relative to prior estimates, with 89% of children with ADHD demonstrating objectively-defined impairment on at least one executive function (62% impaired working memory, 27% impaired inhibitory control, 38% impaired set shifting; 54% impaired on one executive function, 35% impaired on two or all three executive functions). Children with working memory deficits showed higher parent- and teacher-reported ADHD inattentive and hyperactive/impulsive symptoms (BF 10 = 5.23 × 10 4 ), and were slightly younger (BF 10 = 11.35) than children without working memory deficits. Children with vs. without set shifting or inhibitory control deficits did not differ on ADHD symptoms, age, gender, IQ, SES, or medication status. Taken together, these findings confirm that ADHD is characterized by neurocognitive heterogeneity, while suggesting that contemporary, cognitively-informed criteria may provide improved precision for identifying a
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International Nuclear Information System (INIS)
Chrysochoides, N.G.; Cundy, M.R.; Von der Hardt, P.; Husmann, K.; Swanenburg de Veye, R.J.; Tas, A.
1985-01-01
The project of replacing the HFR originated in 1974 when results of several research programmes confirmed severe neutron embrittlement of aluminium alloys suggesting a limited life of the existing facility. This report contains the detailed chronology of events concerning preparation and execution of the replacement. After a 14 months' outage the reactor resumed routine operation on 14th February, 1985. At the end of several years of planning and preparation the reconstruction proceded in the following steps: unloading of the old core, decay of short-lived radioactivity in December 1983, removal of the old tank and of its peripheral equipment in January-February 1984, segmentation and waste disposal of the removed components in March-April, decontamination of the pools, bottom penetration overhauling in May-June, installation of the new tank and other new components in July-September, testing and commissioning, including minor modifications in October-December, and, trials runs and start-up preparation in January-February 1985. The new HFR Petten features increased and improved experimental facilities. Among others the obsolete thermal columns was replaced by two high flux beam tubes. Moreover the new plant has been designed for future increases of reactor power and neutron fluxes. For the next three to four years the reactor has to cope with a large irradiation programme, claiming its capacity to nearly 100%
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Flued head replacement alternatives
International Nuclear Information System (INIS)
Smetters, J.L.
1987-01-01
This paper discusses flued head replacement options. Section 2 discusses complete flued head replacement with a design that eliminates the inaccessible welds. Section 3 discusses alternate flued head support designs that can drastically reduce flued head installation costs. Section 4 describes partial flued head replacement designs. Finally, Section 5 discusses flued head analysis methods. (orig./GL)
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May, Cattleya; Cutting, Katharine N
2014-01-01
The Institute for Healthcare Improvement is an independent not-for-profit organization based in Cambridge, Massachusetts. It is a leading innovator in health and health care improvement with a global following.One important part of the IHI is the development and evolution of the "Open School." Launched in September 2008, the online community currently includes hundreds of thousands of students worldwide. The goals of the Open School are consistent with the IHI initial concepts: to build will for change, seek out innovation, share expertise, and build leaders. Each year, the Open School awards scholarships to select students to attend a Leadership Academy.The Student Quality Leadership Academy allows students to network with other future nurses, physicians, and health care administrators and explores how they feel about leadership. This is important to nursing as we will need to replace many leadership positions in the future, but often new nurses are uncertain about leadership roles.
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Eminovic, Nina; Wyatt, Jeremy C.; Tarpey, Aideen M.; Murray, Gerard; Ingrams, Grant J.
2004-01-01
Background: NHS Direct is a telephone triage service used by the UK public to contact a nurse for any kind of health problem. NHS Direct Online (NHSDO) extends NHS Direct, allowing the telephone to be replaced by the Internet, and introducing new opportunities for informing patients about their
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Tjoflåt, Ingrid; Karlsen, Bjørg; Saetre Hansen, Britt
2016-06-01
To describe how Norwegian expatriate nurses engaged in humanitarian assignments overseas experience working with the local nurses promoting nursing care in the hospital ward. Western countries have a long tradition of providing nurses with expert knowledge in nursing care for humanitarian projects and international work overseas. Studies from humanitarian mission revealed that health workers rarely acknowledge or use the local knowledge. However, there is a lack of studies highlighting expatriate nurses' experiences working with local nurses to promote nursing care in the hospital ward. This study applies a descriptive explorative qualitative design. The data were collected in 2013 by means of seven semi-structured interviews and analysed using qualitative content analysis. The data analyses revealed three themes related to the expatriate nurses' experiences of working with the local nurses to promote nursing care in the hospital ward: (1) Breaking the code, (2) Colliding worlds and (3) Challenges in sharing knowledge. The findings reflect different challenges when working with the local nurses. Findings indicate valuable knowledge gained about local nursing care and the local health and educational system. They also demonstrate challenges for the expatriate nurses related to the local nursing standard in the wards and using the local nurses' experiences and knowledge when working together. The findings can inform nurses, humanitarian organisations and institutions working overseas regarding the recruitment and the preparation of nurses who want to work cross- culturally or in humanitarian missions overseas. © 2016 John Wiley & Sons Ltd.
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The "old internationals": Canadian nurses in an international nursing community.
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.
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Mandell, D.J.; Ward, S.E.
2011-01-01
The neural processes that underlie executive function begin to develop in infancy. However, it is unclear how the behavior manifested by these processes are related or if they can be differentiated early in development. This study seeks to examine early emerging executive functioning skills in
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Nursing: What's a Nurse Practitioner?
... as advanced practice nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification ... NP training emphasizes disease prevention, reduction of health risks, and thorough patient education. Like doctors, NPs are ...
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Directory of Open Access Journals (Sweden)
Andrew Carrothers
2017-10-01
Full Text Available This paper examines the relationship between hedge fund activism and target firm performance, executive compensation, and executive wealth. It introduces a theoretical framework that describes the activism process as a sequence of discrete decisions. The methodology uses regression analysis on a matched sample based on firm size, industry, and market-to-book ratio. All regressions control for industry and year fixed effects. Schedule 13D Securities and Exchange Commission (SEC filings are the source for the statistical sample of hedge fund target firms. I supplement that data with target firm financial, operating, and share price information from the CRSP-COMPUSTAT merged database. Activist hedge funds target undervalued or underperforming firms with high profitability and cash flows. They do not avoid firms with powerful CEOs. Leverage, executive compensation, pay for performance and CEO turnover increase at target firms after the arrival of the activist hedge fund. Target firm executives’ wealth is more sensitive to changes in share price after hedge fund activism events suggesting that the executive team experiences changes to their compensation structure that provides incentive to take action to improve returns to shareholders. The top executives reap rewards for increasing firm value but not for increased risk taking.
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Relationships between critical thinking ability and nursing competence in clinical nurses.
Chang, Mei Jen; Chang, Ying-Ju; Kuo, Shih-Hsien; Yang, Yi-Hsin; Chou, Fan-Hao
2011-11-01
To examine the relationships between critical thinking ability and nursing competence in clinical nurses. There are few evidance-based data related to the relationship between critical thinking ability and nursing competence of clinical nurses. A cross-sectional and correlation research design was used. A total of 570 clinical nurses at a medical centre in southern Taiwan were recruited into this study. Two self-report questionnaires, the Watson-Glaser Critical Thinking Appraisal (WGCTA) and the Nursing Competence Scale (NCS), were used to collect data. The critical thinking ability of clinical nurses was at the middle level. The highest score for the subscales of the WGCTA was 'interpretation ability' and the lowest was 'inference ability'. The nursing competence of clinical nurses was at the middle level and above. The highest score for the subscales was 'caring ability' and the lowest was 'research ability'. Critical thinking ability had a significantly positive correlation with nursing competence. Critical thinking, working years, educational levels and position/title were the significant predictors of nursing competence, accounting for 32·9% of the variance. Critical thinking ability had a significantly positive correlation with nursing competence. The critical thinking ability of clinical nurses with a master's degree was significantly better than those with a bachelor's degree or a diploma and nurses with over five working years was significantly better than those with under five years. The findings of this study can further serve as a reference for nursing education to improve nursing curricula and teaching strategies for nurse preparation. It could also be a guideline for nursing administration personnel in on-the-job training and orientation programs for nursing staff. © 2011 Blackwell Publishing Ltd.
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Validating a tool to measure auxiliary nurse midwife and nurse motivation in rural Nepal.
Morrison, Joanna; Batura, Neha; Thapa, Rita; Basnyat, Regina; Skordis-Worrall, Jolene
2015-05-12
A global shortage of health workers in rural areas increases the salience of motivating and supporting existing health workers. Understandings of motivation may vary in different settings, and it is important to use measurement methods that are contextually appropriate. We identified a measurement tool, previously used in Kenya, and explored its validity and reliability to measure the motivation of auxiliary nurse midwives (ANM) and staff nurses (SN) in rural Nepal. Qualitative and quantitative methods were used to assess the content validity, the construct validity, the internal consistency and the reliability of the tool. We translated the tool into Nepali and it was administered to 137 ANMs and SNs in three districts. We collected qualitative data from 78 nursing personnel and district- and central-level stakeholders using interviews and focus group discussions. We calculated motivation scores for ANMs and SNs using the quantitative data and conducted statistical tests for validity and reliability. Motivation scores were compared with qualitative data. Descriptive exploratory analysis compared mean motivation scores by ANM and SN sociodemographic characteristics. The concept of self-efficacy was added to the tool before data collection. Motivation was revealed through conscientiousness. Teamwork and the exertion of extra effort were not adequately captured by the tool, but important in illustrating motivation. The statement on punctuality was problematic in quantitative analysis, and attendance was more expressive of motivation. The calculated motivation scores usually reflected ANM and SN interview data, with some variation in other stakeholder responses. The tool scored within acceptable limits in validity and reliability testing and was able to distinguish motivation of nursing personnel with different sociodemographic characteristics. We found that with minor modifications, the tool provided valid and internally consistent measures of motivation among ANMs
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Continuing Education Preferences, Facilitators, and Barriers for Nursing Home Nurses.
Dyck, Mary J; Kim, Myoung Jin
2018-01-01
The purpose of the study was to determine the continuing education needs for nursing home nurses in rural central Illinois and to determine any potential facilitators or barriers to obtaining continuing education. Data were collected using the Educational Needs Assessment questionnaire. Descriptive statistics were computed to examine continuing education preferences, facilitators, and barriers among nursing home nurses. Independent samples t tests were used to compare preferences between administrative and staff nurses. The sample included 317 nurses from 34 facilities. The five top needs were related to clinical problems. Administrative nurses had greater needs for professional issues, managerial skills, and quality improvement than staff nurses. Barriers included rural settings, need for vacation time for programs, and inadequate staffing. Continuing education needs of nursing home nurses in Illinois are similar to previous studies conducted in Arizona and North Carolina. Continuing education barriers were mostly organizational, rather than personal. J Contin Nurs Educ. 2018;49(1):26-33. Copyright 2018, SLACK Incorporated.
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Sexual Harassment and Organizational Outcomes Executive Summary
2011-10-01
quid pro quo type of Sexual harassment and Organizational, 4 sexual harassment (e.g., sexual coercion). This should drive organizational efforts to... Sexual Harassment and Organizational Outcomes Executive Summary Charlie L. Law DEFENSE EQUAL...Executive Summary] No. 99-11 Sexual harassment and Organizational, 2 Executive Summary Issue
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Filipino Nurses' Spirituality and Provision of Spiritual Nursing Care.
Labrague, Leodoro J; McEnroe-Petitte, Denise M; Achaso, Romeo H; Cachero, Geifsonne S; Mohammad, Mary Rose A
2016-12-01
This study was to explore the perceptions of Filipino nurses' spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses' Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses' perception of spirituality were Item 7, "I believe that God loves me and cares for me," and Item 8, "Prayer is an important part of my life," with mean scores of 4.87 (SD = 1.36) and 4.88 (SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, "I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.)," and Item 25, "I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed," with mean scores of 3.16 (SD = 1.54) and 2.92 (SD = 1.59). Nurse's spirituality correlated significantly with their understanding of spiritual nursing care (r = .3376, p ≤ .05) and delivery of spiritual nursing care (r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care (r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment. © The Author(s) 2015.
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Rubin, Gerald; Balaji, Rengarajan V; Barcikowski, Robert
2009-11-01
The aims of this study were: (1) to identify barriers to nurse/nursing aide communication and to discuss and provide solutions to some of these problems through a focus group; and (2) to determine the effectiveness of this focus group on job satisfaction-related outcomes. Numerous studies have attributed problems with nurse staffing and turnover to faulty communication between nursing supervisors and nursing aides. Registered nurses (RNs) (n = 2), licensed practical nurses (LPNs) (n = 10) and nursing aides (n = 19) were interviewed; narrative themes from the interviews were then used to guide focus group discussions. A job satisfaction survey in a pre-test/post-test fashion was used to test the efficacy of the focus group. Qualitative data from the interviews highlighted: (1) anger and condescension in communication; and (2) lack of mentoring, empathy and respect. The job satisfaction survey data showed that the attitudes decreased significantly among participants in the focus group but not in the control group (P communication and collegiality, thereby reducing job turnover in nursing homes.
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Implementing Replacement Cost Accounting
1976-12-01
cost accounting Clickener, John Ross Monterey, California. Naval Postgraduate School http://hdl.handle.net/10945/17810 Downloaded from NPS Archive...Calhoun IMPLEMENTING REPLACEMENT COST ACCOUNTING John Ross CHckener NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS IMPLEMENTING REPLACEMENT COST ...Implementing Replacement Cost Accounting 7. AUTHORS John Ross Clickener READ INSTRUCTIONS BEFORE COMPLETING FORM 3. RECIPIENT’S CATALOG NUMBER 9. TYRE OF
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The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement.
Manning, Jennifer
2016-09-01
Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses. The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement. Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form. Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement. Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.
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Executable Architecture Research at Old Dominion University
Tolk, Andreas; Shuman, Edwin A.; Garcia, Johnny J.
2011-01-01
Executable Architectures allow the evaluation of system architectures not only regarding their static, but also their dynamic behavior. However, the systems engineering community do not agree on a common formal specification of executable architectures. To close this gap and identify necessary elements of an executable architecture, a modeling language, and a modeling formalism is topic of ongoing PhD research. In addition, systems are generally defined and applied in an operational context to provide capabilities and enable missions. To maximize the benefits of executable architectures, a second PhD effort introduces the idea of creating an executable context in addition to the executable architecture. The results move the validation of architectures from the current information domain into the knowledge domain and improve the reliability of such validation efforts. The paper presents research and results of both doctoral research efforts and puts them into a common context of state-of-the-art of systems engineering methods supporting more agility.
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Independence and executive remuneration for supervisory board members and non-executive directors
Directory of Open Access Journals (Sweden)
Hana Horak
2011-01-01
Full Text Available In this paper, the author analyses the issues of independence and rewarding members of supervisory boards and non-executive directors in administrative boards. The question of independence was developed as one of the fundamental issues of corporative administration. Members of these organs of society should have the appropriate qualifications, specific knowledge and skills in order to reasonably and impartially weigh up social business and reach decisions in the best interests of society, its members and other interest holders. So that they can act in accordance with this, the presumption is that they are independent. Recently, after financial crises, it is precisely the independence of supervisory members, that is, non-executive directors, which is considered to be the foundation of the fight against the opportunism of administration and main shareholders. The authors analyse the Recommendations on Independence and Executive Remuneration for members of supervisory and administrative boards of the European Union, together with their implementation in Croatian law and practice.
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Characteristics that perinatal nurse managers desire in new nurse hires.
Falls, Emily; Hensel, Desiree
2012-04-01
Nursing leaders have proposed that nurses must have the Quality and Safety Education for Nurses (QSEN) competencies to work in complex health care systems. Using the QSEN framework, this study explored what characteristics perinatal nurse managers desired most in new nurses. This study used a survey design and a convenience sample of perinatal nurse managers working in Indiana hospitals (N = 46). Managers were more likely to hire nurses with experience, positive references, and excellent attendance. Of the QSEN competencies, managers looked most for teamwork and collaboration, followed by safety and patient-centered care. In addition to the traditional qualities desired in new nurses, the QSEN competencies are gaining importance among perinatal managers. Copyright 2012, SLACK Incorporated.
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Nursing 2000: Collaboration to Promote Careers in Registered Nursing.
Wilson, Connie S.; Mitchell, Barbara S.
1999-01-01
The effectiveness of the collaborative Nursing 2000 model in promoting nursing careers was evaluated through a survey of 1,598 nursing students (637 responses). Most effective techniques were the "shadow a nurse" program, publications, classroom and community presentations, and career-counseling telephone calls. (SK)
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Nursing workloads: the results of a study of Queensland Nurses.
Hegney, Desley; Plank, Ashley; Parker, Victoria
2003-09-01
This paper reports the findings of a survey undertaken in Queensland, Australia in October 2001. The participants were registered and enrolled nurses and assistants in nursing who were members of the industrial body - the Queensland Nursing Union (QNU), and who were in paid employment in nursing in Queensland. Participants were selected by random sampling from each of the three major employment groups - the aged care, public and private acute sectors. Of the 2800 invited participants, 1477 responded resulting in an overall response rate of 53%. The findings indicate that over 50% of nurses in the aged-care sector, 32% of nurses in the public and 30% of nurses in the private acute sector experience difficulties in meeting patient needs because of insufficient staffing levels. The nurses in this study also believed that there was poor skills-mix, mostly caused by lack of funding, too few experienced staff or too many inexperienced staff. Many nurses in this study expressed their anger and frustration about their inability to complete their work to their professional satisfaction in the paid time available. Further, many nurses also expressed the view that because of this inability they were planning to leave the nursing profession. These findings are consistent with other research into the nursing workforce both within Australia and internationally.
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The Impact of the Nursing Practice Environment on Missed Nursing Care.
Hessels, Amanda J; Flynn, Linda; Cimiotti, Jeannie P; Cadmus, Edna; Gershon, Robyn R M
2015-12-01
Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals. This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals. Nurses missed delivering a significant amount of necessary patient care (10-27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events. This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care.
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Self-Care Posters Serve as a Low-Cost Option for Physical Activity Promotion of Hospital Nurses.
Raney, Marcella; Van Zanten, Erin
2018-03-01
Hospital nurses play an important role in the nation's short- and long-term patient care. At the same time, nurses often experience high levels of occupational stress and participate in low levels of physical activity (PA). The purpose of this study was to examine the impact of self-monitoring and a poster campaign on the PA behaviors of hospital nurses. Motivational and instructional exercise posters were hung in break rooms of experimental units and replaced biweekly for 8 weeks. A total of 26 nurses (control: n = 13; experimental: n = 13) wore accelerometers for 3 workdays pre-, mid-, and postintervention. Participants were provided a step counter at baseline and a PA report at each stage. Moderate to vigorous PA (MVPA) and step count (SC) increased pre- to midintervention for control (MVPA: 14.8 ± 7.6%; SC: 19.1 ± 7.8%) and experimental (MVPA: 26.7 ± 18.5%, SC: 17.6 ± 8.3%) participants. Physical activity levels returned to baseline postintervention for control ( p > .05) and increased mid- to postintervention for experimental (MVPA: 16.2 ± 5.2%, SC: 10.7 ± 4.7%, p poster campaign may increase PA levels of hospital nurses when combined with personalized PA feedback.
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Tarlier, Denise S; Browne, Annette J
2011-06-01
Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.
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Sibling rivalry in nursing and the role of nurse psychotherapist.
Harrison, K A
1998-01-01
The burgeoning role of the analytically prepared nurse psychotherapist in Great Britain. To describe the struggles of nurses in this role and ways this struggle might be lessened. Observations of the author, an analytically prepared nurse psychotherapist-in-training in Great Britain. The role of the nurse psychotherapist with psychoanalytic training is in its infancy in Great Britain. Barriers to the development are both external, from outside the nursing profession, and internal, in the form of sibling rivalry or envy from less prepared nurses. Increased communication among nurses is encouraged so that a shared understanding and mutual respect may result.
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Thompson, Hannah E; Almaghyuli, Azizah; Noonan, Krist A; Barak, Ohr; Lambon Ralph, Matthew A; Jefferies, Elizabeth
2018-01-03
Semantic cognition, as described by the controlled semantic cognition (CSC) framework (Rogers et al., , Neuropsychologia, 76, 220), involves two key components: activation of coherent, generalizable concepts within a heteromodal 'hub' in combination with modality-specific features (spokes), and a constraining mechanism that manipulates and gates this knowledge to generate time- and task-appropriate behaviour. Executive-semantic goal representations, largely supported by executive regions such as frontal and parietal cortex, are thought to allow the generation of non-dominant aspects of knowledge when these are appropriate for the task or context. Semantic aphasia (SA) patients have executive-semantic deficits, and these are correlated with general executive impairment. If the CSC proposal is correct, patients with executive impairment should not only exhibit impaired semantic cognition, but should also show characteristics that align with those observed in SA. This possibility remains largely untested, as patients selected on the basis that they show executive impairment (i.e., with 'dysexecutive syndrome') have not been extensively tested on tasks tapping semantic control and have not been previously compared with SA cases. We explored conceptual processing in 12 patients showing symptoms consistent with dysexecutive syndrome (DYS) and 24 SA patients, using a range of multimodal semantic assessments which manipulated control demands. Patients with executive impairments, despite not being selected to show semantic impairments, nevertheless showed parallel patterns to SA cases. They showed strong effects of distractor strength, cues and miscues, and probe-target distance, plus minimal effects of word frequency on comprehension (unlike semantic dementia patients with degradation of conceptual knowledge). This supports a component process account of semantic cognition in which retrieval is shaped by control processes, and confirms that deficits in SA patients reflect
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Culture, executive function, and social understanding.
Lewis, Charlie; Koyasu, Masuo; Oh, Seungmi; Ogawa, Ayako; Short, Benjamin; Huang, Zhao
2009-01-01
Much of the evidence from the West has shown links between children's developing self-control (executive function), their social experiences, and their social understanding (Carpendale & Lewis, 2006, chapters 5 and 6), across a range of cultures including China. This chapter describes four studies conducted in three Oriental cultures, suggesting that the relationships among social interaction, executive function, and social understanding are different in these cultures, implying that social and executive skills are underpinned by key cultural processes.
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Contested Practice: Political Activism in Nursing and Implications for Nursing Education.
Buck-McFadyen, Ellen; MacDonnell, Judith
2017-07-27
Canadian nurses have a social mandate to address health inequities for the populations they serve, as well as to speak out on professional and broader social issues. Although Canadian nursing education supports the role of nurses as advocates for social justice and leadership for health care reform, little is known about how nurse educators understand activism and how this translates in the classroom. A comparative life history study using purposeful sampling and a critical feminist lens was undertaken to explore political activism in nursing and how nurse educators foster political practice among their students. Findings from interviews and focus groups with 26 Ontario nurse educators and nursing students suggested that neoliberal dynamics in both the practice setting and in higher education have constrained nurses' activist practice and favour a technical rational approach to nursing education. Implications and strategies to inspire political action in nursing education are discussed.
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Dijk, van D.; Hendrix, E.M.T.
2016-01-01
Operators of underground water supply networks are challenged with pipe replacement
decisions, because pipes are subject to increased failure rates as they age and financial resources
are often limited.We study the optimal replacement time and optimal number of pipe replacements
such
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Strobbe, Stephen; Crowley, Melanie
Alcohol and other substance use by nurses potentially places patients, the public, and nurses themselves at risk for serious injury or death. Nursing students are also at risk for problems related to substance use. When viewed and treated as a chronic medical illness, treatment outcomes for substance use disorders are comparable with those of other diseases and can result in lasting benefits. Professional monitoring programs that employ an alternative-to-discipline approach have been shown to be effective in the treatment of health professionals with substance use disorders and are considered a standard for recovery, with high rates of completion and return to practice. It is the position of the Emergency Nurses Association and the International Nurses Society on Addictions that 1. health care facilities provide education to nurses and other employees regarding alcohol and other drug use and establish policies, procedures, and practices to promote safe, supportive, drug-free workplaces; 2. health care facilities and schools of nursing adopt alternative-to-discipline approaches to treating nurses and nursing students with substance use disorders, with stated goals of retention, rehabilitation, and reentry into safe, professional practice; 3. drug diversion, in the context of personal use, is viewed primarily as a symptom of a serious and treatable disease and not exclusively as a crime; and 4. nurses and nursing students are aware of the risks associated with substance use, impaired practice, and drug diversion and have the responsibility and means to report suspected or actual concerns.
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Nursing practice environment: a strategy for mental health nurse retention?
Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda
2015-06-01
Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required. © 2015 Australian College of Mental Health Nurses Inc.
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Developmental Changes in Executive Functioning
Lee, Kerry; Bull, Rebecca; Ho, Ringo M. H.
2013-01-01
Although early studies of executive functioning in children supported Miyake et al.'s (2000) three-factor model, more recent findings supported a variety of undifferentiated or two-factor structures. Using a cohort-sequential design, this study examined whether there were age-related differences in the structure of executive functioning among…
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ARC Code TI: IPG Execution Service
National Aeronautics and Space Administration — The Execution Service allows users to submit, monitor, and cancel complex jobs. Each job consists of a set of tasks that perform actions such as executing...
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A comparison of ethical issues in nursing practice across nursing units.
Park, Mihyun; Jeon, Sang Hee; Hong, Hyun-Ja; Cho, Sung-Hyun
2014-08-01
The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. The study used a descriptive research design. Ethics/human rights issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. The study sample included 993 staff nurses working in a university hospital in South Korea. This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. The most frequently and disturbingly encountered issues across nursing units were "conflicts in the nurse-physician relationship," "providing care with a possible risk to your health," and "staffing patterns that limit patient access to nursing care." The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses' reflection on their experiences. © The Author(s) 2014.
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[Nurse practitioner's capability].
Cheng, Chen-Hsiu; Chen, Shih-Chien
2007-10-01
Nurse practitioner development affirms the social value of nursing staff and promotes the professional image of nursing. As the medical environment and doctor-patient relations change, how should a nurse practitioner carry out clinical care? Apart from having foundations in medical knowledge and high-quality nursing techniques, nurse practitioners must have other clinical skills, in order to break out of their former difficult position, promote nursing competitiveness, provide a multi -dimensional service, win the people's acclamation and develop international links.
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Questionnaire-based assessment of executive functioning: Psychometrics.
Castellanos, Irina; Kronenberger, William G; Pisoni, David B
2018-01-01
The psychometric properties of the Learning, Executive, and Attention Functioning (LEAF) scale were investigated in an outpatient clinical pediatric sample. As a part of clinical testing, the LEAF scale, which broadly measures neuropsychological abilities related to executive functioning and learning, was administered to parents of 118 children and adolescents referred for psychological testing at a pediatric psychology clinic; 85 teachers also completed LEAF scales to assess reliability across different raters and settings. Scores on neuropsychological tests of executive functioning and academic achievement were abstracted from charts. Psychometric analyses of the LEAF scale demonstrated satisfactory internal consistency, parent-teacher inter-rater reliability in the small to large effect size range, and test-retest reliability in the large effect size range, similar to values for other executive functioning checklists. Correlations between corresponding subscales on the LEAF and other behavior checklists were large, while most correlations with neuropsychological tests of executive functioning and achievement were significant but in the small to medium range. Results support the utility of the LEAF as a reliable and valid questionnaire-based assessment of delays and disturbances in executive functioning and learning. Applications and advantages of the LEAF and other questionnaire measures of executive functioning in clinical neuropsychology settings are discussed.
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EXECUTIVE FUNCTIONING IN SCHIZOPHRENIA
Directory of Open Access Journals (Sweden)
Gricel eOrellana
2013-06-01
Full Text Available The executive function (EF is a set of abilities, which allows us to invoke voluntary control of our behavioral responses. These functions enable human beings to develop and carry out plans, make up analogies, obey social rules, solve problems, adapt to unexpected circumstances, do many tasks simultaneously and locate episodes in time and place. EF includes divided attention and sustained attention, working memory, set-shifting, flexibility, planning and the regulation of goal directed behavior and can be defined as a brain function underlying the human faculty to act or think not only in reaction to external events but also in relation with internal goals and states. EF is mostly associated with dorsolateral prefrontal cortex (PFC. Besides EF, PFC is involved in self-regulation of behavior, i.e. the ability to regulate behavior according to internal goals and constraints, particularly in less structured situations. Self-regulation of behavior is subtended by ventral medial /orbital PFC. Impairment of EF is one of the most commonly observed deficits in schizophrenia through the various disease stages. Impairment in tasks measuring conceptualization, planning, cognitive flexibility, verbal fluency, ability to solve complex problems and working memory occur in schizophrenia. Disorders detected by executive tests are consistent with evidence from functional neuroimaging, which have shown PFC dysfunction in patients while performing these kinds of tasks. Schizophrenics also exhibit deficit in odor identifying, decision-making and self-regulation of behavior suggesting dysfunction of the orbital PFC. However, impairment in executive tests is explained by dysfunction of prefronto-striato-thalamic, prefronto-parietal and prefronto-temporal neural networks mainly. Disorders in executive functions may be considered central facts with respect to schizophrenia and it has been suggested that negative symptoms may be explained by that executive dysfunction.
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[Nursing ethics and the access to nursing care].
Monteverde, Settimio
2013-08-01
The increasing number of ethical issues highlighted in everyday nursing care demonstrates the connectedness between nursing ethics and nursing practice. However, what is the role of ethical theories in this context? This question will be examined in this article by analysing the contribution made by the ethics of care, in particular in understandings of gender roles, asymmetries of power, professional knowledge and experience. The adoption and criticism of an emergent nursing ethics is discussed and stated from different viewpoints. The actuality of the caring approach is affirmed by a new reading of the given situation. This article first describes the traditional perception of nurses as marginalised actors in the health sector. By making reference to the current and growing global scarcity of nursing care, it contends that nursing will no longer be marginalised, but instead at the centre of public health attention and reputation. Nevertheless, marginalisation will persist by increasingly affecting the care receivers, especially those groups that are pushed to the fringes by the consequences of the healthcare market, such as persons of extreme old age, suffering from multiple morbidities, or with poor health literacy. Whereas the "classical" understanding of the ethics of care focuses on the nurse-patient relationship and on individual care and understanding of ethics, the new understanding confirms the classical, but adds an understanding of social ethics: caring for the access to care is seen as a main ethical goal of social justice within a nursing ethic.
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[The Role of Nursing Education in the Advancement of the Nursing Profession].
Chang Yeh, Mei
2017-02-01
The present article discusses the role of nursing education in the advancement of the nursing profession in the context of the three facets of knowledge: generation, dissemination, and application. Nursing is an applied science and the application of knowledge in practice is the ultimate goal of the nursing profession. The reform of the healthcare delivery model requires that nurses acquire and utilize evidence-based clinical knowledge, critical thinking, effective communication, and team collaboration skills in order to ensure the quality of patient care and safety. Therefore, baccalaureate education has become the minimal requirement for pre-licensure nursing education. Schools of nursing are responsible to cultivate competent nurses to respond to the demands on the nursing workforce from the healthcare system. Attaining a master's education in nursing helps cultivate Advanced Practice Registered Nurses (APRNs) to further expand the roles and functions of the nursing profession in order to promote the quality of care in clinical practice. Nursing faculty and scholars of higher education institutions generate nursing knowledge and develop professional scholarship through research. Attaining a doctoral education in nursing cultivates faculties and scholars who will continually generate and disseminate nursing knowledge into the future.
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Nurses' Needs for Care Robots in Integrated Nursing Care Services.
Lee, Jai-Yon; Song, Young Ae; Jung, Ji Young; Kim, Hyun Jeong; Kim, Bo Ram; Do, Hyun-Kyung; Lim, Jae-Young
2018-05-13
To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in an integrated nursing care services. Korea is expected to be a super-aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced 'integrated nursing care services'; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. The study applied a cross-sectional survey. In 2016, we conducted a multi-center survey involving 302 registered nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Trial center nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top three desired primary roles for care robots were 'measuring/monitoring', 'mobility/activity' and 'safety care'. 'Reduction in workload', especially in terms of 'other nursing services' which were categorized as non-value-added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Care robots are expected to be effective in integrated nursing care services, particularly in 'measuring/monitoring'. Such robots should decrease nurses' workload and minimize non-value-added nursing activities efficiently. No matter how excellent care robots are, they must co-operate with and be controlled by nurses. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Statistical Symbolic Execution with Informed Sampling
Filieri, Antonio; Pasareanu, Corina S.; Visser, Willem; Geldenhuys, Jaco
2014-01-01
Symbolic execution techniques have been proposed recently for the probabilistic analysis of programs. These techniques seek to quantify the likelihood of reaching program events of interest, e.g., assert violations. They have many promising applications but have scalability issues due to high computational demand. To address this challenge, we propose a statistical symbolic execution technique that performs Monte Carlo sampling of the symbolic program paths and uses the obtained information for Bayesian estimation and hypothesis testing with respect to the probability of reaching the target events. To speed up the convergence of the statistical analysis, we propose Informed Sampling, an iterative symbolic execution that first explores the paths that have high statistical significance, prunes them from the state space and guides the execution towards less likely paths. The technique combines Bayesian estimation with a partial exact analysis for the pruned paths leading to provably improved convergence of the statistical analysis. We have implemented statistical symbolic execution with in- formed sampling in the Symbolic PathFinder tool. We show experimentally that the informed sampling obtains more precise results and converges faster than a purely statistical analysis and may also be more efficient than an exact symbolic analysis. When the latter does not terminate symbolic execution with informed sampling can give meaningful results under the same time and memory limits.
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Virtually Nursing: Emerging Technologies in Nursing Education.
Foronda, Cynthia L; Alfes, Celeste M; Dev, Parvati; Kleinheksel, A J; Nelson, Douglas A; OʼDonnell, John M; Samosky, Joseph T
Augmented reality and virtual simulation technologies in nursing education are burgeoning. Preliminary evidence suggests that these innovative pedagogical approaches are effective. The aim of this article is to present 6 newly emerged products and systems that may improve nursing education. Technologies may present opportunities to improve teaching efforts, better engage students, and transform nursing education.
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Nurse-to-nurse shift handoffs on medical-surgical units: A process within the flow of nursing care.
Ernst, Katherine M; McComb, Sara A; Ley, Cathaleen
2018-03-01
To qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilising nurse perceptions as the primary measure of quality. Semi-structured focus groups were conducted to discuss nurses' perspectives on ideal handoffs, ways handoffs deviate from the ideal including frequent and significant deviations and the effects on subsequent care. Twenty-one medical-surgical nurses participated in one of five audio-taped focus group sessions. Three sessions were conducted at hospital A; two sessions at unaffiliated hospital B. The general inductive approach was used to analyse verbatim transcripts. Transcript segments relevant for answering the research questions were coded as ideal or not ideal. Conceptual themes were then developed. Two major themes were identified: teams/teamwork and constructing and communicating a shared understanding of the patients' conditions. The importance of nurse preparatory activities was revealed including the incoming nurses reading patients' health records and outgoing nurses rounding on patients. The impact of shared expectations was identified across the team, where teams include, in addition to the two nurses, the electronic health record, other hospital staff and patients/families with a bedside handoff. New potential nurse-centred process and outcome measures were proposed. Evaluating handoffs by their effect on the nursing performance both during and after the handoff offers a new framework to objectively assess handoff effectiveness. The handoff is a process which may significantly affect the incoming nurse's transition into and administration of nursing care. © 2018 John Wiley & Sons
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Toward synthesizing executable models in biology.
Fisher, Jasmin; Piterman, Nir; Bodik, Rastislav
2014-01-01
Over the last decade, executable models of biological behaviors have repeatedly provided new scientific discoveries, uncovered novel insights, and directed new experimental avenues. These models are computer programs whose execution mechanistically simulates aspects of the cell's behaviors. If the observed behavior of the program agrees with the observed biological behavior, then the program explains the phenomena. This approach has proven beneficial for gaining new biological insights and directing new experimental avenues. One advantage of this approach is that techniques for analysis of computer programs can be applied to the analysis of executable models. For example, one can confirm that a model agrees with experiments for all possible executions of the model (corresponding to all environmental conditions), even if there are a huge number of executions. Various formal methods have been adapted for this context, for example, model checking or symbolic analysis of state spaces. To avoid manual construction of executable models, one can apply synthesis, a method to produce programs automatically from high-level specifications. In the context of biological modeling, synthesis would correspond to extracting executable models from experimental data. We survey recent results about the usage of the techniques underlying synthesis of computer programs for the inference of biological models from experimental data. We describe synthesis of biological models from curated mutation experiment data, inferring network connectivity models from phosphoproteomic data, and synthesis of Boolean networks from gene expression data. While much work has been done on automated analysis of similar datasets using machine learning and artificial intelligence, using synthesis techniques provides new opportunities such as efficient computation of disambiguating experiments, as well as the ability to produce different kinds of models automatically from biological data.
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Seeking Connectivity in Nurses' Work Environments: Advancing Nurse Empowerment Theory.
Udod, Sonia
2014-09-01
The purpose of this study was to investigate how staff nurses and their managers exercise power in a hospital setting in order to better understand what fosters or constrains staff nurses' empowerment and to extend nurse empowerment theory. Power is integral to empowerment, and attention to the challenges in nurses' work environment and nurse outcomes by administrators, researchers, and policy-makers has created an imperative to advance a theoretical understanding of power in the nurse-manager relationship. A sample of 26 staff nurses on 3 units of a tertiary hospital in western Canada were observed and interviewed about how the manager affected their ability to do their work. Grounded theory methodology was used. The process of seeking connectivity was the basic social process, indicating that the manager plays a critical role in the work environment and nurses need the manager to share power with them in the provision of safe, quality patient care. Copyright© by Ingram School of Nursing, McGill University.
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Sowan, Azizeh K; Idhail, Jamila Abu
2014-08-01
Nursing students should exhibit competence in nursing skills in order to provide safe and quality patient care. This study describes the design and students' response to an interactive web-based course using streaming video technology tailored to students' needs and the course objectives of the fundamentals of nursing skills clinical course. A mixed-methodology design was used to describe the experience of 102 first-year undergraduate nursing students at a school of nursing in Jordan who were enrolled in the course. A virtual course with streaming videos was designed to demonstrate medication administration fundamental skills. The videos recorded the ideal lab demonstration of the skills, and real-world practice performed by registered nurses for patients in a hospital setting. After course completion, students completed a 30-item satisfaction questionnaire, 8 self-efficacy scales, and a 4-item scale solicited their preferences of using the virtual course as a substitute or a replacement of the lab demonstration. Students' grades in the skill examination of the procedures were measured. Relationships between the main variables and predictors of satisfaction and self-efficacy were examined. Students were satisfied with the virtual course (3.9 ± 0.56, out of a 5-point scale) with a high-perceived overall self-efficacy (4.38 ± 0.42, out of a 5-point scale). Data showed a significant correlation between student satisfaction, self-efficacy and achievement in the virtual course (r = 0.45-0.49, p students accessed the course from home and some faced technical difficulties. Significant predictors of satisfaction were ease of access the course and gender (B = 0.35, 0.25, CI = 0.12-0.57, 0.02-0.48 respectively). The mean achievement score of students in the virtual class (7.5 ± 0.34) was significantly higher than that of a previous comparable cohort who was taught in the traditional method (6.0 ± 0.23) (p students believed that the virtual course is a sufficient
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Nursing domain of CI governance: recommendations for health IT adoption and optimization.
Collins, Sarah A; Alexander, Dana; Moss, Jacqueline
2015-05-01
There is a lack of recommended models for clinical informatics (CI) governance that can facilitate successful health information technology implementation. To understand existing CI governance structures and provide a model with recommended roles, partnerships, and councils based on perspectives of nursing informatics leaders. We conducted a cross-sectional study through administering a survey via telephone to facilitate semistructured interviews from June 2012 through November 2012. We interviewed 12 nursing informatics leaders, across the United States, currently serving in executive- or director-level CI roles at integrated health care systems that have pioneered electronic health records implementation projects. We found the following 4 themes emerge: (1) Interprofessional partnerships are essential. (2) Critical role-based levels of practice and competencies need to be defined. (3) Integration into existing clinical infrastructure facilitates success. (4) CI governance is an evolving process. We described specific lessons learned and a model of CI governance with recommended roles, partnerships, and councils from the perspective of nursing informatics leaders. Applied CI work is highly interprofessional with patient safety implications that heighten the need for best practice models for governance structures, adequate resource allocation, and role-based competencies. Overall, there is a notable lack of a centralized CI group comprised of formally trained informaticians to provide expertise and promote adherence to informatics principles within EHR implementation governance structures. Our model of the nursing domain of CI governance with recommended roles, partnerships, and councils provides a starting point that should be further explored and validated. Not only can the model be used to understand, shape, and standardize roles, competencies, and structures within CI practice for nursing, it can be used within other clinical domains and by other informaticians
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Does Faculty Incivility in Nursing Education Affect Emergency Nursing Practice?
Stokes, Pamela
Incivility in nursing education is a complicated problem which causes disruptions in the learning process and negatively affects future nursing practice. This mixed method research study described incivility as well as incivility's effects through extensive literature review and application of a modified Incivility in Nursing Education (INE) survey. The INE included six demographic items, four quantitative sections, and five open-ended questions. The survey examined emergency nurses' perceptions of incivility and how the experience affected their personal nursing practice. The INE was initially tested in a 2004 pilot study by Dr. Cynthia Clark. For this research study, modifications were made to examine specifically emergency nurse's perceptions of incivility and the effects on their practice. The population was a group of nurses who were members of the emergency nurses association in a Midwestern state. In the quantitative component of the Incivility in Nursing Education (INE) survey, the Likert scale questions indicated that the majority of the participants reported witnessing or experiencing the uncivil behaviors. In the qualitative section of the INE survey, the participants reported that although they have not seen incivility within their own academic career, they had observed faculty incivility with nursing students when the participants were assigned as preceptors as part of their emergency nursing practice.
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EMI Execution Service Specification 1.0
Schuller, B. (JUELICH); Smirnova, O (Lund University); Konstantinov, A. (Oslo University); Skou Andersen, M. (University of Copenhagen); Riedel, M. (JUELICH); Memon, A.S. (JUELICH); Memon, M.S. (JUELICH); Zangrando, L. (INFN); Sgaravatto, M. (INFN); Frizziero, E. (INFN)
2010-01-01
This document provides the interface specification, including related data models such as state model, activity description, resource and activity information, of an execution service, matching the needs of the EMI production middleware stack composed of ARC, gLite and UNICORE components. This service therefore is referred to as the EMI Execution Service (or “ES” for short). This document is a continuation of the work previously known as the GENEVA, then AGU (“ARC, gLite UNICORE”), then PGI execution service.
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PERCEPTIONS OF EXECUTIVE PAYMENT ABUSE IN PUBLIC INSTITUTIONS
Directory of Open Access Journals (Sweden)
Tudor Pendiuc
2013-07-01
Full Text Available In the aftermath of the financial crisis, executive compensation abuse has been deeply criticized. Thus, the actuality of research is undeniable. The article highlights the importance of learning from other institutions’ past and present executive compensation abuse experiences by presenting the participants’ shared experiences (having to do with executive compensation abuse and by studying how participants perceive executive compensation abuse. The main objective of this research lies in exploring participants’ shared experiences concerning executive compensation abuse, as well as their perceptions, discrepancies and unsolved questions – presented within an ample, interconnected qualitative and quantitative methodological approach. A sample of 20 individuals was chosen for the triangulation method. From the resultant triangulation six new themes derive from the interview/questionnaire questions specifically referring to executive payment abuse namely: (a ethics means distinguishing between right and wrong, (b perspectives of ethical behaviour, (c types of executive payment abuse, (d the participant’s perceptions of institution and colleagues.
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An Embodied Account of Early Executive-Function Development
Gottwald, Janna M.; Achermann, Sheila; Marciszko, Carin; Lindskog, Marcus; Gredebäck, Gustaf
2016-01-01
The importance of executive functioning for later life outcomes, along with its potential to be positively affected by intervention programs, motivates the need to find early markers of executive functioning. In this study, 18-month-olds performed three executive-function tasks—involving simple inhibition, working memory, and more complex inhibition—and a motion-capture task assessing prospective motor control during reaching. We demonstrated that prospective motor control, as measured by the peak velocity of the first movement unit, is related to infants’ performance on simple-inhibition and working memory tasks. The current study provides evidence that motor control and executive functioning are intertwined early in life, which suggests an embodied perspective on executive-functioning development. We argue that executive functions and prospective motor control develop from a common source and a single motive: to control action. This is the first demonstration that low-level movement planning is related to higher-order executive control early in life. PMID:27765900
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Sensorimotor and executive function slowing in anesthesiology residents after overnight shifts.
Williams, George W; Shankar, Bairavi; Klier, Eliana M; Chuang, Alice Z; El Marjiya-Villarreal, Salma; Nwokolo, Omonele O; Sharma, Aanchal; Sereno, Anne B
2017-08-01
Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist following a single overnight call versus routine shift, and whether factors like stress, rest and caffeine affect these measures. A prospective, observational, longitudinal, comparison study was conducted. An academic tertiary hospital's main operating room suite staffed by attending anesthesiologists, anesthesiology residents, anesthesiologist assistants and nurse anesthetists. Subjects were 30 anesthesiology residents working daytime shifts and 30 peers working overnight call shifts from the University of Texas Health Science Center at Houston. Before and after their respective work shifts, residents completed the Stanford Sleepiness Scale (SSS) and the ProPoint and AntiPoint tablet-based tasks. These latter tasks are designed to measure sensorimotor and executive functions, respectively. The SSS is a self-reported measure of sleepiness. Response times (RTs) are measured in the pointing tasks. Call residents exhibited increased RTs across their shifts (post-pre) on both ProPoint (p=0.002) and AntiPoint (pRoutine residents. Increased stress was associated with decreases in AntiPoint RT for Routine (p=0.007), but with greater increases in sleepiness for Call residents (proutine daytime shift residents, (2) sensorimotor slowing is greater in overnight Call residents who drink caffeine habitually, and (3) increased stress during a shift reduces (improves) cognitive RTs during routine daytime but not overnight call shifts. Copyright © 2017 Elsevier Inc. All rights reserved.
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Miller, Debbie; Pearsall, Emily; Johnston, Debra; Frecea, Monica; McKenzie, Marg
Enhanced Recovery After Surgery (ERAS) is a multimodal program developed to decrease postoperative complications, improve patient safety and satisfaction, and promote early discharge. In the province of Ontario, Canada, a standardized approach to the care of adult patients undergoing elective colorectal surgery (including benign and malignant diseases) was adopted by 15 hospitals in March 2013. All colorectal surgery patients with or without an ostomy were included in the ERAS program targeting a length of stay of 3 days for colon surgery and 4 days for rectal surgery. To ensure the individual needs of patients requiring an ostomy in an ERAS program were being met, a Provincial ERAS Enterostomal Therapy Nurse Network was established. Our goal was to develop and implement an evidence-based, ostomy-specific best practice guideline addressing the preoperative, postoperative, and discharge phases of care. The guideline was developed over a 3-year period. It is based on existing literature, guidelines, and expert opinion. This article serves as an executive summary for this clinical resource; the full guideline is available as Supplemental Digital Content 1 (available at: http://links.lww.com/JWOCN/A36) to this executive summary.
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Questionnaire-based assessment of executive functioning: Case studies.
Kronenberger, William G; Castellanos, Irina; Pisoni, David B
2018-01-01
Delays in the development of executive functioning skills are frequently observed in pediatric neuropsychology populations and can have a broad and significant impact on quality of life. As a result, assessment of executive functioning is often relevant for the development of formulations and recommendations in pediatric neuropsychology clinical work. Questionnaire-based measures of executive functioning behaviors in everyday life have unique advantages and complement traditional neuropsychological measures of executive functioning. Two case studies of children with spina bifida are presented to illustrate the clinical use of a new questionnaire measure of executive and learning-related functioning, the Learning, Executive, and Attention Functioning Scale (LEAF). The LEAF emphasizes clinical utility in assessment by incorporating four characteristics: brevity in administration, breadth of additional relevant content, efficiency of scoring and interpretation, and ease of availability for use. LEAF results were consistent with another executive functioning checklist in documenting everyday behavior problems related to working memory, planning, and organization while offering additional breadth of assessment of domains such as attention, processing speed, and novel problem-solving. These case study results demonstrate the clinical utility of questionnaire-based measurement of executive functioning in pediatric neuropsychology and provide a new measure for accomplishing this goal.
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Kim, Sunghee; Shin, Gisoo
2016-02-01
Since previous studies on simulation-based education have been focused on fundamental nursing skills for nursing students in South Korea, there is little research available that focuses on clinical nurses in simulation-based training. Further, there is a paucity of research literature related to the integration of the nursing process into simulation training particularly in the emergency nursing care of high-risk maternal and neonatal patients. The purpose of this study was to identify the effects of nursing process-based simulation on knowledge, attitudes, and skills for maternal and child emergency nursing care in clinical nurses in South Korea. Data were collected from 49 nurses, 25 in the experimental group and 24 in the control group, from August 13 to 14, 2013. This study was an equivalent control group pre- and post-test experimental design to compare the differences in knowledge, attitudes, and skills for maternal and child emergency nursing care between the experimental group and the control group. The experimental group was trained by the nursing process-based simulation training program, while the control group received traditional methods of training for maternal and child emergency nursing care. The experimental group was more likely to improve knowledge, attitudes, and skills required for clinical judgment about maternal and child emergency nursing care than the control group. Among five stages of nursing process in simulation, the experimental group was more likely to improve clinical skills required for nursing diagnosis and nursing evaluation than the control group. These results will provide valuable information on developing nursing process-based simulation training to improve clinical competency in nurses. Further research should be conducted to verify the effectiveness of nursing process-based simulation with more diverse nurse groups on more diverse subjects in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning
2016-01-01
This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints. Copyright © 2016 Elsevier Inc. All rights reserved.
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Salzmann-Erikson, Martin; Eriksson, Henrik
2018-02-01
Technology in the healthcare sector is undergoing rapid development. One of the most prominent areas of healthcare in which robots are implemented is nursing homes. However, nursing and technology are often considered as being contradictory, an attitude originating in the view of "the natural" versus "the artificial". Social media mirror this view, including in attitudes and societal debates regarding nursing and care robots. However, little is known about this topic in previous research. To examine user behaviour in social media platforms on the topic of nursing and care robots. A retrospective and cross-sectional observation study design was applied. Data were collected via the Alchemy streaming application programming interface. Data from social media were collected from 1 January 2014 to 5 January 2016. The data set consisted of 12,311 mentions in total. Nursing and care robots are a small-scale topic of discussion in social media. Twitter was found to be the largest channel in terms of volume, followed by Tumblr. News channels had the highest percentage of visibility, while forums and Tumblr had the least. It was found in the data that 67.9% of the mentions were positive, 24.4% were negative and 7.8% were neutral. The volume and visibility of the data on nursing robots found in social media, as well as the attitudes to nursing robots found there, indicate that nursing care robots, which are seen as representing a next step in technological development in healthcare, are a topic on the rise in social media. These findings are likely to be related to the idea that nursing care robots are on the breakthrough of replacing human labour in healthcare worldwide.
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Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.
Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne
2018-06-01
Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.
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Self-supporting method; an alternative method for steel truss bridge element replacement
Arsyad, Muhammad; Sangadji, Senot; As'ad, Sholihin
2017-11-01
Steel truss bridge often requires replacement of its element due to serious damage caused by traffic accidents. This replacement is carried out using temporary supporting structure. It would be difficult when the available space for the temporary structure is quite limited and or the position of work is at a high elevation. The self-supporting method is proposed instead of temporary supporting structure. This paper will discuss an innovative method of bridge rehabilitation by utilizing the existing bridge structure. It requires such temporary connecting structure that installed on the existing bridge element, therefore, the forces during replacement process could be transferred to the bridge foundation directly. By taking the case on a steel truss bridge Jetis Salatiga which requires element replacement due to its damages on two main diagonals, a modeling is carried out to get a proper repair method. Structural analysis is conducted for three temporary connecting structure models: “I,” “V,” and triangular model. Stresses and translations that occur in the structure are used as constraints. Bridge bearings are modeled in two different modes: fixed-fixed system and fixed-free one. Temperature load is given in each condition to obtain the appropriate time for execution. The triangular model is chosen as the best one. In the fixed-fixed mode, this method can be carried out in a temperature range 27-28.8° C, while in fixed-free one, the temperature it is allowed between 27-43.4 °C. The D4 is dismantled first by cutting the D4 leaving an area of 1140.2 mm2 or 127 mm web length to enable plastic condition until the D4 collapses. At the beginning of elongation occurs, immediately performed a slowly jacking on a temporary connecting structure so that the force on D4 is gradually transferred to the temporary connecting structure then the D4 and D5 are set in their place.
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Nurse's use of power to standardise nursing terminology in electronic health records.
Ali, Samira; Sieloff, Christina L
2017-07-01
To describe nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. Little is known about nurses' potential use of power to influence the incorporation of standardised nursing terminology within electronic health records. The theory of group power within organisations informed the design of the descriptive, cross-sectional study used a survey method to assess nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. The Sieloff-King Assessment of Group Power within Organizations © and Nursing Power Scale was used. A total of 232 nurses responded to the survey. The mean power capability score was moderately high at 134.22 (SD 18.49), suggesting that nurses could use power to achieve the incorporation of standardised nursing terminology within electronic health records. The nurses' power capacity was significantly correlated with their power capability (r = 0.96, P power to achieve their goals, such as the incorporation of standardised nursing terminology within electronic health records. Nurse administrators may use their power to influence the incorporation of standardised nursing terminology within electronic health records. If nurses lack power, this could decrease nurses' ability to achieve their goals and contribute to the achievement of effective patient outcomes. © 2017 John Wiley & Sons Ltd.
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An empirical analysis of executive behaviour with hospital executive information systems in Taiwan.
Huang, Wei-Min
2013-01-01
Existing health information systems largely only support the daily operations of a medical centre, and are unable to generate the information required by executives for decision-making. Building on past research concerning information retrieval behaviour and learning through mental models, this study examines the use of information systems by hospital executives in medical centres. It uses a structural equation model to help find ways hospital executives might use information systems more effectively. The results show that computer self-efficacy directly affects the maintenance of mental models, and that system characteristics directly impact learning styles and information retrieval behaviour. Other results include the significant impact of perceived environmental uncertainty on scan searches; information retrieval behaviour and focused searches on mental models and perceived efficiency; scan searches on mental model building; learning styles and model building on perceived efficiency; and finally the impact of mental model maintenance on perceived efficiency and effectiveness.
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Vectorization vs. compilation in query execution
J. Sompolski (Juliusz); M. Zukowski (Marcin); P.A. Boncz (Peter)
2011-01-01
textabstractCompiling database queries into executable (sub-) programs provides substantial benefits comparing to traditional interpreted execution. Many of these benefits, such as reduced interpretation overhead, better instruction code locality, and providing opportunities to use SIMD
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Workplace violence against nursing students and nurses: an Italian experience.
Magnavita, Nicola; Heponiemi, Tarja
2011-06-01
Nurses and nursing students are exposed to workplace violence. To compare the characteristics and effects of violence in nursing students and nurses in order to assess the phenomenon and take preventive action. A retrospective survey was conducted in three Italian university schools of nursing. At the end of a lecture, 346 of 349 students agreed to fill out a questionnaire that included domains on violence, mental health, job stress, and organizational justice. This group was compared with 275 nurses from a general hospital (94.2% participation rate). The prevalence of subjects reporting at least one upsetting episode of physical or verbal violence during their lifetime activity in clinical settings was 43% in nurses and 34% in nursing students. Nurses reported more physical assaults (odds ratio [OR] 2.89, 95% confidence interval [CI] 1.35-6.18), threats (OR 2.84, 95% CI 1.39-5.79), and sexual harassment (OR 2.3, 95% CI 1.15-5.54) during the previous 12 months than students. Nurses were mostly assaulted or harassed by patients or their relatives and friends ("external" violence), whereas students often reported verbal and also physical violence on the part of colleagues, staff, and others, including teachers, doctors, and supervisors ("internal" violence). Verbal violence was associated with high levels of psychological problems, as measured by the 12-item version of the General Health Questionnaire, in both students and nurses. Verbal violence was also associated with high job strain, low social support, and low organizational justice, but only among nursing students. Preventive action is urgently needed to control patient-to-worker and worker-to-worker violence in clinical settings. Not only nurses, but also nursing students, would benefit from multilevel programs of violence prevention. © 2011 Sigma Theta Tau International.
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The culture of patient safety from the perspective of the pediatric emergency nursing team
Directory of Open Access Journals (Sweden)
Taise Rocha Macedo
Full Text Available Abstract OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario.
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Executive dysfunction, brain aging, and political leadership.
Fisher, Mark; Franklin, David L; Post, Jerrold M
2014-01-01
Decision-making is an essential component of executive function, and a critical skill of political leadership. Neuroanatomic localization studies have established the prefrontal cortex as the critical brain site for executive function. In addition to the prefrontal cortex, white matter tracts as well as subcortical brain structures are crucial for optimal executive function. Executive function shows a significant decline beginning at age 60, and this is associated with age-related atrophy of prefrontal cortex, cerebral white matter disease, and cerebral microbleeds. Notably, age-related decline in executive function appears to be a relatively selective cognitive deterioration, generally sparing language and memory function. While an individual may appear to be functioning normally with regard to relatively obvious cognitive functions such as language and memory, that same individual may lack the capacity to integrate these cognitive functions to achieve normal decision-making. From a historical perspective, global decline in cognitive function of political leaders has been alternatively described as a catastrophic event, a slowly progressive deterioration, or a relatively episodic phenomenon. Selective loss of executive function in political leaders is less appreciated, but increased utilization of highly sensitive brain imaging techniques will likely bring greater appreciation to this phenomenon. Former Israeli Prime Minister Ariel Sharon was an example of a political leader with a well-described neurodegenerative condition (cerebral amyloid angiopathy) that creates a neuropathological substrate for executive dysfunction. Based on the known neuroanatomical and neuropathological changes that occur with aging, we should probably assume that a significant proportion of political leaders over the age of 65 have impairment of executive function.
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Pressure ulcers: knowledge and attitude of nurses and nursing assistants in Belgian nursing homes.
Demarre, L.; Vanderwee, K.; Defloor, T.; Verhaeghe, S.; Schoonhoven, L.; Beeckman, D.
2012-01-01
AIMS: To gain insight into the knowledge and attitudes of nurses and nursing assistants and to study the correlation between knowledge, attitudes and the compliance with the pressure ulcer prevention guidelines provided to residents at risk of pressure ulcers in nursing homes. BACKGROUND: There is a
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'Nursing research culture' in the context of clinical nursing practice
DEFF Research Database (Denmark)
Bøttcher Berthelsen, Connie; Hølge-Hazelton, Bibi
2017-01-01
for efficiency, nurses’ barriers to research use and the lack of definition of the concept of nursing research culture make it difficult to establish. Design Concept analysis. Data sources Data were collected through a literature review in PubMed, CINAHL and PsycINFO during March 2016. Methods Walker and Avant......Aim To report an analysis of the concept of nursing research culture in the context of clinical nursing practice. Background Nursing research culture should be valued for its contribution to improving patient care and should be considered as a routine hospital activity. However, the demand......'s eight-step framework for concept analysis. Results Five defining attributes of nursing research culture in the context of clinical nursing practice were identified: strong monodisciplinary nursing professionalism, academic thinking and socialization, research use as a part of daily nursing practice...
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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.
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The aging nursing workforce: How to retain experienced nurses.
Cohen, Jeremye D
2006-01-01
In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.
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Nurse-perceived Patient Adverse Events and Nursing Practice Environment
Directory of Open Access Journals (Sweden)
Jeong-Hee Kang
2014-09-01
Full Text Available Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%, nosocomial infections (51.7%, pressure sores (42.6% and medication errors (33.3%. Among the hospital-level explanatory variables associated with the nursing practice environment, ‘physician- nurse relationship’ correlated with medication errors while ‘education for improving quality of care’ affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.
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Social networks in nursing work processes: an integrative literature review.
Mesquita, Ana Cláudia; Zamarioli, Cristina Mara; Fulquini, Francine Lima; Carvalho, Emilia Campos de; Angerami, Emilia Luigia Saporiti
2017-03-20
To identify and analyze the available evidence in the literature on the use of social networks in nursing work processes. An integrative review of the literature conducted in PubMed, CINAHL, EMBASE and LILACS databases in January 2016, using the descriptors social media, social networking, nursing, enfermagem, redes sociais, mídias sociais, and the keyword nursing practice, without year restriction. The sample consisted of 27 international articles which were published between 2011 and 2016. The social networks used were Facebook (66.5%), Twitter (30%) and WhatsApp (3.5%). In 70.5% of the studies, social networks were used for research purposes, in 18.5% they were used as a tool aimed to assist students in academic activities, and in 11% for executing interventions via the internet. Nurses have used social networks in their work processes such as Facebook, Twitter and WhatsApp to research, teach and watch. The articles show several benefits in using such tools in the nursing profession; however, ethical considerations regarding the use of social networks deserve further discussion. Identificar e analisar as evidências disponíveis na literatura sobre a utilização de redes sociais nos processos de trabalho em enfermagem. Revisão integrativa da literatura realizada em janeiro de 2016, nas bases de dados PubMed, CINAHL, EMBASE e LILACS, com os descritores social media, social networking, nursing, enfermagem, redes sociais, mídias sociais e a palavra-chave nursing practice, sem restrição de ano. A amostra foi composta por 27 artigos, os quais foram publicados entre 2011 e 2016, todos internacionais. As redes sociais utilizadas foram o Facebook (66,5%), o Twitter (30%) e o WhatsApp (3,5%). Em 70,5% dos estudos as redes sociais foram utilizadas para fins de pesquisa, em 18,5% como ferramenta para auxiliar estudantes nas atividades acadêmicas, e em 11% para a realização de intervenções via internet. Em seus processos de trabalho, os enfermeiros têm utilizado
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Nurses' personal and ward accountability and missed nursing care: A cross-sectional study.
Srulovici, Einav; Drach-Zahavy, Anat
2017-10-01
Missed nursing care is considered an act of omission with potentially detrimental consequences for patients, nurses, and organizations. Although the theoretical conceptualization of missed nursing care specifies nurses' values, attitudes, and perceptions of their work environment as its core antecedents, empirical studies have mainly focused on nurses' socio-demographic and professional attributes. Furthermore, assessment of missed nursing care has been mainly based on same-source methods. This study aimed to test the joint effects of personal and ward accountability on missed nursing care, by using both focal (the nurse whose missed nursing care is examined) and incoming (the nurse responsible for the same patients at the subsequent shift) nurses' assessments of missed nursing care. A cross-sectional design, where nurses were nested in wards. A total of 172 focal and 123 incoming nurses from 32 nursing wards in eight hospitals. Missed nursing care was assessed with the 22-item MISSCARE survey using two sources: focal and incoming nurses. Personal and ward accountability were assessed by the focal nurse with two 19-item scales. Nurses' socio-demographics and ward and shift characteristics were also collected. Mixed linear models were used as the analysis strategy. Focal and incoming nurses reported occasional missed nursing care of the focal nurse (Mean=1.87, SD=0.71 and Mean=2.09, SD=0.84, respectively; r=0.55, ppersonal socio-demographic characteristics, higher personal accountability was significantly associated with decreased missed care (β=-0.29, p0.05). The interaction effect was significant (β=-0.31, ppersonal accountability and missed nursing care. Similar patterns were obtained for the incoming nurses' assessment of focal nurse's missed care. Use of focal and incoming nurses' missed nursing care assessments limited the common source bias and strengthened our findings. Personal and ward accountability are significant values, which are associated with
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Hip Replacement: MedlinePlus Health Topic
... invasive hip replacement (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hip Replacement updates ... replacement - precautions Minimally invasive hip replacement Related Health Topics Hip Injuries and Disorders National Institutes of Health ...
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Aorto-right atrial fistula after ascending aortic replacement or aortic value replacement
International Nuclear Information System (INIS)
Zhi Aihua; Dai Ruping; Jiang Shiliang; Lu Bin
2012-01-01
Objective: To evaluate the CT features of aorto-right atrial fistula after aortic valve replacement (AVR) or ascending aortic replacement. Methods: Eighty-seven patients with aortic-right atrial fistula underwent CT after operation. The CT features were retrospectively analyzed. Fistula was measured according to maximum width of the shunt. Results: Aorto-right atrial fistula was detected in 87 patients after aortic valve replacement or ascending aortic replacement by CT scan. Among them, 25 patients were diagnosed as mild aorto-right atrial fistula, 47 patients as moderate, and 15 patients as severe. Thirty-seven patients underwent follow-up CT.Among them, 10 patients with mild to moderate aorto-right atrial fistula were considered to have complete regression, 8 patients with mild aorto-right atrial fistula considered to have incomplete regression, 14 patients with mild to moderate aorto-right atrial fistula considered to have stable condition, and 5 patients with moderate aorto-right atrial fistula considered to have progression at the 3-month follow-up. Conclusion: CT is a useful tool for defining aorto-right atrial fistula after AVR or ascending aortic replacement and for evaluating it in follow-up. (authors)
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Al-Majid, Sadeeka; Al-Majed, Hashmiya; Rakovski, Cyril S; Otten, Rebecca A
2012-05-01
Although many psychiatric hospital nurses in Bahrain attend at least one continuing nursing education (CNE) activity per year, many others do not. This study explored these nurses' perceptions of CNE and factors that promote or hinder participation in CNE activities. A descriptive design was used to gather data from a convenience sample of 200 nurses working at the psychiatric hospital in Bahrain. Nurses believed that CNE improved the quality of patient care and patient outcomes, increased nurses' knowledge and skills, and kept them current with advances in nursing. Participation in CNE was hindered by unavailability of CNE activities related to psychiatric nursing. The majority of nurses had positive perceptions of CNE. Their participation was hindered by unavailability of CNE activities related to psychiatric nursing. Those responsible for planning continuing education in Bahrain should consider these findings when planning future CNE activities. Copyright 2012, SLACK Incorporated.
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Rationalisation of Nursing Education in Limpopo province: Nurse educators’ perspectives
Directory of Open Access Journals (Sweden)
T.R. Makhuvha
2007-09-01
Full Text Available Nursing education institutions are facing a challenge of realigning its functioning according to the changes that are taking place within the country. The intention of the government post apartheid was to correct the imbalances which were brought about by the apartheid government and the following regulations and policies influenced the change in nursing education, that is, Reconstruction and Development Programme (RDP, White Paper on Higher Education (WPHE, and the National Qualification Framework (NQF (South Africa, 1995:6. In 1996 the government introduced the first democratic constitution of the Republic of South Africa (RS A according to Act 108 of 1996. In the light of those increasing changes in nursing education, led by political change, the experiences of nurse educators is a critical issue facing nursing campuses. The purpose of this study was two-fold; namely: to explore and describe the experiences of nurse educators with regard to the rationalisation of nursing education and to use information obtained to describe guidelines for the effective rationalisation of a nursing college in the Limpopo Province. A qualitative, exploratory, descriptive and contextual research design was used. Qualitative interviews were conducted with nurse educators who worked in nursing colleges before and after 1994. Measures to ensure trustworthiness were applied and ethical issues were adhered to throughout the research process. Data was analysed following Tesch’s method (Creswell 1994:154-155. The research established that nurse educators experienced dissatisfaction in several areas relating to the rationalization of nursing education. Support was also expected from bureaucracy at higher level. This study developed guidelines to policy makers and nurse educators to ensure effective rationalisation process.
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Rationalisation of nursing education in Limpopo province : nurse educators' perspectives.
Makhuvha, T R; Davhana-Maselesele, M; Netshandama, V O
2007-12-01
Nursing education institutions are facing a challenge of realigning its functioning according to the changes that are taking place within the country. The intention of the government post apartheid was to correct the imbalances which were brought about by the apartheid government and the following regulations and policies influenced the change in nursing education, that is, Reconstruction and Development Programme (RDP), White Paper on Higher Education (WPHE), and the National Qualification Framework (NQF) (South Africa, 1995:6). In 1996 the government introduced the first democratic constitution of the Republic of South Africa (RSA) according toAct 108 of 1996. In the light of those increasing changes in nursing education, led by political change, the experiences of nurse educators is a critical issue facing nursing campuses. The purpose of this study was two-fold; namely: to explore and describe the experiences of nurse educators with regard to the rationalisation of nursing education and to use information obtained to describe guidelines for the effective rationalisation of a nursing college in the Limpopo Province. A qualitative, exploratory, descriptive and contextual research design was used. Qualitative interviews were conducted with nurse educators who worked in nursing colleges before and after 1994. Measures to ensure trustworthiness were applied and ethical issues were adhered to throughout the research process. Data was analysed following Tesch's method (Creswell 1994:154-155). The research established that nurse educators experienced dissatisfaction in several areas relating to the rationalization of nursing education. Support was also expected from bureaucracy at higher level. This study developed guidelines to policy makers and nurse educators to ensure effective rationalisation process.
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Nursing Needs Big Data and Big Data Needs Nursing.
Brennan, Patricia Flatley; Bakken, Suzanne
2015-09-01
Contemporary big data initiatives in health care will benefit from greater integration with nursing science and nursing practice; in turn, nursing science and nursing practice has much to gain from the data science initiatives. Big data arises secondary to scholarly inquiry (e.g., -omics) and everyday observations like cardiac flow sensors or Twitter feeds. Data science methods that are emerging ensure that these data be leveraged to improve patient care. Big data encompasses data that exceed human comprehension, that exist at a volume unmanageable by standard computer systems, that arrive at a velocity not under the control of the investigator and possess a level of imprecision not found in traditional inquiry. Data science methods are emerging to manage and gain insights from big data. The primary methods included investigation of emerging federal big data initiatives, and exploration of exemplars from nursing informatics research to benchmark where nursing is already poised to participate in the big data revolution. We provide observations and reflections on experiences in the emerging big data initiatives. Existing approaches to large data set analysis provide a necessary but not sufficient foundation for nursing to participate in the big data revolution. Nursing's Social Policy Statement guides a principled, ethical perspective on big data and data science. There are implications for basic and advanced practice clinical nurses in practice, for the nurse scientist who collaborates with data scientists, and for the nurse data scientist. Big data and data science has the potential to provide greater richness in understanding patient phenomena and in tailoring interventional strategies that are personalized to the patient. © 2015 Sigma Theta Tau International.
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2010-07-01
... 39 Postal Service 1 2010-07-01 2010-07-01 false Executive orders and other executive pronouncements; circulars, bulletins, and other issuances of the Office of Management and Budget. 211.3 Section 211.3 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION APPLICATION OF...
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The relationship experiences of professional nurses with nurse ...
African Journals Online (AJOL)
This qualitative study was undertaken to explore and describe the experiences of professional nurses in their relationships with nurse managers. Concerns about declining nursing care standards have been expressed in radio newsbulletins, television interviews and newspapers. This decline is thought to come from the ...
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Nursing curriculums may hinder a career in gerontological nursing: An integrative review.
Garbrah, William; Välimäki, Tarja; Palovaara, Marjo; Kankkunen, Päivi
2017-09-01
To investigate what prevents undergraduate nursing students from choosing gerontological nursing as a career option. This study utilised an integrative literature review, which allows the inclusion of previous studies with diverse research designs to gain a broader view of the reasons why nursing students do not choose a gerontological nursing career. An electronic database search of CINAHL (Ebsco), Scopus and Eric elicited 251 scientific peer-reviewed empirical studies, published from 2006 to March 2016 in English. After meeting the inclusion criteria, 97 qualified for closer examination. Following exclusion, the final analysis and synthesis included 21 articles. Four main themes described nursing students' contributing reasons for not selecting gerontological nursing as a career option: socio-demographic factors; experiences, perceptions and knowledge about ageing; perceptions concerning the nature or status of gerontological nursing; and theoretical studies and practical education of nursing curriculum. Lack of positive experiences with older people before and during nursing students' studies led to their disinterest in gerontological nursing as a career option. The nursing curriculum also reinforces the perception of modern nursing as technical, with more emphasis on acute and critical care. The findings emphasise the need to implement an age-friendly curriculum and have nurses that specialise in gerontology to serve as mentors and role models. It is important to assist nursing students in identifying the potentials for career advancement in terms of gerontological nursing. There is also a need for nursing faculties to liaise with other stakeholders to develop or improve upon the clinical atmosphere for nursing students during gerontological nursing placement. Nursing faculties must review their curriculum to ensure that there is sufficient focus on the needs of older people within the curriculum for every student. Furthermore, respected role models who are
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Benefits of nurse prescribing for patients in pain: nurses' views.
Stenner, Karen; Courtenay, Molly
2008-07-01
This paper is a report of a study to explore nurses' views on the benefits of adopting the role of prescribing for patients with acute and chronic pain. It was envisioned that the advent of nurse prescribing would be beneficial to the efficiency and effectiveness of the United Kingdom National Health Service. Research to date does indeed indicate that nurse prescribing can be beneficial to patients, nurses and the health service in general. Despite the expansion of nurse prescribing, there is little evidence of its impact according to nurses working in specialist areas, such as with patients in acute and chronic pain. Interviews were conducted during 2006 and 2007 with 26 nurses qualified to prescribe medicines for patients in acute and chronic pain. This was a qualitative study and a thematic analysis was conducted. Nurses reported a number of benefits, including faster access to treatment, improved quality of care, more appropriate prescribing of medication, improved safety, improved relations and communication with patients, greater efficiency and cost effectiveness. Nurses benefited from increased job satisfaction, credibility with patients and healthcare professionals and also gained knowledge through prescribing. There is potential for the benefits of nurse prescribing to be expanded beyond the United Kingdom in settings where nurses hold similar roles in the treatment of pain, although further research using a wider range of research methods is recommended to substantiate these findings.
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van Nimwegen, N.; van Nimwegen, N.; van der Erf, R.
2009-01-01
The Demography Monitor 2008 gives a concise overview of current demographic trends and related developments in education, the labour market and retirement for the European Union and some other countries. This executive summary highlights the major findings of the Demography Monitor 2008 and further
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Walusinski, Olivier
2011-01-01
Hospitals in Paris underwent considerable change at the end of the 19th century. As they moved from providing accommodation to care, their mission shifted from helping to healing. The glorification of scientific progress, as opposed to religious obscurantism, affected all of French 'Republican' society, in particular a significant part of the medical profession, led by figures such as D.M. Bourneville, former interne (house officer) under J.M. Charcot and also his publisher. Bourneville helped bring about the creation of nursing schools and the gradual replacement of religious orders by educated secular nurses. Marguerite Bottard, Charcot's chief nurse made famous by A. Brouillet's painting 'Une leçon clinique à La Salpêtrière', would be glorified and decorated as a model for this movement. A letter by G. Gilles de la Tourette to Charcot's successor F. Raymond, never before published, illustrates this progressive current of thought and revisits the struggle to secularise hospitals under the Third Republic in France. At the same time, it renews interest in the exemplary career of a nurse whose name was recently given to a building at La Salpêtrière Hospital. Copyright © 2011 S. Karger AG, Basel.
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Perceived Rewards of Nursing Among Christian Nursing Students in Bangalore, India.
Garner, Shelby L; Prater, Llewellyn S; Putturaj, Meena; Raj, Leena
2015-12-01
Nurses in India face significant challenges and often migrate to practice nursing abroad. Few studies have focused on the rewards of nursing in India. The aim of this study was to illuminate perceived rewards of nursing among Christian student nurses in Bangalore, India. Photovoice, a participatory action methodology was used, and 14 Christian student nurses participated in the study. Thematic interpretation of photographs, journals, critical group dialog sessions, and observational field notes resulted in the identification of two main themes. These themes included intrinsic rewards and lifelong benefits of nursing in India.
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McAllister, Margaret; Levett-Jones, Tracy; Downer, Teresa; Harrison, Penelope; Harvey, Theresa; Reid-Searl, Kerry; Lynch, Kathy; Arthur, Carol; Layh, Janice; Calleja, Pauline
2013-11-01
Simulation in nursing is a flourishing area for nurse educators' practice. Defined as learning that amplifies, mimics or replaces real-life clinical situations, simulation aims to give students opportunity to reason through a clinical problem and make decisions, without the potential for harming actual patients. Educators in nursing are contributing to simulation learning in diverse and creative ways. Yet much of their craft is not being widely disseminated because educators are not always confident in publishing their work. This paper aims to stimulate creative development in simulation by providing short summaries, or snapshots, of diverse approaches that nurse educators are using. The objective is to inspire others to share other ideas in development or in practice that are improving learning for nursing students and practitioners, so that simulation scholarship is advanced. The snapshots presented range from approaches that: better support educators to attend to the whole process of simulation education, give students quick access to short skill-based videos, orientate students to the laboratory environment, harness the power of the group to develop documentation skills, use simulation to enrich lectures, develop multidisciplinary knowledge, and finally, which teach therapeutic communication with children in a fun and imaginative way. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Work-role transition: from staff nurse to clinical nurse educator.
Manning, Liz; Neville, Stephen
2009-07-01
This article presents the findings of a study describing Clinical Nurse Educators' experiences, as they recall their transition from staff nurse to the Clinical Nurse Educator role, within a New Zealand District Health Board. Nurse Educator roles influence clinical practice and professional development of nurses, and although designated as a senior role nationally, the complexities and size of the role are poorly understood. A qualitative descriptive methodology utilising transition theory as a conceptual framework underpinned the study. A sample of eight Clinical Nurse Educators from a New Zealand District Health Board were interviewed about their transition from experienced staff nurse to inexperienced senior nurse. Data were analysed using a general inductive approach. Participants found the Clinical Nurse Educator role was more complex than anticipated, with no preparation for the role and sub-optimal orientation periods being provided by the District Health Board. As a result, signs of stress were evident as the enormity of the role became apparent. Consequently, employers need to ensure that appropriate orientation programmes and mentorship are inherent in health care organisations.
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Towards Synthesizing Executable Models in Biology
Directory of Open Access Journals (Sweden)
Jasmin eFisher
2014-12-01
Full Text Available Over the last decade, executable models of biological behaviors have repeatedly provided new scientific discoveries, uncovered novel insights, and directed new experimental avenues. These models are computer programs whose execution mechanistically simulates aspects of the cell’s behaviors. If the observed behavior of the program agrees with the observed biological behavior, then the program explains the phenomena. This approach has proven beneficial for gaining new biological insights and directing new experimental avenues. One advantage of this approach is that techniques for analysis of computer programs can be applied to the analysis of executable models. For example, one can confirm that a model agrees with experiments for all possible executions of the model (corresponding to all environmental conditions, even if there are a huge number of executions. Various formal methods have been adapted for this context, for example, model checking or symbolic analysis of state spaces. To avoid manual construction of executable models, one can apply synthesis, a method to produce programs automatically from high-level specifications. In the context of biological modelling, synthesis would correspond to extracting executable models from experimental data. We survey recent results about the usage of the techniques underlying synthesis of computer programs for the inference of biological models from experimental data. We describe synthesis of biological models from curated mutation experiment data, inferring network connectivity models from phosphoproteomic data, and synthesis of Boolean networks from gene expression data. While much work has been done on automated analysis of similar datasets using machine learning and artificial intelligence, using synthesis techniques provides new opportunities such as efficient computation of disambiguating experiments, as well as the ability to produce different kinds of models automatically from biological data.
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McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia
2015-09-01
Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.