Sample records for nursing facility development

  1. Skilled Nursing Facility PPS (United States)

    U.S. Department of Health & Human Services — Section 4432(a) of the Balanced Budget Act (BBA) of 1997 modified how payment is made for Medicare skilled nursing facility (SNF) services. Effective with cost...

  2. Skilled nursing or rehabilitation facilities (United States)

    ... ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features on this page, ... to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may determine that you ...

  3. Nursing Facility Initiative Annual Report (United States)

    U.S. Department of Health & Human Services — This annual report summarizes impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This initiative is designed...

  4. Medicare Provider Payment Data - Skilled Nursing Facilities (United States)

    U.S. Department of Health & Human Services — The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare...

  5. Nursing home facilities in Malaysia (premise, shared facilities & individual accommodation: Space requirement): A literature review (United States)

    Nordin, Nik Muhammad Faris Bin Nik; Hasbollah, Hasif Rafidee bin; Ibrahim, Mohd Asrul Hery Bin; Marican, Nor Dalila bin; Halim, Muhd Hafzal bin Abdul; Rashid, Ahmad Faezi Bin Ab.; Yasin, Nurul Hafizah Binti Mohd


    The numbers of elderly in Malaysia are increased every year. The request towards elderly care services necessitated by the Nursing Home are in demand. However, Nursing Home in Malaysia is lack of standard of facilities in order to cater the care services for the elderly. This paper intends review the minimum standard facilities for the Nursing Homes in globally. The paper also offered insights in developing standard Nursing Home facilities in Malaysia.

  6. Assisted Living Facilities - MDC_NursingHome (United States)

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

  7. Nursing educator's satisfaction with library facilities.


    Lenz, E R; Waltz, C F


    This study examined nursing faculty perceptions of the importance of adequate library facilities and their satisfaction with them. Library facilities ranked highest in importance among all job characteristics studied, with faculty who had been most productive in terms of publication assigning the highest value to them. A moderate level of satisfaction was found. Faculty most satisfied with library facilities were those teaching in large schools of nursing with graduate programs and open organ...

  8. Skilled nursing and rehabilitation facilities - choosing (United States)

    ... gov/ency/patientinstructions/000436.htm Choosing a skilled nursing and rehabilitation facility To use the sharing features ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  9. Antimicrobial stewardship in long-term care facilities in Belgium: a questionnaire-based survey of nursing homes to evaluate initiatives and future developments

    Directory of Open Access Journals (Sweden)

    François Kidd


    Full Text Available Abstract Background The use of antimicrobials is intense and often inappropriate in long-term care facilities. Antimicrobial resistance has increased in acute and chronic care facilities, including those in Belgium. Evidence is lacking concerning antimicrobial stewardship programmes in chronic care settings. The medical coordinator practicing in Belgian nursing homes is a general practitioner designated to coordinate medical activity. He is likely to be the key position for effective implementation of such programmes. The aim of this study was to evaluate past, present, and future developments of antimicrobial stewardship programmes by surveying medical coordinators working in long-term care facilities in Belgium. Methods We conducted an online questionnaire-based survey of 327 Belgian medical coordinators. The questionnaire was composed of 33 questions divided into four sections: characteristics of the respondents, organisational frameworks for implementation of the antimicrobial stewardship programme, tools to promote appropriate antimicrobial use and priorities of action. Questions were multiple choice, rating scale, or free text. Results A total of 39 medical coordinators (12 % completed the questionnaire. Past or present antimicrobial stewardship initiatives were reported by 23 % of respondents. The possibility of future developments was rated 2.7/5. The proposed key role of medical coordinators was rated <3/5 by 36 % of respondents. General practitioners, nursing staff, and hospital specialists are accepted as important roles. The use of antimicrobial guidelines was reported by only 19 % of respondents. Education was considered the cornerstone for any future developments. Specific diagnostic recommendations were considered useful, but chest x-rays were judged difficult to undertake. The top priority identified was to reduce unnecessary treatment of asymptomatic urinary infections. Conclusions Our study shows that the implementation of

  10. Nursing Professional Development Organizational Value Demonstration Project. (United States)

    Harper, Mary G; Aucoin, Julia; Warren, Joan I


    A common question nursing professional development (NPD) practitioners ask is, "How many NPD practitioners should my organization have?" This study examined correlations among facility size and structure, NPD practitioner characteristics and time in service, and organizational outcomes. Organizations with a higher rate of NPD full-time equivalents per bed had higher patient satisfaction with nurses' communication and provision of discharge instruction on their HCAHPS (Hospital Consumer Assessment of Healthcare Provider and Systems) scores.

  11. Developing nursing care plans. (United States)

    Ballantyne, Helen


    This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred.

  12. Nursing Information Flow in Long-Term Care Facilities. (United States)

    Wei, Quan; Courtney, Karen L


     Long-term care (LTC), residential care requiring 24-hour nursing services, plays an important role in the health care service delivery system. The purpose of this study was to identify the needed clinical information and information flow to support LTC Registered Nurses (RNs) in care collaboration and clinical decision making.  This descriptive qualitative study combines direct observations and semistructured interviews, conducted at Alberta's LTC facilities between May 2014 and August 2015. The constant comparative method (CCM) of joint coding was used for data analysis.  Nine RNs from six LTC facilities participated in the study. The RN practice environment includes two essential RN information management aspects: information resources and information spaces. Ten commonly used information resources by RNs included: (1) RN-personal notes; (2) facility-specific templates/forms; (3) nursing processes/tasks; (4) paper-based resident profile; (5) daily care plans; (6) RN-notebooks; (7) medication administration records (MARs); (8) reporting software application (RAI-MDS); (9) people (care providers); and (10) references (i.e., books). Nurses used a combination of shared information spaces, such as the Nurses Station or RN-notebook, and personal information spaces, such as personal notebooks or "sticky" notes. Four essential RN information management functions were identified: collection, classification, storage, and distribution. Six sets of information were necessary to perform RN care tasks and communication, including: (1) admission, discharge, and transfer (ADT); (2) assessment; (3) care plan; (4) intervention (with two subsets: medication and care procedure); (5) report; and (6) reference. Based on the RN information management system requirements, a graphic information flow model was constructed.  This baseline study identified key components of a current LTC nursing information management system. The information flow model may assist health information

  13. Power Systems Development Facility

    International Nuclear Information System (INIS)


    The objective of the PSDF would be to provide a modular facility which would support the development of advanced, pilot-scale, coal-based power systems and hot gas clean-up components. These pilot-scale components would be designed to be large enough so that the results can be related and projected to commercial systems. The facility would use a modular approach to enhance the flexibility and capability for testing; consequently, overall capital and operating costs when compared with stand-alone facilities would be reduced by sharing resources common to different modules. The facility would identify and resolve technical barrier, as well as-provide a structure for long-term testing and performance assessment. It is also intended that the facility would evaluate the operational and performance characteristics of the advanced power systems with both bituminous and subbituminous coals. Five technology-based experimental modules are proposed for the PSDF: (1) an advanced gasifier module, (2) a fuel cell test module, (3) a PFBC module, (4) a combustion gas turbine module, and (5) a module comprised of five hot gas cleanup particulate control devices. The final module, the PCD, would capture coal-derived ash and particles from both the PFBC and advanced gasifier gas streams to provide for overall particulate emission control, as well as to protect the combustion turbine and the fuel cell

  14. Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration. (United States)

    Banks, D; Parker, E; Wendel, J


    Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

  15. Turnover of regulated nurses in long-term care facilities. (United States)

    Chu, Charlene H; Wodchis, Walter P; McGilton, Katherine S


    To describe the relationship between nursing staff turnover in long-term care (LTC) homes and organisational factors consisting of leadership practices and behaviours, supervisory support, burnout, job satisfaction and work environment satisfaction. The turnover of regulated nursing staff [Registered Nurses (RNs) and Registered Practical Nurses (RPNs)] in LTC facilities is a pervasive problem, but there is a scarcity of research examining this issue in Canada. The study was conceptualized using a Stress Process model. Distinct surveys were distributed to administrators to measure organisational factors and to regulated nurses to measure personal and job-related sources of stress and workplace support. In total, 324 surveys were used in the linear regression analysis to examine factors associated with high turnover rates. Higher leadership practice scores were associated with lower nursing turnover; a one score increase in leadership correlated with a 49% decrease in nursing turnover. A significant inverse relationship between leadership turnover and nurse turnover was found: the higher the administrator turnover the lower the nurse turnover rate. Leadership practices and administrator turnover are significant in influencing regulated nurse turnover in LTC. Long-term care facilities may want to focus on building good leadership and communication as an upstream method to minimize nurse turnover. © 2013 John Wiley & Sons Ltd.

  16. Basic Stand Alone Skilled Nursing Facility Beneficiary PUF (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Skilled Nursing Facility (SNF) Beneficiary Public Use Files (PUF) with information from Medicare SNF claims. The...

  17. Developing nurses' transformational leadership skills. (United States)

    Fischer, Shelly Ann


    Healthcare is a complex area with significant potential for service improvement despite the effects of increasing economic and social pressures on the quality and safety of patient care. As the largest group of healthcare professionals in direct contact with patients, nurses are well positioned to contribute to improvements in healthcare services and to the development of new policies. To influence healthcare improvements and policies effectively, nurses require leadership skills. Historically, it was thought that only nurses in management roles required leadership skills; however, the ability to influence change is a requirement at all levels of clinical practice. Transformational leadership competencies provide nurses with the skills to contribute to improvements in the quality and safety of patient care, while enhancing their career satisfaction. This article examines how nurses can apply transformational leadership to their practice. It also informs nurses how to conduct an initial self-assessment of their leadership skills and to formulate a transformational leadership development plan.

  18. Power Systems Development Facility

    Energy Technology Data Exchange (ETDEWEB)

    Southern Company Services


    In support of technology development to utilize coal for efficient, affordable, and environmentally clean power generation, the Power Systems Development Facility (PSDF), located in Wilsonville, Alabama, has routinely demonstrated gasification technologies using various types of coals. The PSDF is an engineering scale demonstration of key features of advanced coal-fired power systems, including a Transport Gasifier, a hot gas particulate control device, advanced syngas cleanup systems, and high-pressure solids handling systems. This final report summarizes the results of the technology development work conducted at the PSDF through January 31, 2009. Twenty-one major gasification test campaigns were completed, for a total of more than 11,000 hours of gasification operation. This operational experience has led to significant advancements in gasification technologies.

  19. Insights on the development of TCM nursing


    Jun-Qiang Zhao; Fen Zhou; Ying Sun; Run-Xi Tian; Je Kan Adler-Collins; Yu-Fang Hao


    Background: Traditional Chinese medicine nursing (TCM nursing) is one of the highlights of nursing profession in China, which plays a significant role in Chinese healthcare system. However, bottlenecks exist in TCM nursing development. It’s necessary to explore the discipline connotation and advantages of TCM nursing in nursing education and clinical practice and introduce modern nursing concepts. Methods: We analysis the connotations of TCM nursing, the bottlenecks it faces, and strategie...

  20. Career development: graduate nurse views. (United States)

    Cleary, Michelle; Horsfall, Jan; Muthulakshmi, Paulpandi; Happell, Brenda; Hunt, Glenn E


    To explore recent Singapore nursing graduates' experience of and views about their career development and progress. The recruitment and retention of an adequate number of registered nurses is a continuing workforce issue in Singapore and other major cities. Survey of recent nursing graduates. Recent nursing graduates from the Bachelor programme (n = 147) were sent an individual survey; a response rate of 54% was achieved. Findings show that nurses rated their self-concept in a positive manner and were most satisfied (moderately to very) with helping patients and providing effective care, and the level of patient involvement. They were least satisfied (moderately to only a little) with prestige among the general medical community and the general public, hours of work, lifestyle factors and research opportunities. The following four factors were identified as significant impediments to career development; lack of support in the work place; perceived insufficient clinical career development opportunities; excessive work hours; and limited access to merit-based places in further education. Suggestions made to overcome perceived career development barriers are as follows: broad multifactorial healthcare system changes; decreased and more flexible working hours; and fairer access to further clinical and higher education. Results highlight the value clinical nurses place on having access to career development opportunities, merit-based further education and work place supports. These factors also have the potential to influence patient care and impact on the retention of nurses in their present job and satisfaction with their nursing career. © 2013 Blackwell Publishing Ltd.

  1. Technology Development Facility (TDF)

    International Nuclear Information System (INIS)

    Doggett, J.N.


    We have been studying small, driven, magnetic-mirror-based fusion reactors for the Technology Development Facility (TDF), that will test fusion reactor materials, components, and subsystems. Magnetic mirror systems are particularly interesting for this application because of their inherent steady-state operation, potentially high neutron wall loading, and relatively small size. Our design is a tandem mirror device first described by Fowler and Logan, based on the physics of the TMX experiments at Lawrence Livermore National Laboratory (LLNL). The device produces 20 MW of fusion power with a first-wall, uncollided 14-MeV neutron flux of 1.4 MW/m 2 on an area of approximately 8 m 2 , while consuming approximately 250 MW of electrical power. The work was done by a combined industrial-laboratory-university group

  2. Nursing Competency: Definition, Structure and Development (United States)

    Fukada, Mika


    Nursing competency includes core abilities that are required for fulfilling one’s role as a nurse. Therefore, it is important to clearly define nursing competency to establish a foundation for nursing education curriculum. However, while the concepts surrounding nursing competency are important for improving nursing quality, they are still not yet completely developed. Thus, challenges remain in establishing definitions and structures for nursing competency, competency levels necessary for nursing professionals, training methods and so on. In the present study, we reviewed the research on definitions and attributes of nursing competency in Japan as well as competency structure, its elements and evaluation. Furthermore, we investigated training methods to teach nursing competency. PMID:29599616

  3. Nursing Competency: Definition, Structure and Development. (United States)

    Fukada, Mika


    Nursing competency includes core abilities that are required for fulfilling one's role as a nurse. Therefore, it is important to clearly define nursing competency to establish a foundation for nursing education curriculum. However, while the concepts surrounding nursing competency are important for improving nursing quality, they are still not yet completely developed. Thus, challenges remain in establishing definitions and structures for nursing competency, competency levels necessary for nursing professionals, training methods and so on. In the present study, we reviewed the research on definitions and attributes of nursing competency in Japan as well as competency structure, its elements and evaluation. Furthermore, we investigated training methods to teach nursing competency.

  4. Nursing Competency: Definition, Structure and Development


    Fukada, Mika


    Nursing competency includes core abilities that are required for fulfilling one’s role as a nurse. Therefore, it is important to learly define nursing competency to establish a foundation for nursing education curriculum. However, while the concepts surrounding nursing competency are important for improving nursing quality, they are still not yet completely developed. Thus, challenges remain in establishing finitions and structures for nursing competency, competency levels necessary for nurs...

  5. Leading nurses: emotional intelligence and leadership development effectiveness. (United States)

    Crowne, Kerri Anne; Young, Thomas M; Goldman, Beryl; Patterson, Barbara; Krouse, Anne M; Proenca, Jose


    Purpose The purpose of this paper is to examine the effectiveness of an emotional intelligence (EI) and leadership development education program involving 20 nurse leaders at nursing homes. Also, it investigates the relationship between EI and transformational leadership. Design/methodology/approach Three research questions are posed. Correlation analysis and t-tests were conducted to answer the questions posed. Findings The findings of this paper indicate that the EI educational development was effective, while the personal leadership development was not. The data also showed a positive significant relationship between EI and transformational leadership. Research limitations/implications This paper is limited by the small sample size; thus, a causal relationship between EI and leadership could not be investigated. Additionally, the sample was not randomly selected because of the commitment needed from the participants. Furthermore, the paper was focused on nurse leaders in nursing homes, so it may not be generalizable to other populations. Practical implications With the increasing need for nursing home facilities and the limited training generally provided to nurses who move into managerial roles in these facilities, it is critical for organizations to understand the effectiveness of educational programs that exist. Moreover, the findings of this paper may provide information that would be useful to others who wish to develop EI and/or leadership education for nurses. Originality/value While much research exists on EI and transformational leadership, little of this research focuses on nurses in nursing home facilities. Thus, this paper fills a gap in the literature.

  6. The Impact of Special Focus Facility Nursing Homes on Market Quality (United States)

    Castle, Nicholas G.; Sonon, Kristen; Antonova, Jenya


    Purpose: Special Focus Facilities (SFFs) are nursing facilities designated by the Centers for Medicare & Medicaid Services to be of chronic poor quality. Relatively few nursing facilities are included in this initiative. The purpose of this research was to examine whether nursing facilities included in the 2007 SFF initiative subsequently…

  7. Power Systems Development Facility

    Energy Technology Data Exchange (ETDEWEB)



    This report discusses Test Campaign TC12 of the Kellogg Brown & Root, Inc. (KBR) Transport Gasifier train with a Siemens Westinghouse Power Corporation (SW) particle filter system at the Power Systems Development Facility (PSDF) located in Wilsonville, Alabama. The Transport Gasifier is an advanced circulating fluidized-bed reactor designed to operate as either a combustor or a gasifier using a particulate control device (PCD). While operating as a gasifier, either air or oxygen can be used as the oxidant. Test run TC12 began on May 16, 2003, with the startup of the main air compressor and the lighting of the gasifier start-up burner. The Transport Gasifier operated until May 24, 2003, when a scheduled outage occurred to allow maintenance crews to install the fuel cell test unit and modify the gas clean-up system. On June 18, 2003, the test run resumed when operations relit the start-up burner, and testing continued until the scheduled end of the run on July 14, 2003. TC12 had a total of 733 hours using Powder River Basin (PRB) subbituminous coal. Over the course of the entire test run, gasifier temperatures varied between 1,675 and 1,850 F at pressures from 130 to 210 psig.

  8. Facility planning and site development

    International Nuclear Information System (INIS)

    Reisman, R.C.; Handmaker, H.


    Planning for a magnetic resonance imaging (MRI) facility should provide for the efficient operation of current and future MRI devices and must also take into consideration a broad range of general planning principles. Control of budgeted facility costs and construction schedules is of increasing importance due to the magnitude of expense of MRI facility development as well as the need to protect institutional or entrepreneurial investment. In a competitive environment facility costs may be the determining factor in a project's success


    Energy Technology Data Exchange (ETDEWEB)



    This report discusses test campaign GCT4 of the Kellogg Brown & Root, Inc. (KBR) transport reactor train with a Siemens Westinghouse Power Corporation (Siemens Westinghouse) particle filter system at the Power Systems Development Facility (PSDF) located in Wilsonville, Alabama. The transport reactor is an advanced circulating fluidized-bed reactor designed to operate as either a combustor or a gasifier using one of two possible particulate control devices (PCDs). The transport reactor was operated as a pressurized gasifier during GCT4. GCT4 was planned as a 250-hour test run to continue characterization of the transport reactor using a blend of several Powder River Basin (PRB) coals and Bucyrus limestone from Ohio. The primary test objectives were: Operational Stability--Characterize reactor loop and PCD operations with short-term tests by varying coal-feed rate, air/coal ratio, riser velocity, solids-circulation rate, system pressure, and air distribution. Secondary objectives included the following: Reactor Operations--Study the devolatilization and tar cracking effects from transient conditions during transition from start-up burner to coal. Evaluate the effect of process operations on heat release, heat transfer, and accelerated fuel particle heat-up rates. Study the effect of changes in reactor conditions on transient temperature profiles, pressure balance, and product gas composition. Effects of Reactor Conditions on Synthesis Gas Composition--Evaluate the effect of air distribution, steam/coal ratio, solids-circulation rate, and reactor temperature on CO/CO{sub 2} ratio, synthesis gas Lower Heating Value (LHV), carbon conversion, and cold and hot gas efficiencies. Research Triangle Institute (RTI) Direct Sulfur Recovery Process (DSRP) Testing--Provide syngas in support of the DSRP commissioning. Loop Seal Operations--Optimize loop seal operations and investigate increases to previously achieved maximum solids-circulation rate.

  10. Developing Global Nurse Influencers. (United States)

    Spies, Lori A


    How can universities create engaged citizens and global leaders? Each year, a select group of advanced practice nursing students at Baylor University Louise Herrington School of Nursing travel to Africa for a month-long clinical mission experience. Students work alongside local and missionary healthcare providers in a comprehensive Christian outreach to the community at a high-volume clinic. Creating rich learning experiences in a global setting in significant and sustainable ways is difficult, but intentionally focusing on what we are called to do and who we serve provides ballast for faculty and students. The success of the trip in preparing students to be global influencers is evident by the work graduates elect to do around the world, following graduation.

  11. EVA Training and Development Facilities (United States)

    Cupples, Scott


    Overview: Vast majority of US EVA (ExtraVehicular Activity) training and EVA hardware development occurs at JSC; EVA training facilities used to develop and refine procedures and improve skills; EVA hardware development facilities test hardware to evaluate performance and certify requirement compliance; Environmental chambers enable testing of hardware from as large as suits to as small as individual components in thermal vacuum conditions.

  12. A national study on nurses' retention in healthcare facilities in underserved areas in Lebanon. (United States)

    El-Jardali, Fadi; Alameddine, Mohamad; Jamal, Diana; Dimassi, Hani; Dumit, Nuhad Y; McEwen, Mary K; Jaafar, Maha; Murray, Susan F


    Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student's t-test and ANOVA) tests to describe the respondents and examine the significance between nurses' characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses' intent to stay in underserved areas. A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P job satisfaction and their intent to stay. This study reveals poor retention of nurses in rural and underserved

  13. Development of nurses with specialties: the nurse administrators' perspective. (United States)

    Onishi, Mami; Sasaki, Minako; Nagata, Ayako; Kanda, Katsuya


    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.

  14. Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

    Directory of Open Access Journals (Sweden)

    Peters, Claudia


    Full Text Available [english] Background: The increase of multidrug-resistant organisms (MDROs causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff.Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs.Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution.Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work.

  15. Reducing Hospital Readmissions Through Preferred Networks Of Skilled Nursing Facilities. (United States)

    McHugh, John P; Foster, Andrew; Mor, Vincent; Shield, Renée R; Trivedi, Amal N; Wetle, Terrie; Zinn, Jacqueline S; Tyler, Denise A


    Establishing preferred provider networks of skilled nursing facilities (SNFs) is one approach hospital administrators are using to reduce excess thirty-day readmissions and avoid Medicare penalties or to reduce beneficiaries' costs as part of value-based payment models. However, hospitals are also required to provide patients at discharge with a list of Medicare-eligible providers and cannot explicitly restrict patient choice. This requirement complicates the development of a SNF network. Furthermore, there is little evidence about the effectiveness of network development in reducing readmission rates. We used a concurrent mixed-methods approach, combining Medicare claims data for the period 2009-13 with qualitative data gathered from interviews during site visits to hospitals in eight US markets in March-October 2015, to examine changes in rehospitalization rates and differences in practices between hospitals that did and did not develop formal SNF networks. Four hospitals had developed formal SNF networks as part of their care management efforts. These hospitals saw a relative reduction from 2009 to 2013 in readmission rates for patients discharged to SNFs that was 4.5 percentage points greater than the reduction for hospitals without formal networks. Interviews revealed that those with networks expanded existing relationships with SNFs, effectively managed patient data, and exercised a looser interpretation of patient choice. Project HOPE—The People-to-People Health Foundation, Inc.

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

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

  17. Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities. (United States)

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


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

  18. Management support and perceived consumer satisfaction in skilled nursing facilities. (United States)

    Metlen, Scott; Eveleth, Daniel; Bailey, Jeffrey J


    How managers 'manage' employees influences important firm outcomes. Heskett, Sasser, and Schlesinger contend that the level of internal support for service workers will influence consumer satisfaction. This study empirically explores how skilled nursing facility (SNF) managers affect consumer satisfaction by encouraging employee effectiveness and listening to employees to determine how to improve employee effectiveness. We extend previous research by proposing management as a form of internal support and demonstrating its relationship to service process integration, as a distinct form of internal support. The results of our individual-level investigation of 630 nursing assistants from 45 SNFs provide support for our two-part hypothesis. First, active management support and process integration, as elements of internal support, do lead to increased employee satisfaction and employee effectiveness. Second, the increased employee satisfaction and effectiveness was positively related to consumer satisfaction, as evaluated by the service workers. Thus, there is a positive influence of management's internal support of nursing assistants on perceived consumer satisfaction.

  19. Attitudes of Nursing Facilities' Staff Toward Pharmacy Students' Interaction with its Residents. (United States)

    Adkins, Donna; Gavaza, Paul; Deel, Sharon


    All Appalachian College of Pharmacy second-year students undertake the longitudinal geriatric early pharmacy practice experiences (EPPE) 2 course, which involves interacting with geriatric residents in two nursing facilities over two semesters. The study investigated the nursing staff's perceptions about the rotation and the pharmacy students' interaction with nursing facility residents. Cross-sectional study. Academic setting. 63 nursing facility staff. A 10-item attitude survey administered to nursing staff. Nursing staff attitude toward pharmacy students' interaction with geriatric residents during the course. Sixty-three responses were received (84% response rate). Most respondents were female (95.2%), who occasionally interacted with pharmacy students (54.8%) and had worked at the facilities for an average of 6.8 years (standard deviation [SD] = 6.7) years. Staff reported that pharmacy students practiced interacting with geriatric residents and nursing facility staff, learned about different medications taken by residents as well as their life as a nursing facility resident. In addition, the student visits improved the mood of residents and staff's understanding of medicines, among others. Staff suggested that students spend more time with their residents in the facility as well as ask more questions of staff. The nursing facility staff generally had favorable attitudes about pharmacy students' visits in their nursing facility. Nursing facility staff noted that the geriatric rotation was a great learning experience for the pharmacy students.

  20. Evaluation of a nurse leadership development programme. (United States)

    West, Margaret; Smithgall, Lisa; Rosler, Greta; Winn, Erin


    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.

  1. 20 CFR 655.1116 - Element VI-What notification must facilities provide to registered nurses? (United States)


    ... provide to registered nurses? 655.1116 Section 655.1116 Employees' Benefits EMPLOYMENT AND TRAINING... Requirements Must a Facility Meet to Employ H-1C Nonimmigrant Workers as Registered Nurses? § 655.1116 Element VI—What notification must facilities provide to registered nurses? (a) The sixth attestation element...

  2. Enhancing the nursing discipline and developing nursing science in China

    Directory of Open Access Journals (Sweden)

    Xin-Juan Wu


    Full Text Available To improve our health care services, promote balanced development of inter-regional and inter-disciplinary medical care skills, and effectively implement public hospital reform, the former Ministry of Health, State Chinese Medicine Administration Bureau and the Ministry of Finance allocated state funds in 2010 to support a National Clinical Key Specialty Construction Project. The project supports the acquisition of key equipment, personnel training and development of clinical diagnosis technology in order to develop high-quality medical resources and improve clinical services. Because of the important role nursing plays, clinical nursing and specialty care were also included in the project. The Chinese Nursing Association was commissioned to oversee this project, which awarded 211 million RMB to nursing disciplines in 86 hospitals representing all regions of China. This funding has supported the rapid development of nursing disciplines, the results of which are outlined and described in this review.

  3. Grounding our practice in nursing professional development. (United States)

    Dickerson, Pamela S


    The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice. Copyright 2014, SLACK Incorporated.


    Directory of Open Access Journals (Sweden)

    Le Thi Thanh Tuyen


    Full Text Available As nurses, we seek to better understand how to apply nursing knowledge in our daily practice. Nowadays, the term philosophy is widening used in many areas, including nursing. However, there is existence of unclear understanding about nursing knowledge development derived from standpoint of philosophical and methodological perspectives. This article discusses about this issue and mainly focus on empiricism, postpositivistic view, the philosophy of Buddhism and an example related to asthma.

  5. Facilitators and inhibitors in developing professional values in nursing students. (United States)

    Shafakhah, Mahnaz; Molazem, Zahra; Khademi, Mojgan; Sharif, Farkhondeh


    Values are the basis of nursing practice, especially in making decisions about complicated ethical issues. Despite their key role in nursing, little information exists on the factors affecting their development and manifestation in nursing students. This study identifies and describes the facilitators and inhibitors of the development and manifestation of professional values based on the experiences of nursing students and instructors and nurses. Data were collected through 29 semi-structured interviews and two focus group interviews in 2013-2015 and were analyzed using the conventional content analysis method of Elo and Kyngäs. Participants and research context: In total, 18 nursing undergraduates, five nursing instructors, and five nurses from Shiraz University of Medical Sciences and one of the teaching hospitals in Shiraz were selected through purposive sampling. Ethical considerations: The research was approved by the Ethics Committee of Shiraz University of Medical Sciences and the teaching hospital examined. The findings consisted of two categories: personal and environmental factors. Personal factors consisted of the two subcategories of personal stimuli (work experience and past relationships, inner beliefs and acting on values, belief in God and a divine worldview) and personal inhibitors (the lack of professional motivation and enthusiasm, negative emotions). Environmental factors consisted of the two subcategories of environmental stimuli (cooperation, order and discipline) and environmental inhibitors (unfavorable work environment, society's negative attitude toward nursing, the violation of rights). Given the impact of personal and environmental factors on the development and manifestation of professional values in nursing students, it is upon the education authorities to take account of them in their planning, and nursing managers are also recommended to further address these factors in their development of a proper work environment, provision of

  6. Theoretical development in the context of nursing

    DEFF Research Database (Denmark)

    Hoeck, Bente; Delmar, Charlotte


    are treated as equals. We suggest a framework for the development of nursing knowledge based on a caring-ethical practice, a theory on life phenomena in suffering and relationship-based nursing, and thereby, we may be able to help patients to be cured, to recover, to be alleviated or comforted when suffering.......This article is about nursing theories, the development of nursing knowledge and the underlying, hidden epistemology. The current technical-economical rationality in society and health care calls for a specific kind of knowledge based on a traditional Western, Socratic view of science. This has...... an immense influence on the development of nursing knowledge. The purpose of the article was therefore to discuss the hidden epistemology of nursing knowledge and theories seen in a broad historical context and point to an alternative epistemology for a future context. It is a question about which nursing...

  7. Transformational leadership: implications for nursing leaders in facilities seeking magnet designation. (United States)

    Schwartz, Diane Brady; Spencer, Tammy; Wilson, Brigitte; Wood, Kim


    A perioperative nurse leader's ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting and the leadership style that is present across the organization. The American Nurses Credentialing Center's Magnet™ designation and redesignation process requires the demonstration of transformational leadership as one of the components of excellence. Transformational leadership can increase nurses' job satisfaction and commitment to the organization and organizational culture. Engaging staff members in the transition to transformational leadership and developing a common mission, vision, and goals are keys to success in the surgical setting. Bass's four interrelated leadership components-idealized influence, inspirational motivation, intellectual stimulation, and individual consideration-and associated behaviors were used by surgical services leaders in an East Coast, two-hospital system to successfully achieve redesignation as a Magnet facility. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  8. Testing a diagnosis-related group index for skilled nursing facilities (United States)

    Cotterill, Philip G.


    Interest in case-mix measures for use in nursing home payment systems has been stimulated by the Medicare prospective payment system (PPS) for short-term acute-care hospitals. Appropriately matching payment with care needs is important to equitably compensate providers and to encourage them to admit patients who are most in need of nursing home care. The skilled nursing facility (SNF) Medicare benefit covers skilled convalescent or rehabilitative care following a hospital stay. Therefore, it might appear that diagnosis-related groups (DRG's), the basis for patient classification in PPS, could also be used for the Medicare SNF program. In this study, a DRG-based case-mix index (CMI) was developed and tested to determine how well it explains cost differences among SNF's. The results suggest that a DRG-based SNF payment system would be highly problematic. Incentives of this system would appear to discourage placement of patients who require relatively expensive care. PMID:10311674

  9. 42 CFR 413.350 - Periodic interim payments for skilled nursing facilities receiving payment under the skilled... (United States)


    ... facilities receiving payment under the skilled nursing facility prospective payment system for Part A... nursing facilities receiving payment under the skilled nursing facility prospective payment system for... SNF receiving payment under the prospective payment system may receive periodic interim payments (PIP...

  10. Nurses' engagement in AIDS policy development. (United States)

    Richter, M S; Mill, J; Muller, C E; Kahwa, E; Etowa, J; Dawkins, P; Hepburn, C


    A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care. One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking. A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews. Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development. The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address

  11. Nurse retention in a correctional facility: a study of the relationship between the nurses' perceived barriers and benefits. (United States)

    Chafin, W Sue; Biddle, Wendy L


    Retention of nursing staff is more complex in a correctional facility. After a period of 3 years, only 20% of the staff remained employed at this study facility. Without retention of qualified correctional nurses, there are decreases in access to care, gaps in continuity of care, and less time for mentorship. Trained correctional nurses improve patient and staff safety, provide more education, and are more team-oriented. The purpose of this study was to identify barriers and benefits to nursing staff satisfaction with their job and the likelihood that they will continue to work in correctional settings. Practice and patient care will be favorably impacted if correctional nurses are provided with services such as new hire orientation, clinical ladder programs to recruit and retain nursing staff, and teambuilding.

  12. Developing standardized facility contingency plans

    International Nuclear Information System (INIS)

    Davidson, D.A.


    Texaco consists of several operating departments that are, in effect, independent companies. Each of these departments is responsible for complying with all environmental laws and regulations. This includes the preparation by each facility to respond to an oil spill at that location. For larger spills, however, management of the response will rest with corporate regional response teams. Personnel from all departments make up the regional teams. In 1990, Congress passed the Oil Pollution Act. In 1991, the US Coast Guard began developing oil spill response contingency plan regulations, which they are still working on. Meanwhile, four of the five west coast states have also passed laws requiring contingency plans. (Only Hawaii has chosen to wait and see what the federal regulations will entail). Three of the states have already adopted regulations. Given these laws and regulations, along with its corporate structure, Texaco addressed the need to standardize local facility plans as well as its response organization. This paper discusses how, by working together, the Texaco corporate international oil spill response staff and the Texaco western region on-scene commander developed: A standard contingency plan format crossing corporate boundaries and meeting federal and state requirements. A response organization applicable to any size facility or spill. A strategy to sell the standard contingency plan and response organization to the operating units

  13. 78 FR 69539 - Removal of Attestation Process for Facilities Using H-1A Registered Nurses (United States)


    ... of Attestation Process for Facilities Using H-1A Registered Nurses AGENCY: Employment and Training... registered nurses under the H-1A visa program. These subparts became obsolete after the authorizing statute... nonimmigrant classification exclusively for the temporary admission and employment of registered nurses, which...

  14. Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review. (United States)

    Dwyer, Drew


    The phenomenon of an ageing population is being experienced globally, as countries struggle to change and improve residential models of care and provide services to the elderly. The role of the registered nurse (RN) is considered crucial to the clinical governance and management of care given. To date, however, no systematic review has examined the RN's experience in leadership and management. The objective of this review is to critically appraise, synthesise and present best available evidence on the experiences of RNs as clinical leaders and managers in residential aged care facilities. This review considered qualitative research papers that addressed the experiences of RNs as clinical leaders and managers in residential aged care facilities. Participants of interest were RNs, nurse leaders, nurses holding registration and or regulation under a board of nursing, nurses working in residential aged care and long-term care facilities. The diversity and use of language to describe nurses' roles and models of care for the elderly care environment were considered in the review. The search strategy sought to find both published studies and papers, limited to the English language and published between January 1997 and February 2011. An initial limited search was done in Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index to Nursing and Allied Health Literature databases to identify the key words contained in the title or abstract and index terms used to describe the relevant terms in the article. A second extensive search was undertaken and extended to other relevant databases using all identified keywords and index terms. The third step involved searching reference lists and bibliographies of chosen articles for additional studies. Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management

  15. Developing nursing leadership in social media. (United States)

    Moorley, Calvin; Chinn, Teresa


    A discussion on how nurse leaders are using social media and developing digital leadership in online communities. Social media is relatively new and how it is used by nurse leaders and nurses in a digital space is under explored. Discussion paper. Searches used CINAHL, the Royal College of Nursing webpages, Wordpress (for blogs) and Twitter from 2000-2015. Search terms used were Nursing leadership + Nursing social media. Understanding the development and value of nursing leadership in social media is important for nurses in formal and informal (online) leadership positions. Nurses in formal leadership roles in organizations such as the National Health Service are beginning to leverage social media. Social media has the potential to become a tool for modern nurse leadership, as it is a space where can you listen on a micro level to each individual. In addition to listening, leadership can be achieved on a much larger scale through the use of social media monitoring tools and exploration of data and crowd sourcing. Through the use of data and social media listening tools nursing leaders can seek understanding and insight into a variety of issues. Social media also places nurse leaders in a visible and accessible position as role models. Social media and formal nursing leadership do not have to be against each other, but they can work in harmony as both formal and online leadership possess skills that are transferable. If used wisely social media has the potential to become a tool for modern nurse leadership. © 2016 John Wiley & Sons Ltd.

  16. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies. (United States)


    ... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities and home health agencies. 415.204 Section 415.204 Public Health CENTERS FOR MEDICARE & MEDICAID...

  17. 42 CFR 440.155 - Nursing facility services, other than in institutions for mental diseases. (United States)


    ... institutions for mental diseases. 440.155 Section 440.155 Public Health CENTERS FOR MEDICARE & MEDICAID... PROVISIONS Definitions § 440.155 Nursing facility services, other than in institutions for mental diseases. (a) “Nursing facility services, other than in an institution for mental diseases” means services...

  18. Barriers to ethical nursing practice for older adults in long-term care facilities. (United States)

    Choe, Kwisoon; Kang, Hyunwook; Lee, Aekyung


    To explore barriers to ethical nursing practice for older adults in long-term care facilities from the perspectives of nurses in South Korea. The number of older adults admitted to long-term care facilities is increasing rapidly in South Korea. To provide this population with quality care, a solid moral foundation should be emphasised to ensure the provision of ethical nursing practices. Barriers to implementing an ethical nursing practice for older adults in long-term care facilities have not been fully explored in previous literature. A qualitative, descriptive design was used to explore barriers to ethical nursing practice as perceived by registered nurses in long-term care facilities in South Korea. Individual interviews were conducted with 17 registered nurses recruited using purposive (snowball) sampling who care for older adults in long-term care facilities in South Korea. Data were analysed using qualitative content analysis. Five main themes emerged from the data analysis concerning barriers to the ethical nursing practice of long-term care facilities: emotional distress, treatments restricting freedom of physical activities, difficulty coping with emergencies, difficulty communicating with the older adult patients and friction between nurses and nursing assistants. This study has identified methods that could be used to improve ethical nursing practices for older adults in long-term care facilities. Because it is difficult to improve the quality of care through education and staffing alone, other factors may also require attention. Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study. © 2017 John Wiley & Sons Ltd.

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

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


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

  20. The Behavioral Health Role in Nursing Facility Social Work. (United States)

    Myers, Dennis R; Rogers, Robin K; LeCrone, Harold H; Kelley, Katherine


    Types of compromised resident behaviors licensed nursing facility social workers encounter, the behavioral health role they enact, and effective practices they apply have not been the subject of systematic investigation. Analyses of 20 in-depth interviews with Bachelor of Social Work (BSW)/Master of Social Work (MSW) social workers averaging 8.8 years of experience identified frequently occurring resident behaviors: physical and verbal aggression/disruption, passive disruption, socially and sexually inappropriateness. Six functions of the behavioral health role were care management, educating, investigating, preventing, mediating, and advocating. Skills most frequently applied were attention/affirmation/active listening, assessment, behavior management, building relationship, teamwork, and redirection. Narratives revealed role rewards as well as knowledge deficits, organizational barriers, personal maltreatment, and frustrations. Respondents offered perspectives and prescriptions for behavioral health practice in this setting. The findings expand understanding of the behavioral health role and provide an empirical basis for more research in this area. Recommendations, including educational competencies, are offered.

  1. Job enrichment: creating meaningful career development opportunities for nurses. (United States)

    Duffield, Christine; Baldwin, Richard; Roche, Michael; Wise, Sarah


    This paper presents an evaluation of a career development policy in South Australia which increased the number of senior staff nurse positions and provided senior registered nurses with time away from clinical duties to undertake agreed projects. We use Kanter's model of structural power and commitment theory to understand the dimensions of this policy. Development strategies for experienced staff who wish to remain at the bedside are needed, especially in smaller health services with limited opportunities for horizontal or vertical mobility. Face-to-face semistructured interviews were conducted with 54 senior staff nurses who participated in the career structure arrangements. The policy enhanced the structure of opportunity in three ways: by increasing the number of senior staff nurse positions, the ladder steps were improved; undertaking strategic projects developed new skills; and the job enrichment approach facilitated time out from the immediate pressures of ward work and challenged nurses in a different way. Through job enrichment, South Australia has found a novel way of providing meaningful career development opportunities for experienced nurses. Methods of job enrichment need to be considered as part of career development policy, especially where movement between clinical facilities is limited and staff wish to remain at the bedside. © 2013 John Wiley & Sons Ltd.

  2. Ethical climates in for-profit, nonprofit, and government skilled nursing facilities: managerial implications for partnerships. (United States)

    Filipova, Anna A


    This study investigates ethical climates in government, nonprofit, and for-profit nursing homes and determines their similarities and differences. Surveys were collected from 656 (21.4%) licensed nurses who worked in 100 skilled nursing facilities in one Midwestern state. Shared law and code and caring ethical climates were identified across the 3 sector nursing homes. Those climates were also polarized. Important implications were drawn for consideration of ethical perceptions of each sector during negotiations and contract management.

  3. Facility and market factors affecting transitions from nursing home to community. (United States)

    Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa


    Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

  4. Developments in neonatal care and nursing responses. (United States)

    Healy, Patricia; Fallon, Anne

    This article reviews the origins and evolution of neonatology and considers the role of the neonatal nurse within this specialty. Neonatal nurses are a vital part of the neonatal team that provides care for sick babies. The nursing care required by sick babies and their families on a neonatal unit can be variable and complex. The past century has seen significant changes in the role of the neonatal nurse. This has come about through dramatic technological developments on neonatal units, an increased understanding of neonatal physiology and pathology, changes in the education of neonatal nurses, and active and ongoing clinical research within the specialty. The resulting significant advances in neonatal care, including that provided by neonatal nurses, have made a crucial and steadfast contribution to marked improvements in neonatal outcomes.

  5. Factors Influencing Job Satisfaction and Anticipated Turnover among Nurses in Sidama Zone Public Health Facilities, South Ethiopia. (United States)

    Asegid, Agezegn; Belachew, Tefera; Yimam, Ebrahim


    Background. Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs. Objective. This study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in Sidama zone public health facilities, in Southern Ethiopia. Method. Cross-sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from May 12 to June 05, 2010. Result. A total of 242 nurses were interviewed giving a response rate of 87%. Nearly two-third (68.6%) of the participants were female, and the mean age was 28 (±6.27) years for both sexes. All job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction. Satisfactions with work environment and group cohesion (AOR: 0.25 [95% CI: 0.12, 0.51]), single cohesion (AOR: 2.56 [95% CI: 1.27, 5.13]), and working in hospital (AOR: 2.19 [95% CI: 1.12, 4.30]) were the final significant predictors of anticipated turnover of Sidama zone nurses. Conclusions. More than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations.

  6. Factors Influencing Job Satisfaction and Anticipated Turnover among Nurses in Sidama Zone Public Health Facilities, South Ethiopia

    Directory of Open Access Journals (Sweden)

    Agezegn Asegid


    Full Text Available Background. Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs. Objective. This study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in Sidama zone public health facilities, in Southern Ethiopia. Method. Cross-sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from May 12 to June 05, 2010. Result. A total of 242 nurses were interviewed giving a response rate of 87%. Nearly two-third (68.6% of the participants were female, and the mean age was 28 (±6.27 years for both sexes. All job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction. Satisfactions with work environment and group cohesion (AOR: 0.25 [95% CI: 0.12, 0.51], single cohesion (AOR: 2.56 [95% CI: 1.27, 5.13], and working in hospital (AOR: 2.19 [95% CI: 1.12, 4.30] were the final significant predictors of anticipated turnover of Sidama zone nurses. Conclusions. More than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations.

  7. Factors Influencing Job Satisfaction and Anticipated Turnover among Nurses in Sidama Zone Public Health Facilities, South Ethiopia (United States)

    Belachew, Tefera; Yimam, Ebrahim


    Background. Workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses. However, developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs. Objective. This study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in Sidama zone public health facilities, in Southern Ethiopia. Method. Cross-sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from May 12 to June 05, 2010. Result. A total of 242 nurses were interviewed giving a response rate of 87%. Nearly two-third (68.6%) of the participants were female, and the mean age was 28 (±6.27) years for both sexes. All job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction. Satisfactions with work environment and group cohesion (AOR: 0.25 [95% CI: 0.12, 0.51]), single cohesion (AOR: 2.56 [95% CI: 1.27, 5.13]), and working in hospital (AOR: 2.19 [95% CI: 1.12, 4.30]) were the final significant predictors of anticipated turnover of Sidama zone nurses. Conclusions. More than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations. PMID:24707397

  8. Developing future nurse educators through peer mentoring

    Directory of Open Access Journals (Sweden)

    Rosenau PA


    Full Text Available Patricia A Rosenau, Rita F Lisella, Tracey L Clancy, Lorelli S NowellFaculty of Nursing, University of Calgary, Calgary, AB, CanadaBackground: The nursing workforce and nursing education demographic trends reinforce the urgency to cultivate future nursing leaders, educators, and mentors. The changing realities of health care environments, involving crowded student placements, overtaxed clinical mentors and preceptors, and inexperienced staff, hamper student learning and professional development. Peer mentoring has been used successfully in nursing education to enhance student engagement and the quality of the student learning experience. Although various terms like peer mentor have been used to describe the role of senior students facilitating junior student learning, the literature is silent about how peer mentoring fosters the development of future nursing education leaders.Objectives: The aim of this study was to understand how peer mentorship fosters the development of nursing education leadership in senior undergraduate nursing students enrolled in an elective undergraduate peer-mentoring credit course, Introductory Concepts in Nursing Education and Leadership Through Peer-Led Learning.Design and method: This phenomenological study explored the development of nursing education leadership in senior undergraduate students through the analysis of critical reflections of individual senior students and online discussions between triads of senior students teaching/learning across diverse junior-level theory and practice courses.Participants: Seventeen senior undergraduate nursing students enrolled in the elective course participated in the study.Results: From the critical reflections and online discussions, four themes emerged: "developing teaching philosophies and pedagogies", "learning teaching strategies", "supportive peer relationship", and "benefits of the peer mentorship program".Conclusion: The creation and promotion of peer leadership

  9. [Diabetes care and incidence of severe hypoglycemia in nursing home facilities and nursing services: The Heidelberg Diabetes Study]. (United States)

    Bahrmann, A; Wörz, E; Specht-Leible, N; Oster, P; Bahrmann, P


    The goal of this study was to perform a structured analysis of the treatment quality and acute complications of geriatric patients with diabetes mellitus (DM) cared for by nursing services and nursing home facilities. Secondly, structural problems and potentials for improvement in the care of multimorbid older people with DM treated by nursing homes and nursing services were analysed from the viewpoint of geriatric nurses, managers of nursing homes and general practitioners. In all, 77 older persons with DM from 13 nursing homes and 3 nursing services were included in the analysis (76.6% female, HbA1c 6.9 ± 1.4%, age 81.6 ± 9.9 years). Structural problems and potentials for improvement were collected from 95 geriatric nurses, 9 managers of nursing homes and 6 general practitioners using semistandardized questionnaires. Metabolic control was too strict in care-dependent older people with DM (mean HbA1c value: 6.9 ± 1.4 %; recommended by guidelines: 7-8%). The measurement of HbA1c was performed in 16 of 77 people (20.8%) within the last year despite a high visitation frequency of the general practitioners (12.7 ± 7.7 within the last 6 months). The incidence of severe hypoglycemia was 7.8%/patient/year. Regarding the management in case of diabetes-related acute complications 33 geriatric nurses (34.7%) stated not having any written standard (nursing home 39%, geriatric services 16.7%). Complex insulin therapies are still used in older people with DM with the consequence of a high incidence of severe hypoglycemia. Concrete management standards in the case of diabetes-related acute complications for geriatric nurses are lacking for more than one third of the nursing services.

  10. Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility? (United States)

    Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E


    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.

  11. Developing a prenatal nursing care International Classification for Nursing Practice catalogue. (United States)

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


    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.

  12. Longitudinal charge nurse leadership development and evaluation. (United States)

    Krugman, Mary; Heggem, Laura; Kinney, Lisa Judd; Frueh, Margaret


    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.

  13. Promoting the Construction of an Optimal Nurse's Office Facility: One School District's Experience. (United States)

    McKibben, Cynthia; DiPaolo, Sonja J.


    Details recommendations for updating or constructing nurses' offices based upon a descriptive study done in one midwestern school district. Suggestions are provided on size, location, and equipment needed. Also addressed is the communication process needed to persuade a board of education and school administrators that nursing facilities must be a…

  14. Workplace Violence and Safety Issues in Long-Term Medical Care Facilities: Nurses' Perspectives


    Bankole K. Fasanya; Emmanuel A. Dada


    Background: Workplace violence (WPV) is becoming an issue that needs immediate attention in the United States, especially during this period as more states are adopting the “stand your ground laws to promote worker protection.” This study was conducted to investigate how WPV has contributed to an unsafe environment for nurses and nursing assistants who work in long-term medical care facilities. Methods: A structure questionnaire was used to collect data for the study. Three facilities were...

  15. Developing a general ward nursing dashboard. (United States)

    Russell, Margot; Hogg, Maggie; Leach, Stuart; Penman, Mags; Friel, Susan


    The seventh and final article in the series on Leading Better Care explores some of the challenges in clinical practice relating to the use of data and making information meaningful to senior charge nurses and ward sisters. It describes the collaborative approach taken by NHS Lanarkshire, which involved nursing staff, programme leads and the eHealth team in the development of a general ward nursing dashboard as a means of ensuring safe, effective person-centred care. The article also illustrates how this web-based data-reporting programme is used to support clinical practice.

  16. Strengthening the research and development on nursing instruments

    International Nuclear Information System (INIS)

    Liu Lanying; Zhao Changhe


    The current status about nursing instruments is described. The nursing work is an impotent part of medical treatments, especially in the treatment with radioactive isotopes. Some proposals concerning the future research and development of nursing instruments have been submitted

  17. The DE-PHARM Project: A Pharmacist-Driven Deprescribing Initiative in a Nursing Facility. (United States)

    Pruskowski, Jennifer; Handler, Steven M


    Many residents with life-limiting illnesses are being prescribed and taking potentially inappropriate medications (PIMs) and questionably beneficial medications either near or at the end of life. These medications can contribute to adverse drug reactions, increase morbidity, and increase unnecessary burden and cost. It is crucial that the process of deprescribing be incorporated into the care of these residents. After developing a clinical pharmacist-driven deprescribing initiative in the nursing facility, the objective of this project was to reduce the number of PIMs via accepted recommendations from the clinical pharmacist to the primary team. The Discussion to Ensure the Patient-centered, Health-focused, prognosis-Appropriate, and Rational Medication regimen (DE-PHARM) quality improvement-approved project was conducted in an urban, academic nursing facility in Pittsburgh, Pennsylvania. The pilot phase occurred between October 2015 and April 2016. To be included in this study, participants had to be a custodial resident of the nursing facility with a previously documented comfort-focused treatment plan. All medications used for the management of chronic comorbid diseases were eligible for review. Forty-seven residents managed by eight different primary teams met inclusion criteria. Thirty-nine recommendations for 23 residents were made by the clinical pharmacist, with an average of 0.82 and range of 0-5 recommendations per resident, respectively. Of those, only 10 (26%) were accepted, 1 (3%) was modified, 3 (7%) were rejected, and 25 (64%) had no response within the 120-day response period. Additionally, two residents died during the project, and one resident was readmitted to the hospital for a prolonged period of time. The pilot phase of the DE-PHARM project, a clinical pharmacist-driven deprescribing initiative, was designed and assessed. This project demonstrated the feasibility of such an initiative. Because of the complexity of such a process, special

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

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


    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.

  19. Nursing's Boundary Work: Theory Development and the Making of Nursing Science, ca. 1950-1980. (United States)

    Tobbell, Dominique A

    Beginning in the late 1950s and intensifying through the 1960s and 1970s, nurse educators, researchers, and scholars worked to establish nursing as an academic discipline. These nursing leaders argued that the development of nursing theory was not only critical to nursing's academic project but also to improving nursing practice and patient care. The purpose of the article is to examine the context for the development of nursing theory and the characteristics of early theory development from the 1950s through the early 1980s. The methods used were historical research and analysis of the social, cultural, and political context of nursing theory development from the 1950s through the early 1980s. How this context influenced the work of nurse theorists and researchers in these decades was addressed. The development of nursing theory was influenced by a context that included the increasing complexity of patient care, the relocation of nursing education from hospital-based diploma schools to colleges and universities, and the ongoing efforts of nurses to secure more professional autonomy and authority in the decades after World War II. In particular, from the 1960s through the early 1980s, nurse theorists, researchers, and educators viewed the establishment of nursing science, underpinned by nursing theory, as critical to establishing nursing as an academic discipline. To define nursing science, nurse theorists and researchers engaged in critical boundary work in order to draw epistemic boundaries between nursing science and the existing biomedical and behavioral sciences. By the early 1980s, the boundary work of nurse theorists and researchers was incomplete. Their efforts to define nursing science and establish nursing as an academic discipline were constrained by generational and intraprofessional politics, limited resources, the gendered and hierarchical politics, and the complexity of drawing disciplinary boundaries for a discipline that is inherently

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

    Wu, Yu-Ling; Kao, Yu-Hsiu


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

  1. Computer usage among nurses in rural health-care facilities in South Africa: obstacles and challenges. (United States)

    Asah, Flora


    This study discusses factors inhibiting computer usage for work-related tasks among computer-literate professional nurses within rural healthcare facilities in South Africa. In the past two decades computer literacy courses have not been part of the nursing curricula. Computer courses are offered by the State Information Technology Agency. Despite this, there seems to be limited use of computers by professional nurses in the rural context. Focus group interviews held with 40 professional nurses from three government hospitals in northern KwaZulu-Natal. Contributing factors were found to be lack of information technology infrastructure, restricted access to computers and deficits in regard to the technical and nursing management support. The physical location of computers within the health-care facilities and lack of relevant software emerged as specific obstacles to usage. Provision of continuous and active support from nursing management could positively influence computer usage among professional nurses. A closer integration of information technology and computer literacy skills into existing nursing curricula would foster a positive attitude towards computer usage through early exposure. Responses indicated that change of mindset may be needed on the part of nursing management so that they begin to actively promote ready access to computers as a means of creating greater professionalism and collegiality. © 2011 Blackwell Publishing Ltd.

  2. Exploring the Demands on Nurses Working in Health Care Facilities During a Large-Scale Natural Disaster

    Directory of Open Access Journals (Sweden)

    Gillian C. Scrymgeour


    Full Text Available Nurses are pivotal to an effective societal response to a range of critical events, including disasters. This presents nurses with many significant and complex challenges that require them to function effectively under highly challenging and stressful circumstances and often for prolonged periods of time. The exponential growth in the number of disasters means that knowledge of disaster preparedness and how this knowledge can be implemented to facilitate the development of resilient and adaptive nurses and health care organizations represents an important adjunct to nurse education, policy development, and research considerations. Although this topic has and continues to attract attention in the literature, a lack of systematic understanding of the contingencies makes it difficult to clearly differentiate what is known and what gaps remain in this literature. Providing a sound footing for future research can be facilitated by first systematically reviewing the relevant literature. Focused themes were identified and analyzed using an ecological and interactive systems framework. Ten of the 12 retained studies included evacuation, revealing that evacuation is more likely to occur in an aged care facility than a hospital. The unpredictability of an event also highlighted organizational, functional, and competency issues in regard to the complexity of decision making and overall preparedness. The integrative review also identified that the unique roles, competencies, and demands on nurses working in hospitals and residential health care facilities during a natural disaster appear invisible within the highly visible event.

  3. Leadership and Registered Nurses (RNs) working after-hours in Residential Aged Care Facilities (RACFs): A structured literature review. (United States)

    Nhongo, Dorika; Hendricks, Joyce; Bradshaw, Julie; Bail, Kasia


    Registered nurses (RNs) working in Residential Aged Care Facilities are required to undertake complex management tasks including leading nursing care teams, supervising non-nursing staff, and allocating workloads according to residents' care needs, staff skills and experience. Registered nurses plan, assess, manage medication, evaluate each resident's care, liaise with doctors and allied health professionals and are responsible for evidence-based practice in accordance with the Nursing Standards for Practice (2016). Researchers have commented that effective nurse leadership can improve quality of care, improved resident outcomes and reduce adverse events. The aim of this literature review is to synthesise and analyse the literature pertinent to the RN's competence and confidence to undertake the leadership role when working in residential aged care facilities after-hours and to determine any association of leadership with quality resident outcomes. A review of original research papers based on the structured methodology described by Kable, Pich and Maslin-Prothero (2012). The review was conducted according to the 12-step structured framework by Kable et al. (2012). The search included peer-reviewed papers published between 2002 and 2017 on RN leadership after-hours, factors contributing to or with relationships to nursing leadership. Nineteen papers were found that researched the impact of leadership in aged care settings. The literature review concluded that nursing leadership has been linked to the quality of care and clinical outcomes in the aged care setting. However, RNs in the aged care setting have limited opportunities to develop key leadership competencies and confidence in order to meet the many challenges found in this environment due to lack of access to aged-care-specific leadership education. Minimal publications address the importance of the leadership of after-hours RNs. Results from this literature review will inform future research in this area

  4. Developing an information systems strategy for nursing. (United States)

    Callanan, K M; Hughes, S J


    With the rapidly changing health care environment and information technology advances, organizations need to engage in strategic, planned change in order to allocate limited resources, achieve the organization's goals, and fulfill its mission [1]. One of the most important aspects of the organization's planned strategies for change concerns the information systems. The involvement of the nursing department in this process is critical. This poster presentation will communicate how nurses can develop an information systems strategic plan that will enable them to play an active role as contributors and vital participants in the strategic and business planning processes for information systems. This information systems strategy for nursing will: a) provide direction and purpose, b) guide nursing in identifying the kinds of information technology needed, c) assist in timely implementation of a system that supports nursing, and d) identify desired outcomes and benefits of an information system. The nursing information systems plan must be built on, and support, the organization's mission and business plan and integrate into the over-all information systems plans [2]. Components of the nursing strategic plan include the nursing mission statement and vision, an assessment of the current environment to identify supporting technology needed to achieve the nursing vision, expectations/anticipated outcomes, environmental considerations, and special staffing/expertise considerations. The nursing vision and mission statement is an articulation of the overall direction and purpose of the nursing organization. An assessment of the nursing organization, problem areas, opportunities for growth, the physical environment, existing systems, communications requirements, and resources is carried out to help identify areas where new technologies and automated methods of managing information could be applied. Special staffing and expertise not currently available in the organization, but

  5. Nurses' experiences of participation in a research and development programme

    DEFF Research Database (Denmark)

    Jensen, Kirsten Pryds; Bäck-Pettersson, Siv; Kýlén, Sven


    To describe clinical nurses' experience of participating in a Research and Development (R&D) programme and its influence on their research interest and ability to conduct and apply nursing research......To describe clinical nurses' experience of participating in a Research and Development (R&D) programme and its influence on their research interest and ability to conduct and apply nursing research...

  6. Development and psychometric evaluation of the Core Nurse Resource Scale. (United States)

    Simpson, Michelle R


    To examine the factor structure, internal consistency reliability and concurrent-related validity of the Core Nurse Resource Scale. A cross-sectional survey study design was used to obtain a sample of 149 nurses and nursing staff [Registered Nurse (RNs), Licensed Practical Nurse (LPNs) and Certified Nursing Assistant (CNAs)] working in long-term care facilities. Exploratory factor analysis, Cronbach's alpha and bivariate correlations were used to evaluate validity and reliability. Exploratory factor analysis yielded a scale with 18 items on three factors, accounting for 52% of the variance in scores. Internal consistency reliability for the composite and Core Nurse Resource Scale factors ranged from 0.79 to 0.91. The Core Nurse Resource Scale composite scale and subscales correlated positively with a measure of work engagement (r=0.247-0.572). The initial psychometric evaluation of the Core Nurse Resource Scale demonstrates it is a sound measure. Further validity and reliability assessment will need to be explored and assessed among nurses and other nursing staff working in other practice settings. The intent of the Core Nurse Resource Scale is to evaluate the presence of physical, psychological and social resources of the nursing work environment, to identify workplaces at risk for disengaged (low work engagement) nursing staff and to provide useful diagnostic information to healthcare administrators interested in interventions to improve the nursing work environment. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

  7. Developing resilience: Stories from novice nurse academics. (United States)

    McDermid, Fiona; Peters, Kath; Daly, John; Jackson, Debra


    It is acknowledged that novice nurse academics face many challenges on commencement of their new role. Most are recruited from the clinical arena, with little understanding of the academic triumvirate of teaching, research and service. They struggle with role expectation and experience feelings of isolation and anxiety. The aim of this paper is to report on an exploration of 14 new nurse academics from two major nursing education institutions as they utilised and developed resilience building strategies. The paper is drawn from a qualitative study that sought to see the world through the eyes of the participants through storytelling. Data was collected using semi-structured, conversational style interviews. Interviews were audio recorded and revealed themes that captured resilience strategies. These themes were: Developing supportive collegial relationships; Embracing positivity; and Reflection and transformative growth. The first theme, developing supportive relationships, provides insight into the mentoring process and the relationships developed with peers and colleagues. The second theme, embracing positivity, describes the factors that assisted them to face the adversity and challenges in the new role. The final theme, reflection and transformative growth, demonstrated participants' reflecting on difficult situations and demonstrating the ability to learn from the experiences and move forward. The strategies utilised by the participants in this study were key factors in the development of resilience which assisted in the transition from clinical nurse to academic. These strategies were often tacit and it is imperative that in a time of acute nurse academic shortages where retention is paramount, that employing organisations support employees and contribute to resilience development. Education on resilience building strategies is fundamental for all new academics and is essential in the transition from clinical nurse to academic. Crown Copyright © 2016

  8. Are nursing home survey deficiencies higher in facilities with greater staff turnover. (United States)

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


    To examine CNA and licensed nurse (RN+LPN/LVN) turnover in relation to numbers of deficiencies in nursing homes. A secondary data analysis of information from the National Nursing Home Survey (NNHS) and contemporaneous data from the Online Survey, Certification and Reporting (OSCAR) database. Data were linked by facility as the unit of analysis to determine the relationship of CNA and licensed nurse turnover on nursing home deficiencies. The 2004 NNHS used a multistage sampling strategy to generate a final sample of 1174 nursing homes, which represent 16,100 NHs in the United States. This study focused on the 1151 NNHS facilities with complete deficiency data. Turnover was defined as the total CNAs/licensed nurse full-time equivalents (FTEs) who left during the preceding 3 months (full- and part-time) divided by the total FTE. NHs with high turnover were defined as those with rates above the 75th percentile (25.3% for CNA turnover and 17.9% for licensed nurse turnover) versus all other facilities. This study used selected OSCAR deficiencies from the Quality of Care, Quality of Life, and Resident Behavior categories, which are considered to be more closely related to nursing care. We defined NHs with high deficiencies as those with numbers of deficiencies above the 75th percentile versus all others. Using SUDAAN PROC RLOGIST, we included NNHS sampling design effects and examined associations of CNA/licensed nurse turnover with NH deficiencies, adjusting for staffing, skill mix, bed size, and ownership in binomial logistic regression models. High CNA turnover was associated with high numbers of Quality of Care (OR 1.53, 95% CI 1.10-2.13), Resident Behavior (OR 1.42, 95% CI 1.03-1.97) and total selected deficiencies (OR 1.54, 95% CI 1.12-2.12). Licensed nurse turnover was significantly related to Quality of Care deficiencies (OR 2.06, 95% CI 1.50-2.82) and total selected deficiencies (OR 1.71, 95% CI 1.25-2.33). When both CNA turnover and licensed nurse turnover were

  9. Main principles of development stationary training facilities

    International Nuclear Information System (INIS)

    Tsiptsyura, R.D.


    The designation of stationary training facilities is shown and the main requirements for them are formulated. When considering the above-mentioned requirements, special attention was paid to obligatory correspondence between training experience and practical skill of an operator. It is shown, that the switchboard block is the major unit of the training facility, which should develop skills and habits of an operator

  10. Priorities for the professional development of registered nurses in nursing homes: a Delphi study. (United States)

    Cooper, Emily; Spilsbury, Karen; McCaughan, Dorothy; Thompson, Carl; Butterworth, Tony; Hanratty, Barbara


    To establish a consensus on the care and professional development needs of registered nurses (RNs) employed by UK care homes. Two-stage, online modified Delphi study. A panel (n = 352) of individuals with experience, expertise or interest in care home nursing: (i) care home nurses and managers; (ii) community healthcare professionals (including general practitioners, geriatricians, specialist and district nurses); and (iii) nurse educators in higher education. RNs employed by nursing homes require particular skills, knowledge, competence and experience to provide high-quality care for older residents. The most important responsibilities for the nursing home nurse were: promoting dignity, personhood and wellbeing, ensuring resident safety and enhancing quality of life. Continuing professional development priorities included personal care, dementia care and managing long-term conditions. The main barrier to professional development was staff shortages. Nursing degree programmes were perceived as inadequately preparing nurses for a nursing home role. Nursing homes could improve by providing supportive learning opportunities for students and fostering challenging and rewarding careers for newly RNs. If nurses employed by nursing homes are not fit for purpose, the consequences for the wider health and social-care system are significant. Nursing homes, the NHS, educational and local authorities need to work together to provide challenging and rewarding career paths for RNs and evaluate them. Without well-trained, motivated staff, a high-quality care sector will remain merely an aspiration.

  11. Against the odds: experiences of nurse leaders in Clinical Development Units (Nursing) in Australia. (United States)

    Atsalos, Christine; O'Brien, Louise; Jackson, Debra


    This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence. The concept of Clinical Development Unit (Nursing) in Australia originated in the British Nursing Development Unit movement, which has been widely credited with introducing innovative approaches to developing nurses and nursing. A network of nine Clinical Development Units (Nursing) was set up in a suburban area health service in Australia. The aim was to develop existing wards or units into centres of excellence by disseminating a new vision for Australian nurses that was based on the pioneering work of the British Nursing Development Unit movement. Principles of Heideggerian hermeneutic phenomenology provided a framework for the study. Nine Clinical Development Unit (Nursing) leaders participated in qualitative interviews from 1998 to 2002. These interviews were transcribed into text and thematically analysed. Despite attempts to implement a variety of measures to nurture these Clinical Development Units (Nursing) until they had become well established, the new Clinical Development Unit (Nursing) leaders were unable to maintain the Clinical Development Unit (Nursing) vision with which they had been entrusted. This paper discusses their reactions to the problems they faced and the new understandings they developed of their Clinical Development Unit (Nursing) role over time. The findings illuminate the difficulties involved in maintaining the commitment of all levels of staff and management when attempting to introduce new nursing projects.

  12. Development, validation and testing of a nursing home to emergency room transfer checklist. (United States)

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang


    To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer. Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidence-based transfer instrument, which could fill this gap, is lacking. Development of a nursing home to emergency room transfer checklist, validation of items using the Delphi method and testing the feasibility and benefits of using the nursing home to emergency room transfer checklist. Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart review (baseline data) and a 6-month prospective study design were applied to test the feasibility of using the checklist. Variables for testing the feasibility of the checklist included residents' 30-day readmission rate and length of hospital stay. Development of the nursing home to emergency room transfer checklist resulted in four main parts: (i) demographic data of the nursing home resident; (ii) critical data for nursing home to emergency room transfer; (iii) contact information and (iv) critical data for emergency room to nursing home transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13)-4.98 (.15). Time required to complete the checklist was 3-5 min. Use of the nursing home to emergency room transfer checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%. The nursing home to emergency room transfer checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be an effective tool for this process. Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults

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

    Lohman, Matthew; Leslie, Marc; Powell, Virginia


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

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

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


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

  15. What are the career planning and development practices for nurses in hospitals? Is there a difference between private and public hospitals? (United States)

    Sonmez, Betul; Yildirim, Aytolan


    The aim was to determine the opinions of nurse managers about career planning and development for nurses in hospitals. Career planning and development are defined as an important and necessary tool in the development of nurses as professionals and in retaining nurses in a facility. A descriptive survey. The research population comprised nurse managers in 200+ bed hospitals on the European side of Istanbul province (n = 668). The entire population was targeted and 373 nurse managers were included in the study (55.8% return rate). Data were collected with a 32-item survey form that had three sections to determine the nurse managers' demographic characteristics, the career development practices at the facility where they worked, the nurse managers' responsibilities for career development and their expected competencies and recommendations. The findings of this study suggest that the most common technique used for nurses for career development was education programs, the career development practices of private hospitals were more developed than public hospitals and the nurse managers' perceptions about career development were different according to their management level, age group and educational level (p career development practices identified and the nurse managers did not have agreement on the subject of career development. Hospitals which provide opportunity for horizontal and vertical promotion and have clear development policies will be successful hospitals which are preferred by high quality nurses. This study draws attention to the importance of career planning in nursing and the need for nurse managers to take an active role in career planning and development.

  16. Clinical Research Nursing: Development of a Residency Program
. (United States)

    Showalter, Brandi L; Cline, Debbie; Yungclas, Jan; Frentz, Kelly; Stafford, Susan R; Maresh, Kelly J


    Clinical research nurses are essential in the coordination of clinical trials and the management of research participants. Without a stable, knowledgeable research nurse workforce, the conduct of research is affected. A research nurse residency is a novel approach to preparing new graduate nurses for the oncology research nurse role. This article will describe the development and content of the research nurse residency and how this approach is being used to address a need for clinical research nurses to support burgeoning clinical trials at a National Cancer Institute-designated comprehensive cancer center.

  17. Virtual patients: development in cancer nursing education. (United States)

    Moule, Pam; Pollard, Katherine; Armoogum, Julie; Messer, Simon


    The number of men diagnosed with prostate cancer is increasing and internationally there are high incidence rates. It is important that nurses and healthcare professionals are enabled to provide appropriate care to those men affected by prostate cancer and their families. Despite this need, there is recognition that many professionals feel ill prepared and lack knowledge in a number of areas. This paper presents the development of a Virtual Patient (VP) online resource to support practitioner learning. To develop five online VP simulation scenarios to meet the learning needs of nurses and health-care professionals caring for men with prostate cancer. Topic areas for the VPs were taken from previous work exploring the needs of health care professionals working with men with prostate cancer. An initial scoping exercise involving nursing practitioners, students and a prostate cancer charity confirmed the focus of the case study scenarios. Service users and specialist practitioners reviewed an outline of each case study to ensure fidelity of the simulations scenarios. Cases were entered into UChoose, a web based interactive VP player and authoring tool. The final case studies were reviewed by a sample of both registered and non-registered nurses and nursing students. The majority of respondents reported an increase in knowledge and suggested that they would recommend the resource to others. A number of positive aspects of the resource were highlighted. Respondents also commented about areas of weakness, a number of which have been addressed subsequently. The VP case studies provided an opportunity to develop knowledge and confidence in caring for men with prostate cancer. The mode of delivery and the content was acceptable for less experienced and knowledgeable staff. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Nursing Faculty Professional Development: A Study Using the National League for Nursing (NLN) Core Competencies for Nurse Educators for Development of Novice to Expert Nurse Educators (United States)

    Luoma, Kari L.


    The purpose of this quantitative research study was to identify core competencies that are most significant for nursing faculty to develop as they transition from novice to expert faculty. Professional development in a systematic approach may guide faculty to learn what is significant as they progress in the nurse faculty role. A quantitative…

  19. A collaborative effort of medical and educational facilities for radiation safety training of nurses

    International Nuclear Information System (INIS)

    Matsuda, Naoki; Yoshida, Masahiro; Takao, Hideaki


    The proper understanding of radiation safety by nursing staffs in hospitals are essential not only for radiation protection of themselves against occupational radiation exposure but for quality nursing for patients who receive medical radiation exposure. The education program on radiation in nursing schools in Japan is, however, rather limited, and is insufficient for nurses to acquire basic knowledge of radiation safety and protection. Therefore, the radiation safety training of working nurses is quite important. A hospital-based training needs assignment of radiation technologists and radiologists as instructors, which may result in temporary shortage of these staffs for patients' services. Additionally, the equipments and facilities for radiation training in a hospital might not be satisfactory. In order to provide an effective education regarding radiation for working nurses, the radiation safety training course has been conducted for nurse of the university hospital by the collaboration of medical and educational staffs in Nagasaki University. This course was given for 6 hours in Radioisotope Research Center, a research and education facility for radiation workers using radioisotopes. The curriculum of this course included basics of radiation, effects of radiation on human health, procedures in clinical settings for radiation protection and practical training by using survey meters, which were mainly based on the radiation safety training for beginners according to the Japanese law concerning radiation safety with a modification to focus on medical radiation exposure. This course has been given to approximately 25 nurses in a time, and held 13 times in May 2000 through October 2003 for 317 nurse overall. The pre-instruction questionnaire revealed that 60% of nurses felt fears about radiation diagnosis or therapy, which reduced to less than 15% in the post-instruction surveillance. The course also motivated nurses to give an answer to patients' questions about

  20. Integrative Review of Facility Interventions to Manage Compassion Fatigue in Oncology Nurses. (United States)

    Wentzel, Dorien; Brysiewicz, Petra


    Oncology nurses are regularly exposed to high-stress situations that may lead to compassion fatigue, and many institutions have implemented interventions to reduce burnout in nurses, but knowledge on the feasiblity, effectiveness, and nurses' experience of interventions is lacking.
. Electronic search of literature published from 1992-2015 was performed to evaluate in-facility interventions to manage compassion fatigue in oncology nurses. Databases used included CINAHL®, PubMed, Web of Science, Google Scholar, and PsycINFO®. 
. The goal was to evaluate the effectiveness, feasibility, and nurses' experience of interventions to manage compassion fatigue. The study designs, methods, and limitations were independently screened by the authors. 
. Of 164 studies, 31 met eligibility criteria. 
. The majority of the studies were conducted in Western countries, which suggests the need for additional research in other settings to determine effective interventions that address compassion fatigue and stress cross-culturally. Quantitative and qualitative studies failed to gain high scores in terms of quality. Limited conclusions can be drawn from small studies that report on outcomes with many confounding variables, such as turnover rate or general health of nurses, from a single institution. 
. Lack of empirical precision in evaluating the effectiveness, feasibility, and nurses' experiences of interventions indicates a need for future, more rigorously designed experimental studies. Because of the global increase in the number of patients being diagnosed and living with cancer, oncology nurses should be able to recognize and manage compassion fatigue.

  1. Development of the International Guidelines for Home Health Nursing. (United States)

    Narayan, Mary; Farris, Cindy; Harris, Marilyn D; Hiong, Fong Yoke


    Throughout the world, healthcare is increasingly being provided in home and community-based settings. There is a growing awareness that the most effective, least costly, patient-preferred setting is patients' home. Thus, home healthcare nursing is a growing nursing specialty, requiring a unique set of nursing knowledge and skills. Unlike many other nursing specialties, home healthcare nursing has few professional organizations to develop or support its practice. This article describes how an international network of home healthcare nurses developed international guidelines for home healthcare nurses throughout the world. It outlines how the guidelines for home healthcare nursing practice were developed, how an international panel of reviewers was recruited, and the process they used for reaching a consensus. It also describes the plan for nurses to contribute to future updates to the guidelines.

  2. Regional Comparison of Enteral Nutrition-Related Admission Policies in Skilled Nursing Facilities. (United States)

    Burgermaster, Marissa; Slattery, Eoin; Islam, Nafeesa; Ippolito, Paul R; Seres, David S


    Nursing home admission policies are one driver of increased and earlier gastrostomy placement, a procedure that is not always medically or ethically indicated among patients needing short-term nutrition support. This important clinical decision should be based upon patient prognosis, goals, and needs. We compared nursing home enteral nutrition-related admission policies in New York City and other regions of the United States. We also explored motivations for these policies. We conducted a telephone survey with skilled nursing facility administrators in New York City and a random sample of facilities throughout the United States about enteral nutrition-related admission policies. Survey data were matched with publically available data about facility characteristics from the Centers for Medicare and Medicaid Services. The relationship between facility location and admission policies was described with regression models. Reasons for these policies were thematically analyzed. New York City nursing homes were significantly less likely to admit patients with nasogastric feeding tubes than were nursing homes nationwide, after we controlled for facility characteristics (odds ratio = 0.111; 95% CI, 0.032-0.344). Reasons for refusing nasogastric tubes fell into 5 categories: safety, capacity, policy, perception of appropriate level of care, and patient quality of life. Our findings indicate that enteral nutrition-related admission policies vary greatly between nursing homes in New York City and nationwide. Many administrators cited safety and policy as factors guiding their institutional policies and practices, despite a lack of evidence. This gap in research, practice, and policy has implications for quality and cost of care, length of hospital stay, and patient morbidity and mortality. © 2016 American Society for Parenteral and Enteral Nutrition.

  3. Detector development and test facility

    International Nuclear Information System (INIS)

    Reeder, D.D.


    Following the ideas presented in the proposal to the DoE, we have begun to acquire the equipment needed to design, develop construct and test the electronic and mechanical features of detectors used in High Energy Physics Experiments. A guiding principle for the effort is to achieve integrated electronic and mechanical designs which meet the demanding specifications of the modern hadron collider environment yet minimize costs. This requires state of the art simulation of signal processing as well as detailed calculations of heat transfer and finite element analysis of structural integrity

  4. [A new vision of nursing: the evolution and development of nursing informatics]. (United States)

    Feng, Rung-Chuang; Yeh, Yu-Ting


    Technology development trends in the 21st century are increasingly focused on the development of interdisciplinary applications. Advanced information technology may be applied to integrate nursing care information, simplify nursing processes, and reduce the time spent on work tasks, thereby increasing the amount of time that clinical personnel are available to care for patients and ensuring that patients are provided with high-quality and personalized care services. The development of nursing information began in Taiwan in 2003 and has since expanded and thrived. The ability of nursing information to connect formerly insular national nursing communities promotes the international visibility of Taiwan. The rapid development of nursing information in Taiwan, resulting in the production of informative and outstanding results, has received worldwide attention. The Taiwan Nursing Informatics Association was established in 2006 to nurture nursing information professionals, develop and apply information technology in the health care domain, and facilitate international nursing information exchanges. The association actively promotes nursing information in the areas of administration, education, research, and clinical practice, thereby integrating nursing with empirical applications to enhance the service quality and management of nursing and increase the benefits of nursing teaching and research. To convert information into knowledge, the association develops individualized strategies for managing mobile care and employs an interagency network to exchange and reintegrate resources, establishing active, intelligent nursing based on network characteristics and an empirical foundation. The mid- and long-term objectives of the association involve introducing cloud computing and facilitating the meaningful use of nursing information in both public and government settings, thereby creating a milestone of developing and expanding nursing information unique to Taiwan.

  5. Career planning and development for nurses: the time has come. (United States)

    Donner, G J; Wheeler, M M


    Developments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career-development activities that will enable nurses to continue to provide high-quality care in ever-changing health care systems.

  6. Multilevel examination of facility characteristics, social integration, and health for older adults living in nursing homes. (United States)

    Leedahl, Skye N; Chapin, Rosemary K; Little, Todd D


    Testing a model based on past research and theory, this study assessed relationships between facility characteristics (i.e., culture change efforts, social workers) and residents' social networks and social support across nursing homes; and examined relationships between multiple aspects of social integration (i.e., social networks, social capital, social engagement, social support) and mental and functional health for older adults in nursing homes. Data were collected at nursing homes using a planned missing data design with random sampling techniques. Data collection occurred at the individual-level through in-person structured interviews with older adult nursing home residents (N = 140) and at the facility-level (N = 30) with nursing home staff. The best fitting multilevel structural equation model indicated that the culture change subscale for relationships significantly predicted differences in residents' social networks. Additionally, social networks had a positive indirect relationship with mental and functional health among residents primarily via social engagement. Social capital had a positive direct relationship with both health outcomes. To predict better social integration and mental and functional health outcomes for nursing homes residents, study findings support prioritizing that close relationships exist among staff, residents, and the community as well as increased resident social engagement and social trust. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

  7. Professional development needs of nurse managers. (United States)

    Miltner, Rebecca S; Jukkala, Angela; Dawson, Martha A; Patrician, Patricia A


    Nurse managers have a key role in creating positive work environments where safe, high-quality care is consistently provided. This requires a broad range of skills to be successful within today's complex health care environment; however, managers are frequently selected based on their clinical expertise and are offered little formal preparation for this leadership role. We conducted three focus groups with 20 nurse managers to understand their professional development needs. Transcripts were analyzed using conventional content analysis. Three themes emerged: Managing Versus Leading, Gaining a Voice, and Garnering Support. Managers focused on daily tasks, such as matching staffing to patient needs. However, the data suggested gaps in foundational management skills, such as understanding organizational behavior, use of data to make decisions, and refined problem-solving skills. Professional development activities focusing on higher level leadership competencies could assist managers to be more successful in this challenging, but critical, role. Copyright 2015, SLACK Incorporated.

  8. Development of cancer therapy facility of HANARO

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Byung Jin; Hwang, S. Y.; Kim, M. J. and others


    Facilities of the research and clinical treatments of neutron capture therapy using HANARO are developed, and they are ready to install. They are BNCT irradiation facility and prompt gamma neutron activatiion analysis facility. Since every horizontal neutron facility of HANARO is long and narrow tangential beam tube, it is analysed that sufficient epithermal neutrons for the BNCT cannot be obtained but sufficient thermal neutrons can be obtained by a filter composed of silicon and bismuth single crystals. Since the thermal neutron penetaration increases significantly when the crystals are cooled, a filter cooled by liquid nitrogen is developed. So as to avoid interference with the reactor operation, a water shutter is developed. The irradiation room is designed for the temporary surgical operation as well. Handling tools to remove activated beam port plug and to install water shutter and filter are developed. The basic structure of the irradiation room is already installed and most of other parts are ready to install. Since no free beam port is available for the prompt gamma neutron activation analysis, a method obtaining almost pure thermal neutrons by the vertical diffraction of extra beam for the polarized neutron spectrometer is developed. This method is confirmed by analysis and experiments to give high enough neutron beam. Equipment and devices are provided to install this facility.

  9. Development of cancer therapy facility of HANARO

    International Nuclear Information System (INIS)

    Jun, Byung Jin; Hwang, S. Y.; Kim, M. J. and others


    Facilities of the research and clinical treatments of neutron capture therapy using HANARO are developed, and they are ready to install. They are BNCT irradiation facility and prompt gamma neutron activatiion analysis facility. Since every horizontal neutron facility of HANARO is long and narrow tangential beam tube, it is analysed that sufficient epithermal neutrons for the BNCT cannot be obtained but sufficient thermal neutrons can be obtained by a filter composed of silicon and bismuth single crystals. Since the thermal neutron penetaration increases significantly when the crystals are cooled, a filter cooled by liquid nitrogen is developed. So as to avoid interference with the reactor operation, a water shutter is developed. The irradiation room is designed for the temporary surgical operation as well. Handling tools to remove activated beam port plug and to install water shutter and filter are developed. The basic structure of the irradiation room is already installed and most of other parts are ready to install. Since no free beam port is available for the prompt gamma neutron activation analysis, a method obtaining almost pure thermal neutrons by the vertical diffraction of extra beam for the polarized neutron spectrometer is developed. This method is confirmed by analysis and experiments to give high enough neutron beam. Equipment and devices are provided to install this facility

  10. Mobbing in the workplace by peers and managers: mobbing experienced by nurses working in healthcare facilities in Turkey and its effect on nurses. (United States)

    Yildirim, Aytolan; Yildirim, Dilek


    This research was conducted as a descriptive and cross-sectional study with the purpose of determining the mobbing experienced by nurses who work in healthcare facilities in Turkey, its emotional, social and physiological effects on the nurses and the actions that the individuals take to escape from the mobbing. The term 'mobbing', which includes workplace terrorizing, pressure, frightening, belittling and psycho-terror, is defined as the presence of systematic, directed, unethical communication and antagonistic behaviour by one or more individuals. These actions that occur frequently and continue for a long time are the most serious and effective causes of workplace stress. The person who is the target of the mobbing is left without help, without protection and alone in the workplace. Individuals who are exposed to psychological abuse experience physiological, psychological and social problems that are related to high levels of stress and anxiety. The research participants were 505 nurses of whom 325 (64%) worked in public and 180 (36%) in private hospitals. All of the participants were female. A questionnaire developed by the researchers in the light of information in the literature was used for data collection and had four sections including the participants' demographic characteristics and questions asking about mobbing behaviours, reaction to mobbing incidents and actions taken to escape from the mobbing. The data were collected between October and December 2005 by giving an envelope to the participants and then collecting the responses in the closed envelope. The overwhelming majority (86.5%) of the nurses participating in the research reported facing mobbing behaviour in the workplace in the last 12 months. The nurses working at private hospitals faced statistically significantly more mobbing behaviours than those at public hospitals (pworkplace need to be defined and appropriate policies and procedures need to be developed and shared with all employees to

  11. Developing leadership roles in nursing and midwifery. (United States)

    McGuire, Clare; Ray, Devashish


    This article is the first in a series of seven articles on an initiative undertaken in NHS Lanarkshire where a creative partnership with the University of the West of Scotland established a shared commitment to developing nursing and midwifery leadership. This article describes the national context within Scotland. It provides an overview of the innovative programmes of work and systems devised to support leadership throughout the organisation with a particular focus on quality of care.

  12. Does Nursing Facility Use of Habilitation Therapy Improve Performance on Quality Measures? (United States)

    Fitzler, Sandra; Raia, Paul; Buckley, Fredrick O; Wang, Mei


    The purpose of the project, Centers for Medicare & Medicaid Services (CMS) Innovation study, was to evaluate the impact on 12 quality measures including 10 Minimum Data Set (MDS) publicly reported measures and 2 nursing home process measures using habilitation therapy techniques and a behavior team to manage dementia-related behaviors. A prospective design was used to assess the changes in the measures. A total of 30 Massachusetts nursing homes participated in the project over a 12-month period. Project participation required the creation of an interdisciplinary behavior team, habilitation therapy training, facility visit by the program coordinator, attendance at bimonthly support and sharing calls, and monthly collection of process measure data. Participating facilities showed improvement in 9 of the 12 reported measures. Findings indicate potential quality improvement in having nursing homes learn habilitation therapy techniques and know how to use the interdisciplinary team to manage problem behaviors. © The Author(s) 2016.

  13. Measures to reduce occupational radiation exposure in PET facilities from nurses' point of view

    International Nuclear Information System (INIS)

    Miyazawa, Keiko; Takahashi, Juri; Mochiduki, Yoshikazu


    In parallel with the increase in the number of institutions having PET facilities, the number of nurse working in these facilities has also increased, and the issue of occupational radiation exposure has assumed ever greater importance. In our clinic, since nurses have started to administer FDG intravenous injections, their annual radiation exposure has amounted to 4.8 - 7.1 mSv. To reduce their annual radiation exposure to less than 5 mSv, we identified sources of increased exposure and considered countermeasures based on this information. By implementing countermeasures such as improvements in daily working conditions and ways to avoid various troubles, it was possible to reduce the annual radiation exposure of all nurses to less than 5 mSv. Our experience demonstrates that to provide a working environment with a minimum of occupational radiation exposure, educational training and enhancement of knowledge and technical skills are vital. (author)

  14. Residential Outcomes for Nursing Facility Applicants Who Have Been Diverted: Where Are They 5 Years Later? (United States)

    Chapin, Rosemary; Baca, Beth; Macmillan, Kelley; Rachlin, Roxanne; Zimmerman, Mary


    Purpose: The purpose of this longitudinal study was to determine the length of community tenure for adults aged 60 and older after application for nursing facility (NF) admission and to examine the proportion of older adults who lost community tenure due to either (a) death while a community resident or (b) permanent NF admission. Design and…

  15. Medicare Advantage Members' Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services. (United States)

    Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N


    Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services (United States)

    Keohane, Laura M.; Grebla, Regina C.; Mor, Vincent; Trivedi, Amal N.


    Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans’ expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. PMID:26056208

  17. Minnesota's Nursing Facility Performance-Based Incentive Payment Program: An Innovative Model for Promoting Care Quality (United States)

    Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa


    Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…

  18. Development of nursing research in Jordan (1986-2012). (United States)

    Khalaf, I


    To provide an overview of nursing research in Jordan based on the topic researched, source and setting of data collection, methodology, theoretical framework used and source of funding. Nursing research contributes to nursing education, clinical practice, health policy and the establishment of nursing research priorities in Jordan to guide future research. Databases such as MEDLINE, CINAHL, Google Scholar, PubMed and national sources were searched for published articles related to nursing in Jordan through a range of keywords. Articles were included in the analysis if they were published in English or Arabic through December 2012. The search resulted in the identification of 999 publications, from which 462 articles met the inclusion criteria and were included in the review. The highest percentage of studies (23% of articles) focused on nursing management issues. Forty-four per cent were conducted in a hospital setting; only six studies used a nursing theory. Seventy-seven per cent of the studies were quantitative and 29.0% were funded mostly by universities. Twenty-one per cent were not directly related to improving nursing education or practice in Jordan. A Jordanian Database for nursing research was developed as a result of this review. Jordanian nurses have slowly started to build nursing research, the real nursing research work in Jordan started with the return of the first PhD graduate to Jordan in 1986. Jordanian nurses in collaboration with international colleagues were motivated to publish research and build the body of nursing knowledge. © 2013 International Council of Nurses.

  19. National Ignition Facility frequency converter development

    International Nuclear Information System (INIS)

    Barker, C.E.; Auerbach, J.M.; Adams, C.H.


    A preliminary error budget for the third harmonic converter for the National Ignition Facility (NIF) laser driver has been developed using a root-sum-square-accumulation of error sources. Such a budget sets an upper bound on the allowable magnitude of the various effects that reduce conversion efficiency. Development efforts on crystal mounting technology and crystal quality studies are discussed

  20. Nurses' and managers' perceptions of continuing professional development for older and younger nurses : A focus group study

    NARCIS (Netherlands)

    Pool, I.A.; Poell, R.F.; Ten Cate, O.


    Background Continuing professional development of nurses is increasingly necessary to keep abreast of rapid changes in nursing care. Concurrently, the nursing workforce is growing older. Therefore, future strategies for continuing professional development should be directed at both younger and older

  1. NHS should provide nurses with decent catering facilities. (United States)

    Whelan, Adrian


    How about the NHS gives us access to decent catering facilities or even tables and chairs that aren't a 10 to 15-minute walk away from the ward or unit - which must be taken out of the already paltry half-hour meal break?

  2. Quality Improvement in Skilled Nursing Facilities for Residents With Alzheimer's Disease. (United States)

    Farlow, Martin R; Borson, Soo; Connor, Stephen R; Grossberg, George T; Mittelman, Mary S


    This report describes a quality improvement continuing medical education activity designed to enhance the recognition and treatment of residents with Alzheimer's disease (AD) or other dementias in skilled-nursing facilities (SNFs). Charts were compared in 6 areas prior to and following (stages A and C) a live, faculty-led workshop (stage B). Four SNFs completed stages A (n = 67 residents) and B, and 3 SNFs completed stage C (n = 52 residents). All charts came from residents with AD or a diagnosis of dementia or dementia-like symptoms. The SNFs had >95% baseline performance in both the frequency of cognitive assessments and documented medication reviews. The percentage of residents who received a quality-of-life assessment and those who had a mental health care plan in place represent areas for improvement. As part of this activity, a toolkit was developed to help guide facilities and clinicians in instituting care improvements for residents with AD/dementia. © The Author(s) 2015.

  3. Realism and Relativism in the Development of Nursing as a Discipline. (United States)

    Hirani, Shela Akbar Ali; Richter, Solina; Salami, Bukola Oladunni

    In today's era of nursing, the role of a unique disciplinary knowledge that is grounded in philosophy is essential to inform nursing practice, fill knowledge gaps, improve the quality of nursing education, and guide the theoretical development of nursing. Realism and relativism have contributed to the development of the nursing discipline by providing the basis of evidence-based nursing practice, nursing research, nursing education, and theoretical construction. This article explores the role of realism and relativism in the development of the discipline of nursing and presents their contributions to the work of nurse clinicians, nurse researchers, nurse educators, and nurse theorists.

  4. The problem of bias when nursing facility staff administer customer satisfaction surveys. (United States)

    Hodlewsky, R Tamara; Decker, Frederic H


    Customer satisfaction instruments are being used with increasing frequency to assess and monitor residents' assessments of quality of care in nursing facilities. There is no standard protocol, however, for how or by whom the instruments should be administered when anonymous, written responses are not feasible. Researchers often use outside interviewers to assess satisfaction, but cost considerations may limit the extent to which facilities are able to hire outside interviewers on a regular basis. This study was designed to investigate the existence and extent of any bias caused by staff administering customer satisfaction surveys. Customer satisfaction data were collected in 1998 from 265 residents in 21 nursing facilities in North Dakota. Half the residents in each facility were interviewed by staff members and the other half by outside consultants; scores were compared by interviewer type. In addition to a tabulation of raw scores, ordinary least-squares analysis with facility fixed effects was used to control for resident characteristics and unmeasured facility-level factors that could influence scores. Significant positive bias was found when staff members interviewed residents. The bias was not limited to questions directly affecting staff responsibilities but applied across all types of issues. The bias was robust under varying constructions of satisfaction and dissatisfaction. A uniform method of survey administration appears to be important if satisfaction data are to be used to compare facilities. Bias is an important factor that should be considered and weighed against the costs of obtaining outside interviewers when assessing customer satisfaction among long term care residents.

  5. Development of a Medical Cyclotron Production Facility (United States)

    Allen, Danny R.


    Development of a Cyclotron manufacturing facility begins with a business plan. Geographics, the size and activity of the medical community, the growth potential of the modality being served, and other business connections are all considered. This business used the customer base established by NuTech, Inc., an independent centralized nuclear pharmacy founded by Danny Allen. With two pharmacies in operation in Tyler and College Station and a customer base of 47 hospitals and clinics the existing delivery system and pharmacist staff is used for the cyclotron facility. We then added cyclotron products to contracts with these customers to guarantee a supply. We partnered with a company in the process of developing PET imaging centers. We then built an independent imaging center attached to the cyclotron facility to allow for the use of short-lived isotopes.

  6. Development of a Medical Cyclotron Production Facility

    International Nuclear Information System (INIS)

    Allen, Danny R.


    Development of a Cyclotron manufacturing facility begins with a business plan. Geographics, the size and activity of the medical community, the growth potential of the modality being served, and other business connections are all considered. This business used the customer base established by NuTech, Inc., an independent centralized nuclear pharmacy founded by Danny Allen. With two pharmacies in operation in Tyler and College Station and a customer base of 47 hospitals and clinics the existing delivery system and pharmacist staff is used for the cyclotron facility. We then added cyclotron products to contracts with these customers to guarantee a supply. We partnered with a company in the process of developing PET imaging centers. We then built an independent imaging center attached to the cyclotron facility to allow for the use of short-lived isotopes

  7. DeBeNe Test Facilities for Fast Breeder Development

    International Nuclear Information System (INIS)

    Storz, R.


    This report gives an overview and a short description of the test facilities constructed and operated within the collaboration for fast breeder development in Germany, Belgium and the Netherlands. The facilities are grouped into Sodium Loops (Large Facilities and Laboratory Loops), Special Equipment including Hot Cells and Reprocessing, Test Facilities without Sodium, Zero Power Facilities and In-pile Loops including Irradiation Facilities

  8. An assessment of cultural values and resident-centered culture change in U.S. nursing facilities. (United States)

    Banaszak-Holl, Jane; Castle, Nicholas G; Lin, Michael; Spreitzer, Gretchen


    Culture change initiatives propose to improve care by addressing the lack of managerial supports and prevalent stressful work environments in the industry; however, little is known about how culture change facilities differ from facilities in the industry that have not chosen to affiliate with the resident-centered care movements. The aim of this study was to evaluate representation of organizational culture values within a random sample of U.S. nursing home facilities using the competing values framework and to determine whether organizational values are related to membership in resident-centered culture change initiatives. We collected reports of cultural values using a well-established competing values framework instrument in a random survey of facility administrators and directors of nursing within all states. We received responses from 57% of the facilities that were mailed the survey. Directors of nursing and administrators did not differ significantly in their reports of culture and facility measures combined their responses. Nursing facilities favored market-focused cultural values on average, and developmental values, key to innovation, were the least common across all nursing homes. Approximately 17% of the facilities reported that all cultural values were strong within their facilities. Only high developmental cultural values were linked to participation in culture change initiatives. Culture change facilities were not different from non-culture change facilities in the promotion of employee focus as organizational culture, as emphasized in group culture values. Likewise, culture change facilities were also not more likely to have hierarchical or market foci than non-culture change facilities. Our results counter the argument that culture change facilities have a stronger internal employee focus than facilities more generally but do show that culture change facilities report stronger developmental cultures than non-culture change facilities, which

  9. Decontamination Technology Development for Nuclear Research Facilities

    International Nuclear Information System (INIS)

    Oh, Won Zin; Jung, Chong Hun; Choi, Wang Kyu; Won, Hui Jun; Kim, Gye Nam


    Technology development of surface decontamination in the uranium conversion facility before decommissioning, technology development of component decontamination in the uranium conversion facility after decommissioning, uranium sludge treatment technology development, radioactive waste soil decontamination technology development at the aim of the temporary storage soil of KAERI, Optimum fixation methodology derivation on the soil and uranium waste, and safety assessment methodology development of self disposal of the soil and uranium waste after decontamination have been performed in this study. The unique decontamination technology applicable to the component of the nuclear facility at room temperature was developed. Low concentration chemical decontamination technology which is very powerful so as to decrease the radioactivity of specimen surface under the self disposal level was developed. The component decontamination technology applicable to the nuclear facility after decommissioning by neutral salt electro-polishing was also developed. The volume of the sludge waste could be decreased over 80% by the sludge waste separation method by water. The electrosorption method on selective removal of U(VI) to 1 ppm of unrestricted release level using the uranium-containing lagoon sludge waste was tested and identified. Soil decontamination process and equipment which can reduce the soil volume over 90% were developed. A pilot size of soil decontamination equipment which will be used to development of real scale soil decontamination equipment was designed, fabricated and demonstrated. Optimized fixation methodology on soil and uranium sludge was derived from tests and evaluation of the results. Safety scenario and safety evaluation model were development on soil and uranium sludge aiming at self disposal after decontamination

  10. The impact of market and organizational characteristics on nursing care facility service innovation: a resource dependency perspective. (United States)

    Banaszak-Holl, J; Zinn, J S; Mor, V


    Using resource dependency theory as a conceptual framework, this study investigates both the organizational and environmental factors associated with an emerging health care service delivery innovation, the provision of specialty care in designated units in nursing care facilities. We consider two types of specialty units, Alzheimer's Disease and subacute care. The Medicare/Medicaid Automated Certification Survey (MMACS) data file was merged with local market area data obtained from the 1992 Area Resource File and with state level regulatory data. The likelihood of providing Alzheimer's Disease or subacute care in dedicated units was estimated by separate logistic regressions. Results indicate that facilities with fewer Medicare patients are more likely to operate a dedicated Alzheimer's care unit, while facilities located in markets with a large HMO population and greater hospital supply are more likely to operate a subacute care unit. While competition among nursing homes, for the most part, is an incentive to innovate, greater regulatory stringency appears to constrain the development of specialty care units of both types. Finally, organizational characteristics (e.g., size and proprietary status) appear to be important enabling factors influencing the propensity to provide specialty care in dedicated units. Nursing care facilities are moving toward providing specialty care units partly as a response to a growing demand by resource providers and to maintain a competitive edge in tighter markets. Loosening regulation directed at cost containment would further encourage the development of specialty care but should be preceded by some evaluation of population needs for specialty care and the effectiveness of specialty care units.

  11. Health Care Expenditures After Initiating Long-term Services and Supports in the Community Versus in a Nursing Facility. (United States)

    Newcomer, Robert J; Ko, Michelle; Kang, Taewoon; Harrington, Charlene; Hulett, Denis; Bindman, Andrew B


    Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs. To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care. Retrospective cohort analysis of California dually eligible adult Medicaid and Medicare beneficiaries who initiated Medicaid LTSS, identified as HCBS or extended nursing facility care, in 2006 or 2007. Propensity score matching for demographic, health, and functional characteristics resulted in a subsample of 34,660 users who initiated Medicaid HCBS versus extended nursing facility use. Those with developmental disabilities or in managed care plans were excluded. Average monthly adjusted acute, postacute, long-term, and total Medicare and Medicaid expenditures for the 12 months following initiation of either HCBS or extended nursing facility care. Those initiating extended nursing facility care had, on average, $2919 higher adjusted total health care expenditures per month compared with those who initiated HCBS. The difference was primarily attributable to spending on LTSS $2855. On average, the monthly LTSS expenditures were higher for Medicare $1501 and for Medicaid $1344 when LTSS was provided in a nursing facility rather than in the community. The higher cost of delivering LTSS in a nursing facility rather than in the community was not offset by lower acute and postacute spending. Medicare and Medicaid contribute similar amounts to the LTSS cost difference and both could benefit financially by redirecting care from institutions to the community.

  12. Preliminary design for a maglev development facility

    Energy Technology Data Exchange (ETDEWEB)

    Coffey, H.T.; He, J.L.; Chang, S.L.; Bouillard, J.X.; Chen, S.S.; Cai, Y.; Hoppie, L.O.; Lottes, S.A.; Rote, D.M. (Argonne National Lab., IL (United States)); Zhang, Z.Y. (Polytechnic Univ., Brooklyn, NY (United States)); Myers, G.; Cvercko, A. (Sterling Engineering, Westchester, IL (United States)); Williams, J.R. (Alfred Benesch and Co., Chicago, IL (United States))


    A preliminary design was made of a national user facility for evaluating magnetic-levitation (maglev) technologies in sizes intermediate between laboratory experiments and full-scale systems. A technical advisory committee was established and a conference was held to obtain advice on the potential requirements of operational systems and how the facility might best be configured to test these requirements. The effort included studies of multiple concepts for levitating, guiding, and propelling maglev vehicles, as well as the controls, communications, and data-acquisition and -reduction equipment that would be required in operating the facility. Preliminary designs for versatile, dual 2-MVA power supplies capable of powering attractive or repulsive systems were developed. Facility site requirements were identified. Test vehicles would be about 7.4 m (25 ft) long, would weigh form 3 to 7 metric tons, and would operate at speeds up to 67 m/s (150 mph) on a 3.3-km (2.05-mi) elevated guideway. The facility would utilize modular vehicles and guideways, permitting the substitution of levitation, propulsion, and guideway components of different designs and materials for evaluation. The vehicle would provide a test cell in which individual suspension or propulsion components or subsystems could be tested under realistic conditions. The system would allow economical evaluation of integrated systems under varying weather conditions and in realistic geometries.

  13. Establishing molecular microbiology facilities in developing countries

    Directory of Open Access Journals (Sweden)

    Salman S. Ahmed


    Full Text Available Summary: Microbiology laboratories play an important role in epidemiology and infection control programs. Within microbiology laboratories, molecular microbiology techniques have revolutionized the identification and surveillance of infectious diseases. The combination of excellent sensitivity, specificity, low contamination levels and speed has made molecular techniques appealing methods for the diagnosis of many infectious diseases. In a well-equipped microbiology laboratory, the facility designated for molecular techniques remains indiscrete. However, in most developing countries, poor infrastructure and laboratory mismanagement have precipitated hazardous consequences. The establishment of a molecular microbiology facility within a microbiology laboratory remains fragmented. A high-quality laboratory should include both conventional microbiology methods and molecular microbiology techniques for exceptional performance. Furthermore, it should include appropriate laboratory administration, a well-designed facility, laboratory procedure standardization, a waste management system, a code of practice, equipment installation and laboratory personnel training. This manuscript lays out fundamental issues that need to be addressed when establishing a molecular microbiology facility in developing countries. Keywords: Developing country, Molecular technique, Molecular microbiology laboratory

  14. The development of the Professional Values Model in Nursing. (United States)

    Kaya, Ayla; Boz, İlkay


    One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described. Concepts comprising the conceptual framework of the model and relations between the concepts were explained. It is assumed that awareness about concepts of the model will increase not only the patients' satisfaction with nursing care, but also the nurses' job satisfaction and quality of nursing care. Contemporary literature has been reviewed and synthesized to develop this theoretical paper on the Professional Values Model in nursing. Having high values in nursing increases job satisfaction, which results in the improvement of patient care and satisfaction. Also, individual characteristics are effective in the determination of individual needs, priorities, and values. This relation, proved through research about the Professional Values Model, has been explained. With development of these concepts, individuals' satisfaction with care and nurses' job satisfaction will be enhanced, which will increase the quality of nursing care. Most importantly, nurses can take proper decisions about ethical dilemmas and take ethical action when they take these values into consideration when giving care. The Professional Values Model seems suitable for nurse managers and it is expected that testing will improve it. Implementation of the Professional Values Model by nurse managers may increase motivation of nurses they work with. It is suggested that guidance by the Professional Values Model may help in enhancement of motivation efforts of the nurse managers

  15. School nurse summer institute: a model for professional development. (United States)

    Neighbors, Marianne; Barta, Kathleen


    The components of a professional development model designed to empower school nurses to become leaders in school health services is described. The model was implemented during a 3-day professional development institute that included clinical and leadership components, especially coalition building, with two follow-up sessions in the fall and spring. Coalition building is an important tool to enhance the influence of the school nurse in improving the health of individuals, families, and communities. School nurses and nursing educators with expertise in the specialty of school nursing could replicate this model in their own regions.

  16. Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review. (United States)

    Coventry, Tracey H; Maslin-Prothero, Sian E; Smith, Gilly


    To identify the best evidence on the impact of healthcare organizations' supply of nurses and nursing workload on the continuing professional development opportunities of Registered Nurses in the acute care hospital. To maintain registration and professional competence nurses are expected to participate in continuing professional development. One challenge of recruitment and retention is the Registered Nurse's ability to participate in continuing professional development opportunities. The integrative review method was used to present Registered Nurses perspectives on this area of professional concern. The review was conducted for the period of 2001-February 2015. Keywords were: nurs*, continuing professional development, continuing education, professional development, supply, shortage, staffing, workload, nurse: patient ratio, barrier and deterrent. The integrative review used a structured approach for literature search and data evaluation, analysis and presentation. Eleven international studies met the inclusion criteria. Nurses are reluctant or prevented from leaving clinical settings to attend continuing professional development due to lack of relief cover, obtaining paid or unpaid study leave, use of personal time to undertake mandatory training and organizational culture and leadership issues constraining the implementation of learning to benefit patients. Culture, leadership and workload issues impact nurses' ability to attend continuing professional development. The consequences affect competence to practice, the provision of safe, quality patient care, maintenance of professional registration, job satisfaction, recruitment and retention. Organizational leadership plays an important role in supporting attendance at continuing professional development as an investment for the future. © 2015 John Wiley & Sons Ltd.

  17. Developing an integrated career and competency framework for diabetes nursing. (United States)

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


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

  18. A Discussion of Professional Identity Development in Nursing Students

    Directory of Open Access Journals (Sweden)

    Cathy Maginnis


    Full Text Available Becoming a nurse requires development of professional capabilities, specifically socialisation into the profession and developing a professional identity (PI. A search of the literature highlights a lack of empirical research in PI development during pre-registration nursing education. A range of factors will be explored that relate to PI, including identity, professional socialisation, a sense of belonging to the profession and clinical placement. Exploring the development of a PI in nursing students can assist with identifying drivers and inhibitors. The aim of this paper is to describe PI development in pre-registration nursing students’ education and the relationship between development of a PI and the tertiary provided education. There are a multitude of factors that impact on developing a PI such as identity, professional socialisation, belonging, clinical placements and educators. Nursing students predominantly develop a nursing PI in the pre-registration program with professional socialisation through exposure to academia, clinical practice and role models. The onus of responsibility for developing a PI in nursing students is attributed to educational institutions. An expected outcome of the pre-registration program is that nursing students will have formed a PI. A greater depth of understanding PI is important in supporting the education of the nurses of the future. There may not be one simple explanation for what PI is, or how it is developed, but a greater depth of understanding of PI by both the tertiary sector and the nursing profession is important in supporting the education of the nurses of the future. Further research will enable a dialogue describing the development of a PI in nursing students and an understanding of the attributes and conceptions attributed to a nursing PI.

  19. Effectiveness of narrative pedagogy in developing student nurses' advocacy role. (United States)

    Gazarian, Priscilla K; Fernberg, Lauren M; Sheehan, Kelly D


    The literature and research on nursing ethics and advocacy has shown that generally very few nurses and other clinicians will speak up about an issue they have witnessed regarding a patient advocacy concern and that often advocacy in nursing is not learned until after students have graduated and begun working. To evaluate the effectiveness of narrative pedagogy on the development of advocacy in student nurses, as measured by the Protective Nursing Advocacy Scale. We tested the hypothesis that use of a narrative pedagogy assignment related to ethics would improve student nurse's perception of their advocacy role as measured by the Protective Nursing Advocacy Scale using a quasi-experimental nonrandomized study using a pre-test, intervention, post-test design. Data collection occurred during class time from October 2012 to December 2012. The Protective Nursing Advocacy Scale tool was administered to students in class to assess their baseline and was administered again at the completion of the educational intervention to assess whether narrative pedagogy was effective in developing the nursing student's perception of their role as a patient advocate. Students were informed that their participation was voluntary and that the data collected would be anonymous and confidential. The survey was not a graded assignment, and students did not receive any incentive to participate. The institutional review board of the college determined the study to be exempt from review. School of Nursing at a small liberal arts college in the Northeastern United States. A consecutive, nonprobability sample of 44 senior-level nursing students enrolled in their final nursing semester was utilized. Results indicated significant differences in student nurse's perception of their advocacy role related to environment and educational influences following an education intervention using an ethics digital story. Using the Protective Nursing Advocacy Scale, we were able to measure the effectiveness of

  20. Five generations in the nursing workforce: implications for nursing professional development. (United States)

    Bell, Julie A


    Positive patient outcomes require effective teamwork, communication, and technological literacy. These skills vary among the unprecedented five generations in the nursing workforce, spanning the "Silent Generation" nurses deferring retirement to the newest "iGeneration." Nursing professional development educators must understand generational differences; address communication, information technology, and team-building competencies across generations; and promote integration of learner-centered strategies into professional development activities.

  1. Work Life Stress and Career Resilience of Licensed Nursing Facility Administrators. (United States)

    Myers, Dennis R; Rogers, Rob; LeCrone, Harold H; Kelley, Katherine; Scott, Joel H


    Career resilience provided a frame for understanding how Licensed Nursing Facility Administrators (LNFAs) sustain role performance and even thrive in stressful skilled nursing facility work environments. Quantitative and qualitative analyses of in-depth interviews with18 LNFAs, averaging 24 years of experience were conducted by a five-member research team. Analysis was informed by evidence-based frameworks for career resilience in the health professions as well as the National Association of Long-Term Care Administrator Boards' (NAB) five domains of competent administrative practice. Findings included six sources of work stressors and six sources of professional satisfaction. Also, participants identified seven strategic principles and 10 administrative practices for addressing major sources of stress. Recommendations are provided for research and evidence-based application of the career resilience perspective to LNFA practice aimed at reducing role abandonment and energizing the delivery of the quality of care that each resident deserves.

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

    Small, Jeff A; Montoro-Rodriguez, Julian


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

  3. Capacity Development in an Undergraduate Nursing Program in Vietnam

    Directory of Open Access Journals (Sweden)

    Sunjoo Kang


    Full Text Available Background: Nurses are an essential human resource to ensure a healthy population and support the socio-economic development. However, little research has focused on the capacity development of nurses.Objective: The performance of a capacity development project for an undergraduate nursing program in Vietnam was reviewed to share lessons.Design: A descriptive case report.Setting: A baccalaureate nursing program in Vietnam from June 2014 to June 2016.Methods: A case report was analyzed in terms of the project's process, and the outcomes of 2 years' activities were evaluated.Results: Practice-based curriculum redesign and two basic nursing subjects were developed after five rounds of curriculum workshops. To improve application efficiency, two nursing experts were dispatched to provide instructions regarding the application of the new subjects. Three candidates were invited to complete their master's and doctoral studies in Korea. An advanced nursing education environment was supported with simulation labs equipped within a ubiquitous network. The result of experts' evaluation was excellent by every criterion of the Organization for Economic Co-operation and Development—Development Assistance Committee.Conclusions: The capacity development of a nursing program was possible through ownership, accountability, and results-based management. Gradual improvement in nursing academic and clinical capacity building based on research evidence can empower partner countries' nursing leadership. Introduction.

  4. Bridge to shared governance: developing leadership of frontline nurses. (United States)

    Dearmon, Valorie A; Riley, Bettina H; Mestas, Lisa G; Buckner, Ellen B


    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.

  5. Nurses experiences with deaf patient and recommendations for an effective communication with deaf in medical facility


    Boukalová, Naděžda


    This bachelor thesis whose name is Nurses experiences with deaf patient and recommendations for an effective communication with deaf in medical facility was conceived as pilot research. This thesis consists of two parts, theoretical and experimental. Theoretical part has several chapters, which deal with anatomy of ear, physiology of hearing, deaf in Czech Republic and communication. The last part of this chapter describes certain situations, where is possible to meet the deaf at medical faci...

  6. Job Satisfactions of Nurses and Physicians Working in the Same Health Care Facility in Turkey


    Züleyha Alper; Đlker Ercan; Güven Özkaya; Neriman Akansel


    Background: Job satisfaction is defined as the degree to which employees like or enjoy their jobs and the degreeof satisfaction is based on the importance placed upon this reward and benefit.Objective: Aim of this study was to determine the job satisfaction levels of nurses and physicians working in thesame health care facility, analyze the factors that may affect job satisfaction levels. This study was conducted asa descriptive study and was carried out in one Medical Care Center Northwester...

  7. [Different philosophical traditions for knowledge development in nursing sciences]. (United States)

    Ballard, Ariane; Khadra, Christelle; Le May, Sylvie; Gendron, Sylvie


    doctoral studies in nursing engage a critical reflections about philosophical traditions inherent to knowledge development. critical realism, hermeneutics, postmodernism and poststructuralism refer to philosophical traditions that are generally less explored in nursing, although they are attracting greater attention. this paper offers an introductory presentation to these traditions as the authors also reflect upon their contribution to nursing knowledge development in. for each tradition, ontological and epistemological properties are presented to provide an overview of their main features. Contributions to nursing knowledge development are then discussed. ontology refers to stratified, fixed and changing, or multiple realities, depending on the philosophical tradition. Likewise, epistemology emphasizes the explanatory power of knowledge, intersubjectivity, or inherent power dynamics. the diversity of philosophical traditions represents an asset that can significantly contribute to the advancement of the nursing discipline. clarification of the philosophical dimensions that underlie knowledge development is essential for doctoral nursing students in the process of developing their research projects and future programmes of research.

  8. An integrative review: Developing and measuring creativity in nursing. (United States)

    Ma, Xing; Yang, Yuanyuan; Wang, Xue; Zang, Yuli


    To analyze and synthesise the existing evidence on creativity in nursing. An integrative review. A systematic search was conducted using seven English databases (PubMed, Science Direct, Web of Science, Cochrane, EBSCO, Wiley, and Medline) and the top three best Chinese databases (CNKI, Wanfang Data, and VIP). The combined keywords, creativity and nursing/nurse, were used to search for relevant journal articles that were written in English or Chinese from January 1995 to December 2016. The components of articles, i.e. title, abstract, full-text and the cited reference, were screened, filtered, evaluated and recorded according to the PRISMA statements and Joanna Briggs Institute Checklists. Thematic analysis was performed to synthesise evidence from the full-texts of studies. Fifteen quantitative and seven qualitative studies were included in this review. A joyful affective perspective enriched the conceptualization of creativity in nursing. Many intrinsic factors (e.g. learning styles, thinking styles, intrinsic passion, interest in nursing and achievement motivation) or extrinsic factors (mostly workplace problems and nurses' shortage) could influence nurses' and nursing students' creativity. Artistic expressions (e.g. painting, music, and pottery), self-directed learning and group/team work were reported to have a positive effect on creativity enhancement. None of existing instruments can adequately measure nurses' or nursing students' creativity. The concept of creativity requires an explicit definition, which is essential to the development and evaluation of creativity in nursing education and practice. Many factors influencing nurses' and nursing students' creativity can be implemented to achieve positive outcomes through efforts at artistic expressions, self-directed learning and teamwork. An instrument with satisfactory psychometric properties should be available for monitoring creativity development among nurses and nursing students. Copyright © 2017

  9. Developing leadership in nursing: exploring core factors. (United States)

    Curtis, Elizabeth A; de Vries, Jan; Sheerin, Fintan K

    This article provides an introduction to the issue of nursing leadership, addressing definitions and theories underpinning leadership, factors that enhance leadership in nursing, and the nature of leadership content taught in undergraduate programmes. Highlighted are differences between leadership and management, and the notion that leadership can be 'learned'. The authors also point out that there is a discrepancy between how leading undergraduate nursing programmes prepare students primarily in the transition of education to practice, and the suggestion from a number of nursing publications that leadership in nurses should be fostered throughout their education.

  10. [Clinical nursing manpower: development and future prospects]. (United States)

    Lin, Chiou-Fen; Kao, Ching-Chiu


    The significant changes in nursing manpower utilization in Taiwan over the past two decades are due in large part to the implementation of the National Health Insurance program and the rising need for long-term care. The changes have impacted clinical nursing manpower utilization in two important ways. Firstly, there has been a substantial increase in overall demand for nursing manpower. In particular, the need for clinical nurses has nearly quadrupled during this time period. Secondly, the level of difficulty involved in patient care has risen dramatically, with factors including increased disease severity and increased care quality expectations, among others. These changes, coupled with demands on nursing manpower imposed from other sectors, underpin and further exacerbate the problem of nursing manpower shortages throughout the healthcare system. To raise the quality of the nursing work environment, the Ministry of Health and Welfare (MOHW) brought together Taiwan's key professional nursing organizations to promote 10 care-reform strategies, establish the nursing-aid manpower system, and create the nursing classification system as an approach to effectively attract nurses to take positions in the medical system.


    Directory of Open Access Journals (Sweden)

    Hammad Hammad


    Full Text Available Introduction: Loyalty of nursing student is an important factor that nursing education should pay attention in order to compete with other nursing educations; involved by perceived value, expectation, and quality assurance in nursing higher education. The purpose of this study was to develop a loyalty model of nursing student in nursing higher education. Methods: This study was an explanatory research with cross sectional approach. Population were nursing student in Poltekkes Banjarmasin, with 112 samples which is selected by proportional random sampling. Data was collected by giving questionnaire and analyzed by partial least square. Result: Result of this study indicates that was an effect of costumer expectation on quality assurance in nursing higher education, there was effect of costumer expectation on perceived value in nursing student, there was an effect of customer expectation on student satisfaction (4 there was effect of quality assurance in nursing higher education, there wasn’t any affect of quality assurance in nursing higher education on student satisfaction, there was effect of perceived value in nursing student on student satisfaction, there was effect of student satisfaction on student loyalty. Discussion: Overall result of this research were, student loyalty in nursing higher education developed by student satisfaction. Student satisfaction formed by perceived value. Perceived value developed from two aspects quality assurance, and student expectation, quality assurance of higher education wasn’t directly effect to student sasfaction. However, indirectly effect through student perceived value. Student satisfaction in nursing higher education was stronger effect than any other variable in this loyalty model. Loyalty model in this research can be use for improvement student loyalty on health education that focused on improvement student satisfaction without deny the other aspect. Further research is needed to analyze word of

  12. Assessing the professional development needs of experienced nurse executive leaders. (United States)

    Leach, Linda Searle; McFarland, Patricia


    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.

  13. Children's nursing research: toward development, drudgery or demise? (United States)

    Long, Tony

    This paper, based on a presentation to the UK Association of Chief Children's Nurses, is the author's personal reflection on the nature and future of children's nursing research. Key constitutive elements of this concept are considered to arrive at the conclusion that children's nursing research is research undertaken by children's nurses into questions of relevance to children's nursing practice and services, or wider issues in which children's nursing has a vital role. Three possible futures are presented, of which only the last is positive and desirable: development in line with the reality of practice and population needs. An integrated approach is necessary, with responsibilities both for those in positions of authority in the service and for researchers themselves. In particular, this partnership is essential for children's nursing to evidence the impact of research and for children and young people to reap the greatest benefit from evidence-based practice.

  14. Development of an Instructional Quality Assurance Model in Nursing Science (United States)

    Ajpru, Haruthai; Pasiphol, Shotiga; Wongwanich, Suwimon


    The purpose of this study was to develop an instructional quality assurance model in nursing science. The study was divided into 3 phases; (1) to study the information for instructional quality assurance model development (2) to develop an instructional quality assurance model in nursing science and (3) to audit and the assessment of the developed…

  15. The perceived perceptions of head school nurses in developing school nursing roles within schools. (United States)

    Morberg, Siv; Lagerström, Monica; Dellve, Lotta


    To gain a deeper understanding of how Swedish head school nurses perceive their leadership in developing school health care. A well-functioning school health care is important for promoting the health of children and young people. Constructivist-grounded theory was used to analyse 11 individual interviews with nine head school nurses. Head school nurses strive to find a balance between what they experience as vague formal goals and strong informal goals which leads to creating local goals in order to develop school health care. The head school nurse's job is experienced as a divided and pioneering job in which there is uncertainty about the leadership role. They provide individual support to school nurses, are the link between school nurses and decision makers and highlight the importance of school nurses' work to organizational leaders. This study shows that school health care needs to be founded on evidence-based methods. Therefore, a structured plan for education and training in school health care management, based on research and in cooperation with the academic world, would develop the head school nurses' profession, strengthen the position of school health care and advance the school nurses' work.

  16. Development of Diagnostic Technology for Substation Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, D.J.; Yoon, J.Y. [Korea Electric Power Research Institute, Taejeon (Korea, Republic of)


    This report contains the conceptual design of predictive diagnostic system for KEPCO 765kV substation apparatus which will be operated in 2001. Various kinds of techniques in the world for power transformer and GIS monitoring were examined, then the integrated diagnosis system configuration which will be most effective in our future substation was suggested. In addition, the development of the optimum life management for substation facilities. development of a system to measure the ESDD of substation insulator surfaces at a distance and application study of the degradation sensor(PCS) were described also. (author) 55 refs., 27 figs., 68 tabs.

  17. Leadership mentoring in nursing research, career development and scholarly productivity : A systematic review

    NARCIS (Netherlands)

    Hafsteinsdóttir, Thóra B.; van der Zwaag, Angeli M.; Schuurmans, Marieke J.


    Background Although nursing has been an academic discipline for decades, the infrastructure for nursing research in many countries is still fragile and struggling. Postdoctoral nurses have difficulties developing sustaining careers in nursing research due to lack of career opportunities.

  18. Leadership mentoring in nursing research, career development and scholarly productivity: A systematic review

    NARCIS (Netherlands)

    Thóra Hafsteinsdóttir; Angeli van der Zwaag; Prof. Dr. Marieke J. Schuurmans


    Although nursing has been an academic discipline for decades, the infrastructure for nursing research in many countries is still fragile and struggling. Postdoctoral nurses have difficulties developing sustaining careers in nursing research due to lack of career opportunities. Considerable research

  19. Sail training: an innovative approach to graduate nurse preceptor development. (United States)

    Nicol, Pam; Young, Melisa


    A 1-day sail-training program that aims to increase graduate nurse preceptor skills was evaluated. Preliminary results suggest that this experiential learning is an effective way to develop graduate nurse preceptors. Awareness of graduate nurses' needs has been heightened, and skills in clinical teaching have been developed. It is indicated from the limited results that the outcomes are sustained over time, but further evaluation is needed.

  20. [Development of nursing pratice in family medecine groups]. (United States)

    D'Amour, Danielle; Goudreau, Johanne; Hudon, Eveline; Beaulieu, Marie-Dominique; Lamothe, Lise; Jobin, Guy; Gilbert, Frédéric


    The purpose of the study was to analyze the development of nursing practice in family medicine groups (FMGs). The two-year case study consisted of 73 semi-directed interviews ofnurses, physicians and managers in five FMGs. The findings led to three main observations: nursing practice varies considerably from one FMG to another, the development of nurses' practice seems to be associated with the development of a collaborative relationship, and the satisfaction of the professionals in the FMG, nurses in particular, depends on the type of practice. It is important to implement measures to encourage the optimal use ofnurses' skills in a FMG.

  1. Shaping modern nursing development in China before 1949

    Directory of Open Access Journals (Sweden)

    Jiang Yuhong


    Full Text Available Nursing becoming a respectable, decent profession for educated Chinese women was a challenging undertaking. The early advancement of nursing in China was a collective effort of the missionary medicine, the private foundations, and the endurance, dedication and hardworking of the Chinese as well as foreign nurses. Western missionary introduced modern nursing in China and laid the preliminary foundation for its development, while the upgrading of nursing education from training to higher learning was a contribution by the School of Nursing Peking Union Medical College (PUMC, envisioned and supported by the China Medical Board. Its state-of-the-art and visionary education model, the high standard and the initiatives in public health nursing, and the heroic and patriotic military nursing created by the PUMC's outstanding graduates produced a cohort of leaders in nursing education and profession in China before 1949. All these efforts acting together shaped the modern nursing in China, leaving a great heritage to nursing education and practice to New China.

  2. Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities. (United States)

    Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah


    To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

  3. Workplace Violence and Safety Issues in Long-Term Medical Care Facilities: Nurses' Perspectives. (United States)

    Fasanya, Bankole K; Dada, Emmanuel A


    Workplace violence (WPV) is becoming an issue that needs immediate attention in the United States, especially during this period as more states are adopting the "stand your ground laws to promote worker protection." This study was conducted to investigate how WPV has contributed to an unsafe environment for nurses and nursing assistants who work in long-term medical care facilities. A structure questionnaire was used to collect data for the study. Three facilities were sampled and 80 nurses and certified nursing assistants participated in the study. Ninety-two percent (n = 74) were female and 8% (n = 6) were male. Approximately 62% were black or African American, approximately 33% were Caucasians, and only 2% were from other ethnicities. We found that 65% of the participants had experienced WPV while 41% believed that management shows little or no concern for their safety. Approximately 23% of respondents believed that reporting supervisor's WPV act is an unsafe action. In addition, 22% of those who reported that they have experienced WPV believed that the work environment is not safe to perform their duties. This significant difference in perception of workplace safety between those who had experienced WPV and those who had not was significant (t = 3.95, df = 158, p < 0.0001). WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.

  4. Developing a tool to measure the factors influencing nurses' enjoyment of nursing. (United States)

    Wilkes, Lesley; Doull, Michelle; Ng Chok, Harrison; Mashingaidze, Gladys


    To develop a tool to measure the influencing nurses' enjoyment of nursing. Enjoyment in the workplace is an influential aspect found to boost work morale, job satisfaction leading to higher work retention which is important in nursing given the availability of nurses in the workforce. This study looks to refine the determinants of enjoyment from nurses in a large metropolitan hospital in western Sydney. Quantitative. A 23-item survey questionnaire was used to ask nurses to rate the determinants that affect their enjoyment of nursing on a five-point Likert scale. The survey was distributed in a hard copy and online through a hospital-wide broadcast. Demographic items were also collected. A total of 124 responses were received, of which 54 were from online and 70 from hard copy surveys. The data analysis found 16 determinants of enjoyment. Of these, four were perceived by over 80% of the nurses to negatively impact their enjoyment. In contrast, nine items showed a positive effect on enjoyment with educating others, connecting with others, variety of work, doing and sharing with others, supporting others being the most positive (≥89% of responses). Three items were considered neutral: criticism, busy workload and changing policies. This study has added to the growing evidence on nurse enjoyment and its effects on job satisfaction. Nurses enjoy caring for patients and also find enjoyment and satisfaction in teaching others to care as well as socially connecting. Enjoyment seems to be one of the main reasons nurses continue to stay in nursing even though the system and people are not always supportive, encouraging or conducive to career development. © 2016 John Wiley & Sons Ltd.

  5. Born female: the development of nursing in Thailand. (United States)

    Muecke, M A; Srisuphan, W


    Nursing was the first education-based occupational field for women in Thailand. In the brief span of 90 years since its beginning in hospital bedside care, it has become a professional field that has one of the greatest concentrations of women with doctoral degrees in the nation (n = 23). The academic evolution of nursing was instigated by the decisive contributions of two rich and powerful interests, the monarchy and private U.S.A.-based foundations. A cadre of doctorally prepared nurses has emerged. They, like members of other professions in Thailand, are predominantly from the urban privileged sector of society. The majority of today's nurses have followed a different course starting from petty bourgeoisie origins in towns and moving laterally through provincial bureaucratic channels. To date, lack of basic education has denied the poor and minority ethnic groups from the hill areas access to nursing. We describe the development of the nursing profession in three phases: the beginning of nurse training, 1896-1926; the creation of a small elite of nurses, 1926-1956; and the development of academic nursing, 1956 to the present. The future depends upon how the current polarization between the minority elite of university-prepared nurses and the majority lower middle class nurses proceeds. Since each group is governed and educated by separate government Ministries, and since women do not have access to higher government positions, nursing may have little control over its own development unless its new leaders take new leadership. One strategy is to recruit men into university nursing.

  6. Improving heart failure disease management in skilled nursing facilities: lessons learned. (United States)

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


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

  7. Effects of using the developing nurses' thinking model on nursing students' diagnostic accuracy. (United States)

    Tesoro, Mary Gay


    This quasi-experimental study tested the effectiveness of an educational model, Developing Nurses' Thinking (DNT), on nursing students' clinical reasoning to achieve patient safety. Teaching nursing students to develop effective thinking habits that promote positive patient outcomes and patient safety is a challenging endeavor. Positive patient outcomes and safety are achieved when nurses accurately interpret data and subsequently implement appropriate plans of care. This study's pretest-posttest design determined whether use of the DNT model during 2 weeks of clinical postconferences improved nursing students' (N = 83) diagnostic accuracy. The DNT model helps students to integrate four constructs-patient safety, domain knowledge, critical thinking processes, and repeated practice-to guide their thinking when interpreting patient data and developing effective plans of care. The posttest scores of students from the intervention group showed statistically significant improvement in accuracy. Copyright 2012, SLACK Incorporated.

  8. Clinical leadership development and education for nurses: prospects and opportunities

    Directory of Open Access Journals (Sweden)

    Joseph ML


    Full Text Available M Lindell Joseph, Diane L Huber College of Nursing, The University of Iowa, Iowa City, IA, USA Abstract: With the implementation of the Affordable Care Act, elevated roles for nurses of care coordinator, clinical nurse leader, and advanced practice registered nurse have come to the forefront. Because change occurs so fast, matching development and education to job requirements is a challenging forecasting endeavor. The purpose of this article is to envision clinical leadership development and education opportunities for three emerging roles. The adoption of a common framework for intentional leadership development is proposed for clinical leadership development across the continuum of care. Solutions of innovation and interdependency are framed as core concepts that serve as an opportunity to better inform clinical leadership development and education. Additionally, strategies are proposed to advance knowledge, skills, and abilities for crucial implementation of improvements and new solutions at the point of care. Keywords: clinical leadership, nursing leadership, CNL, care coordination, innovation, interdependency

  9. Workforce Development in Nursing: Priming the Pipeline. (United States)

    Heller, Barbara R.; Nichols, Mary A.


    The University of Maryland School of Nursing is addressing the nursing shortage through public-private partnerships and alliances with the health care industry. Strategies include increasing public awareness through marketing, supporting legislation, expanding articulation agreements, and working with secondary schools to recruit students. (SK)

  10. [The development of a nursing sciences discipline]. (United States)

    Warnet, Sylvie


    Intellectual curiosity has guided the career of Michel Poisson, for the benefit of the gaze and clinical special approach of nurses and quality of care. He is also a historian. He questions the profession with regard to its identity and its desire to construct a discipline in nursing sciences.

  11. Transformational leadership: the development of a model of nursing case management by the army nurse corps. (United States)

    Hocker, Susan M; Trofino, Joan


    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.

  12. Using social media to engage nurses in health policy development. (United States)

    O'Connor, Siobhan


    To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development. Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence. A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software. The framework approach aided thematic analysis to draw out themes. Sixty-four people took part in the Twitter chat (#CNOScot) and posted 444 tweets. Nurses called for investment in technology, nursing research, education and mental health. Primary care and advanced practice roles to support older adults with complex health and social care needs were also seen as vital to develop further. Social media can help reach and engage nurses in policy discussion and ensure there is better continuity between policy and practice but some groups risk being excluded using this digital medium. Nursing leaders should consider social media as one of many engagement strategies to ensure nurses and other stakeholders participate in policy debate that informs health strategy development. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

  13. Surveillance of colonization and infection with Staphylococcus aureus susceptible or resistant to methicillin in a community skilled-nursing facility

    NARCIS (Netherlands)

    Y.-L. Lee (Yee-Lean); T. Cesario (Thomas); G.K. Gupta (Geeta); L. Flionis (Leo); C.T. Tran (Chi); M. Decker (Michael); L.D. Thrupp (Lauri)


    textabstractBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen in acute care hospitals and long-term care facilities. Few studies have been reported in private skilled nursing facilities (SNFs) not experiencing outbreaks of infections caused by MRSA.

  14. Nursing leadership in academic nursing: The wisdom of development and the development of wisdom. (United States)

    Pesut, Daniel J; Thompson, Sarah A

    The purpose of this article is to discuss insights derived from adult cognitive developmental theories and relate the insights to vertical leadership development in academic nursing contexts. Equipped with developmental understanding, academic leaders are in a better position to support the vertical leadership development of one's self, faculty, peers, and colleagues. From a cognitive developmental perspective, the authors' reason as leaders develop, grow, and evolve, sense making becomes more sophisticated and nuanced resulting in the development of wisdom. Leadership wisdom is a function of horizontal (acquisition of information, skills, and competencies) and vertical development (the development of more complex and sophisticated ways of thinking). Ways to enhance vertical development, and sense making to cultivate wisdom are discussed. Principles and practices that promote vertical development in self and others deepens performance expectations of those in the academy and supports personal professional development and organizational success. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. [The nurse answers for health in social inequalities: the development of the nursing critical paradigm.]. (United States)

    Rocco, Gennaro; Stievano, Alessandro


    Until the early Eighties, critical social theory as a philosophical orientation informing nursing science, theory development and practice did not exist. Interest on this topic began to arise only after the mid-Eighties. In fact, nursing scholars questioned the validity of empiricism as the historical foundation for nursing science and the limitations of interpretivism in strengthening nursing knowledge, and thus started to focus on the lack of epistemological perspectives in nursing, giving particular prominence to the peculiar social, political, historical and economic conditions involving those who needed nursing care. The theoretical reflection began to develop, like the empirical paradigm, the post-positivist paradigm and, later, the interpretative paradigm, expanded thanks to the early works by Martha Rogers and Rosemarie Rizzo Parse, were seen as unable to address issues related to power inequities, structural constraints and oppression suffered by vulnerable groups such as the homeless, mental health individuals, people affected by HIV+ and other infectious diseases, unemployed, etc.. Empiricism and interpretative paradigms did not manage to bridge the gap between theory and praxis, and a new theoretical and philosophical approach gradually gained ground. This paradigm, based on critical social theory, was developed by distinguished scholars and intellectuals, such as Max Horkheimer, Theodor Adorno, Herbert Marcuse of the Frankfurt School in the Thirties, and, in recent years, by Giddens, Bourdieu, Foucault, Habermas. On this social field the first works of Allen, Thompson, Stevens, Campbell and Bunting, Kendall, allowed to work out a new paradigmatic nursing approach that would have predicted the employment of the critical theory for particular nursing aspects, as a conceptual framework for nursing education, as a paradigm to carry out participatory action-research and for the development of the discipline. The purpose of this article was to describe this

  16. Analysis of rehabilitation activities within skilled nursing and inpatient rehabilitation facilities after hip replacement for acute hip fracture. (United States)

    Munin, Michael C; Putman, Koen; Hsieh, Ching-Hui; Smout, Randall J; Tian, Wenqiang; DeJong, Gerben; Horn, Susan D


    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.

  17. An empowerment framework for nursing leadership development: supporting evidence. (United States)

    Macphee, Maura; Skelton-Green, Judith; Bouthillette, France; Suryaprakash, Nitya


    This article is a report on a descriptive study of nurse leaders' perspectives of the outcomes of a formal leadership programme. Effective nurse leaders are necessary to address complex issues associated with healthcare systems reforms. Little is known about the types of leadership development programmes that most effectively prepare nurse leaders for healthcare challenges. When nurse leaders use structural and psychological empowerment strategies, the results are safer work environments and better nurse outcomes. The leadership development programme associated with this study is based on a unifying theoretical empowerment framework to empower nurse leaders and enable them to empower others. Twenty seven front-line and mid-level nurse leaders with variable years of experience were interviewed for 1 year after participating in a formal leadership development programme. Data were gathered in 2008-2009 from four programme cohorts. Four researchers independently developed code categories and themes using qualitative content analysis. Evidence of leadership development programme empowerment included nurse leader reports of increased self-confidence with respect to carrying out their roles and responsibilities; positive changes in their leadership styles; and perceptions of staff recognition of positive stylistic changes. Regardless of years of experience, mid-level leaders had a broader appreciation of practice environment issues than front-line leaders. Time for reflection was valuable to all participants, and front-line leaders, in particular, appreciated the time to discuss nurse-specific issues with their colleagues. This study provides evidence that a theoretical empowerment framework and strategies can empower nurse leaders, potentially resulting in staff empowerment. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  18. The biological sciences in nursing: a developing country perspective. (United States)

    Kyriacos, Una; Jordan, Sue; van den Heever, Jean


    This paper reports a study to inform curriculum development by exploring the contribution of bioscience education programmes to nurses' clinical practice, their understanding of the rationale for practice, and their perceptions of their continuing professional development needs. The future of the health services worldwide depends on nurse education programmes equipping practitioners to deliver safe and effective patient care. In the developed world, the structure and indicative content of nursing curricula have been debated extensively. However, despite the rapid expansion in nursing roles brought about by social change, there is little information on the educational needs of nurses in developing countries. This study was undertaken in government teaching hospitals in Cape Town, South Africa in 2003. A purposive sample of 54 nurses from a range of clinical settings completed questionnaires and described critical incidents where bioscience knowledge had directed practice. Questionnaires were analysed descriptively, in the main. Analysis of critical incident reports was based on Akinsanya's bionursing model. Most nurses felt that their understanding of the biological, but not the physical sciences, was adequate or better: all felt confident with their knowledge of anatomy, compared with 57.4% (31/54) for microbiology. Respondents attributed the successes and failures of their education programmes to their teachers' delivery of content, ability to relate to practice and management of the process of learning. The biological, but not the physical, sciences were universally (96-100%) regarded as relevant to nursing. However, the critical incidents and nurses' own reports indicated a need for further education in pharmacology (40/54, 74.1%) and microbiology (29/54, 53.7%). To meet the needs of nurses in developing countries, and empower them to meet the increasingly complex demands of their expanding roles, nurse educators need to consider increasing the curriculum

  19. [Being personal: the development of community psychiatric mental health nursing]. (United States)

    Shiau, Shu-Jen; Lee, Shu-Hong


    Community psychiatric mental health nursing care emphasizes humanistic values and focuses on serving patient and family needs. In Taiwan, such care is delivered largely as part of patient discharge care plans and hospital / community based service models. Issues involved underscore the importance of operating an effective and integrated transfer system, the role and function of nurses and training in relevant competencies (Shiau, Huang & Lin, 2005). This article again emphasizes the importance of 'being personal' in the development of community psychiatric mental health nursing in Taiwan. Critical issues to consider include humanization, empowerment, nursing competencies, regulations, relating on a personal level, and facilitating empowerment and enlightenment on the healing process.

  20. Large sample NAA facility and methodology development

    International Nuclear Information System (INIS)

    Roth, C.; Gugiu, D.; Barbos, D.; Datcu, A.; Aioanei, L.; Dobrea, D.; Taroiu, I. E.; Bucsa, A.; Ghinescu, A.


    A Large Sample Neutron Activation Analysis (LSNAA) facility has been developed at the TRIGA- Annular Core Pulsed Reactor (ACPR) operated by the Institute for Nuclear Research in Pitesti, Romania. The central irradiation cavity of the ACPR core can accommodate a large irradiation device. The ACPR neutron flux characteristics are well known and spectrum adjustment techniques have been successfully applied to enhance the thermal component of the neutron flux in the central irradiation cavity. An analysis methodology was developed by using the MCNP code in order to estimate counting efficiency and correction factors for the major perturbing phenomena. Test experiments, comparison with classical instrumental neutron activation analysis (INAA) methods and international inter-comparison exercise have been performed to validate the new methodology. (authors)

  1. Professional development needs of nurse educators. An Australian case study. (United States)

    Oprescu, Florin; McAllister, Margaret; Duncan, David; Jones, Christian


    Because there is a global shortage of nurse educators, highly productive and committed nurse educators are needed to supply a rapidly expanding and changing health landscape. To support the aforementioned effort professional development needs of nurse educators must be systematically identified. This study explores practical issues around professional development needs of nurse educators. One hundred and thirty eight Australian nurse educators based in Queensland answered an online survey around professional development needs. Results indicate that 83% (n = 115) of the respondents were enthusiastic about nurse education yet only 45% (n = 62) were confident in their skills and less than 10% (n = 13) saw themselves as expert nurse educators. The most desired areas of future development in teaching were information technology skills, assessment and technical knowledge. There seems to be a shared need for developing global online and offline support resources and communities of practice to support nurse educators in their teaching and research endeavours. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Development of an International School Nurse Asthma Care Coordination Model. (United States)

    Garwick, Ann W; Svavarsdóttir, Erla Kolbrun; Seppelt, Ann M; Looman, Wendy S; Anderson, Lori S; Örlygsdóttir, Brynja


    To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10-18) and to develop an asthma school nurse care coordination model. Little is known about how school nurses coordinate care for youth with asthma in different countries. A qualitative descriptive study design using focus group data. Six focus groups with 32 school nurses were conducted in Reykjavik (n = 17) and St. Paul (n = 15) using the same protocol between September 2008 and January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing healthcare needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and healthcare professionals to ensure quality care for youth with asthma. Results indicate a high level of complexity in school nurses' approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations. © 2014 John Wiley & Sons Ltd.

  3. The development of Canadian nursing: professionalization and proletarianization. (United States)

    Coburn, D


    In this article, the development of nursing in Canada is described in terms of three major time periods: the emergence of lay nursing, including organization and registration, 1870-1930; the move to the hospital, 1930-1950; and unionization and the routinization of health care, 1950 to the present. This development is viewed in the light of the orienting concepts of professionalization, proletarianization, and medical dominance (and gender analysis). This historical trajectory of nursing shows an increasing occupational autonomy but continuing struggles over control of the labor process. Nursing is now using theory, organizational changes in health care, and credentialism to help make nursing "separate from but equal to" medicine and to gain control over the day-to-day work of the nurse. Nursing can thus be viewed as undergoing processes of both professionalization and proletarianization. As nursing seeks to control the labor process, its occupational conflicts are joined to the class struggle of white-collar workers in general. Analysis of nursing indicates the problems involved in sorting out the meaning of concepts that are relevant to occupational or class analysis but which focus on the same empirical phenomenon.

  4. Registered Nurses' perceptions of their work and professional development. (United States)

    Hallin, Karin; Danielson, Ella


    This paper is a report of a study to elucidate Registered Nurses' perceptions of their work and professional development 6 years after graduation. Nursing education and health care has rapidly changed in the last two decades. Education and experience are important components in Registered Nurses' ability to promote a high quality of care, but a great deal depends on their work circumstances. This study emphasizes Registered Nurses' view of their work in health care, at a time in their career when they have several years of experience. Data were collected in 2003 from in-depth interviews with 15 Registered Nurses 6 years after their graduation. The interviews were semi-structured and analysed with interpretive content analysis. The findings revealed two themes and five sub-themes. The first theme, An appropriate but demanding profession, consisted of two sub-themes: 'having found one's niche' and 'growing old in nursing may be difficult'. The second theme, A profession with opportunities and obstacles, consisted of three sub-themes: 'being aware of Registered Nurses' potential', 'having knowledge that is seldom made use of' and 'attaining professional growth is no matter of course'. Keeping Registered Nurses' satisfied and avoiding their dissatisfaction is crucial for both educators and employers. It is essential that employers give priority to Registered Nurses' time with patients and to motivate and support them in professional development. Further intervention studies regarding a change of the balance between obstacles and opportunities are needed.

  5. Sports Facilities Development and Urban Generation


    Maassoumeh Barghchi; Dasimah B.   Omar; Mohd S.   Aman


    Problem statement: One major issue on sports facilities construction is the question of their funding and justification for investment. Due to, requirement of huge money for construction, constant maintenance costs and ancillary needs, which are almost certainly with substantial public investment, therefore, sports facilities have been considered. Further, sports facilities construction boom have been started for more than two decades. Approach: Recent sports facilities construction was not p...

  6. Nursing ethics in a developing country

    Directory of Open Access Journals (Sweden)

    Annatjie Botes


    Full Text Available Nursing is a true profession, distinguished by its philosophy of care, its full-time commitment to human well being, its particular blend of knowledge and skills and its valuable service to the community (Curtin & Flaherty, 1982:92. Ethics is vital to nursing. Being a professional implies ethical behaviour and knowledge of what it means to be ethical (Pera & Van Tonder, 1996:v. Ethics is the foundation of committed service to humankind. When nurses practice in an ethical manner they should adhere to ethical principles like autonomy, beneficence, justice, veracity, fidelity, confidentiality and privacy.

  7. Collaborative learning and competence development in school health nursing

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete; Wistoft, Karen


    and the development of their competences in school health nursing. Practical implications The paper outlines how and why collaboration among school nurses should be introduced in a more systematic way in school health nursing. Originality/value The paper investigates the connection between informal educational....... Design/methodology/approach The article is based on data from a three-year health educational development project at primary schools in Denmark. These data are a) Observations from 12 reflective workshops with school nurses b) Two questionnaire surveys c) 5 focus group interviews with 5 of the 6......Purpose The purpose of this paper is to investigate the process and learning outcomes of peer collaboration in a Danish health developmental project in school health nursing. The paper explores how peer collaboration influences the school nurses’ collaborative learning and competence development...

  8. Collaborative Learning and Competence Development in School Health Nursing (United States)

    Nordentoft, Helle Merete; Wistoft, Karen


    Purpose: The purpose of this paper is to investigate the process and learning outcomes of peer collaboration in a Danish health developmental project in school health nursing. The paper explores how peer collaboration influences the school nurses' collaborative learning and competence development. Design/methodology/approach: The article is based…

  9. [Possibilities and problems in the development of forensic nursing in Japan: a questionnaire survey of clinical nurses]. (United States)

    Kodama, Hiromi; Tsuntematsu, Kayoko; Yanai, Keiko


    Forensic nursing scientifically obtains and preserves the criminal damage from victims of domestic violence, child abuse, elder abuse, sexual violence and other related forms of violence. This was developed in North America in the 1980s, and has carried out appropriate nursing care while protecting the human rights of victims. Serious crime in Japan has been increasing, and it would seem that forensic nursing opportunities should expand as well. However, in Japan, there hasn't been much discussion about forensic nursing. Theorizing that support for clinical forensic nursing should be recognized and relevant, we carried out a survey of 581 clinical nurses to investigate the development of forensic nursing in Japan. 93 clinical nurses (16.0%) had a low level of familiarity with forensic nursing; however, 324 nurses (56.3%) had encountered patients who had suffered violence. 264 nurses (45.4%) had a feeling of wanting to be involved in forensic nursing, but were not confident with the knowledge and technology, while 144 nurses (24.8%) were concerned about the larger responsibility they would have. 400 nurses (68.8%) hoped to receive specialized knowledge and technical education. It is necessary to establish an education system for forensic nursing in accordance with the educational status-quo while considering the present state of forensic nursing education.

  10. High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia. (United States)

    Fute, Mathewos; Mengesha, Zelalem Birhanu; Wakgari, Negash; Tessema, Gizachew Assefa


    The rising rate of workplace violence in health care facilities has become a major problem for health care providers including nurses. However, evidences are lacking in Ethiopia particularly in the study area. The aim of this study is to assess the prevalence and associated factors of workplace violence among nurses working at health care facilities in Hawassa City Administration, Southern Ethiopia. An institution-based cross-sectional study was conducted on 660 randomly selected nurses working at public health facilities in Hawassa City Administration in April 2014. A pre-tested and structured questionnaire was used to collect the data. Data were entered using EPI-Info and exported to SPSS for further analysis. Descriptive statistics were done. Logistic regression analyses were used to see the association between different variables and the outcome variable. Odds ratios with 95% Confidence Interval (CI) were computed to determine the presence and strength of the association. In this study, the prevalence of workplace violence was 29.9% [95% CI: 26.5, 33.5)] of which physical violence accounted for 36 (18.22%), verbal abuse for 172 (89.58%) and sexual harassment for 25 (13.02%). Female sex [AOR=2.00, 95% CI: (1.28, 2.39)], short work experience [AOR=8.86, 95% CI: (3.47, 22.64)], age group of 22-25 [AOR=4.17, 95% CI: (2.46, 7.08)], age group of (26-35) [AOR=1.9, 95% CI (1.16, 3.1)], work in emergency [(AOR=4.28, 95% CI: (1.39, 4.34)] and work in the Inpatient Department [(AOR=2.11, 95% CI: (1.98, 2.64)] were the factors positively associated with workplace violence. A significant proportion of nurses faced violence while providing care at in public health facilities. Being female, younger age, short work experience, and assignment in emergency and inpatient departments were positively associated with workplace violence. Policy makers and stakeholders should focus on workplace violence prevention strategies.

  11. Teaching ergonomics to nursing facility managers using computer-based instruction. (United States)

    Harrington, Susan S; Walker, Bonnie L


    This study offers evidence that computer-based training is an effective tool for teaching nursing facility managers about ergonomics and increasing their awareness of potential problems. Study participants (N = 45) were randomly assigned into a treatment or control group. The treatment group completed the ergonomics training and a pre- and posttest. The control group completed the pre- and posttests without training. Treatment group participants improved significantly from 67% on the pretest to 91% on the posttest, a gain of 24%. Differences between mean scores for the control group were not significant for the total score or for any of the subtests.

  12. Developing practical knowledge content of emergency nursing professionals. (United States)

    Chu, Wen; Hsu, Li-Ling


    There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

  13. Use and development of teaching technologies presented in nursing research

    Directory of Open Access Journals (Sweden)

    Pétala Tuani Candido de Oliveira Salvador


    Full Text Available Objective: characterizing teaching technologies used or developed in nursing dissertations and theses in Brazil. Methods: a documentary research that had data collection sourced from directories of theses and dissertations available on the website of the Brazilian Nursing Association, from Volumes Nineteen (XIX (2001 to Twenty-one (XXI (2013. Results: of 6346 studies, 18 (0.28% used or developed teaching technologies, composed of the following categories: use of conceptual map; use of games; development of Virtual Learning Environment; development of educational materials; development of Distance Education courses; and artifact development. Conclusion: national research on the development and use of teaching technology in nursing are still insufficient, especially in the North and Northeast. Multiple benefits of the use of teaching technologies in nursing and learning environments were highlighted, not only for students and professionals, but also for patients.

  14. Training development in Juzbado's Fuel Cycle Facility

    International Nuclear Information System (INIS)

    Perez, A.; Cunado, E.; Ortiz, D.


    In Juzbado's fuel cycle facility, because of the special activities developed, training is a very important issues. Training has been evolved, due to changes on the standards applicable each moment, and also due to the technological resources available. Both aspects have resulted in an evolution of the documents referred to training, such as training programs procedures, Radiation Protection Manual as well as the teaching methods. In the report we are going to present, we will show more precisely the changes that take place, referring to the different training methods used, present training sanitations, and the improvements already planned in training subjects as well as tools used, accomplishing with the legislation and improving in our effort of a better assimilation of the necessary knowledge. (Author)

  15. Developing a transcultural nursing leadership institute in China. (United States)

    Capitulo, Kathleen Leask


    Globalization has been the hallmark of the 21st century. This article focuses on developing the Transcultural Nursing Leadership Institute (TCNLI) in China. This project built a leadership program in Wenzhou, China, empowering and supporting nurses to solve problems in their own practices with evidence-based approaches and local resources using the Dreyfus International Health Foundation's method Problem Solving for Better Health (PSBH).The partnership began when I was a Visiting Professor in Wenzhou, China and established collegial relationships with the Dean of the School of Nursing and the Chief Nursing Officers of the affiliated hospitals. In contrast to previous visiting scholars who went to China to lecture on health issues, I sought to develop a sustainable program and make a lasting contribution to the nursing practice in Wenzhou. The PSBH model was the method for what became the TCNLI. The TCNLI has taught over 200 nursing leaders to develop and implement major projects and connected them to the global nursing community by facilitating joint research, publications, and education. The journeys "across the bridge" from New York to Wenzhou have taken nursing and healthcare leaders from the United States to China and reciprocally welcomed leaders from Wenzhou to the United States for professional experiences. Outcomes of our partnership include more than 200 completed change projects. International partnerships within the global healthcare community provide a vehicle to navigate the complexities of transcultural differences and ultimately a way to bridge the gap and improve global healthcare.

  16. Development of circular filters for active facilities

    International Nuclear Information System (INIS)

    Pratt, R.P.


    An assessment of problems associated with remote handling, changing and disposal of filters suggested that significant improvements to filtration systems could be made if circular geometries were adopted in place of conventional systems. Improved systems have been developed and are now available for a range of applications and air flow rates. Where primary filters are installed within the active cell or cave, circular filters incorporating a lip seal have been developed which enable the filters to be sealed into the facility without recourse to clamping. For smaller cells, a range of push-through filter change systems have been developed, the principal feature being that the filter is passed into the housing from the clean side, but transferred from the housing directly into the cell for subsequent disposal. For plant room applications, circular bag change canister systems have been developed which ease the sealing and bag change operation. Such systems have a rated air flow of up to 3000 m 3 /h whilst still allowing ultimate disposal via the 200 litre waste drum route without prior volume reduction of the filter inserts. (author)

  17. A formative model for student nurse development and evaluation

    Directory of Open Access Journals (Sweden)

    A. S. van der Merwe


    Full Text Available Preparing student nurses for the profession is a complex task for nurse educators; especially when dealing with the development of personal and interpersonal skills, qualities and values held in high esteem by the nursing profession and the community they serve. These researchers developed a model for formative evaluation of students by using the principles of inductive and deductive reasoning. This model was implemented in clinical practice situations and evaluated for its usefulness. It seems that the model enhanced the standards of nursing care because it had a positive effect on the behaviour of students and they were better motivated; the model also improved interpersonal relationships and communication between practising nurses and students.

  18. Developing a longitudinal cancer nursing education program in Honduras. (United States)

    Sheldon, Lisa Kennedy; Wise, Barbara; Carlson, Julie R; Dowds, Cynthia; Sarchet, Vanessa; Sanchez, Jose Angel


    The present paper is a longitudinal study which aims to develop and deliver cancer nursing education conferences in Honduras using volunteer nurse educators. This program intends to (1) perform site assessments of work environments and resources for cancer care in Honduras, (2) develop cancer nursing education programs, (3) survey conference participants continuing education needs, (4) deliver cancer nursing education conferences, and (5) share data with local and global partners for future cancer programs. The study draws on a longitudinal program development with site assessments, data collection, and educational conferences at two time points. Assessments and surveys were used for conference development and delivery by volunteer nurse educators. Site assessments and conferences were delivered twice. Data were collected regarding assessments and surveys to inform program development. Survey data revealed that 65 % had internet access. Participants desired more information about handling of chemotherapy, symptom management, and palliative care. Volunteer nurse educators perform site assessments and develop educational programming for cancer nurses. Local and global partners should explore internet-based programs between site visits to create sustainable education programs.

  19. Medical students' professional identity development in an early nursing attachment. (United States)

    Helmich, Esther; Derksen, Els; Prevoo, Mathieu; Laan, Roland; Bolhuis, Sanneke; Koopmans, Raymond


    The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an assistant nurse while training to be a doctor may offer valuable learning experiences, but may also present the student with difficulties with respect to identity and identification issues. The aim of the present study was to describe first-year medical students' perceptions of nurses, doctors and their own future roles as doctors before and after a nursing attachment. A questionnaire containing open questions concerning students' perceptions of nurses, doctors and their own future roles as doctors was administered to all Year 1 medical students (n=347) before and directly after a 4-week nursing attachment in hospitals and nursing homes. We carried out two confirmatory focus group interviews. We analysed the data using qualitative and quantitative content analyses. The questionnaire was completed by 316 students (response rate 91%). Before starting the attachment students regarded nurses as empathic, communicative and responsible. After the attachment students reported nurses had more competencies and responsibilities than they had expected. Students' views of doctors were ambivalent. Before and after the attachment, doctors were seen as interested and reliable, but also as arrogant, detached and insensible. However, students maintained positive views of their own future roles as doctors. Students' perceptions were influenced by age, gender and place of attachment. An early nursing attachment engenders more respect for the nursing profession. The ambivalent view of doctors needs to be explored further in relation to students' professional development. It would seem relevant to attune supervision to the age and gender differences revealed in this study.

  20. Development of a Quantitative Measure of Holistic Nursing Care. (United States)

    Kinchen, Elizabeth


    Holistic care has long been a defining attribute of nursing practice. From the earliest years of its formal history, nursing has favored a holistic approach in the care of patients, and such an approach has become more important over time. The expansion of nursing's responsibility in delivering comprehensive primary care, the recognition of the importance of relationship-centered care, and the need for evidence-based legitimation of holistic nursing care and practices to insurance companies, policy-makers, health care providers, and patients highlight the need to examine the holistic properties of nursing care. The Holistic Caring Inventory is a theoretically sound, valid, and reliable tool; however, it does not comprehensively address attributes that have come to define holistic nursing care, necessitating the development of a more current instrument to measure the elements of a holistic perspective in nursing care. The development of a current and more comprehensive measure of holistic nursing care may be critical in demonstrating the importance of a holistic approach to patient care that reflects the principles of relationship-based care, shared decision-making, authentic presence, and pattern recognition. © The Author(s) 2014.

  1. Development of the Jyvaeskylae microbeam facility

    Energy Technology Data Exchange (ETDEWEB)

    Norarat, Rattanaporn, E-mail: [Department of Physics, University of Jyvaeskylae, P.O. Box 35 (YFL), FIN-40014 Jyvaeskylae (Finland); Sajavaara, Timo; Laitinen, Mikko; Heikkinen, Pauli; Ranttila, Kimmo; Ylikorkala, Kari; Haenninen, Vaeinoe; Rossi, Mikko; Jones, Pete [Department of Physics, University of Jyvaeskylae, P.O. Box 35 (YFL), FIN-40014 Jyvaeskylae (Finland); Marjomaeki, Varpu; Gilbert, Leona [Department of Environmental and Biological Sciences, University of Jyvaeskylae, P.O. Box 35 (YFL), FIN-40014 Jyvaeskylae (Finland); Whitlow, Harry J. [Department of Physics, University of Jyvaeskylae, P.O. Box 35 (YFL), FIN-40014 Jyvaeskylae (Finland)


    Research highlights: Black-Right-Pointing-Pointer A MeV ion microbeam for biomedical materials research is being developed. Black-Right-Pointing-Pointer High accuracy scanning using electrostatic post-focus deflection. Black-Right-Pointing-Pointer Imaging and direct lithographic image writing using time-stamping methods. Black-Right-Pointing-Pointer New scanning modes and fluorescence detectors permit low ion-fluence cell imaging. Black-Right-Pointing-Pointer Thermal compensated beam-line support design for high positional accuracy. - Abstract: A new microbeam facility is being constructed at the 1.7 MV Pelletron Accelerator in Jyvaeskylae. The facility is designed for easy upgrading and incorporates a number of innovative features. Initially, it is based on a Heidelberg doublet with a design capability of a 3 Multiplication-Sign 5 {mu}m beamspot at PIXE intensities and later upgraded to nanobeam performance. A thermal-expansion compensated rigid frame mounted on a mechanically isolated floor section is used to support the ion optical components. A compact-post focusing electrostatic deflector is used for high linearity beam scanning. This together with a novel time-stamped data collection (TDC) allows dynamic effects in IBIC, fluorescence bleaching to be studied as well as facilitating multi-resolution image support for low-fluence imaging of cells. The target chamber is fitted with a novel low-cost large working distance optical microscope, extremely compact large solid angle photon detectors as well as conventional secondary electron, PIXE and Scanning Transmission Ion Microscopy (STIM) detectors.

  2. A facility specialist model for improving retention of nursing home staff: results from a randomized, controlled study. (United States)

    Pillemer, Karl; Meador, Rhoda; Henderson, Charles; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie


    This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and Connecticut and randomly assigned to treatment and control conditions. Staff outcomes were measured through certified nursing assistant interviews, and turnover rates were measured over the course of the year. In the intervention condition, a staff member was selected to be the facility retention specialist, who would advocate for and implement programs to improve staff retention and commitment throughout the facility. Retention specialists received an intensive 3-day training in retention leadership and in a number of evidence-based retention programs. Ongoing support was provided throughout the project. Treatment facilities experienced significant declines in turnover rates compared to control facilities. As predicted, we found positive effects on certified nursing assistant assessments of the quality of retention efforts and of care provided in the facility; we did not find effects for job satisfaction or stress. The study provides evidence for the effectiveness of the retention specialist model. Findings from a detailed process evaluation suggest modifications of the program that may increase program effects.

  3. Nursing Administrators' Views on Oral Health in Long-Term Care Facilities: An exploratory study. (United States)

    Urata, Janelle Y; Couch, Elizabeth T; Walsh, Margaret M; Rowe, Dorothy J


    Purpose: To explore the knowledge, attitudes, and practices of supervising nurse administrators (SNAs) regarding the oral care provided to long-term care facility (LTCF) residents and the role of dental professionals in those facilities. Methods: The investigators of this study partnered with the National Association of Nursing Administrators to send this cross-sectional study consisting of a 35-item electronic survey to its members whose email addresses were in their database. Online software tabulated responses and calculated frequencies (percentages) of responses for each survey item. Results: Of the 2,359 potential participants, 171 (n=171) completed the survey for a 7% response rate. Only 25% of the respondents were familiar with the expertise of dental hygienists (DHs), however once informed, the majority were interested in having DHs perform oral health staff trainings, oral screenings, and dental referrals and initiate fluoride varnish programs. Most respondents correctly answered the oral health-related knowledge items, understood that oral health is important to general health, but reported that the LTCF residents' oral health was only "good" or "fair." Fewer than half, (48%) of the SNAs were "very satisfied" with the quality of oral care provided to the residents. While more than half reported that they had no dentist on staff or on-site dental equipment, 77% reported that they would consider on-site mobile oral care services. Oral health training for staff was provided primarily by registered nurses, however only 32% reported including identification of dental caries as part of the in-service training. Conclusion: This exploratory study lays the foundation for more extensive research investigating various strategies to improve the oral health of LTCF residents, including increased collaboration between DHs and SNAs. Copyright © 2018 The American Dental Hygienists’ Association.

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

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


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

  5. Development of a state radioactive materials storage facility

    International Nuclear Information System (INIS)

    Schmidt, P.S.


    The paper outlines the site selection and facility development processes of the state of Wisconsin for a radioactive materials facility. The facility was developed for the temporary storage of wastes from abandoned sites. Due to negative public reaction, the military site selected for the facility was removed from consideration. The primary lesson learned during the 3-year campaign was that any project involving radioactive materials is a potential political issue

  6. [Swiss Research Agenda for Nursing (SRAN): the development of an agenda for clinical nursing research in Switzerland]. (United States)

    Imhof, Lorenz; Abderhalden, Christoph; Cignacco, Eva; Eicher, Manuela; Mahrer-Imhof, Romy; Schubert, Maria; Shaha, Maya


    In many Anglo-Saxon and North European countries nursing research agendas have been developed to address priorities in nursing research in accordance with a nationally defined health policy. In Switzerland, due to lack of a nationwide governmental health policy, co-ordination of nursing research so far was scarce. The "Swiss Research Agenda for Nursing (SRAN)" project developed an agenda for clinical nursing research between 2005 and 2007. Based on literature reviews, expert panels and a national survey a project team formulated an agenda which passed a consensus conference. The agenda recommends aspects that should lead research and defines seven research priorities for nursing in Switzerland for the time between 2007 and 2017. Nursing research should prioritize to investigate 1) the effectiveness of nursing interventions; 2) the influences of service adaptations in a changing health care system; 3) the phenomena in patients requiring nursing care; 4) the influence of the work environment on the quality of nursing care; 5) the functioning of family and social systems; 6) varieties of life circumstances and their integration; and 7) the implementation of ethical principles in nursing. Written in German and French, the Swiss Research Agenda for Nursing for the first time formulates priorities for nursing research in Switzerland and can be used for strategic discussions. As a next step, the development of an action plan to enhance nursing research will take place in Switzerland.

  7. Sustainable Facility Development: Perceived Benefits and Challenges (United States)

    Stinnett, Brad; Gibson, Fred


    Purpose: The purpose of this paper is to assess the perceived benefits and challenges of implementing sustainable initiatives in collegiate recreational sports facilities. Additionally, this paper intends to contribute to the evolving field of facility sustainability in higher education. Design/methodology/approach The design included qualitative…

  8. Leadership development needs of managers who supervise foreign nurses. (United States)

    Sherman, Rose O


    This concept paper seeks to outline evidenced-based findings about the current experiences, best practices and leadership development needs of nurse leaders who work with foreign nurses. A qualitative approach was used to collect data for this project. A convenience sample of ten nursing leaders from different geographic areas in the USA was telephone interviewed to obtain information for this project. Recommendations are made about the type of educational programming that leaders who receive foreign nurses in their work environments will need to facilitate a successful transition. The legal, ethical and human resource issues that surround the international recruitment of nurses have received widespread coverage in the media and nursing literature. Although organizations which do foreign recruitment invest significant resources, little has been written about the challenges in the transition of foreign nurses into healthcare practice environments outside their countries of origin. The literature suggests that the successful transition of foreign nurses into the healthcare environment of another country requires supportive leadership but this does not always occur.

  9. Healthcare worker influenza vaccination in Oregon nursing homes: correlates of facility characteristics. (United States)

    Campbell, Lauren J; Li, Qinghua; Li, Yue


    Nursing home (NH) employee influenza vaccination is associated with reductions in morbidity and mortality among residents. Little is known regarding associations between NH characteristics and employee influenza vaccination rates (EVRs). This study identifies NH characteristics that may be associated with EVRs. Data on employee vaccination rates and programs were gathered from the Office for Oregon Health Policy and Research reports for 3 influenza seasons from 2009 to 2012 and merged with Online Survey, Certification, and Reporting files, from which facility characteristics were obtained. Market controls were obtained from the 2010 Area Health Resource File. Multivariate linear and logistic regression were used to model relationships between facility characteristics and EVR per facility per year, whether formal education for employees was conducted, and whether 2010, 2015, and 2020 Healthy People targets were met. Oregon nursing homes from 2009 to 2012. NHs reporting sufficient data to calculate an EVR were included. Based on information obtained from 2009-2010, 2010-2011, and 2011-2012 surveys, EVRs were calculated for 113/140, 129/141, and 137/140 (81%, 91%, and 98% of) NHs, respectively. Dependent variables were EVR per facility per year, whether formal education for employees was conducted, and whether 2010, 2015, and 2020 Healthy People targets were met. Independent variables included facility characteristics and market controls. On average, chain-affiliated NHs had 9% higher EVRs (P = .01) and 73% higher odds of achieving 60% EVR (2010 target, P = .05) than free-standing NHs. For-profit NHs had, on average, 8% lower EVRs (P = .04) than not-for-profit NHs. Surprisingly, a 10% increase in proportion of Medicaid residents was associated with a 2% increase in EVR (P = .01) and higher odds of achieving 60% (odds ratio = 1.20, P = .004) and 70% (2015 target, odds ratio = 1.14, P = .05) EVR. Given that NHs generally have low employee influenza vaccination

  10. Medications Associated with Geriatric Syndromes (MAGS) and their Prevalence in Older Hospitalized Adults Discharged to Skilled Nursing Facilities (United States)

    Saraf, Avantika A.; Peterson, Alec W.; Simmons, Sandra F.; Schnelle, John F.; Bell, Susan P.; Kripalani, Sunil; Myers, Amy P.; Mixon, Amanda S.; Long, Emily A.; Jacobsen, J. Mary Lou; Vasilevskis, Eduard E.


    Background More than half of the hospitalized older adults discharged to skilled nursing facilities (SNFs) have more than three geriatric syndromes. Pharmacotherapy may be contributing to geriatric syndromes in this population. Objectives Develop a list of medications associated with geriatric syndromes and describe their prevalence in patients discharged from acute care to skilled nursing facilities (SNFs) Design Literature review and multidisciplinary expert panel discussion, followed by cross-sectional analysis. Setting Academic Medical Center in the United States Participants 154 hospitalized Medicare beneficiaries discharged to SNFs Measurements Development of a list of medications that are associated with six geriatric syndromes. Prevalence of the medications associated with geriatric syndromes was examined in the hospital discharge sample. Results A list of 513 medications was developed as potentially contributing to 6 geriatric syndromes: cognitive impairment, delirium, falls, reduced appetite or weight loss, urinary incontinence, and depression. Medications included 18 categories. Antiepileptics were associated with all syndromes while antipsychotics, antidepressants, antiparkinsonism and opioid agonists were associated with 5 geriatric syndromes. In the prevalence sample, patients were discharged to SNFs with an overall average of 14.0 (±4.7) medications, including an average of 5.9 (±2.2) medications that could contribute to geriatric syndromes, with falls having the most associated medications at discharge, 5.5 (±2.2). Conclusions Many commonly prescribed medications are associated with geriatric syndromes. Over 40% of all medications ordered upon discharge to SNFs were associated with geriatric syndromes and could be contributing to the high prevalence of geriatric syndromes experienced by this population. PMID:27255830

  11. Developing Adaptive Junior Leaders in the Army Nurse Corps (United States)


    Nursing at the University of Pennsylvania, Eileen Lake, developed the PES-NWI, which reflects the original Nursing Work Index except that data is...First Lieutenant Doe’s objectives so that the developmental plan reflected their consideration of the leadership capability needs of the ANC (the grayed ...2011) for First Lieutenant Doe’s consideration (the gray portion of box 18 in figure 4). Together, the officers develop measures of success, a plan

  12. Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline. (United States)

    Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar


    Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.

  13. [Centennial retrospective on the evolution and development of nursing research in Taiwan]. (United States)

    Tzeng, Wen-Chii; Lu, Meei-Shiow


    Nursing is a distinct branch of science. Nursing research is not only key to developing professional knowledge and but also to promoting nursing as an independent discipline. This paper describes the development and outcomes of nursing research over the past 100 years and then explores the factors that have influenced the focus of nursing research in the past. Findings may be applied to future efforts to promote nursing research. The authors hope that nurses integrate the best research evidence, the best clinical judgment, and the expectations of patients in order to provide the best quality of nursing care through reflection and praxis in nursing research.

  14. Safety analysis of DUPIC fuel development facility

    International Nuclear Information System (INIS)

    Lee, H. H.; Park, J. J.; Shin, J. M.; Yang, M. S.; Baek, S. Y.; Ahn, J. Y.


    Various experimental facilities are necessary in order to perform experimental verification for development of DUPIC fuel fabrication technology. In special, since highly radioactive material such as spent PWR fuel is used for this experiment, DUPIC fuel fabrication has to be performed in hot cell by remote handling. Therefore, it should be provided with proper engineering requirement and safety. M6 hot cell of IMEF which is to used for DUPIC fuel fabrication experiment was constructed as an α-γ hot cell for material examination of small amount of high-burnup fuel. The characteristics and amount of spent fuel for DUPIC fuel fabrication experiment will be different from the original design criteria. Therefore, the increased amount of spent fuel and different characteristics of experiment result in not only change of shielding and enviornmental evaluation results but new requirement of nuclear criticality evaluation. Therefore, this study includes evaluation of shielding, environmental effect and nuclear criticality in case that IMEF M6 hot cell is used for DUPIC fuel fabrication

  15. Further development of NEPTUN photon tagging facility

    Energy Technology Data Exchange (ETDEWEB)

    Symochko, Dmytro; Arnould, Michaela; Aumann, Thomas; Baumann, Martin; Pietralla, Norbert; Scheit, Heiko; Semmler, Diego; Walz, Christopher [Institut fuer Kernphysik, Darmstadt Univ. (Germany)


    The low-energy photon tagging facility NEPTUN at the superconducting Darmstadt linear accelerator (SDALINAC) has been constructed with the aim to study the photoabsorption cross section of the nuclei in the energy regions of Pygmy Dipole and Giant Dipole Resonances. Recently it went through the series of commissioning runs, which proved the concept and the ability of NEPTUN to tag the discreet nuclear states. Also, based on the results of the commissioning, major upgrade was developed to optimize the setup. Upgraded tagger will be able to operate with 60 MeV electron beam and will have extended focal plane with energy bite of more than 10 MeV. After completion of upgrade it will be possible to perform total dipole response measurement in the energy region 5-35 MeV for one target using only 2-3 settings of the spectrometer. Presentation will focus on the analysis results of commissioning runs and details of the proposed upgrade plan.

  16. Nurses' attitudes and experiences surrounding palliative sedation: components for developing policy for nursing professionals. (United States)

    Patel, Bansari; Gorawara-Bhat, Rita; Levine, Stacie; Shega, Joseph W


    Nurses play an integral role in providing care for patients with end of life (EOL) symptoms refractory to conventional treatments and that may necessitate palliative sedation (PS). A paucity of research on nurses' attitudes, knowledge, and experience with PS exists, despite nurses being instrumental in evaluating its appropriateness and carrying out the care plan. The objective of the study was to elicit nurses' perspectives and conceptualizations of knowledge and skills needed to administer PS in order to inform development of a hospital policy that addresses identified concerns. Four focus groups were conducted with nurses likely to have had exposure to PS (oncology, intensive care, and hospice) at an academic medical center. Focus groups were audiotaped, transcribed verbatim, and coded for salient themes. Grounded theory principles were used for the analysis. Among the four focus groups (n=31), 87% were female, 58% between the ages of 36 and 55, and more than 40% reported 10-plus years of providing patient care. Five domains emerged as important in developing a PS policy: 1) ability to define PS; 2) criterion for using PS; 3) skill set for administering PS; 4) policy and procedural guidelines; and 5) education on PS and EOL care. Nurses identified knowledge, skills, and guidelines as key considerations for implementing PS. Comprehensive policies along with adequate training are needed to expand the availability of PS in acute care hospitals and hospice programs.

  17. Nurses' Attitudes and Experiences Surrounding Palliative Sedation: Components for Developing Policy for Nursing Professionals (United States)

    Gorawara-Bhat, Rita; Levine, Stacie; Shega, Joseph W.


    Abstract Background Nurses play an integral role in providing care for patients with end of life (EOL) symptoms refractory to conventional treatments and that may necessitate palliative sedation (PS). A paucity of research on nurses' attitudes, knowledge, and experience with PS exists, despite nurses being instrumental in evaluating its appropriateness and carrying out the care plan. Objective The objective of the study was to elicit nurses' perspectives and conceptualizations of knowledge and skills needed to administer PS in order to inform development of a hospital policy that addresses identified concerns. Methods Four focus groups were conducted with nurses likely to have had exposure to PS (oncology, intensive care, and hospice) at an academic medical center. Focus groups were audiotaped, transcribed verbatim, and coded for salient themes. Grounded theory principles were used for the analysis. Results Among the four focus groups (n=31), 87% were female, 58% between the ages of 36 and 55, and more than 40% reported 10-plus years of providing patient care. Five domains emerged as important in developing a PS policy: 1) ability to define PS; 2) criterion for using PS; 3) skill set for administering PS; 4) policy and procedural guidelines; and 5) education on PS and EOL care. Conclusions Nurses identified knowledge, skills, and guidelines as key considerations for implementing PS. Comprehensive policies along with adequate training are needed to expand the availability of PS in acute care hospitals and hospice programs. PMID:22500480

  18. Using constructive alignment theory to develop nursing skills curricula. (United States)

    Joseph, Sundari; Juwah, Charles


    Constructive alignment theory has been used to underpin the development of curricula in higher education for some time (Biggs and Tang, 2007), however, its use to inform and determine skills curricula in nursing is less well documented. This paper explores the use of constructive alignment theory within a study of undergraduate student nurses undertaking clinical skill acquisition in the final year of a BSc (Hons) Nursing course. Students were followed up as newly qualified nurses (NQN) (n = 58) to ascertain the impact of skill acquisition in this way. Comparisons were made with newly qualified nurses who did not participate in a constructively aligned curriculum. This mixed methods study reported skill identification within the immediate post-registration period and evaluated the constructively aligned curriculum as having positive benefits for NQNs in terms of confidence to practice. This was supported by preceptors' views. The study recommends two process models for nursing skills curriculum development and reports that constructive alignment is a useful theoretical framework for nurse educators. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. 40 CFR 256.42 - Recommendations for assuring facility development. (United States)


    ... facilities and practices to be developed by responsible State and substate agencies or by the private sector... sector initiatives in order to meet the identified facility needs. (e) In any area having fewer than 2... establish procedures for choosing which facilities will get priority for technical or financial assistance...

  20. Decontamination Technology Development for Nuclear Research Facilities

    International Nuclear Information System (INIS)

    Choi, W. K.; Jung, C. H.; Oh, W. Z.


    The originative CO 2 pellet blasting equipment was developed by improving additional components such as feed screw, idle roller and air-lock feeder to clear up the problems of freezing and discontinuity of blasting and by adopting pneumatically operated vacuum suction head and vacuum cup to prevent recontamination by collecting contaminant particulates simultaneously with the decontamination. The optimum decontamination process was established according to the kind of materials such as metal, concrete and plastic and the type of contaminants such as particulate, fixed chemical compound and oil. An excellent decontamination performances were verified by means of the lab-scale hot test with radioactive specimen and the technology demonstration in IMEF hot cell. The PFC dry decontamination equipment applicable to the surface contaminated with high radioactive particulate was developed. This equipment consists of the unit processes such as spray, collection, filtration and dry distillation designed originatively applicable to inside of dry hot cell. Through the demonstration of PFC spray decontamination process in IMEF hot cell, we secured on-site applicability and the decontamination efficiency more than 90 %. We investigated the characteristics of dismantled metal waste melting and the radionuclide(Co, Cs, U) distribution into ingot and slag by melting decontamination experiments using electric arc melter. We obtained the decontamination factors greater than 100 for Cs and of 10∼100 for uranium. The pilot scale(200 kg/batch) demonstration for melting decontamination was carried out successfully using high temperature melting facility at KAERI. The volume reduction factor of 1/7 and the economical feasibility of the melting decontamination were verified.

  1. The Implementation of a Structured Nursing Leadership Development Program for Succession Planning in a Health System. (United States)

    Ramseur, Priscilla; Fuchs, Mary Ann; Edwards, Pamela; Humphreys, Janice


    Preparing future nursing leaders to be successful is important because many current leaders will retire in large numbers in the future. A structured nursing leadership development program utilizing the Essentials of Nurse Manager Orientation online program provided future nursing leaders with content aligned with nursing leadership competencies. Paired with assigned mentors and monthly leadership sessions, the participants increased their perception of leadership competence.

  2. Human rights conflicts experienced by nurses migrating between developed countries. (United States)

    Palese, Alvisa; Dobrowolska, Beata; Squin, Anna; Lupieri, Giulia; Bulfone, Giampiera; Vecchiato, Sara


    Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. The call for investing in nurses and nurses' care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

  3. The embodied nurse: Interdisciplinary knowledge exchange between compassionate nursing and recent developments in embodied leadership studies. (United States)

    Koya, Kushwanth; Anderson, Jane; Sice, Petia


    To report a potential knowledge exchange between nursing studies and the results obtained from a study conducted into the attributes of embodied leadership. Leadership theories have been applied to evaluate, improve, and train nursing practitioners in several previous studies. However, leadership research has entered a new phase where the focus is to produce sustainable leaders through authenticity and compassion, the same two characteristics identified as being of most success in emergent nursing practice. There are few studies that have indicated a knowledge exchange between the latest developments in leadership studies and nursing. An exploratory and qualitative study. Between February 2012 - July 2012, a focused sample of 14 medical care professionals was interviewed across a chain of hospitals. The aim was to evaluate embodied leadership characteristics and understand the factors that contribute to the manifestation of these characteristics. The transcribed interviews were analysed using thematic analysis. Several factors that contribute to the characteristics of embodied leadership have been identified in the interviews and in subsequent literature searches on the characteristics and contributing factors found to be associated with nursing research. These could prompt a knowledge exchange. The results suggest common ground between nursing and contemporary leadership research in the exposition of behaviours; namely, being non-judgmental, listening actively, reflective practice and embracing uncertainty. Several implications can therefore be expected through the exchange of knowledge resulting from collaboration between researchers in the two disciplines. © 2017 John Wiley & Sons Ltd.

  4. Nursing home quality: a comparative analysis using CMS Nursing Home Compare data to examine differences between rural and nonrural facilities. (United States)

    Lutfiyya, May Nawal; Gessert, Charles E; Lipsky, Martin S


    Advances in medicine and an aging US population suggest that there will be an increasing demand for nursing home services. Although nursing homes are highly regulated and scrutinized, their quality remains a concern and may be a greater issue to those living in rural communities. Despite this, few studies have investigated differences in the quality of nursing home care across the rural-urban continuum. The purpose of this study was to compare the quality of rural and nonrural nursing homes by using aggregated rankings on multiple quality measures calculated by the Centers for Medicare and Medicaid Services and reported on their Nursing Home Compare Web site. Independent-sample t tests were performed to compare the mean ratings on the reported quality measures of rural and nonrural nursing homes. A linear mixed binary logistic regression model controlling for state was performed to determine if the covariates of ownership, number of beds, and geographic locale were associated with a higher overall quality rating. Of the 15,177 nursing homes included in the study sample, 69.2% were located in nonrural areas and 30.8% in rural areas. The t test analysis comparing the overall, health inspection, staffing, and quality measure ratings of rural and nonrural nursing homes yielded statistically significant results for 3 measures, 2 of which (overall ratings and health inspections) favored rural nursing homes. Although a higher percentage of nursing homes (44.8%-42.2%) received a 4-star or higher rating, regression analysis using an overall rating of 4 stars or higher as the dependent variable revealed that when controlling for state and adjusting for size and ownership, rural nursing homes were less likely to have a 4-star or higher rating when compared with nonrural nursing homes (OR = .901, 95% CI 0.824-0.986). Mixed model logistic regression analysis suggested that rural nursing home quality was not comparable to that of nonrural nursing homes. When controlling for

  5. Developing and Sustaining a Career as a Transdisciplinary Nurse Scientist. (United States)

    Hickey, Kathleen T


    The purpose of this article is to provide an overview of strategies to build and sustain a career as a nurse scientist. This article examines how to integrate technologies and precision approaches into clinical practice, research, and education of the next generation of nursing scholars. This article presents information for shaping a sustainable transdisciplinary career. Programs of research that utilize self-management to improve quality of life are discussed throughout the article. The ongoing National Institute of Nursing Research-funded (R01 grant) iPhone Helping Evaluate Atrial Fibrillation Rhythm through Technology (iHEART) study is the first prospective, randomized controlled trial to evaluate whether electrocardiographic monitoring with the AliveCor™ device in the real-world setting will improve the time to detection and treatment of recurrent atrial fibrillation over a 6-month period as compared to usual cardiac care. Opportunities to sustain a career as a nurse scientist and build programs of transdisciplinary research are identified. These opportunities are focused within the area of research and precision medicine. Nurse scientists have the potential and ability to shape their careers and become essential members of transdisciplinary partnerships. Exposure to clinical research, expert mentorship, and diverse training opportunities in different areas are essential to ensure that contributions to nursing science are visible through publications and presentations as well as through securing grant funding to develop and maintain programs of research. Transcending boundaries and different disciplines, nurses are essential members of many diverse teams. Nurse scientists are strengthening research approaches, clinical care, and communication and improving health outcomes while also building and shaping the next generation of nurse scientists. © 2017 Sigma Theta Tau International.

  6. Leading the development of nursing within a Nursing Development Unit: the perspectives of leadership by the team leader and a professor of nursing. (United States)

    Graham, Iain


    Leadership within nursing is receiving unprecedented focus and development. This reflective narrative explores the nature of leadership, termed scholarly leadership, by an academic and a clinical leader of a Nursing Development Unit. The narrative explores the characteristics of such leadership and highlights how it empowered a nursing team to further reach its potential. Two areas, patient-centered care and the characteristics of practice, are focused upon to highlight the leadership style that the clinical leader adopted. The paper concludes by suggesting what structural and systems changes need to be put in place in order to bring about change.

  7. Supporting nurse mentor development: An exploration of developmental constellations in nursing mentorship practice. (United States)

    MacLaren, Julie-Ann


    Supervised practice as a mentor is currently an integral component of nurse mentor education. However, workplace education literature tends to focus on dyadic mentor-student relationships rather than developmental relationships between colleagues. This paper explores the supportive relationships of nurses undertaking a mentorship qualification, using the novel technique of constellation development to determine the nature of workplace support for this group. Semi-structured interviews were conducted with three recently qualified nurse mentors. All participants developed a mentorship constellation identifying colleagues significant to their own learning in practice. These significant others were also interviewed alongside practice education, and nurse education leads. Constellations were analysed in relation to network size, breadth, strength of relationships, and attributes of individuals. Findings suggest that dyadic forms of supervisory mentorship may not offer the range of skills and attributes that developing mentors require. Redundancy of mentorship attributes within the constellation (overlapping attributes between members) may counteract problems caused when one mentor attempts to fulfil all mentorship roles. Wider nursing teams are well placed to provide the support and supervision required by mentors in training. Where wider and stronger networks were not available to mentorship students, mentorship learning was at risk. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  8. DOE research and development and field facilities

    Energy Technology Data Exchange (ETDEWEB)


    This report describes the roles of DOE's headquarters, field offices, major multiprogram laboratories, Energy Technology and Mining Operations Centers, and other government-owned, contractor-operated facilities which are located in all regions of the United States. It gives brief descriptions of resources, activities, and capabilities of each field facility (sections III through V). These represent a cumulative capital investment of $12 billion and involve a work force of approximately 12,000 government (field) employees and approximately 100,000 contractor employees.

  9. Comparison of postarthroplasty functional outcomes in skilled nursing facilities among Medicare and Managed Care beneficiaries

    Directory of Open Access Journals (Sweden)

    Brandon A. Haghverdian, BSc


    Full Text Available Background: After home health care, the skilled nursing facility (SNF is the most commonly used postacute care modality, among Medicare beneficiaries, after total joint arthroplasty. Prior studies demonstrated that a loss in postsurgical ambulatory gains is incurred in the interval between hospital discharge and arrival at the SNF. The aim of this present study is to determine the consequences of that loss in function, as well as compare SNF-related outcomes in patients with Medicare vs Managed Care (MC insurance. Methods: We conducted a retrospective analysis of 80 patients (54 Medicare and 26 MC who attended an SNF after hospitalization for total joint arthroplasty. Outcomes from physical therapy records were abstracted from each patient's SNF file. Results: There was an approximately 40% drop-off in gait achievements between hospital discharge and SNF admission. This decline in ambulation was significantly greater in Medicare patients (Medicare: 94.6 ± 123.2 ft, MC: 40.0 ± 48.9 ft, P = .034. Larger reductions in gait achievements between hospital discharge and SNF admission were significantly correlated with longer SNF lengths of stay and poorer gait achievements by SNF discharge. Patients with MC insurance made significant improvements in gait training at the SNF beyond that which was acquired at the hospital, whereas Medicare patients did not (PMedicare = .28, PMC = .003. Conclusions: Large losses in motor function between hospital discharge and SNF admission were associated with poor functional outcomes and longer stays at the SNF. These effects were more pronounced in Medicare patients than those with MC insurance. Keywords: Total joint arthroplasty, Skilled nursing facility, Medicare, Managed Care, Physical therapy

  10. The environmental design of residential care facilities: A sense of home through the eyes of nursing home residents.

    NARCIS (Netherlands)

    J. van Hoof; B.M Janssen; MD E.J.M. Wouters; C.J.M.L. van Dijck-Heinen


    C.J.M.L. van Dijck-Heinen, E.J.M. Wouters, B.M. Janssen, J. van Hoof (2014) The environmental design of residential care facilities: A sense of home through the eyes of nursing home residents. International Journal for Innovative Research in Science & Technology 1(4): 57-69

  11. 42 CFR 440.40 - Nursing facility services for individuals age 21 or older (other than services in an institution... (United States)


    ... older (other than services in an institution for mental disease), EPSDT, and family planning services... institution for mental disease), EPSDT, and family planning services and supplies. (a) Nursing facility... institution for mental diseases”, means services that are— (i) Needed on a daily basis and required to be...

  12. Developing a nurse-led clinic using transformational leadership. (United States)

    Gousy, Mamood; Green, Kim


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

  13. Developing scale for colleague solidarity among nurses in Turkey. (United States)

    Uslusoy, Esin Cetinkaya; Alpar, Sule Ecevit


    There is a need for an appropriate instrument to measure colleague solidarity among nurses. This study was carried out to develop a Colleague Solidarity of Nurses' Scale (CSNS). This study was planned to be descriptive and methodological. The CSNS examined content validity, construct validity, test-retest reliability and internal consistency reliability. The trial form of the CSNS, which was composed of 44 items, was given to 200 nurses, followed by validity and reliability analyses. Following the analyses, 21 items were excluded from the scale, leaving an attitude scale made up of 23 items. Factor analysis of the data showed that the scale has a three sub-factor structure: emotional solidarity, academic solidarity and negative opinions about solidarity. The Cronbach's alpha reliability of the whole scale was 0.80. This study provides evidence that the CSNS possesses robust solidarity among nurses. © 2013 Wiley Publishing Asia Pty Ltd.

  14. Developing optimal nurses work schedule using integer programming (United States)

    Shahidin, Ainon Mardhiyah; Said, Mohd Syazwan Md; Said, Noor Hizwan Mohamad; Sazali, Noor Izatie Amaliena


    Time management is the art of arranging, organizing and scheduling one's time for the purpose of generating more effective work and productivity. Scheduling is the process of deciding how to commit resources between varieties of possible tasks. Thus, it is crucial for every organization to have a good work schedule for their staffs. The job of Ward nurses at hospitals runs for 24 hours every day. Therefore, nurses will be working using shift scheduling. This study is aimed to solve the nurse scheduling problem at an emergency ward of a private hospital. A 7-day work schedule for 7 consecutive weeks satisfying all the constraints set by the hospital will be developed using Integer Programming. The work schedule for the nurses obtained gives an optimal solution where all the constraints are being satisfied successfully.

  15. Clinical staff nurse leadership: Identifying gaps in competency development. (United States)

    Franks-Meeks, Sherron


    To date, there has been no development of a complete, applicable inventory of clinical staff nurse (CSN) leadership role competencies through a valid and reliable methodology. Further, the CSN has not been invited to engage in the identification, definition, or development of their own leadership competencies. Compare existing leadership competencies to identify and highlight gaps in clinical staff nurse leadership role competency development and validation. Literature review. The CSN has not participated in the development of CSN leadership role competencies, nor have the currently identified CSN leadership role competencies been scientifically validated through research. Finally, CSN leadership role competencies are incomplete and do not reflect the CSN perspective. © 2017 Wiley Periodicals, Inc.

  16. Leadership Development Through Peer-Facilitated Simulation in Nursing Education. (United States)

    Brown, Karen M; Rode, Jennifer L


    Baccalaureate nursing graduates must possess leadership skills, yet few opportunities exist to cultivate leadership abilities in a clinical environment. Peer-facilitated learning may increase the leadership skills of competence, self-confidence, self-reflection, and role modeling. Facilitating human patient simulation provides opportunities to develop leadership skills. With faculty supervision, senior baccalaureate students led small-group simulation experiences with sophomore and junior peers and then conducted subsequent debriefings. Quantitative and qualitative descriptive data allowed evaluation of students' satisfaction with this teaching innovation and whether the experience affected students' desire to take on leadership roles. Students expressed satisfaction with the peer-facilitated simulation experience and confidence in mastering the content while developing necessary skills for practice. Peer-facilitated simulation provides an opportunity for leadership development and learning. Study results can inform the development of nursing curricula to best develop the leadership skills of nursing students. [J Nurs Educ. 2018;57(1):53-57.]. Copyright 2018, SLACK Incorporated.

  17. Development of automatic facilities for ZEPHYR

    International Nuclear Information System (INIS)

    Eder, O.; Lackner, E.; Pohl, F.; Schilling, H.B.


    This concept of remotely controlled facilities for repair and maintenance tasks inside the ZEPHYR vacuum vessel uses a supporting structure to insert various types of mobile automatic devices are guided by an egg-shaped disc which is part of the supporting structure. Considerations of adapting the guiding disc to the vessel contour are included. (orig.)

  18. Upgrades of Hanford Engineering Development Laboratory hot cell facilities

    International Nuclear Information System (INIS)

    Daubert, R.L.; DesChane, D.J.


    The Hanford Engineering Development Laboratory operates the 327 Postirradiation Testing Laboratory (PITL) and the 324 Shielded Materials Facility (SMF). These hot cell facilities provide diverse capabilities for the postirradiation examination and testing of irradiated reactor fuels and materials. The primary function of these facilities is to determine failure mechanisms and effects of irradiation on physical and mechanical properties of reactor components. The purpose of this paper is to review major equipment and facility upgrades that enhance customer satisfaction and broaden the engineering capabilities for more diversified programs. These facility and system upgrades are providing higher quality remote nondestructive and destructive examination services with increased productivity, operator comfort, and customer satisfaction

  19. Development of an International School Nurse Asthma Care Coordination Model (United States)

    Garwick, Ann W.; Svavarsdóttir, Erla Kolbrun; Seppelt, Ann M.; Looman, Wendy S.; Anderson, Lori S.; Örlygsdóttir, Brynja


    Aim To identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10–18) and to develop an asthma school nurse care coordination model. Background Little is known about how school nurses coordinate care for youth with asthma in different countries. Design A qualitative descriptive study design using focus group data. Methods Six focus groups with 32 school nurses were conducted in Reykjavik (n=17) and St. Paul (n=15) using the same protocol between September 2008 – January 2009. Descriptive content analytic and constant comparison strategies were used to categorize and compare how school nurses coordinated care, which resulted in the development of an International School Nurse Asthma Care Coordination Model. Findings Participants in both countries spontaneously described a similar asthma care coordination process that involved information gathering, assessing risk for asthma episodes, prioritizing health care needs and anticipating and planning for student needs at the individual and school levels. This process informed how they individualized symptom management, case management and/or asthma education. School nurses played a pivotal part in collaborating with families, school and health care professionals to ensure quality care for youth with asthma. Conclusions Results indicate a high level of complexity in school nurses’ approaches to asthma care coordination that were responsive to the diverse and changing needs of students in school settings. The conceptual model derived provides a framework for investigators to use in examining the asthma care coordination process of school nurses in other geographic locations. PMID:25223389

  20. Statistical thinking: tool for development of nursing as a science

    Directory of Open Access Journals (Sweden)

    Sonia Patricia Carreño Moreno


    Full Text Available Objective: To integrate findings of scientific literature that report on the importance of statistical thinking for development of nursing as a science.  Content synthesis: Literature review of articles published in indexed scientific journals between 1998 and 2017 in databases lilacs, sage Journals, Wiley Online Library, Scopus, bireme, Scielo, ScienceDirect, PubMed, cuiden® y ProQuest. 22 publications were included and findings were extracted, classified, and simplified using descriptor codes, nominal codes, and emerging topics. The following six topics emerged from searches: Education for statistical thinking; Statistical thinking for decision-making in practice; Obstacles to the statistical thinking development; Skills necessary to statistical thinking; Statistics in creating scientific knowledge; and Challenges for statistical thinking development. Conclusion: In the current development of nursing as a science, statistical thinking has primarily been a useful tool for the research field and training of researchers. The existence of obstacles to the statistical thinking development in nurse practitioners has been reported, revealing the need to bound statistics with nursing practice. For this purpose, it is essential to prepare texts and subject of statistics applied to the context of discipline and practice. Descriptors: Biostatistics; Statistics as Topic; Statistics; Science; Nursing(source: decs, bireme.

  1. Report of the committee on a commercially developed space facility (United States)

    Shea, Joseph F.; Stever, H. Guyford; Cutter, W. Bowman, III; Demisch, Wolfgang H.; Fink, Daniel J.; Flax, Alexander H.; Gatos, Harry C.; Glicksman, Martin E.; Lanzerotti, Louis J.; Logsdon, John M., III


    Major facilities that could support significant microgravity research and applications activity are discussed. The ground-based facilities include drop towers, aircraft flying parabolic trajectories, and sounding rockets. Facilities that are intrinsically tied to the Space Shuttle range from Get-Away-Special canisters to Spacelab long modules. There are also orbital facilities which include recoverable capsules launched on expendable launch vehicles, free-flying spacecraft, and space stations. Some of these existing, planned, and proposed facilities are non-U.S. in origin, but potentially available to U.S. investigators. In addition, some are governmentally developed and operated whereas others are planned to be privately developed and/or operated. Tables are provided to show the facility, developer, duration, estimated gravity level, crew interaction, flight frequency, year available, power to payload, payload volume, and maximum payload mass. The potential of direct and indirect benefits of manufacturing in space are presented.

  2. Association between Continuing Education and Job Satisfaction of Nurses Employed in Long-Term Care Facilities. (United States)

    Robertson, Ethel M.; Higgins, Leslie; Rozmus, Cathy; Robinson, James P.


    Continuing-education participation and job satisfaction of 85 licensed practical nurses and 25 registered nurses in long-term care were compared. There were no differences between full- and part-time staff. Nurses with higher family incomes participated more frequently. Registered nurses participated more and had greater job satisfaction. (SK)

  3. Challenges and Consequences of Reduced Skilled Nursing Facility Lengths of Stay. (United States)

    Tyler, Denise A; McHugh, John P; Shield, Renée R; Winblad, Ulrika; Gadbois, Emily A; Mor, Vincent


    To identify the challenges that reductions in length of stay (LOS) pose for skilled nursing facilities (SNFs) and their postacute care (PAC) patients. Seventy interviews with staff in 25 SNFs in eight U.S. cities, LOS data for patients in those SNFs. Data were qualitatively analyzed, and key themes were identified. Interview data from SNFs with and without reductions in median risk-adjusted LOS were compared and contrasted. We conducted 70 semistructured interviews. LOS data were derived from minimum dataset (MDS) admission records available for all patients in all U.S. SNFs from 2012 to 2014. Challenges reported regardless of reductions in LOS included frequent and more complicated re-authorization processes, patients becoming responsible for costs, and discharging patients whom staff felt were unsafe at home. Challenges related to reduced LOS included SNFs being pressured to discharge patients within certain time limits. Some SNFs reported instituting programs and processes for following up with patients after discharge. These programs helped alleviate concerns about patients, but they resulted in nonreimbursable costs for facilities. The push for shorter LOS has resulted in unexpected challenges and costs for SNFs and possible unintended consequences for PAC patients. © Health Research and Educational Trust.

  4. Development of an integrated assay facility

    International Nuclear Information System (INIS)

    Molesworth, T.V.; Bailey, M.; Findlay, D.J.S.; Parsons, T.V.; Sene, M.R.; Swinhoe, M.T.


    The I.R.I.S. concept proposed the use of passive examination and active interrogation techniques in an integrated assay facility. A linac would generate the interrogating gamma and neutron beams. Insufficiently detailed knowledge about active neutron and gamma interrogation of 500 litre drums of cement immobilised intermediate level waste led to a research programme which is now in its main experimental stage. Measurements of interrogation responses are being made using simulated waste drums containing actinide samples and calibration sources, in an experimental assay assembly. Results show that responses are generally consistent with theory, but that improvements are needed in some areas. A preliminary appraisal of the engineering and economic aspects of integrated assay shows that correct operational sequencing is required to achieve the short cycle time needed for high throughput. The main engineering features of a facility have been identified

  5. A review of recent developments in radiometric calibration facilities

    International Nuclear Information System (INIS)

    Corner, B.


    Two new developments concerning radiometric calibration facilities are described in this presentation. The first is the result of the international programme for the monitoring and cross-reference of existing calibration facilities, sponsored by the International Atomic Energy Agency. The second development that is discussed concerns the accuracy of the stripping ratios derived at Pelindaba and has important implications for in situ assaying

  6. The challenge of logistics facilities development (United States)

    Davis, James R.


    The paper discusses the experiences of a group of engineers and logisticians at John F. Kennedy Space center in the design, construction and activation of a consolidated logistics facility for support of Space Transportation System ground operations and maintenance. The planning, methodology and processes are covered, with emphasis placed on unique aspects and lessons learned. The project utilized a progressive design, baseline and build concept for each phase of construction, with the Government exercising funding and configuration oversight.

  7. The Development of a Clinical Nurse Scholar in Baccalaureate Education. (United States)

    Beal, Judy A; Riley, Joan M


    The purpose of this national study was to explore the vision of chief academic officers for baccalaureate nursing education. We invited chief academic nursing officers, randomly selected from a representative sample of accredited baccalaureate nursing programs to participate in the study. Audiotaped interviews were conducted in focus groups at professional meetings or by telephone and were transcribed verbatim. Data collection continued until thematic saturation was reached (N = 29). Analysis of the findings revealed themes that described future vision for baccalaureate education that provides guidance to faculty as they develop curriculum. An overarching theme "We are all Stewards of the Profession" and three supporting themes emerged: "Learning Pathways are Varied," "Faculty Need to Grow," and "New Pedagogies Need to Focus on the Development of 'Who I Am' as a Clinical Scholar." Findings point to a future where diverse learning pathways are integrated throughout the curriculum. The curriculum of tomorrow will place greater emphasis on the development of professional identity as a nurse and calls for expanded stewardship for nursing education. Deans recommended that investing time and resources into well-designed faculty development programs will help all faculty, regardless of appointment, to adapt to changing student needs and rapidly evolving practice environments. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Development and Testing of the Nurse Manager EBP Competency Scale. (United States)

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


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

  9. [The history of nursing development in the Republic of China]. (United States)

    Liu, Chung-Tung


    Modern nursing was introduced into China (and Taiwan) as part of the general Westernization of Chinese culture. It was accepted in its Western and modern form along with medicine as a part of China's modernization. Looking after the sick, one of the basic functions of any society, has traditionally been performed by women. Such basic social function cannot be ignored. Therefore, at the beginning of this paper, the traditional healing and caring systems in China prior to the influence of the West are examined. The second part of this paper shows that the strategy of nineteenth century reformers and later leaders from England and America was incorporated into modern Chinese nursing. Also, patriotic feelings opposed to imperialism and indignation over the Sino-Japanese War benefited the growth of domestic nursing. The last part of this paper examines recent developments and the current status of nursing in Taiwan. Overall, the more than a century of modern nursing history in the R.O.C. is infused with a complex mixture of cultural borrowing from the West, anti-imperialist experience, colonialist influences, and ethical and gender issues. The study methodology adopted for this essay follows that used by Robert Elias. Both the synchronic social context and diachronic historical processes are considered in order to illuminate and highlight the critical events that shaped the history of nursing in the ROC. Due to the researcher's personal academic background and interest, sociological and feminist perspectives were taken while investigating and analyzing materials.

  10. [Development of an evaluation instrument for service quality in nursing homes]. (United States)

    Lee, Jia; Ji, Eun Sun


    The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's α and Cohen's Kappa. Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's α=.95. The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.

  11. Impact of Nursing Learning Environments on Adaptive Competency Development in Baccalaureate Nursing Students. (United States)

    Laschinger, Heather K. Spence


    Kolb's experiential learning theory was used as a framework to study 179 generic baccalaureate students' perceptions of the different types of learning environments and adaptive competencies. Clinical experience and preceptorships contributed more to competency development than did nursing or nonnursing classes. (JOW)

  12. Japan's policy of promoting end-of-life care in nursing homes: impact on facility and resident characteristics associated with the site of death. (United States)

    Ikegami, Naoki; Ikezaki, Sumie


    To evaluate the impact of the policy to encourage nursing homes to provide end-of-life care by comparing facility and resident variables associated with dying within the nursing home and not in hospitals, and by comparing life sustaining treatment (LST) respectively provided. Questionnaires mailed to an 11% random sample of 653 nursing homes in 2009. Facility characteristics from 371 nursing homes (57%) and resident characteristics of the 1158 who had been discharged due to death were obtained from 241 facilities (37%). Facility characteristics related to dying in nursing homes were their policy of providing end-of-life care and physicians being based in home care supporting clinics. Resident characteristics related were not having pneumonia as the cause of death, the family's preference of the nursing home as the site of death and agreement within the family. Preferences on the use of LST were adhered more in residents who had died in nursing homes. Although the percentage of residents dying within the facility has increased, the nursing home as a site of death still composes only 3.2% of the total. To increase the latter, nursing homes should refocus their function to providing end-of-life care to those not preferring aggressive treatment. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Management development: a needs analysis for nurse executives and managers. (United States)

    Kirk, R


    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.

  14. [Development of critical thinking skill evaluation scale for nursing students]. (United States)

    You, So Young; Kim, Nam Cho


    To develop a Critical Thinking Skill Test for Nursing Students. The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed. Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001). The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.

  15. Innovations in coaching and mentoring: implications for nurse leadership development. (United States)

    Fielden, Sandra L; Davidson, Marilyn J; Sutherland, Valerie J


    This longitudinal study sought to examine ways in which coaching and mentoring relationships impact on the professional development of nurses in terms of career and leadership behaviours, and evaluating the differences and similarities between those coaching and mentoring relationships. According to the UK government, leadership in nursing is essential to the improvement of service delivery, and the development and training of all nurses is vital in achieving effective change. A coaching and mentoring programme was used to explore the comparative advantages of these two approaches for the leadership development of nurses in acute, primary care and mental health settings. A longitudinal in-depth study was conducted to measure differences and similarities between the mentoring and coaching process as a result of a six-month coaching/mentoring programme. Five nurses from six UK Health Care Trusts were allocated to a coaching group (n = 15) or a mentoring group (n = 15), these were coached or mentored by a member of the senior directorate from their own Trust. Qualitative and quantitative data were collected at three time points (T1 = baseline, T2 = 4 months and T3 = 9 months) using semi-structured interviews and questionnaires. While mentoring was perceived to be 'support' and coaching was described as 'action', descriptions of the actual process and content were quite similar. However, while both groups reported significant development in terms of career development, leadership skills and capabilities, mentees reported the highest level of development with significantly higher scores in eight areas of leadership and management and in three areas of career impact. Implications for nurses and health services are discussed.

  16. [The development of forensic nursing from the perspective of domestic violence and sexual assault preventive policies]. (United States)

    Hsieh, Hsiu-Fen; Wang, Hsiu-Hung; Chang, Shu-Chen


    Forensic nursing is a new nursing specialty that provides forensic nursing service to domestic violence victims and offenders. Development of the role of forensic nurses has become urgent and necessary. The high rates of domestic violence and sexual assault in Taiwan suggest that forensic nurses have an important role to play in domestic healthcare. This article highlights the significance of forensic nursing in Taiwan in the future in terms of its origin, definitions, models, roles and functions, training and education, and previous studies. Through cooperation among academia, government, industry, and law enforcement agencies, it is expected that forensic nursing will be a positive and important area of expansion for professional nursing.

  17. Resident and Facility Factors Associated With the Incidence of Urinary Tract Infections Identified in the Nursing Home Minimum Data Set. (United States)

    Castle, Nicholas; Engberg, John B; Wagner, Laura M; Handler, Steven


    This research examined resident and facility-specific factors associated with a diagnosis of a urinary tract infection (UTI) in the nursing home setting. Minimum Data Set and Online Survey, Certification and Reporting system data were used to identify all nursing home residents in the United States on April 1, 2006, who did not have a UTI ( n = 1,138,418). Residents were followed until they contracted a UTI (9.5%), died (8.3%), left the nursing home (33.2%), or the year ended (49.0%). A Cox proportional hazards model was estimated, controlling for resident and facility characteristics and for the state of residence. The presence of an indwelling catheter was the primary predictor of whether a resident contracted a UTI (adjusted incidence ratio = 3.35, p factors such as percentage of Medicaid residents, for-profit, and chain status was less significant. Estimates regarding staffing levels indicate that increased contact hours with more highly educated nursing staff are associated with less catheter use. Several facility-specific risk factors are of significance. Of significance, UTIs may be reduced by modifying factors such as staffing levels.

  18. [Centennial retrospective on the evolution and development of the nursing profession in Taiwan]. (United States)

    Wang, Kwua-Yun; Chang, Shu-Rong


    This article explores the evolution and development of the Taiwanese nursing profession. After introducing the origins of nursing, this article proceeds to introduce nursing during various periods in Taiwan, including the early-Qing Dynasty, foreign missionary nursing, the Japanese Colonial Era, and the Nationalist Chinese Era following World War Two up to the present. The authors then present the current situation in the Taiwanese nursing profession in terms of gender issues, high-technology developments, educational issues, the nursing licensing examination, hiring and training, multiple role functions, and the skill-mix care model. Finally, the authors make recommendations for the further development and improvement of the nursing profession in Taiwan.

  19. A Leadership Education and Development Program for Clinical Nurses. (United States)

    Fitzpatrick, Joyce J; Modic, Mary Beth; Van Dyk, Jennifer; Hancock, K Kelly


    The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management. A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion. There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included. There is a need for additional leadership development programs for clinical nurses.

  20. Problem-based learning: Developing resilience in nursing students

    Directory of Open Access Journals (Sweden)

    Jih-Yuan Chen


    Full Text Available A society needs mature and confident nurse practitioners, who are able to think analytically and flexibly, recognize needs for further preparation, and willing to engage in self-development. Concern is raised regarding how educators will build the capacity of resilient students with a knowledge base and a minimum set of skills in responding to various issues and for engaging in self-reflection. Drawing on the framework of nursing competencies and global standards for the education of professional nurses, resilient students may contribute through their social competence, problem-solving ability, sense of purpose, and persistence in the process to achieve the goal of the project. Educators should know how to build the resilient attribute in students by encouraging them to engage in self-reflection. This article discusses four areas that help students build resilience from project-based learning of a small group: the impact of problem-based learning at clinical practice, project/problem-based learning, resilient nursing student, and developing nursing students’ resilience. Self-assessment to check the promoting skills for teaching in a problem-based learning program helps the faculty holding the empowerment to encourage or support the students to face the challenge within the small team.

  1. [Development of a computerized system using standard nursing language for creation of a nursing minimum data set]. (United States)

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


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

  2. Development of simplified decommissioning cost estimation code for nuclear facilities

    International Nuclear Information System (INIS)

    Tachibana, Mitsuo; Shiraishi, Kunio; Ishigami, Tsutomu


    The simplified decommissioning cost estimation code for nuclear facilities (DECOST code) was developed in consideration of features and structures of nuclear facilities and similarity of dismantling methods. The DECOST code could calculate 8 evaluation items of decommissioning cost. Actual dismantling in the Japan Atomic Energy Agency (JAEA) was evaluated; unit conversion factors used to calculate the manpower of dismantling activities were evaluated. Consequently, unit conversion factors of general components could be classified into three kinds. Weights of components and structures of the facility were necessary for calculation of manpower. Methods for evaluating weights of components and structures of the facility were studied. Consequently, the weight of components in the facility was proportional to the weight of structures of the facility. The weight of structures of the facility was proportional to the total area of floors in the facility. Decommissioning costs of 7 nuclear facilities in the JAEA were calculated by using the DECOST code. To verify the calculated results, the calculated manpower was compared with the manpower gained from actual dismantling. Consequently, the calculated manpower and actual manpower were almost equal. The outline of the DECOST code, evaluation results of unit conversion factors, the evaluation method of the weights of components and structures of the facility are described in this report. (author)

  3. Development of fusion first-wall radiation damage facilities

    International Nuclear Information System (INIS)

    McElroy, R.J.; Atkins, T.


    The report describes work performed on the development of fusion-reactor first-wall simulation facilities on the Variable Energy Cyclotron, at Harwell, United Kingdom. Two irradiation facilities have been constructed: i) a device for helium and hydrogen filling up to 1000 ppm for post-irradiation mechanical properties studies, and ii) a helium implantation and damage facility for simultaneous injection of helium and radiation damage into a specimen under stress. These facilities are now fully commissioned and are available for investigations of first-wall radiation damage and for intercorrelation of fission- and fusion -reactor materials behaviour. (U.K.)

  4. A development of multiphase flow facility

    International Nuclear Information System (INIS)

    Ismail Mustapha; Jaafar Abdullah


    Multiphase liquid flow facility shall be enabling to transport of oil/gas/water in pipelines. In horizontal pipelines, the different flow patterns that could be observed. The flow pattern will depend mainly on the gas and liquid velocities, and gas liquid ratio. For very high liquid velocities and low gas liquid ratios, the dispersed bubble flow is observed. For low flow rates of liquid and gas, a smooth or wavy stratified flow is expected. For intermediate liquid velocities, rolling waves of liquids are formed. The rolling waves increase to the point of forming a plug flow and a slug flow. For very high gas velocities, the annular flow is observed Also include a tillable test section allowing for testing at any angle between 0 0 degree from horizontal, lowering the measurement uncertainties and increased capabilities with respect to flow rates and gas fractions. (Author)

  5. Developing a LLW disposal facility in California

    International Nuclear Information System (INIS)

    Romano, S.A.; Gaynor, R.K.; Hanrahan, T.P.


    US Ecology has been designated by the State of California to site and operate a low-level radioactive waste disposal facility. The firm identified three sites for detailed characterization work in February, 1987. Ecological and archaeological studies and related environmental assessments were undertaken to obtain land use permits from the Bureau of Land Management, which holds title to the sites. Geophysics investigations, exploratory borings, well drilling and weather station installation followed. Local Committees were established for each site to assist US Ecology in evaluating socio-economic impacts, and Native Americans were consulted regarding cultural resources. The project's Citizens Advisory Committee assisted in evaluating the three candidate sites. US Ecology systematically integrated citizen involvement into the technical studies leading to selection of the two site finalists. This approach furthered two objectives. Community leaders and the public received accurate information on the nature of low-level radioactive waste and the environmental conditions appropriate for its disposal

  6. Development of the decommissioning techniques for nuclear fuel cycle facilities

    International Nuclear Information System (INIS)

    Tanimoto, Ken-ichi; Sugaya, Toshikatsu; Hara, Mitsuo; Kikuchi, Yutaka; Tobita, Hiroo; Enokido, Yuji


    Being developed the basement techniques such as measurement, decontamination, dismantling, remote handling and data base. For the elevating and systematizing the basement techniques, thinking over the application, forward to the facility decommissionings in the future, including the technique of waste treatment in WDF and the achievement using the dismantling and recycling technique in renewaling the research facilities. (author)

  7. Development of Barnwell as a multinational demonstration facility

    International Nuclear Information System (INIS)

    Colby, L.J. Jr.


    The author takes an existing private business venture (Barnwell) with its assets of facilities, personnel, technology and domestic business commitments (past, present, and future) and develops a role for it which will be compatible with the advancement of multinational reprocessing facilities under international control

  8. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project. (United States)

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A


    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  9. Acute hepatitis B outbreaks in 2 skilled nursing facilities and possible sources of transmission: North Carolina, 2009-2010. (United States)

    Seña, Arlene C; Moorman, Anne; Njord, Levi; Williams, Roxanne E; Colborn, James; Khudyakov, Yury; Drobenuic, Jan; Xia, Guo-Liang; Wood, Hattie; Moore, Zack


    Acute hepatitis B virus (HBV) infections have been reported in long-term care facilities (LTCFs), primarily associated with infection control breaks during assisted blood glucose monitoring. We investigated HBV outbreaks that occurred in separate skilled nursing facilities (SNFs) to determine factors associated with transmission. Outbreak investigation with case-control studies. Two SNFs (facilities A and B) in Durham, North Carolina, during 2009-2010. Residents with acute HBV infection and controls randomly selected from HBV-susceptible residents during the outbreak period. After initial cases were identified, screening was offered to all residents, with repeat testing 3 months later for HBV-susceptible residents. Molecular testing was performed to assess viral relatedness. Infection control practices were observed. Case-control studies were conducted to evaluate associations between exposures and acute HBV infection in each facility. Six acute HBV cases were identified in each SNF. Viral phylogenetic analysis revealed a high degree of HBV relatedness within, but not between, facilities. No evaluated exposures were significantly associated with acute HBV infection in facility A; those associated with infection in facility B (all odds ratios >20) included injections, hospital or emergency room visits, and daily blood glucose monitoring. Observations revealed absence of trained infection control staff at facility A and suboptimal hand hygiene practices during blood glucose monitoring and insulin injections at facility B. These outbreaks underscore the vulnerability of LTCF residents to acute HBV infection, the importance of surveillance and prompt investigation of incident cases, and the need for improved infection control education to prevent transmission.

  10. Group concept mapping for evaluation and development in nursing education. (United States)

    Hagell, Peter; Edfors, Ellinor; Hedin, Gita; Westergren, Albert; Hammarlund, Catharina Sjödahl


    The value of course evaluations has been debated since they frequently fail to capture the complexity of education and learning. Group Concept Mapping (GCM), a participant-centred mixed-method was explored as a tool for evaluation and development in nursing education and to better understand students' learning experiences, using data from a GCM-based evaluation of a research training assignment integrating clinical practice and research data collection within a Swedish university nursing program. Student nurses (n = 47) participated in a one-day GCM exercise. Focus group brainstorming regarding experiences from the assignment that the students considered important and instructive yielded 98 statements that were individually sorted based on their student-perceived relationships, and rated regarding their importance/instructiveness and need for development. Quantitative analysis of sort data produced a 2-dimensional map representing their conceptual relationships, and eight conceptual areas. Average cluster ratings were plotted relative to each other and provided a decision aid for development and planning by identifying areas (i.e., "Research methodology", "Patients' perspectives", and "Interviewer role") considered highly important/instructive and in high need for development. These experiences illustrate the use and potential of GCM as an interactive participant-centred approach to evaluation, planning and development in nursing and other higher health science educations. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Developing the concept of caring in nursing education. (United States)

    Salehian, Maryam; Heydari, Abbas; Moonaghi, Hossein Karimi; Aghebati, Nahid


    Caring is a value-based concept in the nursing field and in education. Exact understanding of caring in education and developing this concept in nursing will result in the evolution of the position of nursing science and profession. The aim of this study was to attempt to develop the concept of caring in nursing education. This qualitative study was conducted in 2016 using directed content analysis. Participants were thirteen subjects (6 instructors and 7 senior and junior nursing students) who were selected using purposeful sampling method. Research environment was the Faculty of Nursing and Midwifery in Mashhad. Data collection method was semi-structured interviews for thirty to ninety minutes and sampling continued until data saturation. Interviews were conducted in Persian language and they were immediately transcribed and analyzed using MAXDA10 software. The text of interviews was reviewed several times. First, open codes were extracted, and after several reviews based on similarity in meaning, they were classified into subcategories and finally, similar subcategories were placed in main classes based on meaning. Results of this study led to the identification of four themes: 1, ethical and religious commitment, 2, development of knowing and cultural sensitivity, 3, soft assertion, 4, clear describing of objectives, expectations, and educational rules for students. Results of this study showed that the cultural and religious background of instructors affects their interaction with students. Instructors' commitment and compliance to values in interacting with students and other educational colleagues has an origin beyond ethical and human subjects and it is originated from their religious education and training.

  12. Concept Development of “Nursing Presence”: Application of Schwartz-Barcott and Kim's Hybrid Model

    Directory of Open Access Journals (Sweden)

    Fatemeh Mohammadipour, PhD


    Conclusion: Co-constructed interaction underscored the value of the nursing presence as an integral component of caring with humanistic and patient-centered approaches. The findings could help clinical nurses have a better understanding of the nursing presence. Findings also can improve educators' and managers' knowledge for developing and conducting appropriate education strategies and caring activities to facilitate the promotion of nursing presence.

  13. Perspectives on Age and Continuing Professional Development for Nurses: A Literature Review (United States)

    Pool, Inge A.; Poell, Rob F.; ten Cate, Th. J.


    The need for nurses to participate in continuing professional development (CPD) is growing to keep abreast of rapid changes in nursing care. Concurrently, the nursing workforce is growing older. Ageing leads to changes in biological, psychological, and social functioning. Little is known about the effects of age-related changes on nurses'…

  14. Home healthcare nurse retention and patient outcome model: discussion and model development. (United States)

    Ellenbecker, Carol Hall; Cushman, Margaret


    This paper discusses additions to an empirically tested model of home healthcare nurse retention. An argument is made that the variables of shared decision-making and organizational commitment be added to the model based on the authors' previous research and additional evidence from the literature. Previous research testing the home healthcare nurse retention model established empirical relationships between nurse, agency, and area characteristics to nurse job satisfaction, intent to stay, and retention. Unexplained model variance prompted a new literature search to augment understanding of nurse retention and patient and agency outcomes. Data come from the authors' previous research, and a literature search from 1990 to 2011 on the topics organizational commitment, shared decision-making, nurse retention, patient outcomes and agency performance. The literature provides a rationale for the additional variables of shared decision-making and affective and continuous organizational commitment, linking these variables to nurse job satisfaction, nurse intent to stay, nurse retention and patient outcomes and agency performance. Implications for nursing.  The new variables in the model suggest that all agencies, even those not struggling to retain nurses, should develop interventions to enhance nurse job satisfaction to assure quality patient outcomes. The new nurse retention and patient outcome model increases our understanding of nurse retention. An understanding of the relationship among these variables will guide future research and the development of interventions to create and maintain nursing work environments that contribute to nurse affective agency commitment, nurse retention and quality of patient outcomes. © 2011 Blackwell Publishing Ltd.

  15. Developing a pedagogy for nursing teaching-learning. (United States)

    Horsfall, Jan; Cleary, Michelle; Hunt, Glenn E


    Each nurse educator's pedagogy underpins their understanding of and approach to teaching and learning, regardless of whether this has been reflected upon or articulated. In this paper, we overview factors and issues that should be considered when developing a teaching philosophy of nursing education and set out broad differences between traditional and contemporary pedagogic models and various ways of knowing. As values underpin any teaching framework these are considered in relation to pedagogies, epistemologies and their relevance to nursing practice. Key teacher roles and strategies that are congruent with a contemporary pedagogy for teaching nursing in the classroom or the clinical setting are also outlined. A premise for writing this paper was that clarifying one's own understandings of education and knowledge and the implicit values held within those terms and processes will contribute to greater self-awareness and more effective teaching of nursing. Education approaches underpinned by a sound teaching philosophy and framework can facilitate an educationally sound and positive experience for learners. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. [Centennial retrospective on the evolution and development of nursing education in Taiwan]. (United States)

    Yeh, Mei Chang


    Nursing education in Taiwan has developed significantly over the past one hundred years. Throughout the first half of the 20th century, nursing education in Taiwan ended at the high school level. However, over the most recent 50 years, this level has been gradually raised, and nursing doctoral programs are now offered today. Changes in the nursing profession over the past century have been influenced by social and political factors, war, the health care policies, and national education policies. Areas of nursing education that have presented key challenges to change and innovation include the nursing faculty, curriculum, teaching materials, and quality of teaching. Today, key future goals for nursing education in Taiwan are: Raising the entry level of generic nursing education from junior high to the high-school level, improving the curricula for master's and doctoral students, cultivating advanced practice nurses, improving the quality of nursing faculties, and establishing a mechanism to ensure the consistent quality of nursing education.

  17. Medical students' professional identity development in an early nursing attachment

    NARCIS (Netherlands)

    Helmich, Esther; Derksen, Els; Prevoo, Mathieu; Laan, Roland; Bolhuis, Sanneke; Koopmans, Raymond

    Objectives The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an

  18. Medical students' professional identity development in an early nursing attachment.

    NARCIS (Netherlands)

    Helmich, E.; Derksen, E.; Prevoo, M.; Laan, R.F.J.M.; Bolhuis, S.; Koopmans, R.T.C.M.


    OBJECTIVES: The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an

  19. Perceptions of final-year nursing students on the facilities, resources and quality of education provided by schools in Turkey. (United States)

    Güner, Perihan


    The purpose of this study is to determine the perceptions of final-year nursing students regarding the adequacy of education, resources and internships in preparation for graduation. The study design was a descriptive cross-sectional study of nursing students (n: 1804) in their final year of education and questionnaires were used to collect data. Information related to student-to-instructor ratios and internships was obtained from each institution. Most students reported receiving instruction or supervision by lecturers and clinicians who did not specialise in the field. Overall, students did not find the facilities, educational or technological resources and the quality of education offered by their respective schools adequate. The proportion of students who found the level of theoretical education, clinical practice and instructor support adequate was higher in state university colleges of nursing/faculties of health sciences than in state university schools of health sciences.

  20. Analysis of touch used by occupational therapy practitioners in skilled nursing facilities. (United States)

    Morris, Douglas; Henegar, J; Khanin, S; Oberle, G; Thacker, S


    Instrumental touch is identified as having purposeful physical contact in order to complete a task. Expressive touch is identified as warm, friendly physical contact and is not solely for performing a task. Expressive touch has been associated with improved client status, increased rapport and greater gains made during therapy. The purpose of the study was to observe the frequency of expressive and instrumental touch utilized by an occupational therapist during an occupational therapy session. Thirty-three occupational therapy professionals, including occupational therapists and occupational therapy assistants, employed at skilled nursing facilities in southwest Florida were observed. Data were collected on the Occupational Therapy Interaction Assessment. The results of the data analysis showed a positive relationship between the gender of the therapist and the frequency of expressive touch. The data also showed that a large majority of touches were instrumental touch and pertained to functional mobility. The results of the study can contribute to a better understanding of the holistic aspects of occupational therapy. By the use of more expressive touch, occupational therapy practitioners may have a positive, beneficial effect on both the client and the therapy process as a whole. Further research is needed to determine the effect an occupational therapy setting has on the frequency of instrumental and expressive touch. A larger sample size and a distinction between evaluation and treatment sessions would benefit future studies. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Predictors of Hospitalization Among Newly Admitted Skilled Nursing Facility Residents: Rethinking the Role of Functional Decline

    Directory of Open Access Journals (Sweden)

    Sun J. Kim


    Full Text Available Purpose: Hospital transfer from a skilled nursing facility (SNF is costly, and many are potentially preventable. This study examines: 1 whether functional decline is a predictor of hospital transfer, and 2 the magnitude of relationships between predictors (functional impairment and chronic medical illness and hospital transfer from SNFs. Methods: We used Minimum Data Set (MDS Version 2.0 in the state of Michigan between 2007 and 2009. In total, 196,662 new SNF admissions were observed. Multilevel generalized estimating equations and regression models were performed for each functional and clinical domain while adjusting for demographic variables and change in activities of daily living (ADL. Results: 65% of recently admitted SNF residents experienced functional decline after SNF admission, and 58% were readmitted to a hospital. Residents who needed extensive assistance or were completely dependent in their functional domains had pressure ulcers, deteriorated mood or lower cognitive performance scale scores. These residents experienced higher chances of hospital transfer. However, a deteriorated ADL played a significant role in all multivariate models, indicating that a decline in ADL is a stronger predictor of hospital transfer than other functional or clinical predictors. Conclusion: Although all functional impairments and chronic medical illness can be associated with hospital transfer, functional decline may be the most important predictor of hospital transfer in patients newly admitted to an SNF.

  2. The Bridge Project: improving heart failure care in skilled nursing facilities. (United States)

    Boxer, Rebecca S; Dolansky, Mary A; Frantz, Megan A; Prosser, Regina; Hitch, Jeanne A; Piña, Ileana L


    Rehospitalization rates and transitions of care for patients with heart failure (HF) continue to be of prominent importance for hospital systems around the United States. Skilled nursing facilities (SNF) are pivotal sites for transition especially for older adults. The purpose of this study was to evaluate in SNF both the (1) current state of HF management (HF admissions, protocols, and staff knowledge) and (2) the acceptability and effect of a HF staff educational program. Four SNF participated in the project, 2 the first year and 2 the second year. SNF were surveyed by discipline as to HF disease management techniques. Staff were evaluated on HF knowledge and confidence in pre- and post-HF disease management training. All-cause rehospitalization rates ranged from 18% to 43% in the 2 SNF evaluated. Overall, there was a lack of identification and tracking of HF patients in all the SNF. There were no HF-specific disease management protocols at any SNF and staff had limited knowledge of HF care. Staff pre and post test scores indicated an improvement in both staff knowledge and confidence in HF management after receiving training. The lack of identification and tracking of patients with HF limits SNF ability to care for patients with HF. HF education for staff is likely important to effective HF management in the SNF. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  3. The hierarchy of the activities of daily living in the Katz index in residents of skilled nursing facilities. (United States)

    Gerrard, Paul


    Nursing facility patients are a population that has not been well studied with regard to functional status and independence previously. As such, the manner in which activities of daily living (ADL) relate to one another is not well understood in this population. An understanding of ADL difficulty ordering has helped to devise systems of functional independence grading in other populations, which have value in understanding patients' global levels of independence and providing expectations regarding changes in function. This study seeks to examine the hierarchy of ADL in the nursing facility population. Data were analyzed from the 2004 National Nursing Home Survey, a cross-sectional data set of 13 507 skilled nursing facility subjects with functional independence items. The ADL difficulty hierarchy was determined using Rasch analysis. Item fit values for the Rasch model using Mean-Square infit statistics were also determined. The robustness of the hierarchy was tested for each ADL. Two grading systems were devised from the results of the item difficulty ordering. One was based on the most difficult item that he or she could perform, and the other assigned a grade based on the least difficult item that a subject could not perform. A total of 13 113 patients were included in this analysis, the majority of whom were female and white. They had an average age of 81 years. An ordered hierarchy of ADL was found with eating being the easiest and bathing the most difficult. All items in the Katz index fit the Rasch model adequately well. The majority of patients able to perform any particular ADL were also able to perform all easier ADL. Cohen's κ for the 2 grading systems was 0.73. This study is the first to show the expected hierarchy of difficulty of the 6 activities of daily proposed in the Katz index in the nursing facility population. The hierarchy found in this population matches the original hierarchy found in older adults in the community and acute care settings

  4. Early malnutrition screening and low cost protein supplementation in elderly patients admitted to a skilled nursing facility. (United States)

    Harding, Krystal M; Dyo, Melissa; Goebel, Joy R; Gorman, Nik; Levine, Julia


    Malnutrition among skilled nursing facility (SNF) patients can lead to hospital readmissions and multiple complications. To evaluate the effect of an existing malnutrition screening and management program on prealbumin levels of patients in skilled nursing facilities. A retrospective design was used to evaluate baseline admission data including a prealbumin level. Patients with malnutrition received an oral protein supplement according to protocol. A comparison prealbumin level was obtained at 30days. Nearly half of the patients were severely malnourished on admission. Patients receiving the prescribed protocol had significantly increased prealbumin levels at 30days than those patients that did not receive the protocol as prescribed. A prealbumin level upon admission at a SNF could represent a reliable tool to evaluate malnutrition. Initiation of an early malnutrition screening and protein supplement program in this setting is essential to identifying and treating at-risk patients before complications occur. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. VA Pipeline for Future Nurse Leaders: an Exploration of Current Nurse Leadership Development in the Veteran’s Health Administration (United States)


    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

  6. Developing an integrated electronic nursing record based on standards. (United States)

    van Grunsven, Arno; Bindels, Rianne; Coenen, Chel; de Bel, Ernst


    The Radboud University Nijmegen Medical Centre in the Netherlands develops a multidisciplinar (Electronic Health Record) based on the latest HL7 v3 (Health Level 7 version 3) D-MIM : Care provision. As part of this process we are trying to establish which nursing diagnoses and activities are minimally required. These NMDS (Nursing Minimal Data Set) are mapped or translated to ICF (for diagnoses) and CEN1828 Structures for (for activities). The mappings will be the foundation for the development of user interfaces for the registration of nursing activities. A homegrown custom-made web based configuration tool is used to exploit the possibilities of HL7 v3. This enables a sparkling launch of user interfaces that can contain the diversity of health care work processes. The first screens will be developed to support history taking for the nursing chart of the Neurology ward. The screens will contain both Dutch NMDS items and ward specific information. This will be configured dynamically per (group of) ward(s).

  7. How the nursing profession can contribute to sustainable development goals. (United States)

    Benton, David; Shaffer, Franklin


    As of 1 January 2016, the UN sustainable development goals (SDGs) became the focus of global efforts on a wide range of development agenda. The SDGs have subsumed the work of the UN millennium development goals (MDGs), so it is timely to reflect on the contribution made by nurses and midwives, so that we can optimise the profession's contribution to the 17 SDGs. This article reports the results of a scientometrics analysis of the published literature related to the MDGs and SDGs indexed in CINAHL, which identified the underlying themes addressed by nurses and midwives. It shows how analysis demonstrates that although nursing was slow to engage with the MDG agenda, it has made some progress in contributing to SDG scholarship. So far this contribution has been narrowly focused, but the profession could contribute to all 17 of the SDG goals. Routine updates of the analysis described here could help monitor progress, identify gaps in nursing's contributions to the goals, and provide further impetus to its engagement in this major global policy initiative.

  8. A Proposal to Develop a Biotechnology Information Facility

    National Research Council Canada - National Science Library

    Spalding, John


    The objective of this grant was to develop facilities and information resources that support current research in biotechnology and to meet the goal of strengthening the biological science programs at HBCUs/Mls...

  9. Development of the radioisotope production facility for the HANARO

    International Nuclear Information System (INIS)

    Lee, Ji Bok; Wu, J. S.; Baik, S. T.


    Hot cell and related facilities were developed in the RI production building of the HANARO. 1. development of concrete H/C and related components 2. development of lead H/C and related components 3. development of the hydraulic transfer system 4. development of radiation monitoring system 5. development of purification system for Co-60 storage pool 6. development of the fire fighting system for H/C 7. development of the experimental equipment. (author). 15 figs

  10. Development and validation of fall risk screening tools for use in residential aged care facilities. (United States)

    Delbaere, Kim; Close, Jacqueline C T; Menz, Hylton B; Cumming, Robert G; Cameron, Ian D; Sambrook, Philip N; March, Lyn M; Lord, Stephen R


    To develop screening tools for predicting falls in nursing home and intermediate-care hostel residents who can and cannot stand unaided. Prospective cohort study in residential aged care facilities in northern Sydney, New South Wales, June 1999-June 2003. 2005 people aged 65-104 years (mean +/- SD, 85.7+/-7.1 years). Demographic, health, and physical function assessment measures; number of falls over a 6-month period; validity of the screening models. Ability to stand unaided was identified as a significant event modifier for falls. In people who could stand unaided, having either poor balance or two of three other risk factors (previous falls, nursing home residence, and urinary incontinence) increased the risk of falling in the next 6 months threefold (sensitivity, 73%; specificity, 55%). In people who could not stand unaided, having any one of three risk factors (previous falls, hostel residence, and using nine or more medications) increased the risk of falling twofold (sensitivity, 87%; specificity, 29%). These two screening models are useful for identifying older people living in residential aged care facilities who are at increased risk of falls. The screens are easy to administer and contain items that are routinely collected in residential aged care facilities in Australia.

  11. Association Between Hospital Admission Risk Profile Score and Skilled Nursing or Acute Rehabilitation Facility Discharges in Hospitalized Older Adults. (United States)

    Liu, Stephen K; Montgomery, Justin; Yan, Yu; Mecchella, John N; Bartels, Stephen J; Masutani, Rebecca; Batsis, John A


    To evaluate whether the Hospital Admission Risk Profile (HARP) score is associated with skilled nursing or acute rehabilitation facility discharge after an acute hospitalization. Retrospective cohort study. Inpatient unit of a rural academic medical center. Hospitalized individuals aged 70 and older from October 1, 2013 to June 1, 2014. Participant age at the time of admission, modified Folstein Mini-Mental State Examination score, and self-reported instrumental activities of daily living 2 weeks before admission were used to calculate HARP score. The primary predictor was HARP score, and the primary outcome was discharge disposition (home, facility, deceased). Multivariate analysis was used to evaluate the association between HARP score and discharge disposition, adjusting for age, sex, comorbidities, and length of stay. Four hundred twenty-eight individuals admitted from home were screened and their HARP scores were categorized as low (n = 162, 37.8%), intermediate (n = 157, 36.7%), or high (n = 109, 25.5%). Participants with high HARP scores were significantly more likely to be discharged to a facility (55%) than those with low HARP scores (20%) (P risk of skilled nursing or acute rehabilitation facility discharge. Early identification for potential facility discharges may allow for targeted interventions to prevent functional decline, improve informed shared decision-making about post-acute care needs, and expedite discharge planning. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  12. Servant leadership in nursing: a framework for developing sustainable research capacity in nursing. (United States)

    Jackson, Debra


    In the current professional climate, research activities are highly valued with nurses in all sectors actively encouraged to participate. However, working environments for many nurses are such that it can be difficult to privilege research activities in any sustained way. A number of organisational challenges coalesce to impede participation in research activities, including limited resources, lack of skills, knowledge and opportunities, and a culture of individualism. Strong, effective research leadership is essential to help mediate some of these negative aspects of organisational life, and promote creative environments to facilitate the development of research capacity. Servant leadership is a service-oriented approach that focuses on valuing and developing people, and offers a participatory and collaborative framework within which to build creative and productive research communities. Such communities can encourage connectedness between people, deepen the capacity for supportive collegiality, and foster a holistic social learning milieu to support researchers of all levels, including early career researchers and research higher degree candidates.

  13. Nursing students' attitudes toward research and development within nursing: Does writing a bachelor thesis make a difference? (United States)

    Uysal Toraman, Aynur; Hamaratçılar, Güler; Tülü, Begüm; Erkin, Özüm


    The aim of this study was to investigate the effect of writing a bachelor's thesis on nursing students' attitudes towards research and development in nursing. The study sample consisted of 91 nursing students who were required to complete a bachelor's thesis and 89 nursing students who were not required to complete a bachelor's thesis. Data were collected via self-report questionnaire that was distributed in May and June 2012. The questionnaire comprised 3 parts: (1) demographic items; (2) questions about "scientific activities," and (3) the nursing students' attitudes towards and awareness of research and development within nursing scale (version 2). The mean age of the students was 23 (1.3) years. The students who wrote a bachelor's thesis achieved a median score of 110.0, whereas the students in the other group had a median score of 105.0 on the scale. All the items were assigned a 3 or higher. A statistically significant difference was found between the 2 groups in their attitudes towards and awareness of research (U = 3265.5; P = .025). The results of this study suggest that writing a thesis in nursing education has a positive influence on nursing students' attitudes towards and awareness of research and development in nursing. © 2017 John Wiley & Sons Australia, Ltd.

  14. [Development of a web-based education program for nurses working in nursing homes on human rights of older adults]. (United States)

    Kim, Ki-Kyong


    This study was done to develop a web-based education program for nurses working in nursing homes. The focus was on the rights of older adults. The program was designed based on the Network-Based Instructional System Design (NBISD) model and was operated and evaluated between July 2007 and June 2008. Out of nursing records of 40 residents from a nursing home, the final 7 cases were deducted through classification using the Resource Utilization Group (RUG)-III. The data on needs for education was collected from 28 nurses working in 15 nursing homes located in Seoul and Gyeonggi Province, who agreed to complete a self-report questionnaire. A comprehensive review of the literature and two focus groups interviews were used to search for risk factors and guidelines for protection of human rights. The education program was developed based on Kolb's experiential learning model and composed of 5 units, which included content on types of human rights and rights to death with dignity, elder abuse, physical liberty, and self-determination. The program was positively evaluated showing a score of 3.35 (SD=0.37) out of 4. The educational program developed in this study should promote nurses' sensitivity to the rights of elders and improve nurses' behaviors in protecting the rights of elders residing in nursing homes.

  15. Collaborating with nurse leaders to develop patient safety practices. (United States)

    Kanerva, Anne; Kivinen, Tuula; Lammintakanen, Johanna


    Purpose The organisational level and leadership development are crucial elements in advancing patient safety, because patient safety weaknesses are often caused by system failures. However, little is known about how frontline leader and director teams can be supported to develop patient safety practices. The purpose of this study is to describe the patient safety development process carried out by nursing leaders and directors. The research questions were: how the chosen development areas progressed in six months' time and how nursing leaders view the participatory development process. Design/methodology/approach Participatory action research was used to engage frontline nursing leaders and directors into developing patient safety practices. Semi-structured group interviews ( N = 10) were used in data collection at the end of a six-month action cycle, and data were analysed using content analysis. Findings The participatory development process enhanced collaboration and gave leaders insights into patient safety as a part of the hospital system and their role in advancing it. The chosen development areas advanced to different extents, with the greatest improvements in those areas with simple guidelines to follow and in which the leaders were most participative. The features of high-reliability organisation were moderately identified in the nursing leaders' actions and views. For example, acting as a change agent to implement patient safety practices was challenging. Participatory methods can be used to support leaders into advancing patient safety. However, it is important that the participants are familiar with the method, and there are enough facilitators to steer development processes. Originality/value Research brings more knowledge of how leaders can increase their effectiveness in advancing patient safety and promoting high-reliability organisation features in the healthcare organisation.

  16. Holifield Radioactive Ion Beam Facility Development and Status

    CERN Document Server

    Tatum, Alan


    The Holifield Radioactive Ion Beam Facility (HRIBF) is a national user facility dedicated to nuclear structure, reactions, and nuclear astrophysics research with radioactive ion beams (RIBs) using the isotope separator on-line (ISOL) technique. An integrated strategic plan for physics, experimental systems, and RIB production facilities have been developed and implementation of the plan is under way. Specific research objectives are defined for studying the nature of nucleonic matter, the origin of elements, solar physics, and synthesis of heavy elements. Experimental systems upgrade plans include new detector arrays and beam lines, and expansion and upgrade of existing devices. A multifaceted facility expansion plan includes a $4.75M High Power Target Laboratory (HPTL), presently under construction, to provide a facility for testing new target materials, target geometries, ion sources, and beam preparation techniques. Additional planned upgrades include a second RIB production system (IRIS2), an external axi...

  17. Accelerator-driven subcritical facility:Conceptual design development (United States)

    Gohar, Yousry; Bolshinsky, Igor; Naberezhnev, Dmitry; Duo, Jose; Belch, Henry; Bailey, James


    A conceptual design development of an accelerator-driven subcritical facility has been carried out in the preparation of a joint activity with Kharkov Institute of Physics and Technology of Ukraine. The main functions of the facility are the medical isotope production and the support of the Ukraine nuclear industry. An electron accelerator is considered to drive the subcritical assembly. The neutron source intensity and spectrum have been studied. The energy deposition, spatial neutron generation, neutron utilization fraction, and target dimensions have been quantified to define the main target performance parameters, and to select the target material and beam parameters. Different target conceptual designs have been developed based the engineering requirements including heat transfer, thermal hydraulics, structure, and material issues. The subcritical assembly is designed to obtain the highest possible neutron flux level with a Keff of 0.98. Different fuel materials, uranium enrichments, and reflector materials are considered in the design process. The possibility of using low enrichment uranium without penalizing the facility performance is carefully evaluated. The mechanical design of the facility has been developed to maximize its utility and minimize the time for replacing the target and the fuel assemblies. Safety, reliability, and environmental considerations are included in the facility conceptual design. The facility is configured to accommodate future design improvements, upgrades, and new missions. In addition, it has large design margins to accommodate different operating conditions and parameters. In this paper, the conceptual design and the design analyses of the facility will be presented.

  18. Domestic violence against nurses by their marital partners: A facility-based study at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kamlesh Kumari Sharma


    Full Text Available Background: In recent times, domestic violence against women by marital partners has emerged as an important public health problem. Objectives: 1. To determine the prevalence, characteristics and impact of domestic violence against nurses by their marital partners, in Delhi, India. 2. To identify nurses′ perceptions regarding acceptable behavior for men and women. Materials and Methods: A facility-based pilot study was conducted at All India Institute of Medical Sciences (AIIMS, New Delhi. Data were collected using self-administered standardized questionnaire, among 60 ever married female nurses working at AIIMS hospital, selected by convenience sampling. The principal outcome variables were controlling behavior, emotional, physical and sexual violence by marital partners. Data were analyzed using SPSS 12 software. The test applied was Fisher′s exact test and 1-sided Fisher′s exact test. Results: Sixty percent of nurses reported marital partner perpetrated controlling behavior, 65% reported emotional violence, 43.3% reported physical violence and 30% reported sexual violence. About 3/5 th of nurses (58% opined that no reason justified violence, except wife infidelity (31.67%. Of the physically or sexually abused respondents, 40% were ever injured, and 56.7% reported that violence affected their physical and mental health. Conclusion: There is a high magnitude of domestic violence against nurses and this is reported to have affected their physical and mental health.

  19. Medical staff organization in nursing homes: scale development and validation. (United States)

    Katz, Paul R; Karuza, Jurgis; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent; Caprio, Thomas; Caprio, Anthony; Dauenhauer, Jason; Lima, Julie


    To construct a multidimensional self-report scale to measure nursing home (NH) medical staff organization (NHMSO) dimensions and then pilot the scale using a national survey of medical directors to provide data on its psychometric properties. Instrument development process consisting of the proceedings from the Nursing Home Physician Workforce Conference and focus groups followed by cognitive interviews, which culminated in a survey of a random sample of American Medical Directors Association (AMDA) affiliated medical directors. Analyses were conducted on surveys matched to Online Survey Certification and Reporting (OSCAR) data from freestanding nonpediatric nursing homes. A total of 202 surveys were available for analysis and comprised the final sample. Dimensions were identified that measured the extent of medical staff organization in nursing homes and included staff composition, appointment process, commitment (physiciancohesion; leadership turnover/capability), departmentalization (physician supervision, autonomy and interdisciplinary involvement), documentation, and informal dynamics. The items developed to measure each dimension were reliable (Cronbach's alpha ranged from 0.81 to 0.65).Intercorrelations among the scale dimensions provided preliminary evidence of the construct validity of the scale. This report, for the first time ever, defines and validates NH medical staff organization dimensions, a critical first step in determining the relationship between physician practice and the quality of care delivered in the NH.

  20. [The development of a caring curriculum in nursing]. (United States)

    Kuo, Chien-Lin; Lee-Hsieh, Jane; Wang, Pi-Ling


    Caring is the essence of nursing and the core of nursing education. This paper describes the experience of developing a caring curriculum in a five-year junior college nursing program which included three core courses in caring, in the hope of stimulating further dialogue with fellow educators and cultivating students' caring competencies. The first course was Introduction to Caring, which gave students an understanding of basic concepts of caring, along with the opportunity to practice and experience caring by caring for oneself, one's family and one's peers. The second course was Application of Caring Concepts, which enabled students to learn about caring models, especially the dynamic caring model, and expanded their knowledge of caring behaviors from interpersonal caring to caring for society. The third course was Professional Caring, which explained professional caring and related caring theories, and introduced the caring model used in nursing in Taiwan, showing students how to practice caring in clinical situations. The participating teachers used the action research method to plan, design, implement, and evaluate the caring curriculum. These teachers set the teaching objectives and developed course materials by working together in workshops and participating in teachers' caring groups. They adopted various teaching strategies, such as role modeling, dialogue, caring groups, confirmation, literature, film, caring action projects, reflection, and journaling, which have been proven to be effective at raising students' learning motivation and caring performance.

  1. National RF Test Facility as a multipurpose development tool

    International Nuclear Information System (INIS)

    McManamy, T.J.; Becraft, W.R.; Berry, L.A.


    Additions and modifications to the National RF Test Facility design have been made that (1) focus its use for technology development for future large systems in the ion cyclotron range of frequencies (ICRF), (2) expand its applicability to technology development in the electron cyclotron range of frequencies (ECRF) at 60 GHz, (3) provide a facility for ELMO Bumpy Torus (EBT) 60-GHz ring physics studies, and (4) permit engineering studies of steady-state plasma systems, including superconducting magnet performance, vacuum vessel heat flux removal, and microwave protection. The facility will continue to function as a test bed for generic technology developments for ICRF and the lower hybrid range of frequencies (LHRF). The upgraded facility is also suitable for mirror halo physics experiments

  2. Trend of development of robots for nuclear facilities

    International Nuclear Information System (INIS)

    Maki, Hideo; Sasaki, Masayoshi


    Robot technology becomes more and more important in the field of atomic energy industries. Hitachi Ltd. has energetically engaged in the development of the robot technology for nuclear facilities, recognizing these situations. The course of the development of robot technology and the robots for nuclear facilities is described. As the practical examples of the robots for nuclear facilities, there have been automatic fuel exchangers, the remotely operated automatic exchangers for control rod driving mechanism, automatic and semi-automatic ultrasonic flaw detectors and so on. As the robots for nuclear facilities under development, control rod driving mechanism disassembling and cleaning system, the volume reduction device for spent fuel channel boxes and control rods and others are reported. (Kako, I.)

  3. Development of the Holifield Radioactive Ion Beam Facility

    International Nuclear Information System (INIS)

    Tatum, B.A.


    The Holifield Radioactive Ion Beam Facility (HRIBF) construction project has been completed and the first radioactive ion beam has been successfully accelerated. The project, which began in 1992, has involved numerous facility modifications. The Oak Ridge Isochronous Cyclotron has been converted from an energy booster for heavy ion beams to a light ion accelerator with internal ion source. A target-ion source and mass analysis system have been commissioned as key components of the facility's radioactive ion beam injector to the 25MV tandem electrostatic accelerator. Beam transport lines have been completed, and new diagnostics for very low intensity beams have been developed. Work continues on a unified control system. Development of research quality radioactive beams for the nuclear structure and nuclear astrophysics communities continues. This paper details facility development to date

  4. Decommissioning Technology Development for Nuclear Research Facilities

    International Nuclear Information System (INIS)

    Lee, K. W.; Kang, Y. A.; Kim, G. H.


    It is predicted that the decommissioning of a nuclear power plant would happen in Korea since 2020 but the need of partial decommissioning and decontamination for periodic inspection and life extension still has been on an increasing trend and its domestic market has gradually been extended. Therefore, in this project we developed following several essential technologies as a decommissioning R and D. The measurement technology for in-pipe radioactive contamination was developed for measuring alpha/beta/gamma emitting nuclides simultaneously inside a in-pipe and it was tested into the liquid waste transfer pipe in KRR-2. And the digital mock-up system for KRR-1 and 2 was developed for choosing the best scenarios among several scenarios on the basis of various decommissioning information(schedule, waste volume, cost, etc.) that are from the DMU and the methodology of decommissioning cost estimation was also developed for estimating a research reactor's decommissioning cost and the DMU and the decommissioning cost estimation system were incorporated into the decommissioning information integrated management system. Finally the treatment and management technology of the irradiated graphites that happened after decommissioning KRR-2 was developed in order to treat and manage the irradiated graphites safely

  5. Decommissioning Technology Development for Nuclear Research Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K. W.; Kang, Y. A.; Kim, G. H. (and others)


    It is predicted that the decommissioning of a nuclear power plant would happen in Korea since 2020 but the need of partial decommissioning and decontamination for periodic inspection and life extension still has been on an increasing trend and its domestic market has gradually been extended. Therefore, in this project we developed following several essential technologies as a decommissioning R and D. The measurement technology for in-pipe radioactive contamination was developed for measuring alpha/beta/gamma emitting nuclides simultaneously inside a in-pipe and it was tested into the liquid waste transfer pipe in KRR-2. And the digital mock-up system for KRR-1 and 2 was developed for choosing the best scenarios among several scenarios on the basis of various decommissioning information(schedule, waste volume, cost, etc.) that are from the DMU and the methodology of decommissioning cost estimation was also developed for estimating a research reactor's decommissioning cost and the DMU and the decommissioning cost estimation system were incorporated into the decommissioning information integrated management system. Finally the treatment and management technology of the irradiated graphites that happened after decommissioning KRR-2 was developed in order to treat and manage the irradiated graphites safely.

  6. The development of professional practice standards for Australian general practice nurses. (United States)

    Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine


    The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.

  7. [Higher professional education as a means for development in nursing]. (United States)

    Alberdi Castell, R


    The author reflects on how higher training contributes to development in Nursing, understanding by this term the discipline but also the set of professionals which exercise it. Therefore, the author analyzes those elements which are part of professional development; be this intrinsic, professional discourse, excellent professional exercise, market dominance, syndical capacity or representation. The author ends her article with a very simple proposal: make a world full of care, with a recognition of successes, a correction of errors and a deepening of attitudes.

  8. Developing the Serious Games potential in nursing education. (United States)

    Petit dit Dariel, Odessa J; Raby, Thibaud; Ravaut, Frédéric; Rothan-Tondeur, Monique


    Shortened hospital stays, high patient acuity and technological advances demand that nurses increasingly make decisions under conditions of uncertainty and risk (Ebright et al., 2003). With rising trends towards out-patient care, nurses will need to perform complex problem-solving within a dynamic and changing environment for which there is not one clear solution (Schofield et al., 2010; Wolff et al., 2009). The development of sharp clinical reasoning skills, as well as skills in detection, monitoring, investigation and evaluation are therefore essential (Aitken et al., 2002). Yet few nursing students have long-term exposure to home-care and community situations. This is primarily due to scarce human resources and the time-consuming requirements of student supervision (Duque et al., 2008). When students are given the opportunity to experience home-care or community visits these tend to be unstructured leading to wide variations in their competencies. New pedagogical tools are needed to adequately and consistently prepare nurses for the skills they will need to care for patients outside acute care settings. Advances in Information and Communications Technologies (ICT) offer an opportunity to explore innovative pedagogical solutions that could help students develop these skills in a safe environment. A three-phased project is underway that aims to create and test a Serious Game to improve nurses' clinical reasoning and detection skills in home-care and community settings. The first phase of this project involves the development of a scenario, the game engine and the graphic design and will be the focus of this paper. The second and third phases will test the Serious Game as an educational intervention and will be reported in subsequent papers. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Facilities for Research and Development of Medical Radioisotopes

    International Nuclear Information System (INIS)

    Shin, Byung Chul; Choung, Won Myung; Park, Jin Ho


    This study is carried out by KAERI(Korea Atomic Energy Research Institute) to construct the basic facilities for development and production of medical radioisotope. For the characteristics of radiopharmaceuticals, the facilities should be complied with the radiation shield and GMP(Good Manufacturing Practice) guideline. The KAERI, which has carried out the research and development of the radiopharmaceuticals, made a design of these facilities and built them in the HANARO Center and opened the technique and facilities to the public to give a foundation for research and development of the radiopharmaceuticals. In the facilities, radiation shielding utilities and GMP instruments were set up and their operating manuals were documented. Every utilities and instruments were performed the test to confirm their efficiency and the approval for use of the facilities will be achieved from MOST(Ministry of Science and Technology). It is expected to be applied in development of therapeutic radioisotope such as Re-188 generator and Ho-166, as well as Tc-99m generator and Sr-89 chloride for medical use. And it also looks forward to the contribution to the related industry through the development of product in high demand and value

  10. The effect of nursing management development program on clinical competency in coronary care unit

    Directory of Open Access Journals (Sweden)

    Ali Akbar Vaezi


    Full Text Available Background: Nurses are the main members in nursing cares and nursing managers can improve their clinical competency by applying better leadership skills. This study carried out to determine the effect of nursing management program on clinical competency of nurses in a coronary care unit (CCU.Methods: A quasi-experimental study was carried out in two educational hospitals in Yazd- Iran. These hospitals were allocated randomly in case and control hospitals. 25 matched nurses were selected by convenience sampling from both case and control hospitals. The clinical competency of nurses was measured by related questioners consisted of two dimensions caring and care management behaviors by self-evaluation and head nurse evaluation in case and control groups. Then, the intervention was implemented in four stages including nurse's development, managers' development, adaptation and supervision period during four months in the case group. After intervention, clinical competency of nurses was measured in both groups.Results: The results showed that before intervention more than 80% of nurses in two groups was in the moderate clinical competency level and they were proficient based on Benner's skill acquisition model. After intervention, nurses' clinical competency improved to higher level in case group but it didn't change in control group (P<0.05. Conclusion: Creating necessary modifications in nursing environments through the management development program by head nurses may improve nurses' clinical competency.

  11. Determinants of Quality of Work Life among Nurses Working in Hawassa Town Public Health Facilities, South Ethiopia: A Cross-Sectional Study. (United States)

    Kelbiso, Lolemo; Belay, Admasu; Woldie, Mirkuzie


    A high quality of work life (QWL) is a crucial issue for health care facilities to have qualified, dedicated, and inspired employees. Among different specialties in health care settings, nurses have a major share among other health care providers. So, they should experience a better QWL to deliver high-quality holistic care to those who need help. To assess the level of quality of work life and its predictors among nurses working in Hawassa town public health facilities, South Ethiopia. A facility based cross-sectional study was conducted on 253 nurses of two hospitals and nine health centers. The total sample size was allocated to each facility based on the number of nurses in each facility. Data were collected using a structured questionnaire. The interitem consistency of the scale used to measure QWL had Cronbach's alpha value of 0.86. A multinomial logistic regression model was fitted to identify significant predictors of quality of work life using SPSS version 20. The study showed that 67.2% of the nurses were dissatisfied with the quality of their work life. We found that educational status, monthly income, working unit, and work environment were strong predictors of quality of work life among nurses ( p quality of their work life. The findings in this study and studies reported from elsewhere pinpoint that perception of nurses about the quality of their work life can be modified if health care managers are considerate of the key issues surrounding QWL.

  12. How nursing home residents develop relationships with peers and staff: a grounded theory study. (United States)

    Roberts, Tonya; Bowers, Barbara


    Social support and social relationships have been repeatedly identified as essential to nursing home resident quality of life. However, little is known about ways residents develop relationships with peers or staff. This study was conducted to explore the ways resident develop relationships with peers and staff in nursing homes. Fifteen cognitively intact nursing home residents from two facilities were interviewed for this grounded theory study. Sampling, interviewing, and analysis occurred in a cyclical process with results at each stage of the study informing decisions about data collection and analysis in the next. Unstructured interviews and field observations were conducted. Data were analyzed with open, axial, and selective coding. Residents developed relationships with peers and staff largely as an unintended consequence of trying to have a life in the nursing home. Having a life was a two-step process. First, life motivations (Being Self and Creating a Positive Atmosphere) influenced resident preferences for daily activities and interaction goals and subsequently their strategies for achieving and establishing both. Second, the strategies residents used for achieving their required daily activities (Passing Time and Getting Needs Met) and interaction goals then influenced the nature of interaction and the subsequent peer or staff response to these interactions. Residents defined relationships as friendly or unfriendly depending on whether peers or staff responded positively or negatively. There was considerable overlap in the ways peer and staff relationships developed and the results highlight the role of peer and staff responsiveness in relationship development. The results provide possible explanations for the success of interventions in the literature designed to improve staff responsiveness to residents. The results suggest that adapting these kinds of interventions for use with peers may also be successful. The conceptual model also presents a number

  13. Philosophical inquiry and the goals of nursing: a critical approach for disciplinary knowledge development and action. (United States)

    Grace, Pamela J; Perry, Donna J


    Philosophical inquiry remains critically important for nursing education, practice, and knowledge development. We propose a 3-level taxonomy of philosophical inquiry to guide nursing curricula and research development. Important background information about philosophy and the development of philosophical methods is given. Then philosophical inquiry is linked to the goals of nursing using our proposed taxonomy: level I-cultivating an attitude of "critical consciousness" related to all nursing situations and actions, level II-analysis and application of philosophical perspectives to nursing problems and level III-generating new knowledge for nursing purposes including new theories of practice and research.

  14. Implementing a Process to Measure Return on Investment for Nursing Professional Development. (United States)

    Garrison, Elisabeth; Beverage, Jodie

    Return on investment (ROI) is one way to quantify the value that nursing professional development brings to the organization. This article describes a process to begin tracking ROI for nursing professional development. Implementing a process of tracking nursing professional development practitioners' ROI increased awareness of the financial impact and effectiveness of the department.

  15. Forge: a short pulse x-ray diagnostic development facility

    International Nuclear Information System (INIS)

    Stradling, G.L.; Hurry, T.R.; Denbow, E.R.; Selph, M.M.; Ameduri, F.P.


    A new short pulse x-ray calibration facility has been brought on line at Los Alamos. This facility is being used for the development, testing and calibration of fast x-ray diagnostic systems. The x-ray source consists of a moderate size, sub-nanosecond laser focused at high intensity on an appropriate target material to generate short pulses of x-ray emission from the resulting plasma. Dynamic performance parameters of fast x-ray diagnostic instruments, such as x-ray streak cameras, can be conveniently measured using this facility

  16. Development and validation of the Nursing Workplace Satisfaction Questionnaire (NWSQ). (United States)

    Fairbrother, Greg; Jones, Aaron; Rivas, Ketty

    A nursing job satisfaction questionnaire was designed by a project group of nurses seeking a suitable job satisfaction measure to track as an outcome in a large Sydney hospital-wide models of nursing care project. Existing tools were rejected by the group as overly lengthy, US-biased and over-using respondent assessment of the character of the work environment as a proxy for job satisfaction, or happiness at work. A one-page, 14-item tool was developed after instrument reviewing and facilitated groupwork. The tool reduces to three measurable domains: intrinsic, extrinsic and relational job satisfaction. Exploratory factor analysis (n = 220 responses) confirmed the validity of this 'three-way' conceptualisation of nursing job satisfaction. Internal consistency analysis on a larger sample of responses (n = 459) yielded high Cronbach's Alpha values for all three domains and for the total overall, suggesting a stable and reliable measure. The NWSQ is short, one page, sensibly worded for Australian conditions and yields scoring against three validated domains. It holds significant potential utility as a standard metric for prospective ward-based or institution-wide performance trending.

  17. Lateral Violence in Nursing Survey: Instrument Development and Validation

    Directory of Open Access Journals (Sweden)

    Lynne S. Nemeth


    Full Text Available An examination of the psychometric properties of the Lateral Violence in Nursing Survey (LVNS, an instrument previously developed to measure the perceived incidence and severity of lateral violence (LV in the nursing workplace, was carried out. Conceptual clustering and principal components analysis were used with survey responses from 663 registered nurses and ancillary nursing staff in a southeastern tertiary care medical center. Where appropriate, Cronbach’s alpha (α evaluated internal consistency. The prevalence/severity of lateral violence items constitute two distinct subscales (LV by self and others with Cronbach’s alpha of 0.74 and 0.86, respectively. The items asking about potential causes of LV are unidimensional and internally consistent (alpha = 0.77 but there is no conceptually coherent theme underlying the various causes. Respondents rating a potential LV cause as “major” scored higher on both prevalence/severity subscales than those rating it a “minor” cause or not a cause. Subsets of items on the LVNS are internally reliable, supporting construct validity. Revisions of the original LVNS instrument will improve its use in future work.

  18. Nondestructive assay system development for a plutonium scrap recovery facility

    International Nuclear Information System (INIS)

    Hsue, S.T.; Baker, M.P.


    A plutonium scrap recovery facility is being constructed at the Savannah River Plant (SRP). The safeguards groups of the Los Alamos National Laboratory have been working since the early design stage of the facility with SRP and other national laboratories to develop a state-of-the-art assay system for this new facility. Not only will the most current assay techniques be incorporated into the system, but also the various nondestructive assay (NDA) instruments are to be integrated with an Instrument Control Computer (ICC). This undertaking is both challenging and ambitious; an entire assay system of this type has never been done before in a working facility. This paper will describe, in particular, the effort of the Los Alamos Safeguards Assay Group in this endeavor. Our effort in this project can be roughly divided into three phases: NDA development, system integration, and integral testing. 6 references

  19. Development of cloud-operating platform for detention facility design (United States)

    Tun Lee, Kwan; Hung, Meng-Chiu; Tseng, Wei-Fan; Chan, Yi-Ping


    In the past 20 years, the population of Taiwan has accumulated in urban areas. The land development has changed the hydrological environment and resulted in the increase of surface runoff and shortened the time to peak discharge. The change of runoff characteristics increases the flood risk and reduces resilient ability of the city during flood. Considering that engineering measures may not be easy to implement in populated cities, detention facilities set on building basements have been proposed to compromise the increase of surface runoff resulting from development activities. In this study, a web-based operational platform has been developed to integrate the GIS technologies, hydrological analyses, as well as relevant regulations for the design of detention facilities. The design procedure embedded in the system includes a prior selection of type and size of the detention facility, integrated hydrological analysis for the developing site, and inspection of relevant regulations. After login the platform, designers can access the system database to retrieve road maps, land use coverages, and storm sewer information. Once the type, size, inlet, and outlet of the detention facility are assigned, the system can acquire the rainfall intensity-duration-frequency information from adjacent rain gauges to perform hydrological analyses for the developing site. The increase of the runoff volume due to the development and the reduction of the outflow peak through the construction of the detention facility can be estimated. The outflow peak at the target site is then checked with relevant regulations to confirm the suitability of the detention facility design. The proposed web-based platform can provide a concise layout of the detention facility and the drainageway of the developing site on a graphical interface. The design information can also be delivered directly through a web link to authorities for inspecting to simplify the complex administrative procedures.

  20. Space facilities: Meeting future needs for research, development, and operations (United States)

    The National Facilities Study (NFS) represents an interagency effort to develop a comprehensive and integrated long-term plan for world-class aeronautical and space facilities that meet current and projected needs for commercial and government aerospace research and development and space operations. At the request of NASA and the DOD, the National Research Council's Committee on Space Facilities has reviewed the space related findings of the NFS. The inventory of more than 2800 facilities will be an important resource, especially if it continues to be updated and maintained as the NFS report recommends. The data in the inventory provide the basis for a much better understanding of the resources available in the national facilities infrastructure, as well as extensive information on which to base rational decisions about current and future facilities needs. The working groups have used the inventory data and other information to make a set of recommendations that include estimates of cast savings and steps for implementation. While it is natural that the NFS focused on cost reduction and consolidations, such a study is most useful to future planning if it gives equal weight to guiding the direction of future facilities needed to satisfy legitimate national aspirations. Even in the context of cost reduction through facilities closures and consolidations, the study is timid about recognizing and proposing program changes and realignments of roles and missions to capture what could be significant savings and increased effectiveness. The recommendations of the Committee on Space Facilities are driven by the clear need to be more realistic and precise both in recognizing current incentives and disincentives in the aerospace industry and in forecasting future conditions for U.S. space activities.

  1. Effects of Caps on Cost Sharing for Skilled Nursing Facility Services in Medicare Advantage Plans. (United States)

    Keohane, Laura M; Rahman, Momotazur; Thomas, Kali S; Trivedi, Amal N


    To evaluate a federal regulation effective in 2011 that limited how much that Medicare Advantage (MA) plans could charge for the first 20 days of care in a skilled nursing facility (SNF). Difference-in-differences retrospective analysis comparing SNF utilization trends from 2008-2012. Select MA plans. Members of 27 plans with mandatory cost sharing reductions (n=132,000) and members of 21 plans without such reductions (n=138,846). Mean monthly number of SNF admissions and days per 1,000 members; annual proportion of MA enrollees exiting the plan. In plans with mandated cost sharing reductions, cost sharing for the first 20 days of SNF care decreased from an average of $2,039 in 2010 to $992 in 2011. In adjusted analyses, plans with mandated cost-sharing reductions averaged 158.1 SNF days (95% confidence interval (CI)=153.2-163.1 days) per 1,000 members per month before the cost sharing cap. This measure increased by 14.3 days (95% CI=3.8-24.8 days, p=0.009) in the 2 years after cap implementation. However, increases in SNF utilization did not significantly differ between plans with and without mandated cost-sharing reductions (adjusted between-group difference: 7.1 days per 1,000 members, 95% CI=-6.5-20.8, p=.30). Disenrollment patterns did not change after the cap took effect. When a federal regulation designed to protect MA members from high out-of-pocket costs for postacute care took effect, the use of SNF services did not change. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  2. First-dollar cost-sharing for skilled nursing facility care in medicare advantage plans. (United States)

    Keohane, Laura M; Grebla, Regina C; Rahman, Momotazur; Mukamel, Dana B; Lee, Yoojin; Mor, Vincent; Trivedi, Amal


    The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010. Copays began on the first day of a SNF admission. We matched these plans to seven matched control plans that did not introduce first-dollar cost-sharing. In a difference-in-differences analysis, we compared changes in SNF and inpatient utilization for the 172,958 members of intervention and control plans. In intervention plans the mean annual number of SNF days per 100 continuously enrolled inpatients decreased from 768.3 to 750.6 days when cost-sharing changes took effect. Control plans experienced a concurrent increase: 721.7 to 808.1 SNF days per 100 inpatients (adjusted difference-in-differences: -87.0 days [95% CI (-112.1,-61.9)]). In intervention plans, we observed no significant changes in the probability of any SNF service use or the number of inpatient days per hospitalized member relative to concurrent trends among control plans. Among several strategies Medicare Advantage plans can employ to moderate SNF use, first-dollar SNF cost-sharing may be one influential factor. Not applicable.

  3. Geriatric Syndromes in Hospitalized Older Adults Discharged to Skilled Nursing Facilities (United States)

    Bell, Susan P.; Vasilevskis, Eduard E.; Saraf, Avantika A.; Jacobsen, J. Mary Lou; Kripalani, Sunil; Mixon, Amanda S.; Schnelle, John F.; Simmons, Sandra F.


    Background Geriatric syndromes are common in older adults and associated with adverse outcomes. The prevalence, recognition, co-occurrence and recent onset of geriatric syndromes in patients transferred from hospital to skilled nursing facilities (SNFs) are largely unknown. Design Quality improvement project. Setting Acute care academic medical center and 23 regional partner SNFs. Participants 686 Medicare beneficiaries hospitalized between January 2013 and April 2014 and referred to SNFs. Measurements Nine geriatric syndromes were measured by project staff -- weight loss, decreased appetite, incontinence and pain (standardized interview), depression (Geriatric Depression Scale), delirium (Brief-Confusion Assessment Method), cognitive impairment (Brief Interview for Mental Status), falls and pressure ulcers (hospital medical record utilizing hospital-implemented screening tools). Estimated prevalence, new-onset prevalence and common coexisting clusters were determined. The extent that syndromes were commonly recognized by treating physicians and communicated to SNFs in hospital discharge documentation was evaluated. Results Geriatric syndromes were prevalent in more than 90% of hospitalized adults referred to SNFs; 55% met criteria for 3 or more co-existing syndromes. Overall the most prevalent syndromes were falls (39%), incontinence (39%), decreased appetite (37%) and weight loss (33%). Of individuals that met criteria for 3 or more syndromes, the most common triad clusters included nutritional syndromes (weight loss, loss of appetite), incontinence and depression. Treating hospital physicians commonly did not recognize and document geriatric syndromes in discharge summaries, missing 33–95% of syndromes present as assessed by research personnel. Conclusion Geriatric syndromes in hospitalized older adults transferred to SNF are prevalent and commonly co-exist with the most frequent clusters including nutritional syndromes, depression and incontinence. Despite

  4. Career advancement and professional development in nursing. (United States)

    Adeniran, Rita K; Smith-Glasgow, Mary Ellen; Bhattacharya, Anand; Xu, Yu


    Excellence underscores the need for nurses to keep their skills and competencies current through participation in professional development and career advancement. Evidence suggests that internationally educated nurses (IENs) progress relatively slowly through the career ladder and participate less in professional development compared with nurses educated in the United States (UENs). Mentorship and self-efficacy are considered major determinants of career advancement. The aim of the study was to understand the differences in levels of mentorship function and self-efficacy as well as the differences in participation in professional development and career advancement between UENs and IENs. A descriptive survey design was implemented using a Web-based survey. Significant disparities were noted in the role model function of mentoring and some professional development and career advancement measures between UENs and IENs. Mentorship is essential for professional growth. Sociodemographic characteristics of mentors are important because mentors are role models. Standardized career advancement structures are needed to promote professional growth. Published by Mosby, Inc.

  5. Creating a culture of shared Governance begins with developing the nurse as scholar. (United States)

    Donohue-Porter, Patricia


    The relationship between shared governance and nursing scholarship is investigated with an emphasis on the connection between stages of scholarly development and nursing action in the evolution of professional practice models. The scholarly image of nursing is described and four critical stages of scholarship (scholarly inquiry, conscious reflection, persistent critique, and intellectual creation) are presented. The development of nursing scholars is described with emphasis on intellectual virtues as described by philosophers and values as described by nursing theorists that are foundational to this process. Shared governance is viewed holistically as a true scholarly process when these elements are in place and are used by nurses.

  6. [The development and current status of men in the nursing profession]. (United States)

    Huang, Chun-Che; Kuo, Ying-Ling


    Nursing has been a quintessentially female-dominated occupation throughout much of its history. Today, educational developments, changes in healthcare service models and promotion of gender equality in education and employment have opened the doors to males to play increasingly important roles in the healthcare services as nursing professionals. The responsibilities of male nursing staff are expected to continue to increase. It remains difficult for male nurses to escape traditional gender stereotypes in nursing. The impact of personal characteristics, occupational roles, and professional identification in real practice are major issues of concern. This study reviewed relevant literature to identify factors of influence on male nursing staff professional practice. We hope this study can be a reference for future research on male nursing staff development, and that male nurses will increasingly create personal core values in a multi-discipline, cross-professional healthcare team, and exercise their abilities as a complement to female nurses.

  7. Use of Motivational Interviewing by Nurse Leaders: Coaching for Performance, Professional Development, and Career Goal Setting. (United States)

    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.

  8. Development of a nursing practice based competency model for the Flemish master of nursing and obstetrics degree. (United States)

    De Clercq, Gerlinde; Goelen, Guido; Danschutter, Dirk; Vermeulen, Joeri; Huyghens, Luc


    The aim was to identify a set of competences for the Flemish academic Master of Nursing and Obstetrics degree that answer perceived needs in health care. The competency model was to demonstrate a degree of consensus among key nurses. The study was conducted in all Flemish hospitals registered to have 400 beds or more. Head nurses of surgery, geriatrics and intensive care units were eligible to participate, as well as one nurse from administration per hospital. A two round Delphi process allowed participants to comment on items identified in an analysis of existing international competency profiles of master level nurses and adapted to the Flemish context. Competences agreed to by 90% of the respondents were considered to have consensus. Fifteen out of 19 eligible hospitals were recruited in the study, 45 nurses participated in the Delphi panel. Consensus was reached on 31 competences that can be assigned to 5 nurse's roles: nursing expert, innovator, researcher, educator and manager. The resulting competency profile is in accordance with published profiles for similar programs. The reported study demonstrates a practical method to develop a consensus competency model for an academic master program based on the input of key individuals in mainstream nursing. 2010 Elsevier Ltd. All rights reserved.

  9. Upgrade and Development of Nuclear Data Production Test Facility

    Energy Technology Data Exchange (ETDEWEB)



    It is necessary to improve the Pohang Neutron Facility (PNF) in order to be used as a nuclear data production facility for users in both domestic and abroad. We improved following items: (1) upgrade the electron linac, (2) collimators inside the TOF beam pipe, (3) the development and installation of an automatic sample changer, (4) the extension of the TOF beam line, and (5) the data acquisition system. We would like to establish a utilization system for users to measure the nuclear data at the PNF. To do this, we made manuals for the accelerator operation and the data acquisition system. We also made an application form to apply for users to measure the nuclear data in both domestic and abroad. The main object of the Pohang Neutron Facility is to measure the nuclear data in the neutron energy region from thermal neutron to few hundreds of eV. In addition to neutron beams produced at the PNF, photon and electron beams are produced in this facility. We thus utilize this facility for other fields, such as test facility for detectors, activation experiments, polarized neutron beam source, and so on. In addition to these, we could use this facility for training students

  10. Upgrade and development of nuclear data production test facility

    Energy Technology Data Exchange (ETDEWEB)

    Namkung, Won; Ko, I. S.; Cho, M. H.; Lee, Y. S.; Kang, H. S. [Pohang Univ. of Science and Technology, Pohang (Korea, Republic of); Kim, G. N. [Kyungpook National Univ., Daegu (Korea, Republic of); Koh, S. K. [Univ. of Ulsan, Ulsan (Korea, Republic of); Ro, T. I. [Donga Univ., Busan (Korea, Republic of); Choi, G. U. [Korea Research Institute of Standards and Science, Daejeon (Korea, Republic of)


    It is necessary to improve the Pohang Neutron Facility (PNF) in order to be used as a nuclear data production facility for users in both domestic and abroad. We improved following items: upgrade the electron linac, collimators inside the TOF beam pipe, the development and installation of an automatic sample changer, the extension of the TOF beam line, and the data acquisition system. We would like to establish a utilization system for users to measure the nuclear data at the PNF. To do this, we made manuals for the accelerator operation and the data acquisition system. We also made an application form to apply for users to measure the nuclear data in both domestic and abroad. The main object of the Pohang Neutron Facility is to measure the nuclear data in the neutron energy region from thermal neutron to few hundreds of eV. In addition to neutron beams produced at the PNF, photon and electron beams are produced in this facility. We thus utilize this facility for other fields, such as test facility for detectors, activation experiments, polarized neutron beam source, and so on. In addition to these, we could use this facility for training students.

  11. Detecting Development Pattern of Urban Business Facilities Using Reviews Data

    Directory of Open Access Journals (Sweden)

    JIANG Botao


    Full Text Available This paper reveals and utilizes the growing power of online customer reviews in the space and time context. The location of commercial facilities and online customer reviews offered by provide an important data source for the study of spatial and temporal dynamics of urban commercial facilities. The constraints of road network are taken into account towards computing the density of urban commercial facilities and associated online customer reviews, as well as their spatial distribution, temporal trend, and the coupling relationship between facility number and stratification level. This paper maps the spatial distribution of commercial facilities onto the nearby road network, reflecting the influences of the locations, number and satisfaction levels of other commercial facilities across various street types. Because more and more customers tend to make a final shopping decision by sorting through search results by ratings and feedback, the research conducted in this paper can provide the proof for quantitative evaluation of urban planning on commercial facility development.

  12. mHealth: Knowledge and use among doctors and nurses in public secondary health-care facilities of Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Bukola Samuel Owolabi


    Full Text Available Objectives: Mobile health (mHealth is gaining importance worldwide, changing and improving the way healthcare and services are provided, but its role is just emerging in Nigeria. This study aimed to assess the knowledge and use of mHealth among health workers and the provisions for its use in public secondary health-care facilities of Lagos State, Nigeria. Methods: The study was a descriptive cross-sectional study carried out among 65 doctors and 135 nurses selected using a two-staged sampling method. Data were collected with pretested self-administered questionnaires and analyzed with EpiInfo™ 7. Results: Majority (doctors 84.6%, nurses 91.1% had not heard of the term “mHealth,” but most (doctors 96.9%, nurses 87.4% were aware of the use of mobile phones in health-care delivery. Only three (27.3% (health call centers/health-care telephone helpline, appointment reminders, and mobile telemedicine out of 11 mHealth components listed were mostly known. Most doctors simply used patient monitoring/surveillance and mobile telemedicine, while nurses mainly used treatment compliance and appointment reminder services. Majority were willing to use more mHealth services if available in their hospital. All the doctors and 97% of nurses had mobile phones. However, only about one-quarter (27.5% had smartphones with applications used for mHealth purposes. Conclusions: Knowledge, awareness, and use of mHealth services were low. Doctors and nurses should be enlightened and trained on ways to use mHealth services to improve health-care delivery, mHealth services should be made available in the hospitals, and use of smartphones encouraged as they portend better adaptability for mHealth use.

  13. Developing scholarly thinking using mind maps in graduate nursing education. (United States)

    Kotcherlakota, Suhasini; Zimmerman, Lani; Berger, Ann M


    Two broad issues that beginning graduate nursing students face are identifying a research focus and learning how to organize complex information. Developing a mind map is 1 strategy to help students clarify their thinking and lay the foundation for in-depth expertise related to their research focus, review of the literature, and conceptual framework. The authors discuss their use of mind mapping combined with feedback using a fishbowl technique.

  14. Developing a model lifeline protection program for DOE facilities

    International Nuclear Information System (INIS)

    Lowing, A.N.


    A National Lifeline Standard Development Program is currently being conducted by FEMA and NIST. The Department of Energy is following these developments and supplementing them to meet Life-Safety and mission requirements for all DOE facilities as part of the Natural Phenomena Hazards Mitigation Plan. The task will be overseen by a DOE management team with technical guidance provided by a Steering Group of management and operating contractor representatives. The DOE will participate in the federal program by conducting a workshop on lifeline protection issues, developing an overall plan, organizing a Steering Group, and conducting a pilot study at a DOE facility

  15. Teamwork in perioperative nursing. Understanding team development, effectiveness, evaluation. (United States)

    Farley, M J


    Teams are an essential part of perioperative nursing practice. Nurses who have a knowledge of teamwork and experience in working on teams have a greater understanding of the processes and problems involved as teams develop from new, immature teams to those that are mature and effective. This understanding will assist nurses in helping their teams achieve a higher level of productivity, and members will be more satisfied with team efforts. Team development progresses through several stages. Each stage has certain characteristics and desired outcomes. At each stage, team members and leaders have certain responsibilities. Team growth does not take place automatically and inevitably, but as a consequence of conscious and unconscious efforts of its leader and members to solve problems and satisfy needs. Building and maintaining a team is certainly work, but work that brings a great deal of satisfaction and feelings of pride in accomplishment. According to I Tenzer, RN, MS, teamwork "is not a panacea; it is a viable approach to developing a hospital's most valuable resource--people."

  16. Development of anti-biofouling methods for gate facilities

    International Nuclear Information System (INIS)

    Fukuoka, Mari; Akamine, Kenichi; Iai, Yuuichi; Takatoo, Norihiro; Fukushima, Noriaki


    In the maintenance and management of gate facilities, a large sum of money and labor are required to remove and clean organisms that attach themselves to the facilities. That is why we developed two anti-biofouling systems, one that uses a weak electric current and another that uses ultrasonic waves. We carried out basic examinations and actual environment examinations to verify the effects of these methods. As a result, it has been confirmed that these methods effectively anti-foul the parts they are applied to, and that they can be used on gate facilities. In the future, we will evaluate their adaptability to aqueducts, such as those used in thermal and nuclear power plants, and marine structures, such as floating breakwaters, in addition to gate facilities. (author)

  17. Outcomes of a career planning and development program for registered nurses. (United States)

    Hall, Linda McGillis; Waddell, Janice; Donner, Gail; Wheeler, Mary M


    The impact of a career planning and development program (CPDP) for registered nurses (RNs) on nurse and system outcomes was examined. The CPDP was effective as participants were able to create a career vision and individualized career plan.

  18. An Introduction to the Partial Credit Model for Developing Nursing Assessments. (United States)

    Fox, Christine


    Demonstrates how the partial credit model, a variation of the Rasch Measurement Model, can be used to develop performance-based assessments for nursing education. Applies the model using the Practical Knowledge Inventory for Nurses. (SK)

  19. Development of a Post-Master's Fellowship Program in Oncology Nursing Education. Final Report. (United States)

    Siegele, Dorothy; Henderson, Billie

    A one-year Post-Master's Fellowship in Oncology Nursing Education for nurse educators was developed through the collaboration of San Jose State University (California) and University of Alabama at Birmingham. The project was designed to: develop or update undergraduate/graduate oncology nursing programs; provide continuing education for practicing…

  20. Family Satisfaction With Nursing Home Care: The Role of Facility Characteristics and Resident Quality-of-Life Scores (United States)

    Shippee, Tetyana P.; Henning-Smith, Carrie; Gaugler, Joseph E.; Held, Robert; Kane, Robert L.


    This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews (n = 16,790 family members), (2) multidimensional survey of resident QOL (n = 13,433 residents), and (3) facility characteristics (n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: “care,” “staff,” “environment,” and “food.” Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics. PMID:26534835

  1. Development of a fault test experimental facility model using Matlab

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Iraci Martinez; Moraes, Davi Almeida, E-mail:, E-mail: [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)


    The Fault Test Experimental Facility was developed to simulate a PWR nuclear power plant and is instrumented with temperature, level and pressure sensors. The Fault Test Experimental Facility can be operated to generate normal and fault data, and these failures can be added initially small, and their magnitude being increasing gradually. This work presents the Fault Test Experimental Facility model developed using the Matlab GUIDE (Graphical User Interface Development Environment) toolbox that consists of a set of functions designed to create interfaces in an easy and fast way. The system model is based on the mass and energy inventory balance equations. Physical as well as operational aspects are taken into consideration. The interface layout looks like a process flowchart and the user can set the input variables. Besides the normal operation conditions, there is the possibility to choose a faulty variable from a list. The program also allows the user to set the noise level for the input variables. Using the model, data were generated for different operational conditions, both under normal and fault conditions with different noise levels added to the input variables. Data generated by the model will be compared with Fault Test Experimental Facility data. The Fault Test Experimental Facility theoretical model results will be used for the development of a Monitoring and Fault Detection System. (author)

  2. Development of a fault test experimental facility model using Matlab

    International Nuclear Information System (INIS)

    Pereira, Iraci Martinez; Moraes, Davi Almeida


    The Fault Test Experimental Facility was developed to simulate a PWR nuclear power plant and is instrumented with temperature, level and pressure sensors. The Fault Test Experimental Facility can be operated to generate normal and fault data, and these failures can be added initially small, and their magnitude being increasing gradually. This work presents the Fault Test Experimental Facility model developed using the Matlab GUIDE (Graphical User Interface Development Environment) toolbox that consists of a set of functions designed to create interfaces in an easy and fast way. The system model is based on the mass and energy inventory balance equations. Physical as well as operational aspects are taken into consideration. The interface layout looks like a process flowchart and the user can set the input variables. Besides the normal operation conditions, there is the possibility to choose a faulty variable from a list. The program also allows the user to set the noise level for the input variables. Using the model, data were generated for different operational conditions, both under normal and fault conditions with different noise levels added to the input variables. Data generated by the model will be compared with Fault Test Experimental Facility data. The Fault Test Experimental Facility theoretical model results will be used for the development of a Monitoring and Fault Detection System. (author)

  3. Graduate nurses' evaluation of mentorship: Development of a new tool. (United States)

    Tiew, Lay Hwa; Koh, Catherine S L; Creedy, Debra K; Tam, W S W


    Develop and test an instrument to measure graduate-nurses' perceptions of a structured mentorship program. New graduate nurses may experience difficulties in the transition from student to practitioner. Mentoring is commonly used to support graduates. However, there is a lack of published tools measuring graduate nurses' perceptions of mentorship. As mentoring is resource intensive, development and testing of a validated tool are important to assist in determining program effectiveness. A pretest-posttest interventional design was used. Following a critical review of literature and content experts' input, the 10-item National University Hospital Mentorship Evaluation (NUH ME) instrument was tested with a convenience sample of 83 graduate nurses. Psychometric tests included internal reliability, stability, content validity, and factor analysis. Changed scores were evaluated using paired samples t-test. Seventy-three graduates (88%) out of a possible 83 completed the pre-and post-program survey. Internal reliability was excellent with a Cronbach's alpha of 0.92. Test-retest reliability was stable over time (ICC=0.81). Exploratory factor analysis supported a 1-factor solution explaining 58.2% of variance. Paired samples t-test showed statistical significance between the pre- and post-program scores (pprograms can be an effective recruitment and retention strategy, but are also resource intensive. Measuring new graduates' perceptions of mentoring contributes to program relevance in addressing their personal, professional and clinical skill development needs. As mentoring engages a diverse range of mentors, feedback through measurement may also positively alter organizational learning culture. Copyright © 2017. Published by Elsevier Ltd.

  4. The effectiveness of evidence-based nursing on development of nursing students' critical thinking: A meta-analysis. (United States)

    Cui, Chuyun; Li, Yufeng; Geng, Dongrong; Zhang, Hui; Jin, Changde


    The aim of this meta-analysis was to assess the effectiveness of evidence-based nursing (EBN) on the development of critical thinking for nursing students. A systematic literature review of original studies on randomized controlled trials was conducted. The relevant randomized controlled trials were retrieved from multiple electronic databases including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health (CINAHL), Chinese BioMed Database (CBM), China National Knowledge Infrastructure (CNKI), and WanFang Database. In order to make a systematic evaluation, studies were selected according to inclusion and exclusion criteria, and then according to extracted data and assessed quality. The data extraction was completed by two independent reviewers, and the methodological quality assessment was completed by another two reviewers. All of the data was analyzed by the software RevMan5.3. A total of nine studies with 1079 nursing students were chosen in this systematic literature review. The result of this meta-analysis showed that the effectiveness of evidence-based nursing was superior to that of traditional teaching on nursing students' critical thinking. The results of this meta-analysis indicate that evidence-based nursing could help nursing students to promote their development of critical thinking. More researches with higher quality and larger sample size can be analyzed in the further. Copyright © 2018. Published by Elsevier Ltd.

  5. [Skin Care to Prevent Development of Pressure Ulcers in Bedridden Nursing Home Residents from Developing Pressure Ulcers in Nursing Home Residents]. (United States)

    Furukawa, Chie


    The purpose of this study was to clarify whether skincare products are effective in preventing development of pressure ulcers in bedridden nursing home residents. The study sample consisted of 21 nursing home residents at a nursing home in Osaka, Japan who use diapers. Participants were assigned to 3 groups and compared to a control group. None of the subjects developed a pressure ulcer and had improved skin condition around the anus.

  6. Social Media Training for Professional Identity Development in Undergraduate Nurses. (United States)

    Mather, Carey; Cummings, Elizabeth; Nichols, Linda


    The growth of social media use has led to tension affecting the perception of professionalism of nurses in healthcare environments. The aim of this cross-sectional study was to explore first and final year undergraduate student use of social media to understand how it was utilised by them during their course. Descriptive statistical analysis was undertaken to compare differences between first and final year student use. No difference indicated there was a lack of development in the use of social media, particularly concerning in relation to expanding their professional networks. There is a need for the curriculum to include opportunities to teach student nurses methods to ensure the appropriate and safe use of social media. Overt teaching and modelling of desired behaviour to guide and support the use of social media to positively promote professional identity formation, which is essential for work-readiness at graduation, is necessary.

  7. Political-ethical skill development in nursing undergraduates

    Directory of Open Access Journals (Sweden)

    Maria Dyrce Dias Meira


    Full Text Available This research aimed to identify political-ethical skills developed in a training process compatible with the expected profile set by the National Curriculum Guidelines for the Undergraduate Nursing Degree. A case study was conducted with units represented by 32 former students from a particular religious teaching institution who already were in the job market. The content of the interviews was analyzed using the thematic analysis technique, which resulted in the following categories: "Political-ethical skills in the formative process" and "Political-ethical skills as a product of the educational process." From the former students’ perspective, these categories reinforced the social role of the nurse and the need for students to be reflective, understanding and participative in the transformation of society.

  8. Professional Development Strategies to Enhance Nurses' Knowledge and Maintain Safe Practice. (United States)

    Bindon, Susan L


    Maintaining competence is a professional responsibility for nurses. Individual nurses are accountable for their practice, as outlined in the American Nurses Association's Nursing: Scope and Standards of Practice. Nurses across clinical settings face the sometimes daunting challenge of staying abreast of regulatory mandates, practice changes, equipment updates, and other workplace expectations. In the complex, evolving perioperative setting, professional development is a priority, and the need for ongoing education is critical. However, nurses' efforts to engage in their own development can be hampered by a lack of time, limited access to educational resources, or cost concerns. This article provides an overview of nursing professional development and offers some resources to help individual nurses maintain or enhance their knowledge, skills, and attitudes. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  9. Creating a Culture of Professional Development for Oncology Nursing in Asia. (United States)

    Yi, Myungsun


    The importance of professional development of oncology nursing in Asia is growing along with growth in the cancer burden and disparity in cancer incidence and mortality between more- and less-developed regions, the latter of which includes most Asian countries. This paper proposes ways to advance the oncology nursing in terms of education, practice, and research in Asia. It also describes major challenges expected in developing and implementing a unique professional role for oncology nurses in Asia. This study will provide insights for Asian oncology nurses in developing culturally sensitive oncology nursing practices with limited health care resources.

  10. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    Directory of Open Access Journals (Sweden)

    Cline Gregory B


    Full Text Available Abstract Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

  11. Development of the flow control irradiation facility for JOYO

    International Nuclear Information System (INIS)

    Soroi, Masatoshi; Miyakawa, Shun-ichi


    This report describes the present situation and problems with the development of the flow control irradiation facility (FLORA). The purpose of FLORA is to run the cladding breach (RTCB) irradiation test under loss of flow conditions in the experimental fast reactor 'JOYO'. FLORA is a facility like FPTF (Fuel Performance Test Facility) plus BFTF (Breached Fuel Test Facility) in EBR-II, USA. The technical feature of FLORA is its annular linear induction pump (A-LIP), which was developed in response to a need identified through the experiences in the mechanical flow control of FPTF. We have already designed the basic system facility of FLORA for the JOYO MK-II core. However, to put FLORA to practical use in the future, we have to confirm the stability of the JOYO MK-III core condition, solve problems and improve the design. We are going to freeze and review the FLORA project, taking into consideration the fuel development situation and the research project of JOYO MK-III core. (J.P.N.)

  12. Development of Experimental Facilities for Advanced Spent Fuel Management Technology

    Energy Technology Data Exchange (ETDEWEB)

    You, G. S.; Jung, W. M.; Ku, J. H. [and others


    The advanced spent fuel management process(ACP), proposed to reduce the overall volume of the PWR spent fuel and improve safety and economy of the long-term storage of spent fuel, is under research and development. This technology convert spent fuels into pure metal-base uranium with removing the highly heat generating materials(Cs, Sr) efficiently and reducing of the decay heat, volume, and radioactivity from spent fuel by 1/4. In the next phase(2004{approx}2006), the demonstration of this technology will be carried out for verification of the ACP in a laboratory scale. For this demonstration, the hot cell facilities of {alpha}-{gamma} type and auxiliary facilities are required essentially for safe handling of high radioactive materials. As the hot cell facilities for demonstration of the ACP, a existing hot cell of {beta}-{gamma} type will be refurbished to minimize construction expenditures of hot cell facility. In this study, the design requirements are established, and the process detail work flow was analysed for the optimum arrangement to ensure effective process operation in hot cell. And also, the basic and detail design of hot cell facility and process, and safety analysis was performed to secure conservative safety of hot cell facility and process.

  13. A collaborative effort of medical and educational facilities for radiation safety training of nurses

    International Nuclear Information System (INIS)

    Matsuda, Naoki; Yoshida, Masahiro; Takao, Hideaki


    The radiation safety training course has been conducted for nurses of the university hospital by the collaboration of medical and educational staffs in Nagasaki University. This course was given for 6 hours covering basics of radiation, effects on human body, tips for radiation protection in clinical settings, and practical training, to more than 350 nurses overall. The pre-instruction survey by questionnaire revealed that 60% of nurses felt fears about radiation when they care for patients, which reduced to less than 15% in the post-instruction survey. The course also motivated nurses to give an answer patients' questions about radiation safety. In contrast, more than 30% of nurses were aware of neither their glass badge readings nor the maximum dose limit of radiation exposure even after the course. These results suggested that medical-educational collaborative training for nurses were effective on reducing nurses' fears about radiation and that repeated and continuous education would be necessary to establish their practice for radiation protection. (author)

  14. Advanced Beginner to Competent Practitioner: New Graduate Nurses' Perceptions of Strategies That Facilitate or Hinder Development. (United States)

    St-Martin, Lyne; Harripaul, Anastasia; Antonacci, Rosetta; Laframboise, Devon; Purden, Margaret


    New graduate nurses (NGNs) are a precious resource, but their development from advanced beginners to competent nurses is challenging. This qualitative descriptive study explored NGNs' perceptions of strategies that influenced their development in the first 2 years of employment. Semistructured interviews were conducted with a sample of 13 nurses. The study revealed that NGNs learn to master aspects of the nursing role as they construct a professional identity. They identified organizational, educational, and personal strategies as being important to their development, including tailored orientation, opportunities for skill acquisition, and personal support. Few strategies supported the development of professional identity. Mastering the nursing role and constructing a professional identity is central to NGNs' development. Further attention from nursing leaders is needed to promote concurrent development in both dimensions. Nurses with a strong professional identity are more likely to remain in the profession. Copyright 2015, SLACK Incorporated.

  15. Nurses' perceptions of critical issues requiring consideration in the development of guidelines for professional registered nurse staffing for perinatal units. (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Wilson, Jane; Ruhl, Catherine


    To solicit input from registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) on critical considerations for review and revision of existing nurse staffing guidelines. Thematic analysis of responses to a cross-sectional on-line survey question: "Please give the staffing task force your input on what they should consider in the development of recommendations for staffing of perinatal units." Members of AWHONN (N = 884). Descriptions of staffing concerns that should be considered when evaluating and revising existing perinatal nurse staffing guidelines. Consistent themes identified included the need for revision of nurse staffing guidelines due to requirements for safe care, increases in patient acuity and complexity, invisibility of the fetus and newborn as separate and distinct patients, difficulties in providing comprehensive care during labor and for mother-baby couplets under current conditions, challenges in staffing small volume units, and the negative effect of inadequate staffing on nurse satisfaction and retention. Participants overwhelmingly indicated current nurse staffing guidelines were inadequate to meet the needs of contemporary perinatal clinical practice and required revision based on significant changes that had occurred since 1983 when the original staffing guidelines were published. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  16. Nurses’ Competencies in Disaster Nursing: Implications for Curriculum Development and Public Health (United States)

    Loke, Alice Yuen; Fung, Olivia Wai Man


    The purpose of this study was to explore Hong Kong nurses’ perceptions of competencies required for disaster nursing. Focus group interviews and written inquiry were adopted to solicit nurses’ perceived required competencies for disaster care. A total of 15 nurses were interviewed and 30 nurses completed the written inquiry on their perceived competencies related to disaster nursing. The International Council for Nurses’ (ICN) framework of disaster nursing competencies, consisting of four themes and ten domains, was used to tabulate the perceived competencies for disaster nursing reported by nurses. The most mentioned required competencies were related to disaster response; with the ethical and legal competencies for disaster nursing were mostly neglected by nurses in Hong Kong. With the complexity nature of disasters, special competencies are required if nurses are to deal with adverse happenings in their serving community. Nurses’ perceived disaster nursing competencies reported by nurses were grossly inadequate, demonstrating the needs to develop a comprehensive curriculum for public health. The establishment of a set of tailor-made disaster nursing core competencies for the community they served is the first step in preparing nurses to deal with disastrous situations for the health of the public. PMID:24658409

  17. Developing perspectives on Korean nursing theory: the influences of Taoism. (United States)

    Shin, K R


    Nursing theory provides a systematic explanation and description of nursing phenomena. Western nursing theories have widely influenced Korean nursing. And yet, although nursing theory has universal aspects, the differences in philosophy and culture that are unique to each country need to be considered. This inquiry seeks to investigate the Korean cultural heritage, which integrates Confucianism, Buddhism, and Taoism, and how it provides a unique worldview of human beings, the universe, health, and nursing. Essential principles and therapies consistent with Taoist philosophy are also identified. This framework is proffered as the basis for establishing understanding between Korean nurses and patients.

  18. [Development and validation of an instrument for initial nursing assessment]. (United States)

    Fernández-Sola, Cayetano; Granero-Molina, José; Mollinedo-Mallea, Judith; de Gonzales, María Hilda Peredo; Aguilera-Manrique, Gabriel; Ponce, Mara Luna


    The objective of this study, conducted in Bolivia from April to July of 2008, is the design and validation of an initial nursing assessment instrument to be used in clinical and educational environments in Santa Cruz (Bolivia). Twelve Bolivian nurses participated; both document analysis as well as consensus techniques were used to determine the categories and criteria to be assessed. Categories included in the nursing assessment instrument are a physical assessment and the eleven Gordon's Functional Health Patterns. The nursing assessment instrument stands out as being concise, easy to complete and utilizing a nursing approach. It does not include items for advanced nursing assessment. However, it incorporates items regarding lifestyle and the patient's autonomy. The nursing assessment instrument contributes to improving the quality of clinical records, supports the nursing diagnosis and implementation of the nursing process, promotes the nurse's role and helps to standardize practice.

  19. Developing a smartphone app to support the nursing community. (United States)

    Colton, Scott; Hunt, Louise


    Healthcare professionals are turning increasingly to the digital sector to access information they need for their work. Mobile technology, such as smartphones and tablets, provides a unique opportunity to place high-quality information directly into users' hands. This article describes the ongoing development of a smartphone app, Preparing for Caring, designed to prepare the future workforce by enabling mentors and nursing students to access supportive material during practice-based learning episodes. The article explores the rationale for designing the app and discusses the challenges and benefits of developing this resource from the perspectives of student, mentor and healthcare manager.

  20. Development of a public health nursing data infrastructure. (United States)

    Monsen, Karen A; Bekemeier, Betty; P Newhouse, Robin; Scutchfield, F Douglas


    An invited group of national public health nursing (PHN) scholars, practitioners, policymakers, and other stakeholders met in October 2010 identifying a critical need for a national PHN data infrastructure to support PHN research. This article summarizes the strengths, limitations, and gaps specific to PHN data and proposes a research agenda for development of a PHN data infrastructure. Future implications are suggested, such as issues related to the development of the proposed PHN data infrastructure and future research possibilities enabled by the infrastructure. Such a data infrastructure has potential to improve accountability and measurement, to demonstrate the value of PHN services, and to improve population health. © 2012 Wiley Periodicals, Inc.

  1. Geriatric Oncology Program Development and Gero-Oncology Nursing. (United States)

    Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann


    To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Diffusion of a nursing education innovation: nursing workforce development through promotion of RN/BSN education. (United States)

    Diaz Swearingen, Connie; Clarke, Pamela N; Gatua, Mary Wairimu; Sumner, Christa Cooper


    Despite state, national, and organizational objectives to increase the proportion of nurses with a bachelor's degree or higher, a majority of nurses hold an associate's degree in nursing. To address the need for a better-prepared nursing workforce in this rural state, an RN/BSN recruitment and retention project was implemented. The authors discuss the Leadership Education to Advance Practice project and its outcomes.

  3. Nurse and midwifery prescribing in Ireland: A scope-of-practice development for worldwide consideration. (United States)

    Wilson, Donna M; Murphy, Jill; Nam, Mavis A; Fahy, Anne; Tella, Susanna


    For 10 years, select Irish nurses and midwives who pass a rigorous 6 month theory and practical program can prescribe medications and other medicinal products. Given the need for timely, accessible, and affordable health-care services in all countries, this nursing/midwifery education and practice development is worthy of examination. Irish nurse/midwife prescribing occurred following long-term deliberative nursing profession advocacy, nursing education planning, nursing administration and practice planning, interdisciplinary health-care team support and complementary efforts, and government action. A review of documents, research, and other articles was undertaken to examine this development process and report evaluative information for consideration by other countries seeking to improve their health-care systems. Nurse/midwife prescribing was accomplished successfully in Ireland, with the steps taken there to initiate and establish nurse/midwife prescribing of value internationally. © 2018 John Wiley & Sons Australia, Ltd.

  4. Development and evaluation of nursing user interface screens using multiple methods. (United States)

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


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

  5. Nursing ward managers' perceptions of pain prevalence at the aged-care facilities in Japan: a nationwide survey. (United States)

    Takai, Yukari; Yamamoto-Mitani, Noriko; Fukahori, Hiroki; Kobayashi, Sayuri; Chiba, Yumi


    This study aimed to examine nursing ward managers' perceptions of pain prevalence among older residents and the strategies of pain management at the Health Service Facilities for the Elderly Requiring Care (HSFERC) in Japan and to investigate the factors related to the prevalence. Nursing ward managers in 3,644 HSFERC were asked to participate in this study. Questionnaires were sent to them regarding pain prevalence among the older residents in their wards, their provisions for pain care, and other pain management strategies. The perceived pain prevalence factors were examined statistically. The final sample comprised 439 participants (12.0%). A total of 5,219 residents (22.3%) were recognized as suffering from pain on the investigation day. Only 8 wards (1.8%) used pain management guidelines or care manuals, and 14 (3.2%) used a standardized pain scale. The ward managers' age (p = .008) and nursing experience (p = .006) showed a significant negative association with pain prevalence estimation. Moreover, there was a significant association between the groups' pain prevalence estimation and the nursing managers' beliefs that older adults were less sensitive to pain (p = .01), that pain was common among older people (p = .007), and that the time to treat residents' pain was insufficient (p = .001). The ward managers' perceptions regarding pain prevalence varied; the perceived pain rates were possibly lower than the actual percentages. Insufficient pain management strategies at the HSFERC were also suggested. An appropriate pain management strategy for Japanese aged care and its dissemination are urgently required. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. Strategic Planning and Doctor Of Nursing Practice Education: Developing Today's and Tomorrow's Leaders. (United States)

    Falk, Nancy L; Garrison, Kenneth F; Brown, Mary-Michael; Pintz, Christine; Bocchino, Joseph


    Strategic planning and thinking skills are essential for today's nurse leaders. Doctor of nursing practice (DNP) programs provide an opportunity for developing effective nurse strategists. A well-designed strategy course can stimulate intellectual growth at all levels of Bloom's Taxonomy. Discussion forums in online education provide new opportunities for rich interaction among peers en route to development of well-informed strategic plans. An interprofessional perspective adds a rich and vital aspect to doctoral nursing education and it serves to inform strategic plan development. A roadmap for teaching strategic planning to current and future nursing leaders will guide the integration of essential content into DNP programs.

  7. Perspectives on age and continuing professional development for nurses : A literature review

    NARCIS (Netherlands)

    Pool, I.A.; Poell, R.F.; Ten Cate, T.J.


    The need for nurses to participate in continuing professional development (CPD) is growing to keep abreast of rapid changes in nursing care. Concurrently, the nursing workforce is growing older. Ageing leads to changes in biological, psychological, and social functioning. Little is known about the

  8. The Development and Evaluation of a Measure Assessing School Nurses' Perceived Barriers to Addressing Pediatric Obesity (United States)

    Wu, Yelena P.; Steele, Ric G.


    School nurses represent an important resource for addressing pediatric obesity and weight-related health. However, school nurses perceive numerous barriers that prevent them from addressing the weight-related health of students. The current study developed and tested a new, comprehensive measure of nurses' perceptions of 10 types of barriers to…

  9. Use of Simulated Psychosocial Role-Playing to Enhance Nursing Students' Development of Soft Skills. (United States)

    Liebrecht, Christina; Montenery, Susan


    Effective communication and interaction enable nurses to develop caring, empathetic, and respectful relationships with patients and families. However, most nurses feel a lack of preparation in the "soft" skills of communication, professionalism, and leadership. Nurse managers are seeking graduates with strong emotional quotient characteristics such as self-awareness, motivation, self-regulation, empathy, and social skills. Assisting nursing students to develop these intangible, high-level skills presents an ongoing challenge to nurse educators. This creative teaching learning strategy examines the use of psychosocial role-playing skits to enhance nursing student development of the soft skills of nursing. In this strategy, senior level nursing students work in small groups to develop and present realistic 3- to 5-minute skits based on common nurse-patient, nurse-family, or nurse-health care team interactions that incorporate the concepts of therapeutic communication, interpersonal interaction, empathy, active listening, teamwork, delegation, and/or professionalism, followed by a debriefing session. Student feedback suggests that confidence and competence related to the skills of therapeutic communication, interpersonal interaction, empathy, active listening, teamwork, delegation, and professionalism may improve by incorporating soft skill psychosocial role-playing into a nursing education course of study.

  10. [The development and impacts of professional nursing in senior care and senior business management: the perspective of a U.S.-based nurse entrepreneur]. (United States)

    Chang, Theresa


    The three main parts of this article include (1) the process of transition from a clinical nurse to a nurse entrepreneur, (2) senior care business management and social responsibility and (3) the development of senior care business in the future as well as the chances for nursing development. The article analyzes the development of gerontology nursing careers in the United States and Taiwan and the role professional nurses can play in ageing societies. A prospective plan for collaboration between gerontology nurses and long-term care health professionals in the United States and Taiwan concludes the article.

  11. Recent developments in the target facilities at Argonne National Laboratory

    International Nuclear Information System (INIS)

    Greene, J.P.; Thomas, G.E.


    A description is given of recent developments in the target facility at Argonne National Laboratory (ANL). Highlights include equipment upgrades which enable us to provide enhanced capabilities for support of the Argonne Heavy-Ion ATLAS Accelerator Project. Also, future plans and additional equipment acquisitions will be discussed. (orig.)

  12. Development of cables for nuclear fuel processing facilities

    International Nuclear Information System (INIS)

    Kamimura, Seiji; Seki, Ikuo; Yamamoto, Yasuaki; Matsuyama, Shigeki; Endo, Shigeru; Yagi, Toshiaki; Kawakami, Waichiro.


    Accompanying the development of nuclear power stations, the expansion and repletion of the facilities for nuclear fuel cycle such as fuel reprocessing facilities and waste treatment facilities are requested. In these facilities, there is the environment which is exposed to very high level radiation, and in this case, the cables withstanding 10 MGy radiation dose are required. As the cables meeting such requirement, the new cables having excellent flexibility and radiation resistance were developed. In this paper, the points of material development and the characteristics of cables are reported. Considering the radiation resistance and others, ethylene propylene rubber was selected as the base polymer of the insulator, and polyethylene chlorosulfonate was selected as the sheath material. In order to give excellent radiation resistance, as the anti-rad, energy transfer type aromatic oil that absorbs and dissipates radiation energy and radical trap type anti-oxidant of amine group that catches and stabilizes the radicals generated in the polymer were added. The bromine group burning retarding agent having excellent radiation resistance was applied. In this way, the cables withstanding high radiation dose up to 10 MGy were able to be developed. (K.I.)

  13. Recent developments in the target facilities at Argonne National Laboratory

    International Nuclear Information System (INIS)

    Greene, J.P.; Thomas, G.E.


    A description is given of recent developments in the target facility at Argonne National Laboratory. Highlights include equipment upgrades which enables us to provide enhanced capabilities for support of the Argonne Heavy-Ion ATLAS Accelerator Project. Also future plans and additional equipment acquisitions will be discussed. 3 refs., 3 tabs

  14. Power Systems Development Facility. Quarterly report, July--September 1995

    Energy Technology Data Exchange (ETDEWEB)



    The objective of this project is to evaluate hot gas particle control technologies using coal-derived gas streams. This will entail the design, construction, installation, and use of a flexible test facility which can operate under realistic gasification and combustion conditions. The major particulate control device issues to be addressed include the integration of the particulate control devices into coal utilization systems, on-line cleaning techniques, chemical and thermal degradation of components, fatigue or structural failures, blinding, collection efficiency as a fimction of particle size, and scale-up of particulate control systems to commercial size. The conceptual design of the facility was extended to include a within scope, phased expansion of the existing Hot Gas Cleanup Test Facility Cooperative Agreement to also address systems integration issues of hot particulate removal in advanced coal-based power generation systems. This expansion included the consideration of the following modules at the test facility in addition to the original Transport Reactor gas source and hot gas cleanup units: carbonizer/pressurized circulating fluidized bed gas source; hot gas cleanup units to mate to all gas streams; combustion gas turbine; and fuel cell and associated gas treatment. This expansion to the Hot Gas Cleanup Test Facility is herein referred to as the Power Systems Development Facility (PSDF). The major emphasis during this reporting period was continuing the detailed design of the facility towards completion and integrating the balance-of-plant processes and particulate control devices (PCDS) into the structural and process designs. Substantial progress in construction activities was achieved during the quarter. Delivery and construction of the process structural steel is nearing completion. Nearly all equipment are set in its place and the FW equipment and the PCDs are being set in the structure.

  15. Accelerator development for a radioactive beam facility based on ATLAS

    International Nuclear Information System (INIS)

    Shepard, K. W.


    The existing superconducting linac ATLAS is in many respects an ideal secondary beam accelerator for an ISOL (Isotope separator on-line) type radioactive beam facility. Such a facility would require the addition of two major accelerator elements: a low charge state injector for the existing heavy ion linac, and a primary beam accelerator providing 220 MV of acceleration for protons and light ions. Development work for both of these elements, including the option of superconducting cavities for the primary beam accelerator is discussed

  16. Development of safeguards information treatment system at the facility level

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Doo; Song, Dae Yong; So, Dong Sup; Kwack, Eun Ho [Korea Atomic Energy Research Institute, Taejeon (Korea)


    Safeguards Information Treatment System(SITS) at the facility level is required to implement efficiently the obligations under the Korea-IAEA Safeguards Agreement, bilateral agreements with other countries and domestic law. In this report, the requirements and major functions of SITS were considered, and the error checking methods and the relationships of safeguards information were reviewed. SITS will be developed to cover the different accounting procedures and methods applied at the various facilities under IAEA safeguards. Also, the resolved result of the Y2K problem in the existing nuclear material accounting program was described. 3 tabs. (Author)

  17. Development of Facilities Master Plan and Laboratory Renovation Project

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Andrea D


    Funding from this grant has allowed Morehouse School of Medicine to complete its first professionally developed, comprehensive campus master plan that is in alignment with the recently completed strategic plan. In addition to master planning activities, funds were used for programming and designing research renovations, and also to supplement other research facility upgrades by providing lighting and equipment. The activities funded by this grant will provide the catalyst for substantial improvement in the School's overall facilities for biomedical education and research, and will also provide much of the information needed to conduct a successful campaign to raise funds for proposed buildings and renovations.

  18. Accelerator development for a radioactive beam facility based on ATLAS.

    Energy Technology Data Exchange (ETDEWEB)

    Shepard, K. W.


    The existing superconducting linac ATLAS is in many respects an ideal secondary beam accelerator for an ISOL (Isotope separator on-line) type radioactive beam facility. Such a facility would require the addition of two major accelerator elements: a low charge state injector for the existing heavy ion linac, and a primary beam accelerator providing 220 MV of acceleration for protons and light ions. Development work for both of these elements, including the option of superconducting cavities for the primary beam accelerator is discussed.

  19. Jamesian pragmatism: a framework for working towards unified diversity in nursing knowledge development. (United States)

    McCready, Jason S


    Abstract Nursing is frequently described as practical or pragmatic and there are many parallels between nursing and pragmatism, the school of thought. Pragmatism is often glancingly referenced by nursing authors, but few have conducted in-depth discussions about its applicability to nursing; and few have identified it as a significant theoretical basis for nursing research. William James's pragmatism has not been discussed substantially in the nursing context, despite obvious complementarities. James's theme of pluralism fits with nursing's diversity and plurality; his emphasis on social conscience in our actions matches nursing's fundamental purpose of improving the lives of others; his continuous testing of pluralistic truths in critically reflective practice pairs well with nursing's focus on developing best-available, holistic evidence; and his conceptualization of truth as being born in practice and becoming an instrument in practice is entirely compatible with nursing's theory-practice identity. The oft-discussed theory-practice gap is seen to hinder the development of nursing knowledge. If nursing is to find its identity in knowledge development and potentiate the knowledge developed, it is imperative to identify and address that which is impeding progress. By way of the pragmatic tenets of William James, I will argue that a significant part of the theory-practice gap lies in how nursing knowledge development is operationalized, creating a false dichotomy between practice and research. I will also argue that the research-practice schism has been widened by continued philosophical and methodological infighting in the research community. I will describe how Jamesian pragmatism can be 'what works' for rebuilding relationships and supporting an engaged plurality within nursing research and bring research and practice together into a collaborative and iterative process of developing nursing knowledge.

  20. Waiving the three-day rule: admissions and length-of-stay at hospitals and skilled nursing facilities did not increase. (United States)

    Grebla, Regina C; Keohane, Laura; Lee, Yoojin; Lipsitz, Lewis A; Rahman, Momotazur; Trivedi, Amal N


    The traditional Medicare program requires an enrollee to have a hospital stay of at least three consecutive calendar days to qualify for coverage of subsequent postacute care in a skilled nursing facility. This long-standing policy, implemented to discourage premature discharges from hospitals, might now be inappropriately lengthening hospital stays for patients who could be transferred sooner. To assess the implications of eliminating the three-day qualifying stay requirement, we compared hospital and postacute skilled nursing facility utilization among Medicare Advantage enrollees in matched plans that did or did not eliminate that requirement in 2006-10. Among hospitalized enrollees with a skilled nursing facility admission, the mean hospital length-of-stay declined from 6.9 days to 6.7 days for those no longer subject to the qualifying stay but increased from 6.1 to 6.6 days among those still subject to it, for a net decline of 0.7 day when the three-day stay requirement was eliminated. The elimination was not associated with more hospital or skilled nursing facility admissions or with longer lengths-of-stay in a skilled nursing facility. These findings suggest that eliminating the three-day stay requirement conferred savings on Medicare Advantage plans and that study of the requirement in traditional Medicare plans is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

  1. [Centennial retrospective on the evolution and development of the nursing practice environment in Taiwan]. (United States)

    Lin, Shou-Ju; Huang, Lain-Hua


    The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.

  2. Enabling professional development in mental health nursing: the role of clinical leadership. (United States)

    Ennis, G; Happell, B; Reid-Searl, K


    Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing. © 2015 John Wiley & Sons Ltd.

  3. Developing a manual for strengthening mental health nurses' clinical supervision

    DEFF Research Database (Denmark)

    Buus, Niels; Cassedy, Paul; Gonge, Henrik


    In this article, we report findings from a study aimed at developing the content and implementation of a manual for a research-based intervention on clinical supervision of mental health nursing staff. The intervention was designed to strengthen already existing supervision practices through...... educational preparation for supervision and systematic reflection on supervision. The intervention consists of three sessions and was implemented on two groups of mental health hospital staff. We present an outline of the manual and explain how the trial sessions made us adjust the preliminary manual....... The effects of implementing the manual will subsequently be analysed in an independent randomised controlled trial....

  4. Development of decommissioning, decontamination and reuse technology for nuclear facilities

    International Nuclear Information System (INIS)

    Lee, K. W.; Moon, J. K.; Choi, B. S.


    In this project, the foundation of decommissioning technology through the development of core technologies applied to maintenance and decommissioning of nuclear facility was established. First of all, we developed the key technology such as safety assessment technology for decommissioning work needed at the preparatory stage of decommissioning of the highly contaminated facilities and simultaneous measurement technology of the high-level alpha/beta contamination applicable to the operation and decommissioning of the nuclear facilities. Second, we developed a remotely controlled laser ablation decontamination system which is useful for a removal of fixed contaminants and developed a chemical gel decontamination technology for a removal of non-fixed contaminants during the maintenance and decommissioning works of high radiation hot cells which have been used for a recycling or treatment of spent fuels. Third, we developed a volume reduction and self-disposal technology for dismantled concrete wastes. Also, the technology for volume reduction and stabilization of the peculiar wastes(HEPA filter and organic mixed wastes), which have been known to be very difficult to treat and manage, generated from the high radioactive facilities in operation, improvement and repair and under decommissioning was developed. Finally, this research project was developed a system for the reduction of radiotoxicity of several uranium mixtures generated in the front- and back-end nuclear fuel cycles with characteristics of highly enhanced proliferation-resistance and more environmental friendliness, which can make the uranium to be recovered or separated from the mixtures with a high purity level enough for the uranium to be reused and to be classified as C-class level for burial near the surface, and then which result in the much reduction in volume of the uranium mixture wastes

  5. Development of a conceptual model of the role of hospital nurses in health promotion in Jordan. (United States)

    Shoqirat, N


    International evidence reveals that hospital nurses have not been able to incorporate health promotion effectively into the framework of their care. This can be attributed to unclear conceptualizing of the barriers and facilitators to the role of nurses in health promotion. An integrative review was carried out to develop a conceptual model to assist hospital nurses in Jordan to understand how health promotion activities can be developed. Factors affecting the involvement of nurses in health promotion - ranging from limited knowledge about health promotion to the social image of nursing - can be structured into three levels: the micro (individual), meso (organizational) and macro (population). By understanding the interplay of factors between and within the levels, nurses and other health professionals can draw on the individual, social and organizational factors that influence nurses' role in health promotion. The proposed model can be considered as a springboard for developing health promotion activities related to hospitals in other Muslim-majority contexts.

  6. Development and validation of a new tool measuring nurses self-reported professional competence--the nurse professional competence (NPC) Scale. (United States)

    Nilsson, Jan; Johansson, Eva; Egmar, Ann-Charlotte; Florin, Jan; Leksell, Janeth; Lepp, Margret; Lindholm, Christina; Nordström, Gun; Theander, Kersti; Wilde-Larsson, Bodil; Carlsson, Marianne; Gardulf, Ann


    To develop and validate a new tool intended for measuring self-reported professional competence among both nurse students prior to graduation and among practicing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines. A methodological study including construction of a new scale and evaluation of its psychometric properties. 1086 newly graduated nurse students from 11 universities/university colleges. The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88 items and covering eight factors: "Nursing care", "Value-based nursing care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership in and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach's alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition, evidence of known-group validity for the NPC Scale was obtained. The NPC Scale, which is based on national and international professional competence requirements for nurses, was comprehensively tested and showed satisfactory psychometrical properties. It can e.g. be used to evaluate the outcomes of nursing education programmes, to assess nurses' professional competences in relation to the needs in healthcare organisations, and to tailor introduction programmes for newly employed nurses. © 2013.

  7. Developing a rural transitional care community case management program using clinical nurse specialists. (United States)

    Baldwin, Kathleen M; Black, Denice; Hammond, Sheri


    This quality improvement project developed a community nursing case management program to decrease preventable readmissions to the hospital and emergency department by providing telephonic case management and, if needed, onsite assessment and treatment by a clinical nurse specialist (CNS) with prescriptive authority. As more people reach Medicare age, the number of individuals with worsening chronic diseases with dramatically increases unless appropriate disease management programs are developed. Care transitions can result in breakdown in continuity of care, resulting in increased preventable readmissions, particularly for indigent patients. The CNS is uniquely educated to managing care transitions and coordination of community resources to prevent readmissions. After a thorough SWOT (strengths, weaknesses, opportunities, and threats) analysis, we developed and implemented a cost-avoidance model to prevent readmissions in our uninsured and underinsured patients. The project CNS used a wide array of interventions to decrease readmissions. In the last 2 years, there have been a total of 22 less than 30-day readmissions to the emergency department or hospital in 13 patients, a significant decrease from readmissions in these patients prior to the program. Three of them required transfer to a larger hospital for a higher level of care. Using advanced practice nurses in transitional care can prevent readmissions, resulting in cost avoidance. The coordination of community resources during transition from hospital to home is a job best suited to CNSs, because they are educated to work within organizations/systems. The money we saved with this project more than justified the cost of hiring a CNS to lead it. More research is needed into this technology. Guidelines for this intervention need to be developed. Replicating our cost-avoidance transitional care model can help other facilities limit that loss.

  8. Leader development transformation in the Army Nurse Corps. (United States)

    Funari, Tamara S; Ford, Kathleen; Schoneboom, Bruce A


    The Army Nurse (AN) Corps is undergoing a historic transformation. Under the leadership of its Chief, MG Patricia Horoho, the Corps developed and implemented the AN Campaign Plan to insure that the Corps has the right capability and capacity to meet the current and future needs of the US Army. This article describes the work conducted by the AN Corps Leadership Imperative Action Team (Leader IAT) to develop full-spectrum leaders for the future. The mission of the Leader IAT is derived from both the AN Campaign plan as well as the operational objectives defined in the AN balanced scorecard. As a result of the analysis conducted during preparation of the AN Campaign Plan, several key gaps were identified regarding the Army Nurse Corps' ability to match leadership talents with the diverse demands of current missions, as well as its adaptability and flexibility to be prepared for unknown future missions. This article also introduces the Leadership Capability Map and other initiatives implemented to ensure the development of full-spectrum leaders who will be effective in the future military healthcare environment.

  9. Construction and engineering report for advanced nuclear fuel development facility

    International Nuclear Information System (INIS)

    Cho, S. W.; Park, J. S.; Kwon, S.J.; Lee, K. W.; Kim, I. J.; Yu, C. H.


    The design and construction of the fuel technology development facility was aimed to accommodate general nuclear fuel research and development for the HANARO fuel fabrication and advanced fuel researches. 1. Building size and room function 1) Building total area : approx. 3,618m 2 , basement 1st floor, ground 3th floor 2) Room function : basement floor(machine room, electrical room, radioactive waste tank room), 1st floor(research reactor fuel fabrication facility, pyroprocess lab., metal fuel lab., nondestructive lab., pellet processing lab., access control room, sintering lab., etc), 2nd floor(thermal properties measurement lab., pellet characterization lab., powder analysis lab., microstructure analysis lab., etc), 3rd floor(AHU and ACU Room) 2. Special facility equipment 1) Environmental pollution protection equipment : ACU(2sets), 2) Emergency operating system : diesel generator(1set), 3) Nuclear material handle, storage and transport system : overhead crane(3sets), monorail hoist(1set), jib crane(2sets), tank(1set) 4) Air conditioning unit facility : AHU(3sets), packaged air conditioning unit(5sets), 5) Automatic control system and fire protection system : central control equipment(1set), lon device(1set), fire hose cabinet(3sets), fire pump(3sets) etc

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

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


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

  11. The educational preparation of nurses in a developing economy and patient mortality. (United States)

    Mahfoud, Z R; Gkantaras, I; Topping, A E; Cannaby, A M; Foreman, B; Watson, R; Thompson, D R; Gray, R


    Most studies have reported that higher levels (baccalaureate degree) of educational attainment by nurses are associated with lower levels of patient mortality. Researchers working in developed economies (e.g. North America and Europe) have almost exclusively conducted these studies. The value of baccalaureate nurse education has not been tested in countries with a developing economy. A retrospective observational study conducted in seven hospitals. Patient mortality was the main outcome of interest. Anonymized data were extracted from nurses and patients from two different administrative sources and linked using the staff identification number that exists in both systems. We used bivariate logistic regression models to test the association between mortality and the educational attainment of the admitting nurse (responsible for assessment and care planning). Data were extracted for 11 918 (12, 830 admissions) patients and 7415 nurses over the first 6 months of 2015. The majority of nurses were educated in South Asia and just over half were educated to at least bachelor degree level. After adjusting for confounding and clustering, nurse education was not found to be associated with mortality. Our observations may suggest that in a developing economy, the academic level of nurses' education is not associated with a reduction in patient mortality. Findings should be interpreted with considerable caution but do challenge widely held assumptions about the value of baccalaureate-prepared nurses. Further research focused on nursing education in developing economies is required to inform health policy and planning. © 2018 International Council of Nurses.

  12. Detection of delirium and its symptoms by nurses working in a long term care facility. (United States)

    Voyer, Philippe; Richard, Sylvie; McCusker, Jane; Cole, Martin G; Monette, Johanne; Champoux, Nathalie; Ciampi, Antonio; Belzile, Eric


    To investigate the ability of nurses to recognize delirium and its symptoms and to investigate the factors associated with undetected delirium. A prospective, observational study with repeated measurements over a 6-month period. Seven long term care settings in Montreal and Quebec City, Canada. Residents aged 65 and older, with or without dementia, admitted to long term care (not respite care) and able to communicate in English or French. Delirium and its symptoms were assessed using the Confusion Assessment Method. Ratings of delirium by nurses based on their observations during routine care were compared with delirium ratings by trained research assistants based on a one-time formal structured evaluation (Confusion Assessment Method and Mini Mental State Examination). This procedure was repeated for 10 delirium symptoms. Sensitivity, specificity, and positive and negative predictive values were calculated. The method of generalized estimating equations was used to identify factors associated with undetected delirium. Research assistants identified delirium in 43 (21.3%) of the 202 residents. Nurses identified delirium in 51% of the cases identified by the research assistants. However, for cases without delirium according to the research assistants, nurses identified 90% of them correctly. Detection rates for delirium symptoms ranged from 25% to 66.7%. Undetected delirium was associated with lower number of depressive symptoms manifested by the resident. Detection of delirium is a major issue for nurses. Strategies to improve nurse recognition of delirium could well reduce adverse outcomes for this vulnerable population. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  13. Cost-Effectiveness Analysis of Interventions to Reduce Risk of Aspiration in Elderly Cancer Survivors Residing in Skilled Nursing Facilities. (United States)

    Mantravadi, S


    Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death. Analyses of cost, decision-tree modeling, and cost effectiveness were performed to compare a hypothetical, interventional model based on best practices with usual (standard) care. A societal perspective was used as the economic view point. Direct costs, caregiver time, and market values for wages were estimated for the 2 interventions. Effectiveness values for the cost-effectiveness and decision-tree analyses were obtained from the literature. The incremental-cost-effectiveness ratio was calculated and used to compare the intervention with usual care. The interventional method was more costly but more effective than usual care. A sensitivity analysis considered the uncertainty of event probability (aspiration vs no aspiration). The interventional protocol for aspiration reduction continued to be more cost effective than usual care. Aspiration takes a financial toll on all facets of health care, including on nurses, skilled nursing facilities, patients, their families, and insurers, among others. Implementing guidelines that describe best practices for aspiration appears to be a cost-effective strategy for reducing aspirations among cancer survivors - especially elderly patients - who live in skilled nursing facilities.

  14. Developing clinical leaders: the impact of an action learning mentoring programme for advanced practice nurses. (United States)

    Leggat, Sandra G; Balding, Cathy; Schiftan, Dan


    To determine whether a formal mentoring programme assists nurse practitioner candidates to develop competence in the clinical leadership competencies required in their advanced practice roles. Nurse practitioner candidates are required to show evidence of defined clinical leadership competencies when they apply for endorsement within the Australian health care system. Aiming to assist the candidates with the development or enhancement of these leadership skills, 18 nurse practitioner candidates participated in a mentoring programme that matched them with senior nurse mentors. A pre-postlongitudinal intervention study. Eighteen nurse practitioner candidates and 17 senior nurses participated in a voluntary mentoring programme that incorporated coaching and action learning over 18 months in 2012 and 2013. Participants completed a pen and paper questionnaire to document baseline measures of self-reported leadership practices prior to commencement of the programme and again at the end of the programme. The mentors and the nurse practitioner candidates qualitatively evaluated the programme as successful and quantitative data illustrated significant improvement in self-reported leadership practices among the nurse practitioner candidates. In particular, the nurse practitioner candidates reported greater competence in the transformational aspects of leadership, which is directly related to the nurse practitioner candidate clinical leadership standard. A formal, structured mentoring programme based on principles of action learning was successful in assisting Australian advanced practice nurses enhance their clinical leadership skills in preparation for formal endorsement as a nurse practitioner and for success in their advanced practice role. Mentoring can assist nurses to transition to new roles and develop knowledge and skills in clinical leadership essential for advanced practice roles. Nurse managers should make greater use of mentoring programmes to support nurses in

  15. The GAMMA ® nursing measure: Its development and testing for ...

    African Journals Online (AJOL)

    Background: In the specialised nursing fields of gerontology, oncology, rehabilitation and home-based care where people live with permanent or temporary disabilities, nurses are unable to perform routine and empirical scoring of their patients' abilities to live independently, because of the lack of valid nursing measures ...

  16. The Transrapid test facility between system development and system application

    Energy Technology Data Exchange (ETDEWEB)

    Baur, L [MVP GmbH, Muenchen (Germany)


    In the development of a new rail technology, such as the magnetic levitation, there is - in contrast to the further development of the railway technology - not the possibility to use existing routes for the technical verification of the system technology until the application. Instead of this there are two possibilities: Cost-effective preliminary development on test beds and small test facilities up to a development stage which justifies the (relatively serious) risk of realising a service route early and to conclude the system trials and verification there; cost-intensive construction of a large-scale test facility which permits an application-related verification of all important system functions and thus creates the technical pre-requisites for a low-risk system application; The presentation deals with the technical requirements of the system at the test facility the challenges and chances linked to its realisation and adjustment to the rapidly progressing state-of-the-art and which this way opens up for a minimisation of the technical application risk. (orig./HW)

  17. Reflecting on practice development school for pre-registration nurses: a student nurse perspective

    Directory of Open Access Journals (Sweden)

    Chelsea Agate


    Full Text Available Background: Practice development has been evolving as a movement in nursing for decades but was first conceptualised by Garbett and McCormack (2002. At its core are the principles that embody a shared intention of developing and improving both professional practice and patient care (McCormack et al., 2013. Through effective, supportive and motivational facilitation, practice development has the capacity to transform dominant and oppressive task-oriented cultures, run by hierarchical leaderships, into cultures that empower and value the contributions of all stakeholders, allowing for transformational and emancipatory learning (McCormack et al., 2013. Aims: Today, there are nine defining principles of practice development (McCormack et al., 2013. Based loosely on Kolb’s model of reflection (1998, this article is an in-depth critical evaluation of my own learning, which took place in the context of a practice development school for pre-registration nurses. I have chosen to focus on the practice development principle that I found to be most transformative. Principle number eight states: ‘Practice development is associated with a set of processes including skilled facilitation that can be translated into a specific skill set required as near to the interface of care as possible’. Conclusions and implications for practice: This journey has taught me that knowledge and experience will inevitably influence facilitation (Crisp and Wilson, 2011. However, the skills and attributes embodied by an effective facilitator are multifaceted and the evolution of my own facilitation expertise will continue alongside with my journey as a practice developer. On the journey so far, I have learned to appreciate the value of authentic and meaningful engagement, how to inspire and evoke it, and to what extent it has the potential to influence effective facilitation. I have learned to use various facilitation methods to create and sustain high levels of engagement

  18. Professional excellence and career advancement in nursing: a conceptual framework for clinical leadership development. (United States)

    Adeniran, Rita Kudirat; Bhattacharya, Anand; Adeniran, Anthony A


    Increasingly, stakeholders in the health care community are recognizing nursing as key to solving the nation's health care issues. This acknowledgment provides a unique opportunity for nursing to demonstrate leadership by developing clinical nurse leaders to collaborate with the multidisciplinary care team in driving evidence-based, safe quality, cost-effective health care services. One approach for nursing success is standardizing the entry-level education for nurses and developing a uniform professional development and career advancement trajectory with appropriate incentives to encourage participation. A framework to guide and provide scientific evidence of how frontline nurses can be engaged will be paramount. The model for professional excellence and career advancement provides a framework that offers a clear path for researchers to examine variables influencing nurses' professional development and career advancement in a systematic manner. Professional Excellence and Career Advancement in Nursing underscores professional preparedness of a registered nurse as central to leadership development. It also describes the elements that influence nurses' participation in professional development and career advancement under 4 main categories emphasizing mentorship and self-efficacy as essential variables.

  19. Conceptual development of a test facility for spent fuel management

    Energy Technology Data Exchange (ETDEWEB)

    Park, S.W.; Lee, H.H.; Lee, J.Y.; Lee, J.S.; Ro, S.G. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)


    Spent fuel management is an important issue for nuclear power program, requiring careful planning and implementation. With the wait-and-see policy on spent fuel management in Korea, research efforts are directed at KAERI to develop advanced technologies for safer and more efficient management of the accumulating spent fuels. In support of these research perspectives, a test facility of pilot scale is being developed with provisions for integral demonstration of a multitude of technical functions required for spent fuel management. The facility, baptized SMART (Spent fuel MAnagement technology Research and Test facility), is to be capable of handling full size assembly of spent PWR fuel (as well as CANDU fuel) with a maximum capacity of 10 MTU/y (about 24 assemblies of PWR type). Major functions of the facility are consolidation of spent PWR fuel assembly into a half-volume package and optionally transformation of the fuel rod into a fuel of CANDU type (called DUPIC). Objectives of these functions are to demonstrate volume reduction of spent fuel (for either longer-term dry storage or direct disposal ) in the former case and direct refabrication of the spent PWR fuel into CANDU-type DUPIC fuel for reuse in CANDU reactors in the latter case, respectively. In addition to these major functions, there are other associated technologies to be demonstrated : such as waste treatment, remote maintenance, safeguards, etc. As the facility is to demonstrate not only the functional processes but also the safety and efficiency of the test operations, engineering criteria equivalent to industrial standards are incorporated in the design concept. The hot cell structure enclosing the radioactive materials is configured in such way to maximize costs within the given functional and operational requirements. (author). 3 tabs., 4 figs.

  20. Conceptual development of a test facility for spent fuel management

    International Nuclear Information System (INIS)

    Park, S.W.; Lee, H.H.; Lee, J.Y.; Lee, J.S.; Ro, S.G.


    Spent fuel management is an important issue for nuclear power program, requiring careful planning and implementation. With the wait-and-see policy on spent fuel management in Korea, research efforts are directed at KAERI to develop advanced technologies for safer and more efficient management of the accumulating spent fuels. In support of these research perspectives, a test facility of pilot scale is being developed with provisions for integral demonstration of a multitude of technical functions required for spent fuel management. The facility, baptized SMART (Spent fuel MAnagement technology Research and Test facility), is to be capable of handling full size assembly of spent PWR fuel (as well as CANDU fuel) with a maximum capacity of 10 MTU/y (about 24 assemblies of PWR type). Major functions of the facility are consolidation of spent PWR fuel assembly into a half-volume package and optionally transformation of the fuel rod into a fuel of CANDU type (called DUPIC). Objectives of these functions are to demonstrate volume reduction of spent fuel (for either longer-term dry storage or direct disposal ) in the former case and direct refabrication of the spent PWR fuel into CANDU-type DUPIC fuel for reuse in CANDU reactors in the latter case, respectively. In addition to these major functions, there are other associated technologies to be demonstrated : such as waste treatment, remote maintenance, safeguards, etc. As the facility is to demonstrate not only the functional processes but also the safety and efficiency of the test operations, engineering criteria equivalent to industrial standards are incorporated in the design concept. The hot cell structure enclosing the radioactive materials is configured in such way to maximize costs within the given functional and operational requirements. (author). 3 tabs., 4 figs

  1. Development and Evaluation of a Systems Thinking Education Strategy for Baccalaureate Nursing Curriculum: A Pilot Study. (United States)

    Fura, Louise A; Wisser, Kathleen Z

    Nurse educators are charged to develop and evaluate curricula on systems thinking to prepare future nurses to provide safe nursing care. The goal of this pilot study was to design and evaluate a four-hour educational strategy that prepares future professional nurses to use systems thinking approaches in the delivery of safe patient care. This study exposed prelicensure baccalaureate nursing students to systems thinking principles, which included didactic and experiential activities. A descriptive design was used to determine the effect of an on-campus educational strategy. A paired samples t-test revealed statistical significance from pretest to posttest.

  2. The evolution and development of an instrument to measure essential professional nursing practices. (United States)

    Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia


    Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.

  3. A children's nurse's role in the global development of a child with diabetes mellitus. (United States)

    Kenny, Jodie; Corkin, Doris


    The nursing care of a six year old with type 1 diabetes reveals the importance of accurate control of the condition for normal physical, emotional and cognitive development. Clearly the children's nurse can educate and support the child, parents and extended family towards achieving independence and self-care. Theoretical knowledge of normal child maturation can guide nurses to constantly adapt their modes of communication and nursing skills, so as to promote every aspect and stage of the child's growth. Prevalence of type 1 diabetes is increasing, and nurses should use their close professional involvement with patients to assist research at every opportunity.

  4. [A new vision of nursing: the evolution and development of evidence-based nursing]. (United States)

    Chiang, Li-Chi


    The concept and principles of evidence-based medicine (EBM), first introduced in 1996 in the UK and Canada, have greatly impacted healthcare worldwide. Evidence-based care is a new approach to healthcare that works to reduce the gap between evidence and practice in order to further the scientific credentials and practices of the nursing profession. The revolution in healthcare has perhaps most noticeably impacted the nursing sciences. Today, new methodologies are increasingly synthesizing knowledge, while expanded access to publication resources is creating a new era in evidence-based nursing. Therefore, we expect to see in Taiwan the increased sharing of innovative implementations of evidence-based nursing practice and promotion campaigns and the exploration of a new evidence-based nursing paradigm for incorporating evidence-based concepts into the policymaking process, nursing practice, and nursing education. All scientists in clinical care, education, and research are responsible to establish scientific nursing knowledge in support of the evidence-based nursing practice.

  5. Thermal fuel research and development facilities in BNFL

    International Nuclear Information System (INIS)

    Roberts, V.A.; Vickers, J.


    BNFL is committed to providing high quality, cost effective nuclear fuel cycle services to customers on a National and International level. BNFL's services, products and expertise span the complete fuel cycle; from fuel manufacture through to fuel reprocessing, transport, waste management and decommissioning and the Company maintains its technical and commercial lead by investment in continued research and development (R and D). This paper discusses BNFL's involvement in R and D and gives an account of the current facilities available together with a description of the advanced R and D facilities constructed or planned at Springfields and Sellafield. It outlines the work being carried out to support the company fuel technology business, to (1) develop more cost effective routes to existing fuel products; (2) maximize the use of recycled uranium, plutonium and tails uranium and (3) support a successful MOX business

  6. A transdisciplinary approach to developing a web-based nursing experiential log system for advanced practice nursing clinical experiences. (United States)

    Olson, Brandon D; Fauchald, Sally K


    This article describes a transdisciplinary project between the computer information systems department and the graduate nursing department of a higher education institution. The project is the planning, development, and implementation of a Web-based nursing experiential log system for advanced practice nursing clinical experiences, which was funded by a Nursing Education Practice and Retention grant from the Health Resources and Services Administration. The article explains the concept and benefits of the transdisciplinary nature of the project. The design team, project leadership, and roles within the team are reviewed, including the role of end-user faculty in the design process. The article describes the focus and scope of the Web-based experiential log system database that is used to document and track advanced practice nursing student clinical experiences, as well as a summary of the design process used to develop the log system and the specific functionality of the database system. The implementation process, including end-user training, pilot implementation, and modifications, lessons learned, and future directions of the project are addressed. The article concludes with the benefits to the clinical experience and graduate nursing program that have been noted since the implementation of the system.

  7. Development of BNL Heat Transfer Facility 1: flashing experiments

    International Nuclear Information System (INIS)

    Leonhardt, W.J.; Klein, J.H.; Zimmer, G.A.; Abuaf, N.; Jones, O.C. Jr.


    A major area of interest to reactor safety technology is the prediction of actual vapor generation rates under conditions of thermal nonequilibrium as would be encountered during a loss-of-coolant accident (LOCA) in a light water reactor. In support of the development of advanced codes dealing with LOCA induced flashing, analytical models of the nonequilibrium vapor generation processes of interest have been formulated, and an experimental facility has been constructed to provide data to verify these models. This facility is known as BNL Heat Transfer Facility. The experimental facility consists of a flow loop, test section and the data acquisition and analysis system. The main portion of the flow loop is constructed from three inch nominal (7.6 cm) stainless steel pipe. High purity water is circulated through the loop using a centrifugal pump rated 1500 l/min at 600 kPa. Very close and stable control of all loop parameters is required since flashing is sensitive to very small changes in such parameters as flow rate, subcooling, and pressure

  8. Management and Development of the RT Research Facilities and Infrastructures

    International Nuclear Information System (INIS)

    Kim, Won Ho; Nho, Young Chang; Kim, Jae Sung


    The purpose of this project are to operate the core facilities of the research for the Radiation Technology in stable and to assist the research activities efficiently in the industry, academic, and research laboratory. By developing the infrastructure of the national radio technology industry, we can activate the researching area of the RT and the related industry, and obtain the primary and original technology. The key point in the study of the RT and the assistance of the industry, academic, and research laboratory for the RT area smoothly, is managing the various of unique radiation facilities in our country. The gamma Phytotron and Gene Bank are essential in the agribiology because these facilities are used to preserve and utilize the genes and to provide an experimental field for the environment and biotechnology. The Radiation Fusion Technology research supporting facilities are the core support facilities, and are used to develop the high-tech fusion areas. In addition, the most advanced analytical instruments, whose costs are very high, should be managed in stable and be utilized in supporting works, and the experimental animal supporting laboratory and Gamma Cell have to be maintained in high level and managed in stable also. The ARTI have been developed the 30MeV cyclotron during 2005∼2006, aimed to produce radioisotopes and to research the beam applications as a result of the project, 'Establishment of the Infrastructure for the Atomic Energy Research Expansion', collaborated with the Korea Institute of Radiological and Medical Sciences. In addition, the ARTI is in the progress of establishing cyclotron integrated complex as a core research facility, using a proton beam to produce radioisotopes and to support a various research areas. The measurement and evaluation of the irradiation dose, and irradiation supporting technology of the Good Irradiation Practice(GIP) are essential in various researching areas. One thing to remember is that the publicity

  9. Rural-Urban Differences in End-of-Life Nursing Home Care: Facility and Environmental Factors (United States)

    Temkin-Greener, Helena; Zheng, Nan Tracy; Mukamel, Dana B.


    Purpose of the study: This study examines urban-rural differences in end-of-life (EOL) quality of care provided to nursing home (NH) residents. Data and Methods: We constructed 3 risk-adjusted EOL quality measures (QMs) for long-term decedent residents: in-hospital death, hospice referral before death, and presence of severe pain. We used…

  10. Development of a water detritiation facility for JET

    International Nuclear Information System (INIS)

    Perevezentsev, A.N.; Bell, A.C.; Brennan, P.D.; Hemmerich, J.L.


    A water detritiation facility, based on a world-wide adopted combined electrolysis catalytic exchange (CECE) process, for the JET active gas handling plant is described. A research and development programme is presented. The programme includes the testing of structured inert packing with an incorporated hydrophobic catalyst for increased throughput of a liquid phase catalytic exchange (LPCE) column, a vapour phase catalytic exchange (VPCE) process for reduction of tritium inventory in the alkali electrolyser and a column of high effectiveness for alkali retention

  11. Latest development in project site radwaste treatment facility (SRTF) Sanmen

    International Nuclear Information System (INIS)

    Mennicken, K.; Lohmann, P.


    Westinghouse Electric Germany GmbH (WEG) was successful in being awarded a contract as to the planning, delivery, installation and commissioning of radwaste treatment systems for the AP1000 units at Sanmen site, PR China. Operational low and intermediate level radioactive waste will be processed in the Site Radwaste Treatment Facility (SRTF). This paper explains the latest developments of the project, especially the experience with customer-hired Chinese planning partners, installation companies and Customer operating personnel. (authors)

  12. [The challenges of sustainable development in healthcare facilities]. (United States)

    Mourgues, François; Muret, Jane; Pauchard, Jean-Claude


    Healthcare and medical-social facilities have a major responsibility within society, that of the quality of care, but also that of developing a system of sustainable and socially-responsible health. This system must meet the three pillars which constitute such an approach: economic, social and environmental sustainability. Innovation remains central to the sustainable evolution of practices and the first results are now visible. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  13. Currently developing opportunities in food irradiation and modern irradiation facilities

    International Nuclear Information System (INIS)

    Wanke, R.


    I. Factor currently influencing advancing opportunities for food irradiation include: heightened incidence and awareness of food borne illnesses and causes. Concerns about ensuring food safety in international as well as domestic trade. Regulatory actions regarding commonly used fumigants/pesticides e.g. Me Br. II. Modern irradiator design: the SteriGenics M ini Cell . A new design for new opportunities. Faster installation of facility. Operationally and space efficient. Provides local o nsite control . Red meat: a currently developing opportunity. (Author)

  14. Development of the pulsed muon facility at ISIS

    International Nuclear Information System (INIS)

    Eaton, G.H.; Scott, C.A.; Williams, W.G.


    The ISIS pulsed surface muon facility at RAL is presently undergoing a major expansion to provide three experimental ports with simultaneous single muon pulses at 50 Hz. This upgrade, funded by the European Community (EC), is described together with recent development results which are relevant to its future scientific programme. These new beam lines are expected to be available for experiments in June 1993. (orig.)

  15. [Development and Testing of the Taiwanese Hospital Nurses' Job Satisfaction Scale]. (United States)

    Tzeng, Wen-Chii; Lin, Chiou-Fen; Lin, Lih-Ying; Lu, Meei-Shiow; Chiang, Li-Chi


    In the context of professional nursing, the concept of job satisfaction includes the degree to which a nurse is satisfied with the nursing profession, his/her personal adaptation to this profession, and his/her current working environment. No validated scale that addresses the job satisfaction of nurses working in hospitals currently exists in Taiwan. To develop a reliable and validated scale for measuring the job satisfaction of hospital nurses in Taiwan. A three-phase, cross-sectional study design was used. First, a literature review and expert focus group discussion were conducted to develop the initial scale items. Second, experts were invited to validate the content of the draft scale. Finally, convenience sampling was used to recruit 427 hospital nurses from 6 hospitals. These nurses completed the scale and the results were analyzed using item analysis, factor analysis, and internal consistency analysis. The 31-item Taiwanese hospital nurse job satisfaction scale developed in the present study addresses 5 factors, including supportive working environment, professional autonomy and growth, interpersonal interaction and collaboration, leadership style, and nursing workload. The overall Cronbach's α was .96. The results indicate that the developed scale provides good reliability and validity. This study confirms the validity and reliability of the developed scale. It may be used to measure the job satisfaction of nurses working in hospitals.

  16. The Nursing Diagnosis Development of Unemployment Disorder: Content Validation With Nursing Experts. (United States)

    Bocchino, Anna; Medialdea, María Jesús; Lepiani, Isabel; Mejías, Concepción; Dueñas, María


    This study aimed to validate the definition and define the characteristics and related factors of unemployment disorder, a proposed nursing diagnosis. Using Fehring's diagnostic content validity model, Spanish experts were asked to assess the adequacy of the label, defining the characteristics and other related factors. The content validity index was 0.8690. A total of 16 defining characteristics reached major criteria (>0.80). The present study supports the proposed development of a nursing diagnosis for the human response to unemployment. The results suggest that the inclusion of the "unemployment disorder" diagnostic NANDA-I taxonomy would allow nursing professionals to identify the disorder and its causes and manifestations, and therefore provide the information needed for planning more relevant interventions and results. Validación de la definición, características definitorias y factores relacionados de trastorno por desempleo, una propuesta de diagnóstico enfermero. METODOLOGÍA: Usando el modelo de validación de contenido de Fehring, se consensuó mediante expertos españoles la denominación de la etiqueta, las características definitorias y otros factores relacionados. El índice de validez de contenido global fue 0.8690. Un total de 16 características definitorias alcanzaron carácter crítico (>0.80). CONCLUSIÓN: El presente estudio apoya la propuesta de elaborar un diagnóstico de enfermería para la respuesta humana al desempleo. IMPLICACIONES PRÁCTICAS: Los resultados obtenidos sugieren que la inclusión en la taxonomía NANDA-I del diagnóstico "trastorno por desempleo" permitiría a los profesionales de enfermería identificar el problema, sus causas y manifestaciones, y por lo tanto ofrecerían la información necesaria para planificar las intervenciones y resultados más pertinentes. © 2016 NANDA International, Inc.

  17. Developing nursing ethical competences online versus in the traditional classroom. (United States)

    Trobec, Irena; Starcic, Andreja Istenic


    The development of society and science, especially medical science, gives rise to new moral and ethical challenges in healthcare. In order to respond to the contemporary challenges that require autonomous decision-making in different work contexts, a pedagogical experiment was conducted to identify the readiness and responsiveness of current organisation of nursing higher education in Slovenia. It compared the successfulness of active learning methods online (experimental group) and in the traditional classroom (control group) and their impact on the ethical competences of nursing students. The hypothesis set in the experiment, hypothesis 1 (the experimental group will be successful and will have good achievements in comprehension and application of ethical principles) was confirmed based on pre-tests and post-tests. The hypothesis tested by the questionnaire, hypothesis 2 (according to the students, the active learning methods online in the experimental group have a positive impact on the development of ethical competences) was confirmed. The pedagogical experiment was supported by a multiple-case study that enabled the in-depth analysis of the students' attitudes towards the active learning methods in both settings. The study included Slovenian first-year nursing students (N = 211) of all the enrolled students (N = 225) at the University of Ljubljana and University of Primorska in the academic year 2010/2011. Before the study ethical permission was obtained from the managements of both participating faculties. The students were given all the necessary information of the experiment before the tutorials. No significant difference was found between the two learning settings and both had a positive impact upon learning. The results of the content analysis show that the students' active engagement with the active learning methods in the group enables the development of ethical competences and the related communicative competences, interpersonal skills, collaboration

  18. Developing Flanagan's critical incident technique to elicit indicators of high and low quality nursing care from patients and their nurses. (United States)

    Norman, I J; Redfern, S J; Tomalin, D A; Oliver, S


    This paper discusses a development of Flanagan's critical incident technique (CIT) to elicit indicators of high and low quality nursing from patients and their nurses on medical, surgical and elderly care wards. Stages in undertaking the CIT are identified and presuppositions held by most researchers about the nature of the technique are identified. The paper describes how the authors moved to a different set of presuppositions during the course of the study. Preliminary analysis of interview transcripts revealed that critical incidents need not always be demarcated scenes with a clear beginning and end, but may arise from respondents summarizing their overall experience within their description of one incident. Characteristically respondents were unable to give a detailed account of such incidents but validity may be established by the fact that respondents appear to recount what actually happened as they saw it, and what they said was clearly important to them. The researchers found that the most appropriate basic unit of analysis was not the incident itself but 'happenings' revealed by incidents that are 'critical' by virtue of being important to respondents with respect to the quality of nursing care. The importance of CIT researchers achieving an understanding of the 'meaning' of critical happenings to respondents is emphasized. Analysis of the interview transcripts is facilitated by the use of INGRES, a relational database computer program which should enable a 'personal theory' of quality nursing for each respondent, both patients and nurses, to be described. The study suggests that the CIT is a flexible technique which may be adapted to meet the demands of nursing research. If carefully applied, the CIT seems capable of capitalizing on respondents' own stories and avoids the loss of information which occurs when complex narratives are reduced to simple descriptive categories. Patients and nurses have unique perspectives on nursing and their views are of

  19. Beginnings of nursing education and nurses’ contribution to nursing professional development in Serbia

    Directory of Open Access Journals (Sweden)

    Vlaisavljević Željko


    Full Text Available The oldest records of developmental beginnings of patients’ healthcare relate to the first hospital founded by St. Sava at the monastery Studenica in 1199. The profile of the Kosovian girl became the hallmark of nursing profession in Serbia. The first school for midwives was founded in 1899 at the Department of Gynecology and Obstetrics of the General State Hospital in Belgrade. However, there were no other schools for nurses in Serbia until the foundation of the School for Midwives of the Red Cross Society in 1021. Until then the healthcare of patients and the injured was carried out by self-taught volunteer nurses with completed short courses of patients’ healthcare. The first course for male and female nurses was organized by the Serbian Red Cross at the beginning of the First Serbian-Turkish War in 1876. During wars with Serbian participation in 19th and 20th centuries with Serbian participation, nurses gave a remarkable contribution being exposed to extreme efforts and often sacrificing their own lives. In war times great merit belongs to the members of the humanitarian society the Circle of Serbian Sisters founded in Belgrade in 1903, which was the resource of a great number of nurses who became the pride of nursing profession. Generations of nurses were educated on their example. In 2004 the annual award “Dušica Spasić” was established which is awarded to the best medical nurse in Serbia. Dušica Spasić was a medical nurse that died at her workplace, when aged 23 years, nursing the sick from variola.

  20. Development of Curriculum Content for a Unique Career Ladder Multi-Entry/Multi-Exit Nursing Program. Final Report. (United States)

    Rosbach, Ellen M.

    A project was undertaken to develop the curriculum content for a unique career ladder multi-entry/multi-exit nursing program that would provide training for nurse aides, practical nurses, and registered nurses. The major objectives of the project were to conduct a review of the literature on curriculum materials presently in use, to develop 11…

  1. Development and validation of a nursing professionalism evaluation model in a career ladder system. (United States)

    Kim, Yeon Hee; Jung, Young Sun; Min, Ja; Song, Eun Young; Ok, Jung Hui; Lim, Changwon; Kim, Kyunghee; Kim, Ji-Su


    The clinical ladder system categorizes the degree of nursing professionalism and rewards and is an important human resource tool for managing nursing. We developed a model to evaluate nursing professionalism, which determines the clinical ladder system levels, and verified its validity. Data were collected using a clinical competence tool developed in this study, and existing methods such as the nursing professionalism evaluation tool, peer reviews, and face-to-face interviews to evaluate promotions and verify the presented content in a medical institution. Reliability and convergent and discriminant validity of the clinical competence evaluation tool were verified using SmartPLS software. The validity of the model for evaluating overall nursing professionalism was also analyzed. Clinical competence was determined by five dimensions of nursing practice: scientific, technical, ethical, aesthetic, and existential. The structural model explained 66% of the variance. Clinical competence scales, peer reviews, and face-to-face interviews directly determined nursing professionalism levels. The evaluation system can be used for evaluating nurses' professionalism in actual medical institutions from a nursing practice perspective. A conceptual framework for establishing a human resources management system for nurses and a tool for evaluating nursing professionalism at medical institutions is provided.

  2. Profile of an excellent nurse manager: identifying and developing health care team leaders. (United States)

    Kallas, Kathryn D


    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.

  3. Mobile learning: a workforce development strategy for nurse supervisors. (United States)

    Mather, Carey; Cummings, Elizabeth


    Digital technology provides opportunities for using mobile learning strategies in healthcare environments. To realise the vision of the National Workforce Development Strategy there needs to be innovation of health professionals to further develop knowledge and skills of clinical supervisors to access and gain an understanding of the value of mobile learning at the workplace. The use of digital technology by clinical supervisors was explored in 2012 as part of a teaching development grant to evaluate the use of Web 2.0 technology to develop a community of practice about clinical supervision. Prior to developing the virtual network of clinical supervisors, feedback about the use of Web 2.0 technology by clinicians was sought via an online survey. Over 90% of respondents used social media, 85% understood what a blog and wiki were and approximately half of the respondents used smart phones. More than one-third indicated they would participate in a virtual community of practice and would like to receive information about clinical facilitation at least once per week. Findings indicate both inhibitors and opportunities for workforce development within healthcare environments that need to be addressed. Support of graduate-ready nurses can be achieved through an integrated outlook that enables health professionals within organisations to undertake mobile learning in situ. A flexible and collaborative approach to continuing professional development within organisations could enhance practice development and could positively impact on workforce development.

  4. Development of an Extreme Environment Materials Research Facility at Princeton

    International Nuclear Information System (INIS)

    Cohen, A.B.; Gentile, C.A.; Tully, C.G.; Austin, R.; Calaprice, F.; McDonald, K.; Ascione, G.; Baker, G.; Davidson, R.; Dudek, L.; Grisham, L.; Kugel, H.; Pagdon, K.; Stevenson, T.; Woolley, R.; Zwicker, A.


    The need for a fundamental understanding of material response to a neutron and/or high heat flux environment can yield development of improved materials and operations with existing materials. Such understanding has numerous applications in fields such as nuclear power (for the current fleet and future fission and fusion reactors), aerospace, and other research fields (e.g., high-intensity proton accelerator facilities for high energy physics research). A proposal has been advanced to develop a facility for testing various materials under extreme heat and neutron exposure conditions at Princeton. The Extreme Environment Materials Research Facility comprises an environmentally controlled chamber (48 m 3 ) capable of high vacuum conditions, with extreme flux beams and probe beams accessing a central, large volume target. The facility will have the capability to expose large surface areas (1 m 2 ) to 14 MeV neutrons at a fluence in excess of 10 13 n/s. Depending on the operating mode. Additionally beam line power on the order of 15-75 MW/m 2 for durations of 1-15 seconds are planned. The multi-second duration of exposure can be repeated every 2-10 minutes for periods of 10-12 hours. The facility will be housed in the test cell that held the Tokamak Fusion Test Reactor (TFTR), which has the desired radiation and safety controls as well as the necessary loading and assembly infrastructure. The facility will allow testing of various materials to their physical limit of thermal endurance and allow for exploring the interplay between radiation-induced embrittlement, swelling and deformation of materials, and the fatigue and fracturing that occur in response to thermal shocks. The combination of high neutron energies and intense fluences will enable accelerated time scale studies. The results will make contributions for refining predictive failure modes (modeling) in extreme environments, as well as providing a technical platform for the development of new alloys, new

  5. The impact of nursing leadership on patient safety in a developing country. (United States)

    Stewart, Lee; Usher, Kim


    This article is a report of a study to identify the ways nursing leaders and managers in a developing country have an impact on patient safety. The attempt to address the problem of patient safety in health care is a global issue. Literature addressing the significant impact that nursing leadership has on patient safety is extensive and focuses almost exclusively on the developed world. A critical ethnography was conducted with senior registered nursing leaders and managers throughout the Fiji Islands, specifically those in the Head Office of the Fiji Ministry of Health and the most senior nurse in a hospital or community health service. Semi-structured interviews were conducted with senior nursing leaders and managers in Fiji. Thematic analysis of the interviews was undertaken from a critical theory perspective, with reference to the macro socio-political system of the Fiji Ministry of Health. Four interrelated issues regarding the nursing leaders and managers' impact on patient safety emerged from the study. Empowerment of nursing leaders and managers, an increased focus on the patient, the necessity to explore conditions for front-line nurses and the direct relationship between improved nursing conditions and increased patient safety mirrored literature from developed countries. The findings have significant implications for developing countries and it is crucial that support for patient safety in developing countries become a focus for the international nursing community. Nursing leaders and managers' increased focus on their own place in the hierarchy of the health care system and on nursing conditions as these affect patient safety could decrease adverse patient outcomes. The findings could assist the global nursing community to better support developing countries in pursuing a patient safety agenda. © 2010 Blackwell Publishing Ltd.

  6. Development of advanced nursing practice in China: Act local and think global

    Directory of Open Access Journals (Sweden)

    Frances Kam Yuet Wong


    Full Text Available This paper discusses the development of advanced nursing practice in China in the context of global development. The scope of nursing is evolving over time, with increasing demands for the management of complex healthcare situations at individual, community and system levels. These demands are aggravated by the specialization of medical practice, with advanced treatment plans and patients requiring care in focused areas. The qualifications and competencies of the initial entrants into nursing practice are not adequate to deal with these demands. Advanced nursing practice (ANP developed first in response to service demands, and education programs were introduced to prepare nurses for practicing at a higher level. This paper will first review the historical development of ANP in China, followed by a discussion of the differentiation of competence levels in nursing practice and the classification of specializations. It concludes by exploring how education in combination with experience protected by regulation of practice can support nurses to gradually evolve from registered nurse, specialty nurse to advanced practiced nurse.

  7. Use of a Balanced Scorecard in strengthening health systems in developing countries: an analysis based on nationally representative Bangladesh Health Facility Survey. (United States)

    Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar


    This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Qualification of University graduates nursing for the management of radiodiagnostic facilities

    International Nuclear Information System (INIS)

    Haro, G.; Herrador, M.; Hernandez, A.; Benitez, J. J.; Roman, J. J.; Gomez, A.; Luis, J.


    Since 1987, the nursery specialization degrees, such as Radiology and Electrotechnical were cancelled. Afterwards, an education and training deficiency has existed in the nursery career. The professional college of Graduated in Nursery in Seville, recognized the lack of training in their members to develop properly the profession, specially in radiation protection within the radiodiagnosis area. Therefore, advanced training courses were organised by this college to overcome the training deficiency and to provide skills for the correct management of the radiodiagnosis facilities. These courses are accredited by the Spanish Nuclear Safety Council. These courses have been performing annually since 1994 and cover the following items: Theoretical content: Electromagnetic Radiations. Radiobiology. Radiation Protection. Laws and Legislation. Seminaries. Practical content: Radiation Monitors. Evaluation of a X-ray room shielding. Quality control of the x-ray films and direct beam radiation. Seminaries. More than 300 nursery professionals ha been trained by these courses. They have acquired enough knowledge to offer radiological safety to their users within the ALARA frame, in state and private establishments. (Author) 4 refs

  9. [Development of nursing key performance indicators for an intensive care unit by using a balanced scorecard]. (United States)

    Choi, Yun Jeong; Lim, Ji Young; Lee, Young Whee; Kim, Hwa Soon


    The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC). This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs. Two main visions of nursing service for ICUs were established. These were 'realization of harmonized professional nursing with human respect' and 'recovery of health through specialized nursing' respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC. The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

  10. Development of a Health System-Based Nurse-Delivered Aromatherapy Program. (United States)

    Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A


    Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

  11. Development of the power ramping facility at JMTR

    International Nuclear Information System (INIS)

    Nakata, Hirokatsu; Sezaki, Katsuji; Nakazaki, Chosaburo; Ishii, Tadahiko; Ito, Haruhiko; Abe, Hiroshi


    The LWR fuel power ramping facility have been being developed at JMTR since 1978. This report, following previous reports, JAERI-M 8533 and 9343, summarizes the results of performance test performed in 1981 on the 3 He power controlled boiling water capsule, which is a basic part of the facility. Various measurements were carried out during reactor operation on each part of the capsule, i.e. capsule itself, capsule control unit and 3 He power control unit, after a long-time cold run test of the units. Through the test, it was confirmed that the capsule satisfies the specifications which stated that LWR fuel pin should be power-ramped under BWR conditions up to 50 kW/m with a change factor of more than 2, and that the control units operate in a good condition. (author)

  12. Technical viability and development needs for waste forms and facilities

    Energy Technology Data Exchange (ETDEWEB)

    Pegg, I.; Gould, T.


    The objective of this breakout session was to provide a forum to discuss technical issues relating to plutonium-bearing waste forms and their disposal facilities. Specific topics for discussion included the technical viability and development needs associated with the waste forms and/or disposal facilities. The expected end result of the session was an in-depth (so far as the limited time would allow) discussion of key issues by the session participants. The session chairs expressed allowance for, and encouragement of, alternative points of view, as well as encouragement for discussion of any relevant topics not addressed in the paper presentations. It was not the intent of this session to recommend or advocate any one technology over another.

  13. Development of decommissioning technology for nuclear fuel facility

    International Nuclear Information System (INIS)

    Tanimoto, Ken-ichi


    There are many kinds of objects for decommissioning and their properties are greatly different in respects of morphology, constituent materials, contamination history, etc. Therefore, the techniques for decontamination and dismantlement are required to have a great applicability. In addition, most of contamination nuclides have long half-life and so, it is desirable to rapidly take measures to stop or close a contaminated facility. In consideration of these characteristics developments of elementary techniques for decontamination have been attempted. This report summarized the present states of decommissioning technology for nuclear fuel facility. The function and performance of each elementary technique were examined through test operation and simulation was made for the important techniques of them aiming at generalization and optimization. For remote handling technology, two operation tools; 'metal splitting saw cutting tool' and 'plasma cutting tool' were produced and utilizations of these tools in combination with a robot for conveyance are under investigation now. (M.N.)

  14. Progress in developing the concept for the irradiation research facility

    International Nuclear Information System (INIS)

    Lee, A.G.; Bishop, W.E.; Gillespie, G.E.; Zeng, Y.


    At the 16th annual Canadian Nuclear Society conference, AECL presented the case for replacing the NRU reactor with an Irradiation Research Facility (IRF) to test CANDU fuels and materials and to perform advanced materials research using neutrons. AECL developed a cost estimate of $500 million for the reference IRF concept, and estimated that it would require 87 months to complete. AECL has initiated a pre-project program to develop the IRF concept and to minimize uncertainties related to feasibility and licensability, and to examine options for reducing the overall project cost before project implementation begins. (author) 10 refs., 2 figs

  15. Conceptual design of a technology development facility (TDF)

    International Nuclear Information System (INIS)

    Doggett, J.N.; Damm, C.C.


    We have developed a concept for employing a single-cell mirror machine in a facility for testing and developing fusion reactor materials, components, and subsystems in a fusion reactor environment. Our approach is similar to that of the 1974 FERF study, except that we have added an auxiliary thermal-barrier cell at each end of the yin-yang magnet. In this way, we provide for plasma microstability by confining a warm plasma component between potential peaks at each end of the device (just as in the tandem mirror with auxiliary barrier cells) while we further improve confinement by the inherent reduction in ambipolar potential drop in the central cell

  16. The development and issues of nursing education in China: a national data analysis. (United States)

    You, Li-ming; Ke, Ying-ying; Zheng, Jing; Wan, Li-hong


    The development of and the issues arising in the nursing educational sector as the provider for nursing workforce have drawn increasing attention. To describe the development of nursing education in mainland China and to analyze related issues. A retrospective, descriptive study with secondary data analysis. The scale and composition of nursing education programs from 2006 to 2012 in mainland China were analyzed, and changes in the scale of the nursing workforce from 2002 to 2013 were compared to facilitate an interpretation of nursing education. The scale of initial nursing education was large and expanded rapidly. In 2012, the total recruitment was 515,710, including 39,747 (7.71%) students training for a baccalaureate degree, 143,726 (27.87%) students training for an advanced diploma, and 332,237 (64.42%) students training in secondary diploma programs. The nursing workforce in China grew dramatically, with an increase of 120,000 to 286,000 nurses each year since 2006, but the nurse shortage remained existed (there were only 2.05 nurses per 1000 population, and the nurse to doctor ratio was 1:1 in 2013). The recruitment of nursing students per 1000 population was greater in the west (0.51) and middle (0.40) regions than in the east region (0.28), while the number of nurses per 1000 population had the opposite pattern (1.71, 1.75, and 2.02 nurses per 1000 population in the west, middle, and east regions, respectively) in 2012. Nursing education in China has developed rapidly, and some issues require attention. We suggest that initial nursing education be improved by increasing the recruitment to advanced diploma and baccalaureate programs and decreasing the recruitment to secondary diploma programs and by ensuring the quality of education. Multiple strategies should be taken to effectively raise the social status and prestige of the nursing profession and to ease the nurse shortage. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. A pilot study on the feasibility of training nurses to formulate multicomponent oral health interventions in a residential aged care facility. (United States)

    Deutsch, Alan; Siegel, Emma; Cations, Monica; Wright, Clive; Naganathan, Vasi; Brodaty, Henry


    This 10 weeks feasibility study investigated whether residential care nurses with 12 hours advanced oral health training in assessments and saliva testing could formulate, implement and monitor individualised oral care plans of early dementia residents. Four trained lead advocate nurses using SXI-D, OHIP14, oral health assessment tool (OHAT) assessments and a modified saliva test formulated nurse scheduled comprehensive oral care plans (NSCOCPs) by selecting and scheduling preventive products and procedures multiple times throughout the day to alkalise the mouth of 8 residents as an adjunct to assisted brushing and high-fluoride toothpaste. Nurse assessments, saliva tests and care plans were validated against oral health therapist (OHT) findings. Care plan agreement between Nurse and OHT intervention selection and scheduling was high (75%-88%). Untrained nurse compliance was very high, 86%-99% for the 4930 scheduled interventions. Untrained nurses delivered multiple scheduled interventions by following NSCOCPs despite initially not understanding the reason for each of 9 interventions categories. NSCOCPs could track and monitor whether a recommended intervention had been completed by general nursing staff over 3 nursing shifts. The role of nurses may have to be expanded beyond traditional roles to meet the growth and changes in oral health needs in residential facilities. Intensive training of a few lead advocate nurses to assess risk and formulate individualised NSCOCPs provides a method to transfer knowledge to untrained staff and deliver multicomponent preventive interventions soon after entry into residential care where timely visits by dental professionals to examine residents and prescribe preventive interventions are infrequent or unlikely. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  18. Developing nursing capacity for health systems and services research in Cuba, 2008-2011. (United States)

    Martínez, Nelcy


    Health systems and services research by nursing personnel could inform decision-making and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates. Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana. The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation. Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing ministerial-level priorities) to research nursing issues at selected centers. A systematic strategy to build nursing capacity for health

  19. Framework for 21st Century School Nursing Practice: Framing Professional Development. (United States)

    Allen-Johnson, Ann


    The NASN Code of Ethics upholds that it is the responsibility of the school nurse to maintain competency and pursue personal and professional growth. Designing professional development activities that are relevant and support the needs of the school nurse can be a challenge. The Framework for 21st Century School Nursing Practice provides a model rooted in evidence-based standards of practice that can be utilized to assess an existing professional development program and identify gaps in learning opportunities. Nurse leaders can use the Framework for 21st Century Nursing Practice to provide a roadmap toward a professional development program that will be meaningful to school nurse staff, help restore or maintain joy in their practice, and allow them to achieve the goal of advancing the well-being, academic success, and lifelong achievement and health of students.

  20. Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management. (United States)

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


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

  1. Diagnostic development and support of MHD test facilities

    Energy Technology Data Exchange (ETDEWEB)


    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs. 25 figs., 6 tabs.

  2. Diagnostic development and support of MHD (magnetohydrodynamics) test facilities

    Energy Technology Data Exchange (ETDEWEB)


    Mississippi State University (MSU) is developing diagnostic instruments for Magnetohydrodynamics (MHD) power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for HRSR support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with MHD Energy Center computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. MSU personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs.

  3. Diagnostic development and support of MHD test facilities

    International Nuclear Information System (INIS)

    Shepard, W.S.; Cook, R.L.


    The Diagnostic Instrumentation and Analysis Laboratory (DIAL) at Mississippi State University (MSU) is developing diagnostic instruments for MHD power train data acquisition and for support of MHD component development test facilities. Microprocessor-controlled optical instruments, initially developed for Heat Recovery/ Seed Recovery support, are being refined, and new systems to measure temperatures and gas-seed-slag stream characteristics are being developed. To further data acquisition and analysis capabilities, the diagnostic systems are being interfaced with DIAL's computers. Technical support for the diagnostic needs of the national MHD research effort is being provided. DIAL personnel will also cooperate with government agencies and private industries to improve the transformation of research and development results into processes, products and services applicable to their needs

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

    Juvé-Udina, Maria-Eulàlia


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

  5. Self-assessment of clinical nurse mentors as dimensions of professional development and the capability of developing ethical values at nursing students: A correlational research study. (United States)

    Skela-Savič, Brigita; Kiger, Alice


    Providing adequate training for mentors, fostering a positive mentorship culture and establishing the necessary operational procedures for ensuring mentorship quality are the keys to effective clinical mentoring of nursing students. The purpose of the research was to explain different dimensions of clinical mentors' professional development and their capability of developing ethical values in nursing students. A non-experimental quantitative research design was employed. Data were collected by means of a questionnaire administered to the population of clinical mentors (N=143). The total number of questions was 36. Descriptive statistics were used, and bivariate analysis, factor analysis, correlation analysis and linear regression analysis were performed. The professional development of clinical nurse mentors was explained (R(2)=0.256) by career advancement (p=0.000), research and learning (p=0.024) and having a career development plan (p=0.043). Increased professional self-confidence (R(2)=0.188) was explained by career advancement (p=0.000) and the time engaged in record keeping (p=0.028). Responsibility for the development of ethical values in nursing students (R(2)=0.145) was explained by the respondents' level of education (p=0.020) and research and learning (p=0.024). Applying ethical principles and norms into practice (R(2)=0.212) was explained by self-assessed knowledge in ethics (p=0.037) and research and learning (p=0.044). Clinical nurse mentors tended to lack a career development plan, had low work time spent on research and insufficiently participated in education and training activities, which turned out to be significant explanatory factors of their professional development and their capability of developing ethical values in nursing students. The research showed that nursing and higher education managers often failed to assume responsibility for the professional development of clinical nurse mentors. Copyright © 2015 Elsevier Ltd. All rights

  6. Preliminary Report of a Pilot Tele-Health Palliative Care and Bioethics Program for Residents in Skilled Nursing Facilities

    Directory of Open Access Journals (Sweden)

    Sean O’Mahony


    Full Text Available Currently about 25% of Americans die in nursing homes, many with poorly controlled pain and other symptoms, with minimal provisions for psychosocial support. New models are necessary to lessen structural and process barriers to give effective end-of-life care in nursing homes. Objectives: 1 To extend hospital-based Bioethics Consultation Services (BCS and Palliative Care Services (PCS at Montefiore Medical Center (MMC in the Bronx to two local Skilled Nursing Facilities (SNFs, Morningside House Aging in America (MSH using direct face-to-face consultations and Beth Abraham Health Systems (BAHS via video consultations (VC; 2 Achieve improvements in quality of life and comfort for elderly residents and their families; 2a Improve the level of practice and increase staff satisfaction with palliative care content-related knowledge and bioethical analysis. Methods: We report preliminary findings of this two group quasi experimental project with results of pre- and post- tests rating content-related knowledge in aspects of end-of-life care for staff. Select pre-test and post-test questions were given to physicians and other staff, but were re-configured for, registered and licensed practice nurses, social workers, and certified nursing assistants from the End-of-Life Physician Education Resource Center (EPERC. Patient, family, and staff ratings of the quality of palliative care were measured with a Palliative Outcomes Scale (POS one week prior to and post consultation. Results: 72 staff attended in-services; 53 completed pre-tests and 49 post-tests. Overall knowledge scores increased for 9 of the 16 items that were analyzed. There were improvements in knowledge scores in 12 of 16 items tested for staff content related knowledge which were statistically significant in regard to management of cancer pain from 63.8% to 81.5% (p = 0.03 and a trend to significance for assessment and management of delirium from 31.6% to 61.9% (p = 0.073. Seventy five POS

  7. Development of the Nursing Outcome (NOC) label: hyperactivity level. (United States)

    Caldwell, Carol L; Wasson, Dianne; Anderson, Mary Ann; Brighton, Veronica; Dixon, Lois


    Hyperactivity, a persistent, severe pattern of inattention or impulsivity, places children at risk for impaired functioning in many developmental areas. This behavior is characterized by short attention span, low frustration tolerance, impulsivity, distractibility, and increased physical activity. Responses from multiple sources in the child's environment must be monitored to manage childhood hyperactivity. Success at school, in peer relationships, and parent-child interactions is frequently affected by hyperactivity. Using a focus group approach, a Nursing Outcomes Classification (NOC) label, definition, and indicators were developed for Hyperactivity Level. Review of the literature allowed for a content analysis approach and conceptualization of hyperactivity at several levels. Twenty three (23) measurable indicators were formulated and refined into conceptually and clinically coherent outcomes. Clinical relevance and utility were presented through a case study approach.

  8. Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument. (United States)

    Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin


    To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting

  9. Development of thermo-plastic heating and compaction facility

    International Nuclear Information System (INIS)

    Ko, Dae Hak; Lim, Suk Nam


    Low- and intermediate-level radioactive wastes consist of spent resin, spent filter, concentrated waste and dry active waste(DAW) and they are solidified or packaged into drums or high integrated containers(HICs). DAWs occupy 50 percent of all low- and intermediate-level radioactive wastes generated from nuclear power plants in Korea. Incinerable wastes in the DAWs are about 60 percent. Therefore, it is very important for us to reduce the volume of incinerable wastes in DAWs. Experience of supercompaction turned out that thermo-plastic wastes have a swelling effect after supercompaction process due to their repulsive power. And the thermo-plastic heating and compaction facility has been developed by KEPCO. In conclusion, heating and compaction facility can reduce the volume of DAWs as well as upgrade the quality of treated wastes, because the swelling effect by repulsive power after compaction is removed, final wastes form the shape of block and they have no free-standing water in the wastes. Plan for practical use is that this facility will be installed in other nuclear power plants in Korea in 1999. (Cho, G. S.). 1 tab., 2 figs

  10. Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service. (United States)

    Dwyer, Trudy; Craswell, Alison; Rossi, Dolene; Holzberger, Darren


    Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia. Donabedian's structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardised interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings. Structural dimensions identified included the 'in-reach' nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction. This study provides valuable insights into the contribution of the NP model of care within an aged care

  11. A Practice Improvement Education Program Using a Mentored Approach to Improve Nursing Facility Depression Care-Preliminary Data. (United States)

    Chodosh, Joshua; Price, Rachel M; Cadogan, Mary P; Damron-Rodriguez, JoAnn; Osterweil, Dan; Czerwinski, Alfredo; Tan, Zaldy S; Merkin, Sharon S; Gans, Daphna; Frank, Janet C


    Depression is common in nursing facility residents. Depression data obtained using the Minimum Data Set (MDS) 3.0 offer opportunities for improving diagnostic accuracy and care quality. How best to integrate MDS 3.0 and other data into quality improvement (QI) activity is untested. The objective was to increase nursing home (NH) capability in using QI processes and to improve depression assessment and management through focused mentorship and team building. This was a 6-month intervention with five components: facilitated collection of MDS 3.0 nine-item Patient Health Questionnaire (PHQ-9) and medication data for diagnostic interpretation; education and modeling on QI approaches, team building, and nonpharmacological depression care; mentored team meetings; educational webinars; and technical assistance. PHQ-9 and medication data were collected at baseline and 6 and 9 months. Progress was measured using team participation measures, attitude and care process self-appraisal, mentor assessments, and resident depression outcomes. Five NHs established interprofessional teams that included nursing (44.1%), social work (20.6%), physicians (8.8%), and other disciplines (26.5%). Members participated in 61% of eight offered educational meetings (three onsite mentored team meetings and five webinars). Competency self-ratings improved on four depression care measures (P = .05 to depression scores did not change while medication use declined, from 37.2% of residents at baseline to 31.0% at 9 months (P care processes, achieved medication reductions, and was well received. Application to other NH-prevalent syndromes is possible. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  12. DCDS: A Real-time Data Capture and Personalized Decision Support System for Heart Failure Patients in Skilled Nursing Facilities. (United States)

    Zhu, Wei; Luo, Lingyun; Jain, Tarun; Boxer, Rebecca S; Cui, Licong; Zhang, Guo-Qiang


    Heart disease is the leading cause of death in the United States. Heart failure disease management can improve health outcomes for elderly community dwelling patients with heart failure. This paper describes DCDS, a real-time data capture and personalized decision support system for a Randomized Controlled Trial Investigating the Effect of a Heart Failure Disease Management Program (HF-DMP) in Skilled Nursing Facilities (SNF). SNF is a study funded by the NIH National Heart, Lung, and Blood Institute (NHLBI). The HF-DMP involves proactive weekly monitoring, evaluation, and management, following National HF Guidelines. DCDS collects a wide variety of data including 7 elements considered standard of care for patients with heart failure: documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7 day follow up appointment post SNF discharge and patient education. We present the design and implementation of DCDS and describe our preliminary testing results.

  13. [A development and evaluation of nursing KMS using QFD in outpatient departments]. (United States)

    Lee, Han Na; Yun, Eun Kyoung


    This study was done to develop and implement the Nursing KMS (knowledge management system) in order to improve knowledge sharing and creation among clinical nurses in outpatient departments. This study was a methodological research using the 'System Development Life Cycle': consisting of planning, analyzing, design, implementation, and evaluation. Quality Function Deployment (QFD) was applied to establish nurse requirements and to identify important design requirements. Participants were 32 nurses and for evaluation data were collected pre and post intervention at K Hospital in Seoul, a tertiary hospital with over 1,000 beds. The Nursing KMS was built using a Linux-based operating system, Oracle DBMS, and Java 1.6 web programming tools. The system was implemented as a sub-system of the hospital information system. There was statistically significant differences in the sharing of knowledge but creating of knowledge was no statistically meaningful difference observed. In terms of satisfaction with the system, system efficiency ranked first followed by system convenience, information suitability and information usefulness. The results indicate that the use of Nursing KMS increases nurses' knowledge sharing and can contribute to increased quality of nursing knowledge and provide more opportunities for nurses to gain expertise from knowledge shared among nurses.

  14. Processes influencing the development of graduate nurse capabilities in clinical risk management: an Australian study. (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga


    To explore and describe key processes influencing the development of graduate nurse capabilities in clinical risk management (CRM). This study was undertaken using an exploratory descriptive case study method. Four sample units of analysis were used, notably: 2 cohorts of graduate nurses (n = 11) undertaking a 12-month graduate nurse transition program; key stakeholders (n = 34), that is, nurse unit managers, clinical teachers, preceptors, a quality manager, a librarian, and senior nurse administrators employed by the participating health service; patient outcome data; and pertinent literature. Data strongly suggested that graduate nurse capabilities in CRM were most influenced not by their supposed lack of clinical knowledge and skills but by their lack of corporate knowledge. The failure to provide new graduate nurses with pertinent information on CRM at the beginning of their employment and thereafter at pertinent intervals during the graduate nurse year program aslo hindered the development of their capabilities to manage clinical risk. Management and educational processes pertinent to informing and involving new graduate nurses in a hospital's local CRM program (including information about the organization's local policies and procedures) need to be implemented systematically at the very beginning of a new graduate's employment and thereafter throughout the remainder of the graduate nurse year.

  15. Quality assurance of nursing web sites: development and implications of the ALEU method. (United States)

    Cambil-Martín, Jacobo; Flynn, Maria; Villaverde-Gutiérrez, Carmen


    This article presents a study that evaluated the physical accessibility, readability, and usability of Spanish nursing Web sites and discusses the quality assurance issues raised, which are relevant to the wider nursing community. The Internet is recognized as an important source of health information for both nurses and the general public. Although it makes health-related information universally available, the wide variation in the overall quality of health Web sites is problematic. This raises many questions for the nursing profession: about what constitutes a good-quality Web site, about the nature of the information that nurses are finding and using to support their professional education, research, and clinical practice, and about the impact that Internet information ultimately has on health interactions and nursing care. The process of completing this small study showed that it is possible to usefully assess dimensions of Web site quality and suggested that it may be feasible to develop tools to help nurses evaluate national and international nursing Web sites. More research is needed to understand how nurses use the Internet to support their everyday professional practices, but the development and application of international Web site quality assurance tools may be important for maintaining professional nursing standards in the Internet age.

  16. [Development of a set of nursing-sensitive indicators for Swiss practice]. (United States)

    Kleinknecht-Dolf, Michael; Baumberger, Dieter; Jucker, Thomas; Kliem, Uwe; Zimmermann, Natalie; Spirig, Rebecca


    The SwissDRG prospective payment system is known to inadequately account for nursing intensity due to the DRG group criteria insufficiently describing the variability of nursing intensity within individual diagnosis-related groups. In order to allow for appropriate reimbursement and resource allocation, nursing intensity must be able to be explicitly quantified and accounted for. The aim of this project was to develop a set of nursing-sensitive indicators intended to reduce the variation within individual diagnosis-related groups, supplementary to existing SwissDRG group criteria. The approach comprised a variety of methods. A systematic literature review, input from an advisory board and an expert panel, as well as three focus group interviews with nurses and nurse managers formed the basis for the synthesis of data and information gathered from these sources. A set of 14 nursing-sensitive indicators was developed. The indicators are intended to improve the homogeneity of nursing intensity within SwissDRG diagnosis-related groups. Before these nursing indicators can be adopted as group criteria, they must be formulated to conform with SwissDRG and tested empirically. This set of indicators can be seen at as a first step towards nursing intensity being adequately represented in SwissDRG diagnosis-related groups. The next challenge to be met is operationalising the indicators in codable form.

  17. The impact of the prospective payment system for skilled nursing facilities on therapy service provision: a transaction cost approach. (United States)

    Zinn, Jacqueline S; Mor, Vincent; Intrator, Orna; Feng, Zhanlian; Angelelli, Joseph; Davis, Jullet A


    To examine skilled nursing facilities (SNFs) "make-or-buy" decisions with respect to rehabilitation therapy service provision in the 1990s, both before and after implementation of Medicare's Prospective Payment System (PPS) for SNFs. Longitudinal On-line Survey Certification and Reporting (OSCAR) data (1992-2001) on a sample of 10,241 freestanding urban SNFs. We estimated a longitudinal multinomial logistic regression model derived from transaction cost economic theory to predict the probability of the outcome in each of four service provision categories (all employed staff, all contract, mixed, and no services provided). Transaction frequency, uncertainty, and complexity result in greater control over therapy services through employment as opposed to outside contracting. For-profit status and chain affiliation were associated with greater control over therapy services. Following PPS, nursing homes acted to limit transaction costs by either exiting the rehabilitation market or exerting greater control over therapy services by managing rehabilitation services in-house. The financial incentives associated with changes in reimbursement methodology have implications that extend beyond the boundaries of the health care industry segment directly affected. Unintended quality and access consequences need to be carefully monitored by the Medicare program.

  18. Role development of nurses for technology-dependent children attending mainstream schools in Japan. (United States)

    Shimizu, Fumie; Suzuki, Machiko


    To describe the role development of nurses caring for medical technology-dependent children attending Japanese mainstream schools. Semi-structured interviews with 21 nurses caring for technology-dependent children were conducted and analyzed using the modified grounded theory approach. Nurses developed roles centered on maintaining technology-dependent children's physical health to support children's learning with each other, through building relationships, learning how to interact with children, understanding the children and the school community, and realizing the meaning of supporting technology-dependent children. These findings support nurses to build relationships of mutual trust with teachers and children, and learn on the job in mainstream schools. © 2015, Wiley Periodicals, Inc.

  19. Development and Field Test of Competency Based Instructional Material for a Career Mobility Program for Licensed Practical Nurses. Final Report. (United States)

    Bergen Community Coll., Paramus, NJ.

    The Associate Degree Nursing Program at Bergen Community College developed and field tested competency-based instructional modules in a program designed to allow licensed practical nurses to qualify to take the certification examination for registered nurses after a year of study. Thirteen licensed practical nurses were enrolled in the first class…

  20. [The concept of transcultural nursing: the analysis of its development in a Master degree dissertation]. (United States)

    Queiroz, M V; Pagliuca, L M


    This is an analytic-bibliographic study which analyzes the concept of nursing in Leininger's Theory and the conceptual development of Nursing presented in the master's degree dissertation chosen for this study. Barnum's model for the analysis and evaluation of theories (Barnum 1998) was used, in relation to the clarity and consistency of the concept, together with questions about Nursing. The group of statements presented in Leininger's transcultural nursing concept and in the dissertation shows what is the focus of nursing and the intrinsic relation to the process of looking after somebody, which must be developed coherently with culture. It also demonstrates that Nursing has a body of specific professional knowledge which guides the care for the client, valuing one's individuality, subjectivity and way of seeing the world. The study made it possible to validate concepts taken from the Theory of Universality and Cultural Diversity of caring and their use in the research according to the analyzed criteria.

  1. Effectiveness of interventions for the development of leadership skills among nurses: a systematic review protocol. (United States)

    Darragh, Michael; Traynor, Victoria; Joyce-McCoach, Joanne


    What interventions are the most effective for the development of leadership skills for nurses?The review objective is to systematically review the evidence to identify the effectiveness of interventions for the development of leadership skills among nurses. Centre for Evidence-based Initiatives in Health Care - University of Wollongong: an Affiliate Center of the Joanna Briggs Institute.

  2. Development and Validation of the Geriatric In-Hospital Nursing Care Questionnaire

    NARCIS (Netherlands)

    Persoon, Anke; Bakker, Franka C.; van der Wal-Huisman, Hanneke; Rikkert, Marcel G. M. Olde

    ObjectivesTo develop a questionnaire, the Geriatric In-hospital Nursing Care Questionnaire (GerINCQ), to measure, in an integrated way, the care that older adults receive in the hospital and nurses' attitudes toward and perceptions about caring for older adults. DesignQuestionnaire development.

  3. Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study. (United States)

    Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E


    Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

  4. Professional development for nurses: mentoring along the u-shaped curve. (United States)

    Johnson, Joyce E; Billingsley, Molly; Crichlow, Tori; Ferrell, Eileen


    Shortages of nurses are expected to continue throughout the coming decade. To meet the demand, nursing leaders must develop creative approaches for nurturing and sustaining nursing talent. Traditionally, nursing has embraced a variety of development strategies to enhance the leadership abilities of nurses and to fill the leadership ranks with top talent. We describe the rationale, design, and impact of a 3-pronged organizational approach to mentoring nursing talent at Georgetown University Hospital, the first Magnet hospital in Washington, District of Columbia. The design of these programs was driven by the demographics of our nursing staff. Analysis of length of tenure revealed a modified "U-shaped curve" with the majority of new nurses with tenure less than 5 years, few in the middle between 5 and 15 years, and a moderate number with 15 or more years. Investment in all our nurses' leadership development required integrating a diverse developmental process into our organizational culture, which values personal growth and mastery. A strong mentoring program makes good business sense in terms of employee job satisfaction, improved cost control, and better patient outcomes. Our experience suggests that voluntary mentoring programs work synergistically to further the development of a mentoring culture in today's hospitals.

  5. Development of a quality system for a contract irradiation facility

    International Nuclear Information System (INIS)

    Siyakus, G.


    The use of Industrial Irradiation Systems, in order to process medical supplies and food commodities, has almost 50 years experiences in the world. The food irradiation process has been approved by more than 40 countries around the world and it has been endorsed or supported by numerous national and international organizations and professional groups. Today, radiation sterilization of medical supplies is the most preferred technology in almost every developed country. Other applications: such as waste and flue gas treatment, polymer processing are also put into practice in wider range than before. Higher capital cost compared to the operation cost, the nature of continuous decay of the radiation sources used to obtain gamma rays, obligate the owners of gamma facilities to operate systems based on the 24 hours a day and 7 days per week. On the other hand, higher throughput capacity and economical brake point for profitability, force irradiation companies to offer service for the varied products of the companies. Industrial irradiation facilities providing services for varied companies by irradiating different kind of commodities so called contract irradiator or multipurpose irradiator and most of the irradiation facilities, particularly gamma irradiators running in different locations of the World, operates as contract irradiators. The radiation facilities are considered as a part of the manufacturing process, and must conform to the pertinent general Code of Good Manufacturing Practice (GMP) which has been declared by the principal producer. Customers of these facilities may have petitions, such as irradiation temperature, dose rate, minimal and maximal doses; storage conditions before and after irradiation. Design parameters related to the dose rate, product size, density and weight, irradiation and storage temperatures are the main limitations. Varied process conditions can be easily applied in the laboratory may set forth difficulties in industrial processes

  6. Currently developing opportunities in food irradiation and modern irradiation facilities

    Energy Technology Data Exchange (ETDEWEB)

    Wanke, R [Director Business Development. SteriGenics International Inc. 17901 East Warren Avenue No. 4, Detroit, Michigan 48224-1333 (United States)


    I. Factor currently influencing advancing opportunities for food irradiation include: heightened incidence and awareness of food borne illnesses and causes. Concerns about ensuring food safety in international as well as domestic trade. Regulatory actions regarding commonly used fumigants/pesticides e.g. Me Br. II. Modern irradiator design: the SteriGenics {sup M}ini Cell{sup .} A new design for new opportunities. Faster installation of facility. Operationally and space efficient. Provides local {sup o}nsite control{sup .} Red meat: a currently developing opportunity. (Author)

  7. Currently developing opportunities in food irradiation and modern irradiation facilities

    Energy Technology Data Exchange (ETDEWEB)

    Wanke, R. [Director Business Development. SteriGenics International Inc. 17901 East Warren Avenue No. 4, Detroit, Michigan 48224-1333 (United States)


    I. Factor currently influencing advancing opportunities for food irradiation include: heightened incidence and awareness of food borne illnesses and causes. Concerns about ensuring food safety in international as well as domestic trade. Regulatory actions regarding commonly used fumigants/pesticides e.g. Me Br. II. Modern irradiator design: the SteriGenics {sup M}ini Cell{sup .} A new design for new opportunities. Faster installation of facility. Operationally and space efficient. Provides local {sup o}nsite control{sup .} Red meat: a currently developing opportunity. (Author)

  8. Developing nurse leaders: a program enhancing staff nurse leadership skills and professionalism. (United States)

    Abraham, Pauline J


    This study aims to determine whether participation in the Nursing Leadership Perspectives Program (NLPP) at Mayo Clinic in Rochester, Minnesota, produced a change in leadership skills, increased professional activities, leadership promotion, and retention rates of participants. The NLPP is an educational program designed to enhance leadership skills and promote professionalism of registered nurses. The 6-month program provides participants with theoretical knowledge, core competencies, and opportunities to practice application of leadership skills. Outcome metrics were collected from registered nurses who completed the program (n = 15). Data analysis included descriptive and nonparametric methods. Participants reported statistically significant changes in their leadership skills after participation in the program (P = .007) on the Leadership Practices Inventory. Changes in professional behavior were also statistically significant as rated by the Nursing Activity Scale (P = .001). Participants demonstrated a change in leadership skills and professional behavior following the program.

  9. Balancing nurses' workload in hospital wards: study protocol of developing a method to manage workload. (United States)

    van den Oetelaar, W F J M; van Stel, H F; van Rhenen, W; Stellato, R K; Grolman, W


    Hospitals pursue different goals at the same time: excellent service to their patients, good quality care, operational excellence, retaining employees. This requires a good balance between patient needs and nursing staff. One way to ensure a proper fit between patient needs and nursing staff is to work with a workload management method. In our view, a nursing workload management method needs to have the following characteristics: easy to interpret; limited additional registration; applicable to different types of hospital wards; supported by nurses; covers all activities of nurses and suitable for prospective planning of nursing staff. At present, no such method is available. The research follows several steps to come to a workload management method for staff nurses. First, a list of patient characteristics relevant to care time will be composed by performing a Delphi study among staff nurses. Next, a time study of nurses' activities will be carried out. The 2 can be combined to estimate care time per patient group and estimate the time nurses spend on non-patient-related activities. These 2 estimates can be combined and compared with available nursing resources: this gives an estimate of nurses' workload. The research will take place in an academic hospital in the Netherlands. 6 surgical wards will be included, capacity 15-30 beds. The study protocol was submitted to the Medical Ethical Review Board of the University Medical Center (UMC) Utrecht and received a positive advice, protocol number 14-165/C. This method will be developed in close cooperation with staff nurses and ward management. The strong involvement of the end users will contribute to a broader support of the results. The method we will develop may also be useful for planning purposes; this is a strong advantage compared with existing methods, which tend to focus on retrospective analysis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

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


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


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

  11. How coaching can play a key role in the development of nurse managers. (United States)

    Westcott, Liz


    The aim of this study was to explore empirically the role that coaching plays in the development of nurse managers in order to inform further research and policy makers about the potential utility and value of this means of development. There is evidence of the importance of the role of nurse managers who are first line managers of a team of nurses within any health sector. However, there appears to be little understanding of the United Kingdom wide scope of nurse manager development across the United Kingdom and the means to increase its effectiveness. At the same time, it appears that some nurse managers receive coaching to help in their development. This is a mixed methods study, using a pragmatist paradigm. Data was gathered from a quantitative survey and qualitative interviews. This paper is reporting the results of the qualitative interviews only. Twenty-one qualitative interviews were undertaken with nurse managers, coaches and directors of nursing to draw out their own experiences of coaching for nurse managers. Thematic analysis framework was used for data interrogation, identifying new patterns and emerging themes. Themes that emerged from interviews include how nurse managers were introduced to coaching, how they balanced transitions, the role of reflection, the value of relationships and overlaps between clinical supervision, mentoring and coaching. Findings show that following coaching, nurse managers gained increased resilience, confidence and better coping mechanisms. This resulted in perceived improved team management and cohesion and appeared to lead to better quality of care for patients. This study suggests the importance of nurse managers accessing coaching, to enable transformational leadership of their teams of nurses. It suggests also the importance of organisations supporting a coaching culture, to ensure staff satisfaction, motivation and improved quality of patient care. © 2016 John Wiley & Sons Ltd.

  12. Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program. (United States)

    Viljoen, Myra; Coetzee, Isabel; Heyns, Tanya


    Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low. To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program. A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital. The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications. Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs. ©2016 American Association of Critical-Care Nurses.

  13. Depression in dementia: development and testing of a nursing guideline.

    NARCIS (Netherlands)

    Verkaik, R.


    Guideline for pleasure in dementia care Depression in nursing home residents with dementia can be decreased by the introduction of a nursing guideline. This is the main conclusion of the PhD thesis on depression in dementia that was presented by researcher Renate Verkaik on April 20th at the

  14. Upgrade of the BATMAN test facility for H- source development (United States)

    Heinemann, B.; Fröschle, M.; Falter, H.-D.; Fantz, U.; Franzen, P.; Kraus, W.; Nocentini, R.; Riedl, R.; Ruf, B.


    The development of a radio frequency (RF) driven source for negative hydrogen ions for the neutral beam heating devices of fusion experiments has been successfully carried out at IPP since 1996 on the test facility BATMAN. The required ITER parameters have been achieved with the prototype source consisting of a cylindrical driver on the back side of a racetrack like expansion chamber. The extraction system, called "Large Area Grid" (LAG) was derived from a positive ion accelerator from ASDEX Upgrade (AUG) using its aperture size (ø 8 mm) and pattern but replacing the first two electrodes and masking down the extraction area to 70 cm2. BATMAN is a well diagnosed and highly flexible test facility which will be kept operational in parallel to the half size ITER source test facility ELISE for further developments to improve the RF efficiency and the beam properties. It is therefore planned to upgrade BATMAN with a new ITER-like grid system (ILG) representing almost one ITER beamlet group, namely 5 × 14 apertures (ø 14 mm). Additionally to the standard three grid extraction system a repeller electrode upstream of the grounded grid can optionally be installed which is positively charged against it by 2 kV. This is designated to affect the onset of the space charge compensation downstream of the grounded grid and to reduce the backstreaming of positive ions from the drift space backwards into the ion source. For magnetic filter field studies a plasma grid current up to 3 kA will be available as well as permanent magnets embedded into a diagnostic flange or in an external magnet frame. Furthermore different source vessels and source configurations are under discussion for BATMAN, e.g. using the AUG type racetrack RF source as driver instead of the circular one or modifying the expansion chamber for a more flexible position of the external magnet frame.

  15. Upgrade of the BATMAN test facility for H− source development

    International Nuclear Information System (INIS)

    Heinemann, B.; Fröschle, M.; Falter, H.-D.; Fantz, U.; Franzen, P.; Kraus, W.; Nocentini, R.; Riedl, R.; Ruf, B.


    The development of a radio frequency (RF) driven source for negative hydrogen ions for the neutral beam heating devices of fusion experiments has been successfully carried out at IPP since 1996 on the test facility BATMAN. The required ITER parameters have been achieved with the prototype source consisting of a cylindrical driver on the back side of a racetrack like expansion chamber. The extraction system, called “Large Area Grid” (LAG) was derived from a positive ion accelerator from ASDEX Upgrade (AUG) using its aperture size (ø 8 mm) and pattern but replacing the first two electrodes and masking down the extraction area to 70 cm2. BATMAN is a well diagnosed and highly flexible test facility which will be kept operational in parallel to the half size ITER source test facility ELISE for further developments to improve the RF efficiency and the beam properties. It is therefore planned to upgrade BATMAN with a new ITER-like grid system (ILG) representing almost one ITER beamlet group, namely 5 × 14 apertures (ø 14 mm). Additionally to the standard three grid extraction system a repeller electrode upstream of the grounded grid can optionally be installed which is positively charged against it by 2 kV. This is designated to affect the onset of the space charge compensation downstream of the grounded grid and to reduce the backstreaming of positive ions from the drift space backwards into the ion source. For magnetic filter field studies a plasma grid current up to 3 kA will be available as well as permanent magnets embedded into a diagnostic flange or in an external magnet frame. Furthermore different source vessels and source configurations are under discussion for BATMAN, e.g. using the AUG type racetrack RF source as driver instead of the circular one or modifying the expansion chamber for a more flexible position of the external magnet frame

  16. Global Nursing Issues and Development: Analysis of World Health Organization Documents. (United States)

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


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

  17. Nurses' Views Highlight a Need for the Systematic Development of Patient Safety Culture in Forensic Psychiatry Nursing. (United States)

    Kuosmanen, Anssi; Tiihonen, Jari; Repo-Tiihonen, Eila; Eronen, Markku; Turunen, Hannele


    Although forensic nurses work with the most challenging psychiatric patients and manifest a safety culture in their interactions with patients, there have been few studies on patient safety culture in forensic psychiatric nursing. The aim of this qualitative study was to describe nurses' views of patient safety culture in their working unit and daily hospital work in 2 forensic hospitals in Finland. Data were collected over a period of 1 month by inviting nurses to answer an open-ended question in an anonymous Web-based questionnaire. A qualitative inductive analysis was performed on nurses' (n = 72) written descriptions of patient safety culture in state-owned forensic hospitals where most Finnish forensic patients are treated. Six main themes were identified: "systematization of an open and trusting communication culture," "visible and close interaction between managers and staff," "nonpunitive responses to errors, learning and developing," "balancing staff and patient perspectives on safety culture," "operational safety guidelines," and "adequate human resources to ensure safety." The findings highlight the influence of the prevailing culture on safety behaviors and outcomes for both healthcare workers and patients. Additionally, they underline the importance of an open culture with open communication and protocols.

  18. Social networks of nursing staff and organizational performance. A study in long-term care facilities

    NARCIS (Netherlands)

    Beek, A.P.A van


    Over the years, there has been increasing attention for the role of social networks in explaining performance differences between organizations. Yet, research on social networks within healthcare organizations in general and long-term care facilities specifically has been rare, despite growing

  19. Workplace Violence and Safety Issues in Long-Term Medical Care Facilities: Nurses' Perspectives

    Directory of Open Access Journals (Sweden)

    Bankole K. Fasanya


    Conclusion: WPV is an epidemic problem that affects all health-care professionals. The findings of this study could help long-term medical care facilities' management identify the areas to focus on mitigating, controlling, and/or eliminating incidents of WPV.

  20. Research and Development for a Course in Ethics in Nursing Practice for Community College Associate Degree Nursing Students. Final Report. (United States)

    Roediger, Jeanette

    A project was undertaken to research and acquire the instructional sources needed for a course in ethics for community college associate degree nursing students and to develop such a course. Addressed in the individual units of the course were the following topics: bioethics and ethical decision making, basic ethical concepts and principles,…

  1. Power conditioning development for the National Ignition Facility

    International Nuclear Information System (INIS)

    Newton, M.A.; Larson, D.W.; Wilson, J.M.; Harjes, H.C.; Savage, M.E.; Anderson, R.L.


    The National Ignition Facility (NIF) is a high energy glass laser system and target chamber that will be used for research in inertial confinement fusion. The 192 beams of the NIF laser system are pumped by over 8600 Xenon flashlamps. The power conditioning system for NIF must deliver nearly 300 MJ of energy to the flashlamps in a cost effective and reliable manner. The present system design has over 200 capacitive energy storage modules that store approximately 1.7 MJ each and deliver that energy through a single switch assembly to 20 parallel sets of two series flashlamps. Although there are many possible system designs, few will meet the aggressive cost goals necessary to make the system affordable. Sandia National Laboratory (SNL) and Lawrence Livermore National Laboratory (LLNL) are developing the system and component technologies that will be required to build the power conditioning system for the National Ignition Facility. This paper will describe the ongoing development activities for the NIF power conditioning system

  2. Development of PSA procedure for a criticality in reprocessing facilities

    International Nuclear Information System (INIS)

    Endo, Shigeki; Takanashi, Mitsuhiro; Ueda, Yoshinori


    Utilization of risk information for the nuclear safety regulation is being discussed in Japan. The development of probabilistic safety assessment (PSA) procedure is indispensable for the utilization of risk information. The Japan Nuclear Energy Safety Organization (JNES) has been conducting trial PSA to a model plant for major events, i.e. hydrogen explosion, solution boiling, rapid decomposition of TBP complexes, criticality, solvent fire, leakage of molten glass, leakage of high active concentrated liquid waste, loss of all AC electricity, drop of a fuel assembly, for the purpose of developing the PSA procedure for reprocessing facilities. For criticality events results of trial PSA were summarized as a report in which how to evaluate an amount of radioactive materials released from a facility and a health effect on the public were emphasized. Therefore, for criticality events the results of trial PSA were summarized in this report to emphasize procedures from making event progression scenarios to quantifying event sequences, which were not handled in the previous report, in a style of a document describing PSA procedures. (author)

  3. Geoscience Workforce Development at UNAVCO: Leveraging the NSF GAGE Facility (United States)

    Morris, A. R.; Charlevoix, D. J.; Miller, M.


    Global economic development demands that the United States remain competitive in the STEM fields, and developing a forward-looking and well-trained geoscience workforce is imperative. According to the Bureau of Labor Statistics, the geosciences will experience a growth of 19% by 2016. Fifty percent of the current geoscience workforce is within 10-15 years of retirement, and as a result, the U.S. is facing a gap between the supply of prepared geoscientists and the demand for well-trained labor. Barring aggressive intervention, the imbalance in the geoscience workforce will continue to grow, leaving the increased demand unmet. UNAVCO, Inc. is well situated to prepare undergraduate students for placement in geoscience technical positions and advanced graduate study. UNAVCO is a university-governed consortium facilitating research and education in the geosciences and in addition UNAVCO manages the NSF Geodesy Advancing Geosciences and EarthScope (GAGE) facility. The GAGE facility supports many facets of geoscience research including instrumentation and infrastructure, data analysis, cyberinfrastructure, and broader impacts. UNAVCO supports the Research Experiences in the Solid Earth Sciences for Students (RESESS), an NSF-funded multiyear geoscience research internship, community support, and professional development program. The primary goal of the RESESS program is to increase the number of historically underrepresented students entering graduate school in the geosciences. RESESS has met with high success in the first 9 years of the program, as more than 75% of RESESS alumni are currently in Master's and PhD programs across the U.S. Building upon the successes of RESESS, UNAVCO is launching a comprehensive workforce development program that will network underrepresented groups in the geosciences to research and opportunities throughout the geosciences. This presentation will focus on the successes of the RESESS program and plans to expand on this success with broader

  4. [Computers in nursing: development of free software application with care and management]. (United States)

    dos Santos, Sérgio Ribeiro


    This study aimed at developing an information system in nursing with the implementation of nursing care and management of the service. The SisEnf--Information System in Nursing--is a free software module that comprises the care of nursing: history, clinical examination and care plan; the management module consists of: service shifts, personnel management, hospital indicators and other elements. The system was implemented at the Medical Clinic of the Lauro Wanderley University Hospital, at Universidade Federal da Paraiba. In view of the need to bring user and developer closer, in addition to the constant change of functional requirements during the interactive process, the method of unified process was used. The SisEnf was developed on a WEB platform and using free software. Hence, the work developed aimed at assisting in the working process of nursing, which will now have the opportunity to incorporate information technology in their work routine.

  5. Strategies for continuing professional development among younger, middle-aged, and older nurses: a biographical approach. (United States)

    Pool, Inge A; Poell, Rob F; Berings, Marjolein G M C; ten Cate, Olle


    A nursing career can last for more than 40 years, during which continuing professional development is essential. Nurses participate in a variety of learning activities that correspond with their developmental motives. Lifespan psychology shows that work-related motives change with age, leading to the expectation that motives for continuing professional development also change. Nevertheless, little is known about nurses' continuing professional development strategies in different age groups. To explore continuing professional development strategies among younger, middle-aged, and older nurses. A qualitative study using semi-structured interviews, from a biographical perspective. Data were analysed using a vertical process aimed at creating individual learning biographies, and a horizontal process directed at discovering differences and similarities between age groups. Twenty-one nurses in three age groups from general and academic hospitals in the Netherlands. In all age groups, daily work was an important trigger for professional development on the ward. Performing extra or new tasks appeared to be an additional trigger for undertaking learning activities external to the ward. Learning experiences in nurses' private lives also contributed to their continuing professional development. Besides these similarities, the data revealed differences in career stages and private lives, which appeared to be related to differences in continuing professional development strategy; 'gaining experience and building a career' held particularly true among younger nurses, 'work-life balance' and 'keeping work interesting and varied' to middle-aged nurses, and 'consistency at work' to older nurses. Professional development strategies can aim at performing daily patient care, extra tasks and other roles. Age differences in these strategies appear to relate to tenure, perspectives on the future, and situations at home. These insights could help hospitals to orientate continuing

  6. Virtual Simulations: A Creative, Evidence-Based Approach to Develop and Educate Nurses. (United States)

    Leibold, Nancyruth; Schwarz, Laura


    The use of virtual simulations in nursing is an innovative strategy that is increasing in application. There are several terms related to virtual simulation; although some are used interchangeably, the meanings are not the same. This article presents examples of virtual simulation, virtual worlds, and virtual patients in continuing education, staff development, and academic nursing education. Virtual simulations in nursing use technology to provide safe, as realistic as possible clinical practice for nurses and nursing students. Virtual simulations are useful for learning new skills; practicing a skill that puts content, high-order thinking, and psychomotor elements together; skill competency learning; and assessment for low-volume, high-risk skills. The purpose of this article is to describe the related terms, examples, uses, theoretical frameworks, challenges, and evidence related to virtual simulations in nursing.

  7. Education as a springboard for transformational leadership development: listening to the voices of nurses. (United States)

    Galuska, Lee A


    Nurses must assume a transformational leadership role in increasing the quality, safety, access, and value in the health care system. To lead effectively in this transformation process, nurses must be prepared for leadership roles. A strong leadership knowledge based acquired through education provides the springboard for nursing leadership competency development. This metasynthesis of 27 studies provided a broad understanding of the contribution and effectiveness of education for leadership competency from the perspective of nurses who have experienced it. Four overarching t