Meeting the criteria of a nursing diagnosis classification: Evaluation of ICNP, ICF, NANDA and ZEFP.

PubMed

Müller-Staub, Maria; Lavin, Mary Ann; Needham, Ian; van Achterberg, Theo

2007-07-01

Few studies described nursing diagnosis classification criteria and how classifications meet these criteria. The purpose was to identify criteria for nursing diagnosis classifications and to assess how these criteria are met by different classifications. First, a literature review was conducted (N=50) to identify criteria for nursing diagnoses classifications and to evaluate how these criteria are met by the International Classification of Nursing Practice (ICNP), the International Classification of Functioning, Disability and Health (ICF), the International Nursing Diagnoses Classification (NANDA), and the Nursing Diagnostic System of the Centre for Nursing Development and Research (ZEFP). Using literature review based general and specific criteria, the principal investigator evaluated each classification, applying a matrix. Second, a convenience sample of 20 nursing experts from different Swiss care institutions answered standardized interview forms, querying current national and international classification state and use. The first general criterion is that a diagnosis classification should describe the knowledge base and subject matter for which the nursing profession is responsible. ICNP) and NANDA meet this goal. The second general criterion is that each class fits within a central concept. The ICF and NANDA are the only two classifications built on conceptually driven classes. The third general classification criterion is that each diagnosis possesses a description, diagnostic criteria, and related etiologies. Although ICF and ICNP describe diagnostic terms, only NANDA fulfils this criterion. The analysis indicated that NANDA fulfilled most of the specific classification criteria in the matrix. The nursing experts considered NANDA to be the best-researched and most widely implemented classification in Switzerland and internationally. The international literature and the opinion of Swiss expert nurses indicate that-from the perspective of classifying

[A short form of the positions on nursing diagnosis scale: development and psychometric testing].

PubMed

Romero-Sánchez, José Manuel; Paloma-Castro, Olga; Paramio-Cuevas, Juan Carlos; Pastor-Montero, Sonia María; O'Ferrall-González, Cristina; Gabaldón-Bravo, Eva Maria; González-Domínguez, Maria Eugenia; Castro-Yuste, Cristina; Frandsen, Anna J; Martínez-Sabater, Antonio

2013-06-01

The Positions on Nursing Diagnosis (PND) is a scale that uses the semantic differential technique to measure nurses' attitudes towards the nursing diagnosis concept. The aim of this study was to develop a shortened form of the Spanish version of this scale and evaluate its psychometric properties and efficiency. A double theoretical-empirical approach was used to obtain a short form of the PND, the PND-7-SV, which would be equivalent to the original. Using a cross-sectional survey design, the reliability (internal consistency and test-retest reliability), construct (exploratory factor analysis, known-groups technique and discriminant validity) and criterion-related validity (concurrent validity), sensitivity to change and efficiency of the PND-7-SV were assessed in a sample of 476 Spanish nursing students. The results endorsed the utility of the PND-7-SV to measure attitudes toward nursing diagnosis in an equivalent manner to the complete form of the scale and in a shorter time.

[Nursing diagnosis "impaired walking" in elderly patients: integrative literature review].

PubMed

Marques-Vieira, Cristina Maria Alves; de Sousa, Luís Manuel Mota; de Matos Machado Carias, João Filipe; Caldeira, Sílvia Maria Alves

2015-03-01

The impaired walking nursing diagnosis has been included in NANDA International classification taxonomy in 1998, and this review aims to identify the defining characteristics and related factors in elderly patients in recent literature. Integrative literature review based on the following guiding question: Are there more defining characteristics and factors related to the nursing diagnosis impaired walking than those included in NANDA International classification taxonomy in elderly patients? Search conducted in 2007-2013 on international and Portuguese databases. Sample composed of 15 papers. Among the 6 defining characteristics classified at NANDA International, 3 were identified in the search results, but 13 were not included in the classification. Regarding the 14 related factors that are classified, 9 were identified in the sample and 12 were not included in the NANDA International taxonomy. This review allowed the identification of new elements not included in NANDA International Taxonomy and may contribute to the development of taxonomy and nursing knowledge.

[Variability in nursing workload within Swiss Diagnosis Related Groups].

PubMed

Baumberger, Dieter; Bürgin, Reto; Bartholomeyczik, Sabine

2014-04-01

Nursing care inputs represent one of the major cost components in the Swiss Diagnosis Related Group (DRG) structure. High and low nursing workloads in individual cases are supposed to balance out via the DRG group. Research results indicating possible problems in this area cannot be reliably extrapolated to SwissDRG. An analysis of nursing workload figures with DRG indicators was carried out in order to decide whether there is a need to develop SwissDRG classification criteria that are specific to nursing care. The case groups were determined with SwissDRG 0.1, and nursing workload with LEP Nursing 2. Robust statistical methods were used. The evaluation of classification accuracy was carried out with R2 as the measurement of variance reduction and the coefficient of homogeneity (CH). To ensure reliable conclusions, statistical tests with bootstrapping methods were performed. The sample included 213 groups with a total of 73930 cases from ten hospitals. The DRG classification was seen to have limited explanatory power for variability in nursing workload inputs, both for all cases (R2 = 0.16) and for inliers (R2 = 0.32). Nursing workload homogeneity was statistically significant unsatisfactory (CH < 0.67) in 123 groups, including 24 groups in which it was significant defective (CH < 0.60). Therefore, there is a high risk of high and low nursing workloads not balancing out in these groups, and, as a result, of financial resources being wrongly allocated. The development of nursing-care-specific SwissDRG classification criteria for improved homogeneity and variance reduction is therefore indicated.

[Review of nursing diagnosis sedentary lifestyle in individuals with hypertension: conceptual analysis].

PubMed

Guedes, Nirla Gomes; Lopes, Marcos Venicios de Oliveira; Cavalcante, Tahissa Frota; Moreira, Rafaella Pessoa; de Araujo, Thelma Leite

2013-06-01

This study aims to review the components of the nursing diagnosis Sedentary Lifestyle (SL) proposed by NANDA (North American Nursing Diagnosis Association)-l in individuals with hypertension. The review was developed based on a concept analysis and supported by the Integrative Literature Review method, through which 43 articles were surveyed from five databases (LILACS, CINAHL, PUBMED, SCOPUS and COCHRANE). The following combinations of descriptors and their English and Spanish equivalents were used: Sedentary Lifestyle and Hypertension and Sedentary and Hypertension. Based on the review process, we found that the SL definition has changed, some clinical indicators have been identified and other indicators have been added to the definition. The study promotes a direction for diagnostic efficiency of clinical SL indicators, contributing to the refinement and improvement of this diagnosis and its components.

Cross-mapping the ICNP with NANDA, HHCC, Omaha System and NIC for unified nursing language system development. International Classification for Nursing Practice. International Council of Nurses. North American Nursing Diagnosis Association. Home Health Care Classification. Nursing Interventions Classification.

PubMed

Hyun, S; Park, H A

2002-06-01

Nursing language plays an important role in describing and defining nursing phenomena and nursing actions. There are numerous vocabularies describing nursing diagnoses, interventions and outcomes in nursing. However, the lack of a standardized unified nursing language is considered a problem for further development of the discipline of nursing. In an effort to unify the nursing languages, the International Council of Nurses (ICN) has proposed the International Classification for Nursing Practice (ICNP) as a unified nursing language system. The purpose of this study was to evaluate the inclusiveness and expressiveness of the ICNP terms by cross-mapping them with the existing nursing terminologies, specifically the North American Nursing Diagnosis Association (NANDA) taxonomy I, the Omaha System, the Home Health Care Classification (HHCC) and the Nursing Interventions Classification (NIC). Nine hundred and seventy-four terms from these four classifications were cross-mapped with the ICNP terms. This was performed in accordance with the Guidelines for Composing a Nursing Diagnosis and Guidelines for Composing a Nursing Intervention, which were suggested by the ICNP development team. An expert group verified the results. The ICNP Phenomena Classification described 87.5% of the NANDA diagnoses, 89.7% of the HHCC diagnoses and 72.7% of the Omaha System problem classification scheme. The ICNP Action Classification described 79.4% of the NIC interventions, 80.6% of the HHCC interventions and 71.4% of the Omaha System intervention scheme. The results of this study suggest that the ICNP has a sound starting structure for a unified nursing language system and can be used to describe most of the existing terminologies. Recommendations for the addition of terms to the ICNP are provided.

[Design and validation of a questionnaire for psychosocial nursing diagnosis in Primary Care].

PubMed

Brito-Brito, Pedro Ruymán; Rodríguez-Álvarez, Cristobalina; Sierra-López, Antonio; Rodríguez-Gómez, José Ángel; Aguirre-Jaime, Armando

2012-01-01

To develop a valid, reliable and easy-to-use questionnaire for a psychosocial nursing diagnosis. The study was performed in two phases: first phase, questionnaire design and construction; second phase, validity and reliability tests. A bank of items was constructed using the NANDA classification as a theoretical framework. Each item was assigned a Likert scale or dichotomous response. The combination of responses to the items constituted the diagnostic rules to assign up to 28 labels. A group of experts carried out the validity test for content. Other validated scales were used as reference standards for the criterion validity tests. Forty-five nurses provided the questionnaire to the patients on three separate occasions over a period of three weeks, and the other validated scales only once to 188 randomly selected patients in Primary Care centres in Tenerife (Spain). Validity tests for construct confirmed the six dimensions of the questionnaire with 91% of total variance explained. Validity tests for criterion showed a specificity of 66%-100%, and showed high correlations with the reference scales when the questionnaire was assigning nursing diagnoses. Reliability tests showed agreement of 56%-91% (P<.001), and a 93% internal consistency. The Questionnaire for Psychosocial Nursing Diagnosis was called CdePS, and included 61 items. The CdePS is a valid, reliable and easy-to-use tool in Primary Care centres to improve the assigning of a psychosocial nursing diagnosis. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Clinical validation of the nursing diagnosis Risk for Aspiration among patients who experienced a cerebrovascular accident.

PubMed

Cavalcante, Tahissa Frota; de Araújo, Thelma Leite; Moreira, Rafaella Pessoa; Guedes, Nirla Gomes; Lopes, Marcos Venicios de Oliveira; da Silva, Viviane Martins

2013-01-01

the study's objective was the clinical validation of the nursing diagnosis Risk for Aspiration among patients who experienced cerebrovascular accidents (CVA). a prospective cohort study was conducted with 24 patients hospitalized due to a CVA. The instrument used to collect the data addressed the risk factors for respiratory aspiration, validated by concept analysis and by experts. the most frequent risk factors for respiratory aspiration were: dysphagia (54.2%) and impaired physical mobility (41.7%). The prevalence of the nursing diagnosis Risk for Aspiration was 58.3% and the prevalence of respiratory aspiration over the span of 48 hours (monitoring period) was 37.5%. Risk factors for dysphagia and impaired physical mobility were significantly associated with respiratory aspiration. the risk factors dysphagia and impaired physical mobility are good predictors of the nursing diagnosis Risk for Aspiration. This study contributed to improving the NANDA-I Taxonomy and the systematization of the nursing process.

The Nursing Diagnosis Development of Unemployment Disorder: Content Validation With Nursing Experts.

PubMed

Bocchino, Anna; Medialdea, María Jesús; Lepiani, Isabel; Mejías, Concepción; Dueñas, María

2017-10-01

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.

Accuracy of nursing diagnosis "readiness for enhanced hope" in patients with chronic kidney disease.

PubMed

Silva, Renan Alves; Melo, Geórgia Alcântara Alencar; Caetano, Joselany Áfio; Lopes, Marcos Venícios Oliveira; Butcher, Howard Karl; Silva, Viviane Martins da

2017-07-06

To analyse the accuracy of the nursing diagnosis readiness for enhanced hope in patients with chronic kidney disease. This is a cross-sectional study with 62 patients in the haemodialysis clinic conducted from August to November 2015. The Hearth Hope Scale was used to create definitions of the defining characteristics of the North American Nursing Diagnosis Association International. We analysed the measures of sensitivity, specificity, predictive value, likelihood ratio, and odds ratio of the defining characteristics of the diagnosis. Of the characteristics, 82.22% presented the diagnosis. The defining characteristics "Expresses the desire to enhance congruency of expectations with desires" and "Expresses the desire to enhance problem solving to meet goals" increased the chance of having the diagnosis by eleven and five, respectively. The characteristics, "Expresses desire to enhance congruency of expectations with desires" and "Expresses desire to enhance problem solving to meet goals" had good accuracy measures.

The connection between nursing diagnosis and the use of healthcare resources.

PubMed

Company-Sancho, María Consuelo; Estupiñán-Ramírez, Marcos; Sánchez-Janáriz, Hilda; Tristancho-Ajamil, Rita

The health service invests up to 75% of its resources on chronic care where the focus should be on caring rather than curing. Nursing staff focuses their work on such care. Care requires being redorded in health histories through the standardized languages. These records enable useful analyses to organisational and healthcare decision-making. Our proposal is to know the association of between nursing diagnosis and a higher total expenditure on health. An observational cross-sectional analytical study was performed based on data from electronic health records in Primary Care (Drago-AP), hospital discharges (CMBD-AH) and prescriptions (REC-SCS) of patients over 50 from 2012-2013 in the Canary Islands. A descriptive, bivariate and multivariate analysis was undertaken to create a predictive model on the use of resources. Sociodemographic (age, sex, type of health-care affiliation, type of prescription charge) and nursing diagnosis (ND) recorded in late 2012. Dependent variables: Resources consumed in 2013. 582,171 patients met the criteria for inclusion. 53.0% of them were women with an average age of 64.3 years (SD 10.8years). 53.2% were pensioners. 49% of the included population had an ND, with an average of 2.1ND per patient. The average costs per patient were 1824.62€ (with a median of 827.5€) 25 and 27 percentiles of 264.1€ and 1824.7€, respectively. The bivariate analysis showed a significant correlation between these expenses and all the demographic variables; the expenses increased when a nursing diagnosis has been made (Spearman's rank=0.37: the more diagnoses, the more expenses). In the multivariate analysis, a first linear regression with the sociodemographic variables as independent variables explains 13.7% of the variability of the logarithm of the full costs (R 2 =0.137). If we add to this model the presence of nursing diagnoses, the explanatory capacity reaches 19.77% (R 2 =0.1977). Compared with a model that only consists of sociodemographic

A Prototype Model for Automating Nursing Diagnosis, Nurse Care Planning and Patient Classification.

DTIC Science & Technology

1986-03-01

Each diagnosis has an assessment level. Assessment levels are defining characteristics observed by the nurse or subjectively stated by the patient... characteristics of this order line. Select IV Order (Figure 4.l.1.le] is the first screen of a series of three. Select IV Order has up to 10 selections...For I F Upatient orders. Input Files Used: IVC.Scr and Procfile.Prg * Output Files Used: None Calling Routine: IUB.Prg * Routine Called: None

Identifying core nursing sensitive outcomes associated with the most frequently used North American Nursing Diagnosis Association-International nursing diagnoses for patients with cerebrovascular disease in Korea.

PubMed

Lee, Eunjoo; Park, Hyejin; Whyte, James; Kim, Youngae; Park, Sang Youn

2014-12-01

The purpose of this study was to identify the core nursing sensitive outcomes according to the most frequently used five North American Nursing Diagnosis Association-International for patients with cerebrovascular disease using the Nursing Outcomes Classification (NOC). A cross-sectional survey design was used. First, nursing problems were identified through 78 charts review, and then linkages between each of nursing problems and nursing sensitive outcomes were established and validated by an expert group for questionnaires. Second, 80 nurses working in the neurosurgical intensive care unit and neurosurgery departments of five Korean hospitals were asked to evaluate how important each outcome is and how often each outcome used to evaluate patient outcomes using 5-point Likert scale. Although there were some differences in the core outcomes identified for each of the nursing problem, consciousness, cognitive orientation, neurologic status and communication were considered the most critical nursing sensitive outcomes for patients suffering cerebrovascular disease. Core nursing sensitive outcomes of patients suffering cerebrovascular disease using NOC were identified to measure the effectiveness of nursing care. © 2013 Wiley Publishing Asia Pty Ltd.

The most common nursing diagnosis among adults/seniors hospitalised with cancer: integrative review.

PubMed

Jomar, Rafael Tavares; de Souza Bispo, Vitória Régia

2014-01-01

The nursing process, with emphasis on the diagnosis phase, is essential to oncology hospital services due to a high frequency of physical and psychological problems that compromise the quality of life of patients undergoing cancer treatment. The goal of this study was to identify, according to NANDA International, the most common nursing diagnosis among adults/seniors with cancer who are hospitalised. This study is an integrative review of the literature completed in 2013 using five electronic databases, resulting in the selection and analysis of nine articles. This review identified the following eight actual diagnoses and two risk diagnoses that are more common among hospitalised adults/seniors with cancer: anxiety, deficient knowledge, constipation, self-care deficit for bathing/hygiene, body image disturbance, acute/chronic pain, fear, disturbed sleep pattern, risk of infection, and risk of deficient fluid volume. The heterogeneity of the studies used in this review may not have allowed the identification of all the common nursing diagnoses in the practice of oncology nursing in hospitals. However, even though the results are not based on the highest possible level of scientific evidence, their correlation to clinical practice can contribute to the enhancement of the nursing process in oncology services provided by hospitals.

The most common nursing diagnosis among adults/seniors hospitalised with cancer: integrative review

PubMed Central

Jomar, Rafael Tavares; de Souza Bispo, Vitória Régia

2014-01-01

The nursing process, with emphasis on the diagnosis phase, is essential to oncology hospital services due to a high frequency of physical and psychological problems that compromise the quality of life of patients undergoing cancer treatment. The goal of this study was to identify, according to NANDA International, the most common nursing diagnosis among adults/seniors with cancer who are hospitalised. This study is an integrative review of the literature completed in 2013 using five electronic databases, resulting in the selection and analysis of nine articles. This review identified the following eight actual diagnoses and two risk diagnoses that are more common among hospitalised adults/seniors with cancer: anxiety, deficient knowledge, constipation, self-care deficit for bathing/hygiene, body image disturbance, acute/chronic pain, fear, disturbed sleep pattern, risk of infection, and risk of deficient fluid volume. The heterogeneity of the studies used in this review may not have allowed the identification of all the common nursing diagnoses in the practice of oncology nursing in hospitals. However, even though the results are not based on the highest possible level of scientific evidence, their correlation to clinical practice can contribute to the enhancement of the nursing process in oncology services provided by hospitals. PMID:25228918

Nursing Process in Post Tonsillectomy Pain Diagnosis: A Systematic Review

PubMed Central

Soleymanifard, Fateme; Khademolhoseyni, Seyyed Mohamad; Nouri, Jamile Mokhtari

2015-01-01

Objective: Tonsillectomy is the most common surgery in the field of ENT. Pain is the most common post tonsillectomy complaint. Considering the importance of nursing cares in relieving post-surgery pain in general and post-tonsillectomy pain in particular, this study is conducted with the aim of presenting nursing process in post tonsillectomy pain diagnosis for decreasing loss of appropriate opportunities in nursing cares and achieving appropriate results in taking care of the patients. Methods: This study is a targeted systematic review focusing on “effective nursing measures in relieving children’s post tonsillectomy pain”. The main stages of searching strategy included searching in electronic sources of Latin databases; Pub Med, Science Direct, and EMBASE and Persian databases; SID, Iran medex, ISC to find published articles from 2009 to 2014. In the end, final synthesis was done on eight articles in English. Findings: Effective nursing measurements for relieving post tonsillectomy pain include: decreasing children’s anxiety through children and their families’ psychological preparation by nurses and other caregivers, using cold compress to reduce neck and jaw pain, presenting distraction techniques, offering fluids and cold foods immediately in the period after surgery, creating a comfortable environment for the children, avoiding too much of talking and adequate sleep. Conclusion: It is recommended to the nursing managers and nurses to perform cares achieved from this systematic review to achieve appropriate results in relieving post tonsillectomy pain. PMID:25560345

The forensic nursing in sexual assaults: the immunochemical diagnosis and prevention of its adverse effects.

PubMed

Vitale, Elsa

2012-04-01

Sexual assault was a ubiquitous and serious problem in our society. The world's care centers and forensic associations, which were at the forefront of scientific research in sexual assaults, discussed the role of the Forensic Nursing in their early diagnosis and their prevention, but little has been written in literature regarding their appropriate management. This article focuses on the immunochemical laboratory investigation in diagnosis and prevention of its adverse effects in sexual assaults and the role of the Forensic Nursing played in this task. After a careful reading of all the material received from many of the care centers and the associations contacted, a Forensic Nursing Examination Program, with specific immunochemical address, is identified.

Nursing Diagnosis of "Spiritual Distress" in Women With Breast Cancer: Prevalence and Major Defining Characteristics.

PubMed

Caldeira, Sílvia; Timmins, Fiona; de Carvalho, Emília C; Vieira, Margarida

2016-01-01

Spirituality and spiritual needs of cancer patients are frequently mentioned in the nursing literature, but the most significant defining characteristics of spiritual distress in the context of clinical reasoning and nursing diagnosis are rarely explored. Understanding of these is important for effective spiritual intervention. The aim of this study was to identify the prevalence and the defining characteristics of the nursing diagnosis "spiritual distress," as classified according to NANDA International, among women with breast cancer. This was a quantitative and cross-sectional study, comprising the third phase of a larger study investigating the clinical validation of spiritual distress in cancer patients undergoing chemotherapy. Fehring's clinical diagnostic validation model was used to identify the prevalence and the major defining characteristics of the diagnosis. A convenience sample was used, and data were collected by structured interview. A total of 70 women participated; most were married (62.9%) and had a mean age of 54 years, and 55.7% reported having at least 1 person depending on them. The average length of time since the cancer diagnosis was 30.9 months. Twenty-seven participants were experiencing spiritual distress (38.6%). Eleven defining characteristics were classified as major. The prevalence of spiritual distress and the major defining characteristics give clinical evidence about the nurse's role in providing spiritual care. The results are useful for the improved use of the NANDA International diagnoses within this domain. The findings highlight the importance of assessing the defining characteristics of the diagnosis as an objective strategy to improve clinical reasoning related to spirituality and to facilitate more effective interventions.

Noncompliance in people living with HIV: accuracy of defining characteristics of the nursing diagnosis1.

PubMed

Silva, Richardson Augusto Rosendo da; Costa, Mayara Mirna do Nascimento; Souza, Vinicius Lino de; Silva, Bárbara Coeli Oliveira da; Costa, Cristiane da Silva; Andrade, Itaísa Fernandes Cardoso de

2017-10-30

to evaluate the accuracy of the defining characteristics of the NANDA International nursing diagnosis, noncompliance, in people with HIV. study of diagnostic accuracy, performed in two stages. In the first stage, 113 people with HIV from a hospital of infectious diseases in the Northeast of Brazil were assessed for identification of clinical indicators of noncompliance. In the second, the defining characteristics were evaluated by six specialist nurses, analyzing the presence or absence of the diagnosis. For accuracy of the clinical indicators, the specificity, sensitivity, predictive values and likelihood ratios were measured. the presence of the noncompliance diagnosis was shown in 69% (n=78) of people with HIV. The most sensitive indicator was, missing of appointments (OR: 28.93, 95% CI: 1.112-2.126, p = 0.002). On the other hand, nonadherence behavior (OR: 15.00, 95% CI: 1.829-3.981, p = 0.001) and failure to meet outcomes (OR: 13.41; 95% CI: 1.272-2.508; P = 0.003) achieved higher specificity. the most accurate defining characteristics were nonadherence behavior, missing of appointments, and failure to meet outcomes. Thus, in the presence of these, the nurse can identify, with greater security, the diagnosis studied.

Noncompliance in people living with HIV: accuracy of defining characteristics of the nursing diagnosis 1

PubMed Central

da Silva, Richardson Augusto Rosendo; Costa, Mayara Mirna do Nascimento; de Souza, Vinicius Lino; da Silva, Bárbara Coeli Oliveira; Costa, Cristiane da Silva; de Andrade, Itaísa Fernandes Cardoso

2017-01-01

ABSTRACT Objective: to evaluate the accuracy of the defining characteristics of the NANDA International nursing diagnosis, noncompliance, in people with HIV. Method: study of diagnostic accuracy, performed in two stages. In the first stage, 113 people with HIV from a hospital of infectious diseases in the Northeast of Brazil were assessed for identification of clinical indicators of noncompliance. In the second, the defining characteristics were evaluated by six specialist nurses, analyzing the presence or absence of the diagnosis. For accuracy of the clinical indicators, the specificity, sensitivity, predictive values and likelihood ratios were measured. Results: the presence of the noncompliance diagnosis was shown in 69% (n=78) of people with HIV. The most sensitive indicator was, missing of appointments (OR: 28.93, 95% CI: 1.112-2.126, p = 0.002). On the other hand, nonadherence behavior (OR: 15.00, 95% CI: 1.829-3.981, p = 0.001) and failure to meet outcomes (OR: 13.41; 95% CI: 1.272-2.508; P = 0.003) achieved higher specificity. Conclusion: the most accurate defining characteristics were nonadherence behavior, missing of appointments, and failure to meet outcomes. Thus, in the presence of these, the nurse can identify, with greater security, the diagnosis studied. PMID:29091125

Testing a diagnosis-related group index for skilled nursing facilities.

PubMed

Cotterill, P G

1986-01-01

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.

Testing a diagnosis-related group index for skilled nursing facilities

PubMed Central

Cotterill, Philip G.

1986-01-01

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

Integrating nursing diagnostic concepts into the medical entities dictionary using the ISO Reference Terminology Model for Nursing Diagnosis.

PubMed

Hwang, Jee-In; Cimino, James J; Bakken, Suzanne

2003-01-01

The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process.

Integrating Nursing Diagnostic Concepts into the Medical Entities Dictionary Using the ISO Reference Terminology Model for Nursing Diagnosis

PubMed Central

Hwang, Jee-In; Cimino, James J.; Bakken, Suzanne

2003-01-01

Objective: The purposes of the study were (1) to evaluate the usefulness of the International Standards Organization (ISO) Reference Terminology Model for Nursing Diagnoses as a terminology model for defining nursing diagnostic concepts in the Medical Entities Dictionary (MED) and (2) to create the additional hierarchical structures required for integration of nursing diagnostic concepts into the MED. Design and Measurements: The authors dissected nursing diagnostic terms from two source terminologies (Home Health Care Classification and the Omaha System) into the semantic categories of the ISO model. Consistent with the ISO model, they selected Focus and Judgment as required semantic categories for creating intensional definitions of nursing diagnostic concepts in the MED. Because the MED does not include Focus and Judgment hierarchies, the authors developed them to define the nursing diagnostic concepts. Results: The ISO model was sufficient for dissecting the source terminologies into atomic terms. The authors identified 162 unique focus concepts from the 266 nursing diagnosis terms for inclusion in the Focus hierarchy. For the Judgment hierarchy, the authors precoordinated Judgment and Potentiality instead of using Potentiality as a qualifier of Judgment as in the ISO model. Impairment and Alteration were the most frequently occurring judgments. Conclusions: Nursing care represents a large proportion of health care activities; thus, it is vital that terms used by nurses are integrated into concept-oriented terminologies that provide broad coverage for the domain of health care. This study supports the utility of the ISO Reference Terminology Model for Nursing Diagnoses as a facilitator for the integration process. PMID:12668692

Clinical Validation of the "Sedentary Lifestyle" Nursing Diagnosis in Secondary School Students

ERIC Educational Resources Information Center

de Oliveira, Marcos Renato; da Silva, Viviane Martins; Guedes, Nirla Gomes; de Oliveira Lopes, Marcos Venícios

2016-01-01

This study clinically validated the nursing diagnosis of "sedentary lifestyle" (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel--Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining…

[Nursing diagnosis sedentary lifestyle in individuals with hypertension: an analysis of accuracy].

PubMed

Martins, Larissa Castelo Guedes; Lopes, Marcos Venícios de Oliveira; Guedes, Nirla Gomes; Teixeira, Iane Ximenes; Souza, Vanessa Emille Carvalho de; Montoril, Michelle Helcias

2014-10-01

Assessing the accuracy of the defining characteristics (DC) of the nursing diagnosis Sedentary Lifestyle (SL) in people with hypertension. A cross-sectional study carried out in a referral center in the outpatient care of people with hypertension and diabetes, with a sample of 285 individuals. The form used in the study was designed from operational definitions constructed for each DC of the diagnosis. Four nurses with training to carry out diagnostic inferences did the clinical assessment for the presence of SL. The prevalence of SL was 55.8%. Regarding measures of accuracy, the main DC for SL was chooses a daily routine lacking physical exercise, with sensitivity of 100% and specificity of 84.13%. Two DC stood out in the logistic regression, namely: reports preference for activities low in physical activity and poor performance in instrumental activities of daily living (IADL). The results allowed identifying the best clinical indicators for SL in hypertensive adults.

Identification of nursing management diagnoses.

PubMed

Morrison, R S

1997-02-01

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

Perceptions and Attitudes Toward NANDA-I Nursing Diagnoses: A Cross-Sectional Study of Jordanian Nursing Students.

PubMed

Abed El-Rahman, Mona; Al Kalaldeh, Mahmoud T; Malak, Malakeh Z

2017-01-01

To assess the perceptions and attitudes of undergraduate nursing students toward NANDA-I nursing diagnosis. A descriptive cross-sectional design was used. A convenient sample was recruited from nursing students at Zarqa University/Jordan. Perceptions toward NANDA-I Nursing Diagnosis scale and Positions on Nursing Diagnosis scale were used. A total of 101 nursing students were included. A correct perception toward NANDA-I nursing diagnosis was evident. Attitudes toward NANDA appeared positive. However, insufficient distinction between nursing diagnosis and medical diagnosis and feeling less comfort while using NANDA-I were reported. Nursing students showed correct perceptions and positive attitudes toward the application of NANDA-I. Proper implementation of NANDA-I is a prerequisite to the better understanding of nursing language. © 2015 NANDA International, Inc.

Clinical validation of the nursing diagnosis of ineffective protection in haemodialysis patients.

PubMed

de Sá Tinôco, Jéssica Dantas; de Paiva, Maria das Graças Mariano Nunes; de Queiroz Frazão, Cecília Maria Farias; Lucio, Kadyjina Daiane Batista; Fernandes, Maria Isabel da Conceição Dias; de Oliveira Lopes, Marcos Venicios; de Carvalho Lira, Ana Luisa Brandão

2018-01-01

To evaluate the clinical validity of indicators of the nursing diagnosis of "ineffective protection" in haemodialysis patients. Haemodialysis patients have reduced protection. Studies on the nursing diagnosis of "ineffective protection" are scarce in the literature. The use of indicators to diagnose "ineffective protection" could improve the care of haemodialysis patients. The clinical usefulness of the indicators requires clinical validation. This was a diagnostic accuracy study. This study assessed a sample of 200 patients undergoing haemodialysis in a reference clinic for nephrology during the first half of 2015. Operational definitions were created for each clinical indicator based on concept analysis and content validation by experts for these indicators. Diagnostic accuracy measurement was performed with latent class analysis with randomised effects. The clinical indicator of "fatigue" had high sensitivity (p = .999) and specificity (p = 1.000) for the identification of "ineffective protection." Additionally, "maladaptive response to stress" (p = .711) and "coagulation change" (p = .653) were sensitive indicators. The main indicators that showed high specificity were "fever" (p = .987), "increased number of hospitalisations" (p = .911), "weakness" (p = .937), "infected vascular access" (p = .962) and "vascular access dysfunction" (p = .722). A set of nine clinical indicators of "ineffective protection" were accurate and statistically significant for haemodialysis patients. Three clinical indicators showed sensitivity, and six indicators showed specificity. Accurate measures for nursing diagnoses can help nurses confirm or rule out the probability of the occurrence of "ineffective protection" in patients undergoing haemodialysis. © 2017 John Wiley & Sons Ltd.

Clinical validation of the nursing diagnosis of dysfunctional family processes related to alcoholism.

PubMed

Mangueira, Suzana de Oliveira; Lopes, Marcos Venícios de Oliveira

2016-10-01

To evaluate the clinical validity indicators for the nursing diagnosis of dysfunctional family processes related to alcohol abuse. Alcoholism is a chronic disease that negatively affects family relationships. Studies on the nursing diagnosis of dysfunctional family processes are scarce in the literature. This diagnosis is currently composed of 115 defining characteristics, hindering their use in practice and highlighting the need for clinical validation. This was a diagnostic accuracy study. A sample of 110 alcoholics admitted to a reference centre for alcohol treatment was assessed during the second half of 2013 for the presence or absence of the defining characteristics of the diagnosis. Operational definitions were created for each defining characteristic based on concept analysis and experts evaluated the content of these definitions. Diagnostic accuracy measures were calculated from latent class models with random effects. All 89 clinical indicators were found in the sample and a set of 24 clinical indicators was identified as clinically valid for a diagnostic screening for family dysfunction from the report of alcoholics. Main clinical indicators with high specificity included sexual abuse, disturbance in academic performance in children and manipulation. The main indicators that showed high sensitivity values were distress, loss, anxiety, low self-esteem, confusion, embarrassment, insecurity, anger, loneliness, deterioration in family relationships and disturbance in family dynamics. Eighteen clinical indicators showed a high capacity for diagnostic screening for alcoholics (high sensitivity) and six indicators can be used for confirmatory diagnosis (high specificity). © 2016 John Wiley & Sons Ltd.

[Criterion and Construct Validity in Nursing Diagnosis "Sedentary Lifestyle" in People over 50 Years Old].

PubMed

Guirao-Goris, Silamani J; Ferrer Ferrandis, Esperanza; Montejano Lozoya, Raimunda

2016-02-18

The aim of the study is to identify the construct and criterion validity of the nursing diagnosis label Sedentary Lifestyle. A cross-sectional study in a nursing consultation in primary health care was conducted. Participants were all people that was attended for one year over 50 who voluntarily wish to participate (n=85) in the study. Objective weekly physical activity was measured in METs with an Accelerometer, objective measure of performance was measured by gait speed EPESE Battery (both measures that were used as the gold standard), and physical activity questionnaires (RAPA), the COOP-WONCA physical fitness chart. Spearman correlation coefficients, mean comparison tests and analysis of sensitivity and specificity were used as statistical analysis. The diagnosis "Sedentary Lifestyle" showed a positive correlation between its manifestations and physical activity measured in METs (r=0.39) and EPESE gait speed (r=0.35). The diagnosis showed a sensitivity of 85.1% and a specificity of 65.2% and showed ability to discriminate active people from those that are not using METs as a measure of physical activity (t=-4.4). The diagnosis "Sedentary Lifestyle" shows criterion and construct validity.

Validation of nursing management diagnoses.

PubMed

Morrison, R S

1995-01-01

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

[Facilitating the diagnosis of depression and burnout by identifying demographic and work-related risk and protective factors among nurses].

PubMed

Ádám, Szilvia; Nistor, Anikó; Nistor, Katalin; Cserháti, Zoltán; Mészáros, Veronika

2015-08-09

Depression and burnout are frequent comorbidities among nurses. Despite similar symptoms, their management differ. Therefore, their timely diagnosis is essential. To identify demographic and work-related risk and protective factors of burnout and depression, and facilitate their diagnosis. A cross-sectional study among 1,713 nurses was carried out. Depression and burnout were assessed by the shortened Beck Depression Questionnaire and Maclach Burnout Inventory, respectively. Risk and protective factors were explored using t-tests and analysis of variance. The prevalence of depression and moderate-to-high burnout was 35.1% and 34-74%, respectively. Having a partner/child and longer employment in the outpatient setting protected from burnout. Lack of a partner and male sex emerged as risk factors of depression and depersonalisation, respectively. High prevalence of depression and burnout among nurses poses a significant public health issue. Familiarity with the disease-specific risk and protective factors identified in this research may facilitate timely diagnosis and effective disease management.

Diagnosis, treatment, and nursing care of patients with chronic leukemia.

PubMed

Breed, Cheryl D

2003-05-01

To provide an update on the impact of new information about the molecular biology of chronic leukemia and new treatment modalities available to patients. Published articles, books, and research studies. There has been significant progress in the diagnosis and management of chronic myeloid and chronic lymphocytic leukemia. New therapies provide more options for patients and longer treatment periods. With increasing treatment options and longer survival, patients with chronic myelogenous or chronic lymphocytic leukemia need increased education, support, and assistance with symptom management. Nurses caring for these patients must remain knowledgeable about new treatments and their management.

Establishing Priorities for Oncology Nursing Research: Nurse and Patient Collaboration.

PubMed

Cox, Anna; Arber, Anne; Gallagher, Ann; MacKenzie, Mairead; Ream, Emma

2017-03-01

To obtain consensus on priorities for oncology nursing research in the United Kingdom.
. A three-round online Delphi survey.
. Oncology nurses were invited via the United Kingdom Oncology Nursing Society (UKONS) database. Patient participation was invited through patient organizations.
. 50 oncology nurses and 18 patients.
. Eligible and consenting individuals reported five priorities for oncology nursing research (round 1), rated their level of agreement with them (round 2), and restated and revised their responses in light of the group's responses (round 3). Consensus was defined as 80% agreement.
. Research priorities for oncology nursing as reported by oncology nurses and patients. 
. Consensus was reached on 50 of 107 research priorities. These priorities reflected the entire cancer pathway, from diagnosis to palliative care. Highest agreement was reached within and across groups on the need for research relating to prevention, screening, early diagnosis, and psychological care across the cancer trajectory. Little consensus was reached regarding symptoms and side effects. Some evident divergence existed. Oncology nurses and patients do not necessarily prioritize the same research areas. Prevention, screening, and early diagnosis are of the highest priority for future research among oncology nurses and patients. 
. Patients usually play little part in priority setting for research. This study provided the opportunity for meaningful patient and nurse involvement in setting a research agenda for oncology nursing that is relevant and beneficial to oncology nurses and patients.

Spiritual Well-Being and Spiritual Distress in Cancer Patients Undergoing Chemotherapy: Utilizing the SWBQ as Component of Holistic Nursing Diagnosis.

PubMed

Caldeira, Sílvia; Timmins, Fiona; de Carvalho, Emília Campos; Vieira, Margarida

2017-08-01

Holistic nursing care requires attention to the spiritual dimension. This is particularly important when caring for patients with cancer. This research presents the results of the assessment of spiritual well-being using the Spiritual Well-Being Questionnaire (SWBQ) to validate the nursing diagnosis of spiritual distress. Structured interviews were conducted with 169 patients in one hospital in Portugal. We concluded that the SWBQ is a useful and reliable instrument to assess spiritual distress, which highlights the importance of listening to patients and questioning them about spiritual needs as well as the importance of differential diagnosis aimed at effective interventions.

A 10-year retrospective study of teaching nursing diagnosis to baccalaureate students in Italy.

PubMed

Palese, Alvisa; De Silvestre, Daniele; Valoppi, Graziella; Tomietto, Marco

2009-01-01

The aim of this 10-year retrospective study was to evaluate the impact of teaching nursing process to students at different levels of baccalaureate education, using the North American Nursing Diagnosis Association International (NANDA-I) Taxonomy. Nursing care plans written between 1996 and 2006 by 3,784 students who had completed a baccalaureate course in nursing process at a university in northern Italy were evaluated. At least three of the four steps of the nursing process were included in the evaluation: assessing, planning, intervening, and evaluating. An average of 6.3 (range 0-31; +/-3.9; median 6) problems were identified in each care plan. Of these, 5.1 (range 0-29; +/-3.06; median 5) were related to nursing diagnoses concerning either an actual problem or the risk of developing a problem; the remaining 1.2 (range 0-20; +/-1.9; median 0) diagnoses were concerned either with collaborative problems or with potential complications. The students demonstrated significant improvement in accurately identifying 75 diagnostic titles from the NANDA-I Taxonomy as they progressed through their first, second, and third years of baccalaureate study. These findings suggest that the ability to use the NANDA-I Taxonomy accurately is acquired over time. Thus, the theory and practice of using nursing process should be introduced in a formal course during the first year of baccalaureate nursing education and should be reinforced throughout the remaining courses. Students can then progressively improve their knowledge, critical thinking abilities, and use of the NANDA-I Taxonomy during their second and third years of study. Teaching strategies to reinforce students' learning are recommended.

Teaching differential diagnosis to nurse practitioner students in a distance program.

PubMed

Colella, Christine L; Beery, Theresa A

2014-08-01

An interactive case study (ICS) is a novel way to enhance the teaching of differential diagnosis to distance learning nurse practitioner students. Distance education renders the use of many teaching strategies commonly used with face-to-face students difficult, if not impossible. To meet this new pedagogical dilemma and to provide excellence in education, the ICS was developed. Kolb's theory of experiential learning supported efforts to follow the utilization of the ICS. This study sought to determine whether learning outcomes for the distance learning students were equivalent to those of on-campus students who engaged in a live-patient encounter. Accuracy of differential diagnosis lists generated by onsite and online students was compared. Equivalency testing assessed clinical, rather than only statistical, significance in data from 291 students. The ICS responses from the distance learning and onsite students differed by 4.9%, which was within the a priori equivalence estimate of 10%. Narrative data supported the findings. Copyright 2014, SLACK Incorporated.

Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

PubMed Central

Murray, Bethany; McNew, Brittany

2015-01-01

Abstract Purpose This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs). Data sources PubMed searches were conducted using the following keywords: “bipolar disorder and primary care,” restricted to dates 2000 to present; “bipolar disorder and nurse practitioner”; and “bipolar disorder and clinical nurse specialist.” Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals. Conclusions BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients. Implications for practice Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients. PMID:26172568

Casemix and nursing.

PubMed

Diers, D

1999-01-01

The American Nurses' Association did not embrace the introduction of diagnosis related groups, believing they would not recognise nursing activity nor acuity and would bring about the economic demise of nursing. Australian nurses, by contrast, recognised the window of opportunity that the work towards Australian national diagnosis related groups and funding mechanisms provided to move nursing resources into the political and policy mainstream. This paper reviews the American and Australian nursing experience with casemix, acuity and cost weighting. It uses examples from more recent work to argue for the use of casemix information in new ways, for 'process improvement' or 'evidence-based management'. The paper concludes that the next great leap forward in casemix may require attention to building the information and human infrastructures, so that the valuable clinical-financial information produced by casemix-based information systems can truly inform management and policy.

The Difficulty of Selecting the NANDA-I Nursing Diagnosis (2015-2017) of "Death Anxiety" in Japan.

PubMed

Shimomai, Kimiyo; Furukawa, Hidetoshi; Kuroda, Yuko; Fukuda, Kazuaki; Masuda, Mitsumi; Koizumi, Junko

2018-01-01

The purpose of our study was to clarify any difficulties or problems that exist in Japanese healthcare sites regarding the selection of death anxiety as a nursing diagnosis. This study was a qualitative, inductive research design. The semistructured interviews were conducted on the participants who were nurses and had 3 or more years of clinical experience in Japan. Results showed four categories: "The Japanese have a culture of avoiding death," "It is extremely difficult to match diagnostic indicators and related factors with specific patient cases," "Other diagnoses exist that are effective and enable proactive intervention," and "The definition of death anxiety and the meaning of its diagnostic indicators are unintelligible." It is thought that nursing diagnoses that reflect specific cultural backgrounds require definitions appropriate to each country and appropriate revisions to diagnostic indicators. © 2016 NANDA International, Inc.

[Follow-up of primary care patients with a NANDA I nursing diagnosis of low self-esteem].

PubMed

Díaz-Martín, Alicia; González-Carpio Paredes, Óscar

2013-01-01

To describe the evolution and characteristics of the NANDA taxonomy I nursing diagnosis of «situational low self-esteem» (SLS) and its related factors in Primary Care patients from the towns of Fuenlabrada and Leganés in the Autonomous Community of Madrid, in the period 2003-2009. An observational retrospective case series of patients diagnosed by their Primary Care nurse with SLS according to the NANDA I taxonomy. This case series was performed in the towns of Fuenlabrada and Leganes (Madrid). Descriptive analysis of the variables obtained from the database management software for electronic health records in Primary Care (OMI AP). Data observed in percentages. The main variable is 00120 NANDA I diagnosis: SLS. A total of 342 care plans with a SLS diagnosis having completed all the nursing process phases. The NANDA, NOC and NIC classifications were used for the diagnostic formulas, the performance criteria to measure the effectiveness and efficiency of care, and the interventions that were performed to achieve them. The assessment of the nursing process was made according to the Marjory Gordon Functional Health Patterns. The incidence between 2003 and 2009 increased 8-fold. The large majority (80%) were women, with 52.4% between 40 and 64 years. Eighteen percent of the cases were closed, with 88% positively resolved. The most frequent distinctive characteristic was «negative self-verbalization» (26.5%). The main related factors were «disturbed body image» (23.8%). The most established NOC was «to improve the self-esteem» (41.3%) and its evolution was positive in 61%. Just over half (53.2%) of the interventions were «to increase facing up to responsibilities» and «to boost self-esteem». More than half (55%) of the diagnoses were made due to psychological causes, with episodes of a feeling anxiety-nervousness-tension in 33%. Although the approach is still difficul, the resolution of psychosocial problems, particularly those of self-esteem, continue to

The Nursing Diagnosis of risk for pressure ulcer: content validation.

PubMed

Santos, Cássia Teixeira Dos; Almeida, Miriam de Abreu; Lucena, Amália de Fátima

2016-06-14

to validate the content of the new nursing diagnosis, termed risk for pressure ulcer. the content validation with a sample made up of 24 nurses who were specialists in skin care from six different hospitals in the South and Southeast of Brazil. Data collection took place electronically, through an instrument constructed using the SurveyMonkey program, containing a title, definition, and 19 risk factors for the nursing diagnosis. The data were analyzed using Fehring's method and descriptive statistics. The project was approved by a Research Ethics Committee. title, definition and seven risk factors were validated as "very important": physical immobilization, pressure, surface friction, shearing forces, skin moisture, alteration in sensation and malnutrition. Among the other risk factors, 11 were validated as "important": dehydration, obesity, anemia, decrease in serum albumin level, prematurity, aging, smoking, edema, impaired circulation, and decrease in oxygenation and in tissue perfusion. The risk factor of hyperthermia was discarded. the content validation of these components of the nursing diagnosis corroborated the importance of the same, being able to facilitate the nurse's clinical reasoning and guiding clinical practice in the preventive care for pressure ulcers. validar o conteúdo do novo diagnóstico de enfermagem, denominado risco de úlcera por pressão. trata-se de uma validação de conteúdo, com amostra composta por 24 enfermeiros especialistas no cuidado à pele, procedentes de seis diferentes hospitais do Sul e Sudeste brasileiro. A coleta de dados ocorreu por meio eletrônico, em instrumento construído pelo programa SurveyMonkey, que continha título, definição e 19 fatores de risco para o diagnóstico de enfermagem. Os dados foram analisados pelo método de Fehring e pela estatística descritiva. O projeto foi aprovado em Comitê de Ética em Pesquisa. título, definição e sete fatores de risco foram validados como "muito importante

Nursing diagnosis in intensive care unit: the Turkey experience.

PubMed

Korhan, Esra Akn; Yönt, Gülendam Hakverdioğlu; Erdemir, Firdevs; Müller-Staub, Maria

2014-01-01

The purpose of this study was to determine intensive care unit nurses diagnostic abilities and diagnoses that they provide. A vignette study was performed. The vignette contained a patient's history, treatment, and signs/symptoms of 18 nursing diagnoses based on NANDA-I as the criterion standard. Turkish intensive care unit nurses (N = 45) stated nursing diagnoses described by patient data in the vignette. The resulting nursing diagnoses were grouped into Gordon's Functional Health Patterns, and descriptive analyses were performed. One-way analysis of variance was used to detect possible differences in diagnostic abilities based on nurses' education levels. Nurses identified 14 nursing diagnoses. Four of the predetermined psychosocial nursing diagnoses were not identified. The highest percentage of diagnoses was risk for impaired skin integrity (62.2%) and impaired oral mucous membrane (60.0%). The lowest number of diagnoses was impaired verbal communication (2.2%). A statistically significant difference was found between the educational level of nurses and their abilities to determine nursing diagnoses (P < .05). The findings are important for nursing education. They demonstrate the need to focus on patients as complete human beings, covering not only biological aspects but also cultural and social values, as well as emotional and spiritual care needs.

Hypertension in a female nursing staff--Pattern of occurrence, diagnosis, and treatment.

PubMed

Aquino, E M; Magalhães, L B; Araújo, M J; Almeida , M C; Leto, J P

2001-03-01

To report the pattern of occurrence, diagnosis, and treatment of hypertension in a female nursing staff of an emergency hospital. We carried out a cross-sectional study that included interviews and blood pressure measurements of 494 nursing professionals at an emergency hospital in the city of Salvador, in the state of Bahia, Brazil. We considered hypertensive all individual with blood pressure > or = 140/90 mmHg or normal pressure if on regular treatment. We found a prevalence of hypertension of 36.4%. Only 18.3% of the individuals ignored their hypertensive condition, and 64.2% admitted not being having regular treatment. Of those individuals who were having treatment, 69.4% had elevated blood pressure on examination. The major reasons for not being on treatment was the occasional elevation of blood pressure (22.2%) and medical counseling (20.0%). The results point to the need to introduce hypertension control measures in this occupational group, because of the magnitude of the disease and the potential impact on diffusion of knowledge and measures to control hypertension.

A Focus Group Study Exploring Student Nurse's Experiences of an Educational Intervention Focuse don Working with People with a Diagnosis of Personality Disorder.

PubMed

Stacey, G; Baldwin, V; Thompson, B; Aubeeluck, A

2018-05-21

Negative attitudes exist in practice towards those with a diagnosis of personality disorder. Preregistration training offers the opportunity to address this by developing understanding of the diagnosis, confidence in working with people with the diagnosis and empowering new nurses to challenge prevailing attitudes. Attempts to integrate and evaluate specific educational interventions of this nature into pre-registration nurse education have not been explored elsewhere. To explore preregistration nurses' experience of a programme of training focused on personality disorder and their perception of its influence on attitudes, understanding of clients and their experience of practice. A qualitative study using thematic analysis of two focus groups of pre-registration mental health nursing students. Evidence of positive attitudes and confidence to supportively challenge negative attitudes in practice were found. Students showed a shift away from a focus on changing the perceived 'difficult' behaviour of a client towards an understanding of their own emotional responses to the behaviours. The Knowledge and Understanding Framework training shows potential for students to change attitudes and develop progressive practice working with people with personality disorder. The integration of the Knowledge and Understanding Framework should be considered as part of preregistration training. Further research into the sustained influence of the training post registration is required. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Fuzzy cognitive map in differential diagnosis of alterations in urinary elimination: a nursing approach.

PubMed

Lopes, Maria Helena Baena de Moraes; Ortega, Neli Regina Siqueira; Silveira, Paulo Sérgio Panse; Massad, Eduardo; Higa, Rosângela; Marin, Heimar de Fátima

2013-03-01

To develop a decision support system to discriminate the diagnoses of alterations in urinary elimination, according to the nursing terminology of NANDA International (NANDA-I). A fuzzy cognitive map (FCM) was structured considering six possible diagnoses: stress urinary incontinence, reflex urinary incontinence, urge urinary incontinence, functional urinary incontinence, total urinary incontinence and urinary retention; and 39 signals associated with them. The model was implemented in Microsoft Visual C++(®) Edition 2005 and applied in 195 real cases. Its performance was evaluated through the agreement test, comparing its results with the diagnoses determined by three experts (nurses). The sensitivity and specificity of the model were calculated considering the expert's opinion as a gold standard. In order to compute the Kappa's values we considered two situations, since more than one diagnosis was possible: the overestimation of the accordance in which the case was considered as concordant when at least one diagnoses was equal; and the underestimation of the accordance, in which the case was considered as discordant when at least one diagnosis was different. The overestimation of the accordance showed an excellent agreement (kappa=0.92, p<0.0001); and the underestimation provided a moderate agreement (kappa=0.42, p<0.0001). In general the FCM model showed high sensitivity and specificity, of 0.95 and 0.92, respectively, but provided a low specificity value in determining the diagnosis of urge urinary incontinence (0.43) and a low sensitivity value to total urinary incontinence (0.42). The decision support system developed presented a good performance compared to other types of expert systems for differential diagnosis of alterations in urinary elimination. Since there are few similar studies in the literature, we are convinced of the importance of investing in this kind of modeling, both from the theoretical and from the health applied points of view. In spite of

Fuzzy cognitive map in differential diagnosis of alterations in urinary elimination: A nursing approach

PubMed Central

de Moraes Lopes, Maria Helena Baena; Ortega, Neli Regina Siqueira; Silveira, Paulo Sérgio Panse; Massad, Eduardo; Higa, Rosângela; de Fátima Marin, Heimar

2013-01-01

Purpose To develop a decision support system to discriminate the diagnoses of alterations in urinary elimination, according to the nursing terminology of NANDA International (NANDA-I). Methods A fuzzy cognitive map (FCM) was structured considering six possible diagnoses: stress urinary incontinence, reflex urinary incontinence, urge urinary incontinence, functional urinary incontinence, total urinary incontinence and urinary retention; and 39 signals associated with them. The model was implemented in Microsoft Visual C++® Edition 2005 and applied in 195 real cases. Its performance was evaluated through the agreement test, comparing its results with the diagnoses determined by three experts (nurses). The sensitivity and specificity of the model were calculated considering the expert’s opinion as a gold standard. In order to compute the Kappa’s values we considered two situations, since more than one diagnosis was possible: the overestimation of the accordance in which the case was considered as concordant when at least one diagnoses was equal; and the underestimation of the accordance, in which the case was considered as discordant when at least one diagnosis was different. Results The overestimation of the accordance showed an excellent agreement (kappa = 0.92, p < 0.0001); and the underestimation provided a moderate agreement (kappa = 0.42, p < 0.0001). In general the FCM model showed high sensitivity and specificity, of 0.95 and 0.92, respectively, but provided a low specificity value in determining the diagnosis of urge urinary incontinence (0.43) and a low sensitivity value to total urinary incontinence (0.42). Conclusions The decision support system developed presented a good performance compared to other types of expert systems for differential diagnosis of alterations in urinary elimination. Since there are few similar studies in the literature, we are convinced of the importance of investing in this kind of modeling, both from the theoretical and from

Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients1

PubMed Central

Luzia, Melissa de Freitas; Victor, Marco Antonio de Goes; Lucena, Amália de Fátima

2014-01-01

Objectives to identify the prevalence of the Nursing Diagnosis (ND) Risk for falls in the hospitalizations of adult patients in clinical and surgical units, to characterize the clinical profile and to identify the risk factors of the patients with this ND. Method a cross-sectional study with 174 patients. The data was collected from the computerized nursing care prescriptions system and on-line hospital records, and analyzed statistically. Results the prevalence of the ND Risk for falls was 4%. The patients' profile indicated older adults, males (57%), those hospitalized in the clinical units (63.2%), with a median length of hospitalization of 20 (10-24) days, with neurological illnesses (26%), cardio-vascular illnesses (74.1%) and various co-morbidities (3±1.8). The prevalent risk factors were neurological alterations (43.1%), impaired mobility (35.6%) and extremes of age (10.3%). Conclusion the findings contributed to evidencing the profile of the patients with a risk of falling hospitalized in clinical and surgical wards, which favors the planning of interventions for preventing this adverse event. PMID:26107834

Accuracy in inference of nursing diagnoses in heart failure patients.

PubMed

Pereira, Juliana de Melo Vellozo; Cavalcanti, Ana Carla Dantas; Lopes, Marcos Venícios de Oliveira; da Silva, Valéria Gonçalves; de Souza, Rosana Oliveira; Gonçalves, Ludmila Cuzatis

2015-01-01

Heart failure (HF) is a common cause of hospitalization and requires accuracy in clinical judgment and appropriate nursing diagnoses. to determine the accuracy of nursing diagnoses of fatigue, intolerance to activity and decreased cardiac output in hospitalized HF patients. descriptive study applied to nurses with experience in NANDA-I and/or HF nursing diagnoses. Evaluation and accuracy were determined by calculating efficacy (E), false negative (FN), false positive (FP) and trend (T) measures. Nurses who showed acceptable inspection for two diagnoses were selected. the nursing diagnosis of fatigue was the most commonly mistaken diagnosis identified by the nursing evaluators. the search for improving diagnostic accuracy reaffirms the need for continuous and specific training to improve the diagnosis capability of nurses. the training allowed the exercise of clinical judgment and better accuracy of nurses.

The role of UK district nurses in providing care for adult patients with a terminal diagnosis: a meta-ethnography.

PubMed

Offen, John

2015-03-01

To explore the role of UK district nurses in providing care for adult patients with a terminal diagnosis by reviewing qualitative research. Meta-ethnography was used to conduct the synthesis. CINAHL, MEDLINE and British Nursing Index (BNI) were searched comprehensively for primary research relating to the role of UK district nurses in palliative care. The abstracts and titles of 700 papers were screened against inclusion criteria, of these 97 full papers were appraised. Some 24 studies reported in 25 papers were selected for inclusion in the synthesis. In total, five key themes were identified: valuing the role; practical role; relationships with patients and families; providing psychological support; and role uncertainty. Further synthesis yielded two 'lines of argument'. The concept of the 'expert friend' argues that the atypical relationship district nurses cultivate with patients underpins district nurses' provision of palliative care and profoundly influences the nature of psychological support given. Secondly, the concept of 'threat and opportunity' encapsulates the threat district nurses can feel to their traditional role in palliative care through changing health and social policy, while recognising the benefits that access to specialist knowledge and better training can bring. The findings have implications for understanding the motivators and barriers experienced by district nurses delivering palliative care in a time of unprecedented change to community health services.

Nursing cost by DRG: nursing intensity weights.

PubMed

Knauf, Robert A; Ballard, Karen; Mossman, Philip N; Lichtig, Leo K

2006-11-01

Although diagnosis-related group (DRG) reimbursement is used for Medicare and many other payors, nursing--the largest portion of hospital costs--is not specifically identified and quantified in deriving payments in any of the DRG reimbursement systems except that of New York State. In New York, nursing costs are allocated to each DRG in payment rate formulation by means of nursing intensity weights (NIWs)--relative values reflecting the quantity and types of nursing services provided to patients in each DRG. In the absence of charges for nursing services, these NIWs are derived from scores for each DRG provided by a representative panel of nurses through a modified Delphi technique. NIWs have been shown to correlate with hospitals' nursing costs per day. They are used to set cost-based payment weights, thereby avoiding compression caused by using flat cost-to-charge or cost-per-day averages for all acute and intensive care patients.

Nursing diagnoses for the elderly using the International Classification for Nursing Practice and the activities of living model.

PubMed

de Medeiros, Ana Claudia Torres; da Nóbrega, Maria Miriam Lima; Rodrigues, Rosalina Aparecida Partezani; Fernandes, Maria das Graças Melo

2013-01-01

To develop nursing diagnosis statements for the elderly based on the Activities of Living Model and on the International Classification for Nursing Practice. Descriptive and exploratory study, put in practice in two stages: 1) collection of terms and concepts that are considered clinically and culturally relevant for nursing care delivered to the elderly, in order to develop a database of terms and 2) development of nursing diagnosis statements for the elderly in primary health care, based on the guidelines of the International Council of Nurses and on the database of terms for nursing practice involving the elderly. 414 terms were identified and submitted to the content validation process, with the participation of ten nursing experts, which resulted in 263 validated terms. These terms were submitted to cross mapping with the terms of the International Classification for Nursing Practice, resulting in the identification of 115 listed terms and 148 non-listed terms, which constituted the database of terms, from which 127 nursing diagnosis statements were prepared and classified into factors that affect the performance of the elderly's activities of living - 69 into biological factors, 19 into psychological, 31 into sociocultural, five into environmental, and three into political-economic factors. After clinical validation, these statements can serve as a guide for nursing consultations with elderly patients, without ignoring clinical experience, critical thinking and decision-making.

Palliative Care: Delivering Comprehensive Oncology Nursing Care.

PubMed

Dahlin, Constance

2015-11-01

To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

Identification of Nursing Diagnosis-Outcome-Intervention Linkages for Inpatients in the Obstetrics Department Nursing Unit in South Korea.

PubMed

Yang, Min Ji; Kim, Hye Young; Ko, Eun; Kim, Hyun Kyung

2017-09-08

To identify the NANDA-I-NOC-NIC (NNN) linkages for inpatients of the obstetrics nursing unit using electronic nursing records. In this retrospective, descriptive survey, the electronic nursing records for 220 adult patients aged ≥18 years who were discharged after obstetrics nursing unit were analyzed. The 7 most frequent nursing diagnoses were found to be associated with 9 nursing outcomes and 26 nursing interventions. Herein, the list of nursing diagnoses was observed to comprise the safety/protection domain, the list of nursing outcomes the physiological health domain, and the list of nursing interventions the physiological: complex domain. This result can contribute to improving the nursing quality and will help continuing education and documentation system refinement. © 2017 NANDA International, Inc.

Nurse practitioner malpractice data: Informing nursing education.

PubMed

Sweeney, Casey Fryer; LeMahieu, Anna; Fryer, George E

Nurse practitioners (NPs) are often identified in medical malpractice claims. However, the use of malpractice data to inform the development of nursing curriculum is limited. The purpose of this study is to examine medical errors committed by NPs. Using National Practitioner Data Bank public use data, years 1990 to 2014, NP malpractice claims were classified by event type, patient outcome, setting, and number of practitioners involved. The greatest proportion of malpractice claims involving nurse practitioners were diagnosis related (41.46%) and treatment related (30.79%). Severe patient outcomes most often occurred in the outpatient setting. Nurse practitioners were independently responsible for the event in the majority of the analyzed claims. Moving forward, nurse practitioner malpractice data should be continuously analyzed and used to inform the development of nurse practitioner education standards and graduate program curriculum to address areas of clinical weakness and improve quality of care and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Novel nursing terminologies for the rapid response system.

PubMed

Wong, Elizabeth

2009-01-01

Nursing terminology with implications for the rapid response system (RRS) is introduced and proposed: critical incident nursing diagnosis (CIND), defined as the recognition of an acute life-threatening event that occurs as a result of disease, surgery, treatment, or medication; critical incident nursing intervention, defined as any indirect or direct care registered nurse-initiated treatment, based upon clinical judgment and knowledge that a registered nurse performs in response to a CIND; and critical incident control, defined as a response that attempts to reverse a life-threatening condition. The current literature, research studies, meta-analyses from a variety of disciplines, and personal clinical experience serve as the data sources for this article. The current nursing diagnoses, nursing interventions, and nursing outcomes listed in the North American Nursing Diagnosis Association International Classification, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), respectively, are inaccurate or inadequate for describing nursing care during life-threatening situations. The lack of such standardized nursing terminology creates a barrier that may impede critical communication and patient care during life-threatening situations when activating the RRS. The North American Nursing Diagnosis Association International Classification, NIC, and NOC are urged to refine their classifications and include CIND, critical incident nursing intervention, and critical incident control. The RRS should incorporate standardized nursing terminology to describe patient care during life-threatening situations. Refining the diagnoses, interventions, and outcomes classifications will permit nursing researchers, among others, to conduct studies on the efficacy of the proposed novel nursing terminology when providing care to patients during life-threatening situations. In addition, including the proposed novel nursing terminology in the RRS offers a

Diagnostic accuracy of Parkinson's disease and atypical parkinsonism in nursing homes.

PubMed

Weerkamp, N J; Tissingh, G; Poels, P J E; Zuidema, S U; Munneke, M; Koopmans, R T C M; Bloem, B R

2014-11-01

Management of Parkinson's disease (PD) and atypical parkinsonism in nursing homes depends on a timely and accurate diagnosis. However, little is known about the diagnostic accuracy of these parkinsonian syndromes in nursing homes. We examined this issue in a large group of Dutch nursing home residents. Twelve large nursing home organizations in the Netherlands accounting for 100 nursing homes with a total population of 5480 residents participated. Residents with PD or atypical parkinsonism were identified according to their nursing home medical chart diagnosis. Additionally, local pharmacists provided a list of all residents using antiparkinson medication. We compared the admission diagnosis to a clinical diagnosis made in the study, based upon interview and detailed neurological examination by movement disorders experts. Diagnoses were based on accepted clinical criteria for PD and atypical parkinsonism. In the total population of 5480 residents, 258 had previously been diagnosed with a form of parkinsonism according to their medical record. In 53 of these residents (20.5%) we changed or rejected the diagnosis. Specifically, we found no parkinsonism in 22 of these 53 residents (8.5% of all patients with suspected parkinsonism). In the remaining 31 residents (12%), we established a new diagnosis within the parkinsonian spectrum. In a large population of Dutch nursing home residents, 20% of diagnoses within the parkinsonian spectrum were inaccurate. Almost 9% of residents had inadvertently received a diagnosis of parkinsonism. Better recognition of parkinsonism in nursing homes is important, because of the consequences for management and prognosis. Copyright © 2014. Published by Elsevier Ltd.

Concept analysis and validation of the nursing diagnosis, delayed surgical recovery.

PubMed

Appoloni, Aline Helena; Herdman, T Heather; Napoleão, Anamaria Alves; Campos de Carvalho, Emilia; Hortense, Priscilla

2013-10-01

To analyze the human response of delayed surgical recovery, approved by NANDA-I, and to validate its defining characteristics (DCs) and related factors (RFs). This was a two-part study using a concept analysis based on the method of Walker and Avant, and diagnostic content validation based on Fehring's model. Three of the original DCs, and three proposed DCs identified from the concept analysis, were validated in this study; five of the original RFs and four proposed RFs were validated. A revision of the concept studied is suggested, incorporating the validation of some of the DCs and RFs presented by NANDA-I, and the insertion of new, validated DCs and RFs. This study may enable the extension of the use of this diagnosis and contribute to quality surgical care of clients. © 2013, The Authors. International Journal of Nursing Knowledge © 2013, NANDA International.

Analysis of the Nursing Documentation in Use in Portugal - Building a Clinical Data Model of Nursing Centered on the Management of Treatment Regimen.

PubMed

Cruz, Inês; Bastos, Fernanda; Pereira, Filipe; Silva, Abel; Sousa, Paulino

2016-01-01

The use of technology to support information produced by nurses, especially information and communication technologies, is a current reality, but the proliferation of different statements of nursing diagnosis has made it more difficult for the production of indicators, hindering semantic interoperability of data. This study analyzed all statements of diagnosis focused on the management of medication regimen, customized to the Nursing Practice Support System (SAPE®) that was being used in Portugal in 2013. A total of 598 statements of nursing diagnoses about the phenomenon under study were analyzed, through an a priori analysis model - the ISO 18104 standard: 2003. The purpose was to identify terms used by nurses to describe the range of diagnoses, thus avoiding conceptual redundancy. After a content analysis process conducted by researchers and a broader group of experts, and when excluded all conceptual redundancy, 30 statements of nursing diagnosis were identified.

[Analysis of the implementation of Nursing Assistance Systematization in a rehabilitation unit].

PubMed

Neves, Rinaldo de Souza; Shimizu, Helena Eri

2010-01-01

This study seeks to analyze the execution of the Infirmary Attendance Systematization Nursing stages through an exploratory, qualitative and retrospective approach. The retrospective analysis took place using 25 medic reports containing 25 historical reports, 12 diagnosis reports, 100 prescriptions and 100 nursing evolution reports. The results demonstrated the many difficulties the nurses faced to make Nursing Assistance Systematization operational. Although all Nursing Assistance Systematization stages were accomplished - historical, diagnosis, prescription, evolution and nursing - it was verified a larger frequency in filling prescription and historical related forms and a lesser one related with evolution and diagnosis related forms. In short, Nursing Assistance Systematization procedures still are fragmentized, showing the need to reorganize this attendance methodology attendance, and, above all, to invest in continuous nursing training to improve the customer care services quality.

Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care.

PubMed

Mao, Alexandra J; Anastasi, Joyce K

2010-02-01

To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care. Selected research, clinical studies, clinical practice guidelines, and review articles. Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease. The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.

The nursing process in crisis-oriented psychiatric home care.

PubMed

Boomsma, J; Dingemans, C A; Dassen, T W

1997-08-01

Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.

Evidence for the Existing American Nurses Association-Recognized Standardized Nursing Terminologies: A Systematic Review

PubMed Central

Tastan, Sevinc; Linch, Graciele C. F.; Keenan, Gail M.; Stifter, Janet; McKinney, Dawn; Fahey, Linda; Dunn Lopez, Karen; Yao, Yingwei; Wilkie, Diana J.

2014-01-01

Objective To determine the state of the science for the five standardized nursing terminology sets in terms of level of evidence and study focus. Design Systematic Review. Data sources Keyword search of PubMed, CINAHL, and EMBASE databases from 1960s to March 19, 2012 revealed 1,257 publications. Review Methods From abstract review we removed duplicate articles, those not in English or with no identifiable standardized nursing terminology, and those with a low-level of evidence. From full text review of the remaining 312 articles, eight trained raters used a coding system to record standardized nursing terminology names, publication year, country, and study focus. Inter-rater reliability confirmed the level of evidence. We analyzed coded results. Results On average there were 4 studies per year between 1985 and 1995. The yearly number increased to 14 for the decade between 1996–2005, 21 between 2006–2010, and 25 in 2011. Investigators conducted the research in 27 countries. By evidence level for the 312 studies 72.4% were descriptive, 18.9% were observational, and 8.7% were intervention studies. Of the 312 reports, 72.1% focused on North American Nursing Diagnosis-International, Nursing Interventions Classification, Nursing Outcome Classification, or some combination of those three standardized nursing terminologies; 9.6% on Omaha System; 7.1% on International Classification for Nursing Practice; 1.6% on Clinical Care Classification/Home Health Care Classification; 1.6% on Perioperative Nursing Data Set; and 8.0% on two or more standardized nursing terminology sets. There were studies in all 10 foci categories including those focused on concept analysis/classification infrastructure (n = 43), the identification of the standardized nursing terminology concepts applicable to a health setting from registered nurses’ documentation (n = 54), mapping one terminology to another (n = 58), implementation of standardized nursing terminologies into electronic health

Prelude to specialization: US cancer nursing, 1920-50.

PubMed

Lusk, Brigid

2005-12-01

This study used historical research methodology to assess the work of US nurses caring for patients with cancer from 1920 to 1950. Primary sources, obtained from several US archives, included nursing procedure books, student nurses' lecture notes, hospital and nursing annual reports, and meeting minutes. Secondary sources included journal articles and textbooks. The aim was to document the clinical work of nurses caring for patients with cancer and assess this work for evidence of emerging specialization in cancer nursing. Following a review of cancer in the 1920s, nursing education specific to cancer, nursing care related to specific cancer therapies, and the practice of concealing a diagnosis of cancer, were examined. Nurses were consistently educated in cancer nursing, but their cancer education became more focused over the decades. Nurses were closely involved with cancer patients as they monitored their patients' radium or assisted patients following radical surgery. The issue of concealing the diagnosis of cancer was problematic to some nurses. This paper reveals the nature of nurses' hospital work with cancer patients and demonstrates a core body of cancer nursing knowledge. The emergence of cancer nursing as a specialty is presented.

Interventions to improve mental health nurses' skills, attitudes, and knowledge related to people with a diagnosis of borderline personality disorder: Systematic review.

PubMed

Dickens, Geoffrey L; Hallett, Nutmeg; Lamont, Emma

2016-04-01

There is some evidence that mental health nurses have poor attitudes towards people with a diagnosis of borderline personality disorder and that this might impact negatively on the development of helpful therapeutic relationships. We aimed to collate the current evidence about interventions that have been devised to improve the responses of mental health nurses towards this group of people. Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement. Comprehensive terms were used to search CINAHL, PsycINFO, Medline, Biomedical Reference Collection: Comprehensive, Web of Science, ASSIA, Cochrane Library, EMBASE, ProQuest [including Dissertations/Theses], and Google Scholar for relevant studies. Included studies were those that described an intervention whose aim was to improve attitudes towards, knowledge about or responses to people with a diagnosis of borderline personality disorder. The sample described had to include mental health nurses. Information about study characteristics, intervention content and mode of delivery was extracted. Study quality was assessed, and effect sizes of interventions and potential moderators of those interventions were extracted and converted to Cohen's d to aid comparison. The search strategy yielded a total of eight studies, half of which were judged to be methodologically weak with the remaining four studies judged to be of moderate quality. Only one study employed a control group. The largest effect sizes were found for changes related to cognitive attitudes including knowledge; smaller effect sizes were found in relation to changes in affective outcomes. Self-reported behavioural change in the form of increased use of components of Dialectical Behaviour Therapy following training in this treatment was associated with moderate effect sizes. The largest effect sizes were found among those with poorer baseline attitudes and without previous training about borderline

Mental Health Nursing in Greece: Nursing Diagnoses and Interventions in Major Depression.

PubMed

Prokofieva, Margarita; Koukia, Evmorfia; Dikeos, Dimitris

2016-08-01

The aim of the study was to assess nursing diagnoses and nursing interventions that were accordingly implemented during the care of inpatients with major depression in Greece. Twelve nurses working in three major psychiatric hospitals were recruited. Semi-structured interviews were used and audio-recorded data indicated that risk for suicide, social isolation, low self-esteem, sleep problems, and imbalanced nutrition are the nursing diagnoses most commonly reported. Establishing trust and rapport is the primary intervention, followed by specific interventions according to each diagnosis and the individualized care plan. The findings of the study also highlight the need for nursing training in order to teach nurses initial assessment procedures and appropriate evidence-based intervention techniques.

The role of nurses/social workers in using a multidimensional guideline for diagnosis of anxiety and challenging behaviour in people with intellectual disabilities.

PubMed

Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; Teerenstra, Steven; van Achterberg, Theo

2015-07-01

This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline. Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process. This study employed a comparative multiple case study design. Qualitative and quantitative research methods. Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process. Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process. After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours. © 2015 John Wiley & Sons Ltd.

Application of 4G wireless network-based system for remote diagnosis and nursing of stomal complications

PubMed Central

Xu, Xiulian; Cao, Yingjuan; Luan, Xiaorong

2014-01-01

Background: This study aims to apply 4G wireless network in the remote diagnosis of stoma complications for the first time. Background: Remote diagnosis and nursing care for a variety of illnesses are urgently needed in clinical settings. Objectives: Combining with relevant clinical manifestations, an Android phone-based intelligent diagnosis system was designed to construct a universe, easy access to exploitation and human-computer interaction database and exploitation environment for applications and programs. Methods: “Production rule” and forward reasoning method were utilized to design arborescence structures and logic reasoner associated with stoma complications. Stoma physicians were responsible for delivering evaluation scores on patients’ health status using analytic hierarchy process. The emphasis of this study is to exploit an “Android phone-based system for remote diagnosis of stoma”, which is of certain universe usage. Results: Such system was tested in the Medicine Information Center of Qilu Hospital of Shandong University and initially applied in the city of De Zhou, Shandong province, China. Conclusions: These results collectively demonstrated that the system is easy to carry, of high utility and free from the limitations of wire network environment, etc. It provides clinical evidence for establishing a novel type model for the exchange between patients and physicians. PMID:25550986

[Development of a set of nursing-sensitive indicators for Swiss practice].

PubMed

Kleinknecht-Dolf, Michael; Baumberger, Dieter; Jucker, Thomas; Kliem, Uwe; Zimmermann, Natalie; Spirig, Rebecca

2016-02-01

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.

The interface of genomic technologies and nursing.

PubMed

Loescher, Lois J; Merkle, Carrie J

2005-01-01

(a) to summarize views of the interface of technology, genomic technology, and nursing; (b) provide an overview of current and emerging genomic technologies; (c) present clinical exemplars of uses of genomic technology in two disease conditions; and (d) list genomic-focused nursing research on genomic technologies. A discussion of genomic technology in the context of nurses' views of technology, the importance of genomic technology for nurses, linking the central dogma of molecular biology to state-of-the-art tests and assays, and nurses' current use of technologies. Human genome discoveries will continue to be an integral part of disease prevention, diagnosis, treatment, and management. These discoveries also have the potential for being integrated into nursing science. Genomic technologies are becoming a driving force in patient management, so that nurses will be unable to provide quality care without knowledge of the types of genomic technologies, the rationale for their use, and the possible sequelae that can result from genetic diagnosis or treatment. Many nurses already are using genomic technologies to conduct genomic-focused nursing research. The biobehavioral nature of much of this research further indicates the important contributions of nurses in genomics.

An Exploration of Nursing Students' Clinical Decision-Making Process.

PubMed

Zaybak, Ayten; Özdemir, Handan; Erol, Ahmet; Ismailoğlu, Elif Günay

2017-11-03

This study was carried out descriptively and retrospectively with the purpose of determining nursing diagnoses used by intern students in their clinical practice. The study data were obtained by checking the care plans of the internship files of 248 students studying at a nursing faculty. The students determined 77 different nursing diagnoses in 13 domains of North American Nursing Diagnosis Association (NANDA)-I taxonomy II. The total number of nursing diagnosis used in the care plans was 1,469. Most of the diagnoses determined by the students were in the "safety/ protection" domain; however, they determined no diagnoses in the "life principles" domain. © 2017 NANDA International, Inc.

[New nursing diagnoses in imaging: submission to NANDA International].

PubMed

Juchem, Beatriz Cavalcanti; Almeida, Míriam de Abreu; Lucena, Amália de Fátima

2010-01-01

The present work reports the experiment on the creation and submission to North American Nursing Diagnosis Association International (NANDA-I) of Nursing Diagnosis in the imageology area: "Adverse Reaction to Iodinated Contrast Media" and "Risk of Adverse Reaction to Iodinated Contrast Media". For this experiment the method of integrative revision of literature was utilized associated with the experience in clinical practice. The document for submission was elaborated according to guidance offered by NANDA-I and sent for appreciation to the Diagnosis Development Committee. The risk diagnose was approved and the real diagnose is still in evaluation process by the Diagnosis Development Committee. With this experiment we hope to motivate Brazilian nurses to contribute to the taxonomy of NANDA-I and participate in the building ofnursing knowledge.

Nursing diagnoses related to psychiatric adult inpatient care.

PubMed

Frauenfelder, Fritz; van Achterberg, Theo; Müller Staub, Maria

2018-02-01

To detect the prevalence of NANDA-I diagnoses and possible relationships between those and patient characteristics such as gender, age, medical diagnoses and psychiatric specialty/setting. There is a lack on studies about psychiatric inpatient characteristics and possible relationships among these characteristics with nursing diagnoses. A quantitative-descriptive, cross-sectional, completed data sampling study was performed. The data were collected from the electronic patient record system. Frequencies for the social-demographic data, the prevalence of the NANDA-I diagnoses and the explanatory variables were calculated. In total, 410 nursing phenomena were found representing 85 different NANDA-I diagnoses in 312 patients. The NANDA-I diagnosis "Ineffective Coping" was the most frequently stated diagnosis followed by "Ineffective Health Maintenance," "Hopelessness" and "Risk for Other-Directed Violence". Men were more frequently affected by the diagnoses "Ineffective Coping," "Hopelessness," "Risk for Self-Directed Violence," "Defensive Coping" and "Risk for Suicide," whereas the diagnoses "Insomnia," "Chronic Confusion," "Chronic Low Self-Esteem" and "Anxiety" were more common in women. Patients under the age of 45 years were more frequently affected by "Chronic Low Self-Esteem" and "Anxiety" than older patients. "Ineffective Coping" was the most prevalent diagnosis by patients with mental disorders due to psychoactive substance use. Patients with schizophrenia were primarily affected by the diagnoses "Ineffective Coping," "Impaired Social Interaction" and "Chronic Low Self-Esteem." This study demonstrates the complexity and diversity of nursing care in inpatient psychiatric settings. Patients' gender, age and psychiatric diagnoses and settings are a key factor for specific nursing diagnosis. There are tendencies for relationships between certain nursing diagnosis and patient characteristics in psychiatric adult inpatients. This enhances the specific, extended

Clinical Validation of the "Sedentary Lifestyle" Nursing Diagnosis in Secondary School Students.

PubMed

de Oliveira, Marcos Renato; da Silva, Viviane Martins; Guedes, Nirla Gomes; de Oliveira Lopes, Marcos Venícios

2016-06-01

This study clinically validated the nursing diagnosis of "sedentary lifestyle" (SL) among 564 Brazilian adolescents. Measures of diagnostic accuracy were calculated for defining characteristics, and Mantel-Haenszel analysis was used to identify related factors. The measures of diagnostic accuracy showed that the following defining characteristics were statistically significant: "average daily physical activity less than recommended for gender and age," "preference for activity low in physical activity," "nonengagement in leisure time physical activities," and "diminished respiratory capacity." An SL showed statistically significant associations with the following related factors: insufficient motivation for physical activity; insufficient interest in physical activity; insufficient resources for physical activity; insufficient social support for physical activity; attitudes, beliefs, and health habits that hinder physical activity; and insufficient confidence for practicing physical exercises. The study highlighted the four defining characteristics and six related factors for making decisions related to SL among adolescents. © The Author(s) 2015.

Understanding nursing units with data and theory.

PubMed

Diers, Donna; Hendrickson, Karrie; Rimar, Joan; Donovan, Donna

2013-01-01

Nursing units are social systems whose function depends on many variables. Available nursing data, combined with a theory of organizational diagnosis, can be used to understand nursing unit performance. One troubled unit served as a case study in organizational diagnosis and treatment using modern methods of data mining and performance improvement. Systems theory did not prescribe how to fix an underbounded system. The theory did suggest, however, that addressing the characteristics of overbounded and underbounded systems can provide some order and structure and identify helpful resources. In this instance, the data analysis served to help define the unit's problems in conjunction with information gained from talking with the nurses and touring the unit, but it was the theory that gave hints for direction for change.

[Systematization of nursing assistance in critical care unit].

PubMed

Truppel, Thiago Christel; Meier, Marineli Joaquim; Calixto, Riciana do Carmo; Peruzzo, Simone Aparecida; Crozeta, Karla

2009-01-01

This is a methodological research, which aimed at organizing the systematization of nursing assistance in a critical care unit. The following steps were carried out: description of the nursing practice; transcription of nursing diagnoses; elaboration of a protocol for nursing diagnosis based in International Classification for Nursing Practice (ICNP); determination of nursing prescriptions and the elaboration of guidelines for care and procedures. The nursing practice and care complexity in ICU were characterized. Thus, systematization of nursing assistance is understood as a valuable tool for nursing practice.

Classifying clinical decision making: interpreting nursing intuition, heuristics and medical diagnosis.

PubMed

Buckingham, C D; Adams, A

2000-10-01

This is the second of two linked papers exploring decision making in nursing. The first paper, 'Classifying clinical decision making: a unifying approach' investigated difficulties with applying a range of decision-making theories to nursing practice. This is due to the diversity of terminology and theoretical concepts used, which militate against nurses being able to compare the outcomes of decisions analysed within different frameworks. It is therefore problematic for nurses to assess how good their decisions are, and where improvements can be made. However, despite the range of nomenclature, it was argued that there are underlying similarities between all theories of decision processes and that these should be exposed through integration within a single explanatory framework. A proposed solution was to use a general model of psychological classification to clarify and compare terms, concepts and processes identified across the different theories. The unifying framework of classification was described and this paper operationalizes it to demonstrate how different approaches to clinical decision making can be re-interpreted as classification behaviour. Particular attention is focused on classification in nursing, and on re-evaluating heuristic reasoning, which has been particularly prone to theoretical and terminological confusion. Demonstrating similarities in how different disciplines make decisions should promote improved multidisciplinary collaboration and a weakening of clinical elitism, thereby enhancing organizational effectiveness in health care and nurses' professional status. This is particularly important as nurses' roles continue to expand to embrace elements of managerial, medical and therapeutic work. Analysing nurses' decisions as classification behaviour will also enhance clinical effectiveness, and assist in making nurses' expertise more visible. In addition, the classification framework explodes the myth that intuition, traditionally associated

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

ERIC Educational Resources Information Center

Pobocik, Tamara J.

2013-01-01

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

Competence of newly qualified registered nurses from a nursing college.

PubMed

Morolong, B G; Chabeli, M M

2005-05-01

of research. A descriptive statistical method of data analysis was used in this study. Findings revealed that newly qualified registered nurses were not competent. The highest score obtained was 51% and the lowest score was 22% with an average score of 34.05%. The results concerning the implementation of the phases of the nursing process indicated that participants were fairly competent in terms of knowledge, skills, attitudes and values of assessment. Participants had very little knowledge of nursing diagnosis and were not competent on the skills of diagnosis. Participants lacked basic knowledge, skills, attitudes and values of the nursing process. They lacked critical thinking skills in their approach to providing quality patient care. The recommendations of the study relate to improving the system of clinical accompaniment, reviewing the clinical facilities where learners are allocated, reviewing the implementation of the curriculum, the methods of teaching and the quality assurance mechanisms that are in place. Further research is recommended on competence of newly qualified registered nurses at other nursing colleges or similar context.

Identifying nursing interventions associated with the accuracy used nursing diagnoses for patients with liver cirrhosis 1

PubMed Central

Gimenes, Fernanda Raphael Escobar; Motta, Ana Paula Gobbo; da Silva, Patrícia Costa dos Santos; Gobbo, Ana Flora Fogaça; Atila, Elisabeth; de Carvalho, Emilia Campos

2017-01-01

ABSTRACT Objective: to identify the nursing interventions associated with the most accurate and frequently used NANDA International, Inc. (NANDA-I) nursing diagnoses for patients with liver cirrhosis. Method: this is a descriptive, quantitative, cross-sectional study. Results: a total of 12 nursing diagnoses were evaluated, seven of which showed high accuracy (IVC ≥ 0.8); 70 interventions were identified and 23 (32.86%) were common to more than one diagnosis. Conclusion: in general, nurses often perform nursing interventions suggested in the NIC for the seven highly accurate nursing diagnoses identified in this study to care patients with liver cirrhosis. Accurate and valid nursing diagnoses guide the selection of appropriate interventions that nurses can perform to enhance patient safety and thus improve patient health outcomes.

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

PubMed

Lee, Nam-Ju; Cho, Eunhee; Bakken, Suzanne

2010-03-01

The purposes of this study were to develop a taxonomy for detection of errors related to hypertension management and to apply the taxonomy to retrospectively analyze the documentation of nurses in Advanced Practice Nurse (APN) training. We developed the Hypertension Diagnosis and Management Error Taxonomy and applied it in a sample of adult patient encounters (N = 15,862) that were documented in a personal digital assistant-based clinical log by registered nurses in APN training. We used Standard Query Language queries to retrieve hypertension-related data from the central database. The data were summarized using descriptive statistics. Blood pressure was documented in 77.5% (n = 12,297) of encounters; 21% had high blood pressure values. Missed diagnosis, incomplete diagnosis and misdiagnosis rates were 63.7%, 6.8% and 7.5% respectively. In terms of treatment, the omission rates were 17.9% for essential medications and 69.9% for essential patient teaching. Contraindicated anti-hypertensive medications were documented in 12% of encounters with co-occurring diagnoses of hypertension and asthma. The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies. Copyright © 2010 Korean Society of Nursing Science. Published by . All rights reserved.

Nursing diagnoses in elderly residents of a nursing home: a case in Turkey.

PubMed

Güler, Elem Kocaçal; Eşer, Ismet; Khorshid, Leyla; Yücel, Sebnem Çinar

2012-01-01

There are limited studies on nursing diagnoses of the elderly living in nursing homes worldwide. This study aimed to define the most frequent nursing diagnoses in the elderly residents of a nursing home elder care and rehabilitation center. Seventy-four elderly individuals were included in the study. Data were collected using the "Elderly Individual's Introduction Form" between April 2007 to August 2007. The content of the form was based on a guide to gerontologic assessment, and Gordon's Functional Health Patterns. The nursing diagnoses (NANDA-I Taxonomy II) were identified by the 2 researchers separately according to the defining characteristics and the risk factors. The consistency between the nursing diagnoses defined by the 2 researchers was evaluated using Cohen's kappa (κ). There was an 84.7% agreement about nursing diagnoses defined by the 2 researchers separately. The weighted kappa consistency analyses showed there was an adequate level of consistency (κ = 0.710), and the findings were significant (p < 0.0001). The most frequent diagnoses were ineffective role performance (86.5%), ineffective health maintenance (81.2%), risk for falls (77%), and impaired physical mobility (73%). The diagnosis of ineffective role performance was more frequent in patients with dementia (x(2) =10.993, df = 1, p = 0.001). There was a very significant relationship between dementia and the diagnosis of impaired verbal communication (x(2) = 32.718, df = 1, p = 0.0001). The relationship between mobility disorder and self-care deficit was also significant (x(2) = 19.411, df = 1, p = 0.0001). To improve quality in patient care, nurses should use nursing diagnoses with a systematic assessment and should help the elderly in health promotion or use of the maximum current potential. Copyright © 2012 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-09-01

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

[Evaluation of nursing care systematization through the phases of nursing process performance and registration in a teaching hospital].

PubMed

Reppetto, Maria Angela; de Souza, Mariana Fernandes

2005-01-01

This descriptive study was carried out in a teaching hospital at São Paulo city and had as objective to identify the phases performance and registration of nursing care systematization and the most frequent nursing diagnoses. Data were collected retrospectively from 135 patients records of three units: Cardiology, Adult Infectious Diseases and Neurosurgery, from January to July, 2002. The phases: history, nursing diagnoses, prescription, evolution and assessment were performed and registered in the three units, however, it was verified systematization gaps performance related to nursing diagnoses registered without the realization of nursing history and nursing prescriptions without evolution. The most frequent nursing diagnosis in the three units was risk for infection.

Dementia diagnosis and disclosure: a dilemma in practice.

PubMed

Monaghan, Catherine; Begley, Ann

2004-03-01

Providing the individual with the correct information about their diagnosis can help maximize the patient's autonomy, however empirical evidence identifies inconsistencies in the practice of diagnosis disclosure in dementia. Within health care, ethical problems arise frequently and these present a challenge for health care professionals. This challenge can also give rise to conflict when professionals are torn between respecting autonomy, doing good and avoiding paternalism. The aim of this paper is to highlight the need for interprofessional collaboration when faced with ethical dilemmas such as diagnosis disclosure in the care of adults with dementia. The use of a dialogue and supplementary notes are used to explore crucial ethical points raised by health care professionals. The increasing rate of dementia and the need for patients to have access to timely and appropriate information about their diagnosis has prompted much debate about disclosing the diagnosis with the individual who has dementia. This paper may also be useful for educational purposes when used as a framework for discussion/debate in student nurse education. Ethical theories are of benefit in assisting the members of the multidisciplinary team to reach a morally defensible decision. Making ethical decisions in practice can cause the nurse concern. While there is no complete set of 'rules' that can provide an answer to each ethical dilemma, it is of immense value to nurses working within the multidisciplinary team to possess a sound knowledge of ethical positions in order to analyse the many complex situations that nurses encounter. The pivotal role of the health care professional is to work in collaboration and engage in sharing the diagnosis with the patient. It is hoped that this paper will stimulate and encourage further debate and study regarding the individual with dementia and diagnosis disclosure. Recommendations for practice, education, policy and research will also be highlighted.

Coining and defining novel nursing terminology. Part 2: critical incident nursing intervention.

PubMed

Wong, Elizabeth

2008-01-01

In the second of a three-part series, a novel nursing terminology is introduced and proposed for inclusion in the Nursing Interventions Classification (NIC): Critical incident nursing intervention (CINI), defined as any indirect or direct care registered nurse-initiated treatment, based upon clinical judgment and knowledge that a registered nurse performs in response to a critical incident nursing diagnosis (CIND). A CIND is defined as recognition of an acute life-threatening event that occurs as a result of disease, surgery, treatment, or medication. The literature, research studies, meta-analyses from a variety of disciplines, and personal clinical experience serve as the data sources for this article. The current nursing interventions in the NIC are inaccurate or inadequate for describing nursing care during life-threatening situations. The lack of standardized nursing terminology creates a barrier that may impede critical communication and patient care during life-threatening situations. Coining and defining novel nursing terminology, CINI, for patient care during life-threatening situations is important and fills the gap in the current standardized nursing terminology. Refining the NIC will permit nursing researchers, among others, to conduct studies on nursing interventions in conjunction with the proposed novel nursing terminology, CINI. The first article in this series (Part 1) introduced the novel nursing terminology: CIND; the present article (Part 2) introduces the novel nursing terminology: CINI; and the third article in this series (Part 3) will introduce the novel nursing terminology: critical incident control.

The Opinions of Nursing Students Regarding the Nursing Process and Their Levels of Proficiency in Turkey.

PubMed

Taskın Yilmaz, Feride; Sabanciogullari, Selma; Aldemir, Kadriye

2015-12-01

Nursing process, as a scientific method of nursing practice, is an important tool for putting nursing knowledge into practice which increases the quality of nursing care. The study was aimed to determine the opinions of nursing students regarding the nursing process and their levels of proficiency. A total of 44 nursing students participated in this descriptive study. Data were collected by a three-part questionnaire including the opinion of students on nursing process, Gordon's functional health patterns model and the NANDA diagnoses. Data were analyzed by SPSS software. Most of the students (65.9%) believed that the nursing process was necessary. half of the students explained the diagnosis, 58.3% explained the planning, 41.3% explained the implementation, and 43.6% explained the evaluation sufficiently. It is suggested for instructors to use different teaching methods in order to develop critical thinking while teaching the nursing process.

Risk for Complicated Immigration Transition: New Diagnosis for NANDA-International.

PubMed

Rifà-Ros, Rosa; Espinosa Fresnedo, Carme; Alcázar París, Mireia; Raigal Aran, Laia; Ferré Grau, Carme

2018-02-27

The objective of this article is to describe the developmental processes for the creation of the new diagnosis risk for complicated immigration transition for the NANDA-I. The study followed the recommended steps of developmental processes for NANDA-I. The identification of risk factors,which cause those who have migrated to feel vulnerable, is the result of two different research studies aimed at identifying nursing diagnosis related to the immigration process. A proposal of label, definition and risk factors of risk for complicated immigration transition. This new nursing diagnosis will reinforce the strategies for nursing interventions directed to empower immigrant people to acquire and/or develop the resources needed to cope with the immigration process. © 2018 NANDA International, Inc.

Nurses' understanding influences comprehension of patients admitted in the observation unit.

PubMed

Desme, Aline; Mendes, Nathalie; Perruche, Franck; Veillard, Elsa; Elie, Caroline; Moulinet, Françoise; Sanson, Fabienne; Georget, Jean-Michel; Tissier, Anne; Pourriat, Jean-Louis; Claessens, Yann-Erick

2013-01-01

Comprehension is poor in patients admitted in the emergency observation unit. Teamwork communication gaps could contribute to patients' misunderstanding of their health condition. To determine in patients admitted in the emergency observation unit whether comprehension of diagnosis, prognosis, and management depended on nurses' comprehension, the authors conducted a prospective observational study in a busy adult emergency department of a tertiary teaching hospital in Paris over 2 months. Consecutive patients admitted in the emergency observation unit were included. Patients' and nurses' comprehension of diagnosis, prognosis, and management was compared with the statements of the emergency department attending physicians for these items. The authors observed whether patients' misunderstanding was associated with nurses' misunderstanding. A total of 544 patients were evaluated. For each patient, nurses' and patients' comprehension was available. Patients understood severity in 40%, organ involved in 69%, medical wording in 57%, reason for admission in 48%, and discharge instruction in 67%. In comparison with patients, nurses better understood each item except for discharge instruction. The authors observed that patients' comprehension was better when nurses understood diagnosis (p <.0001), reasons for admission (p =.032) and discharge instructions (p =.002). Nurses' understanding of severity did not modify patients' comprehension. These results support the conclusions that communication gaps in teamwork alter patients' comprehension and that nurses' and patients' misunderstandings are associated. Therefore, improving communication by nurses and physicians to patients may improve patients' understanding.

Nursing as concrete philosophy, Part I: Risjord on nursing knowledge.

PubMed

Theodoridis, Kyriakos

2018-04-01

This essay addresses the problem of the essentiality of nursing knowledge and what kind of theory, if any, is essential to nursing practice. The overarching aim of the essay was to argue for the thesis that nursing may be described as a kind of philosophical activity, and, consequently, that philosophy is the kind of "theory" that is essential to nursing practice and to the nursing discipline at large. The essay consists of two papers. The present paper, Part I, is a critical examination of Mark Risjord's discussion of the problem of the theory-practice gap in his Nursing Knowledge: Practice, Science, Philosophy, from 2010. According to Risjord, the cause of the theory-practice gap originates in an erroneous conception of science (logical positivism) which had a decisive influence upon the way nursing scholars appropriated theoretical frameworks for the nursing discipline. This philosophical influence is considered in effect to have generated the theory-practice gap. In order to bridge the gap, Risjord suggests, the nursing discipline needs to adopt a standpoint epistemology conjoined with a postpositivist conception of scientific theory. In this way, a legitimate brand of nursing science may be developed and the theory-practice gap overcome. I will argue that neither Risjord's diagnosis of the problem, nor his recommended cure, may succeed in rescuing the nursing discipline from the theory-practice gap. Rather, the real cause of the theory-practice gap, I will claim, derives from an erroneous conception of nursing (not of science), namely the conception of nursing as a kind of science (roughly speaking). On my view, to overcome the gap, the nursing discipline needs to make salient the inherently philosophical character of nursing. In the second paper (Part II), I will continue the discussion of nursing knowledge and delineate the thesis of nursing as a kind of concrete philosophy. © 2017 John Wiley & Sons Ltd.

The Opinions of Nursing Students Regarding the Nursing Process and Their Levels of Proficiency in Turkey

PubMed Central

Taskın Yilmaz, Feride; Sabanciogullari, Selma; Aldemir, Kadriye

2015-01-01

Introduction: Nursing process, as a scientific method of nursing practice, is an important tool for putting nursing knowledge into practice which increases the quality of nursing care. The study was aimed to determine the opinions of nursing students regarding the nursing process and their levels of proficiency. Methods: A total of 44 nursing students participated in this descriptive study. Data were collected by a three-part questionnaire including the opinion of students on nursing process, Gordon’s functional health patterns model and the NANDA diagnoses. Data were analyzed by SPSS software. Results: Most of the students (65.9%) believed that the nursing process was necessary. half of the students explained the diagnosis, 58.3% explained the planning, 41.3% explained the implementation, and 43.6% explained the evaluation sufficiently. Conclusion: It is suggested for instructors to use different teaching methods in order to develop critical thinking while teaching the nursing process. PMID:26744726

Nursing Assessment Tool for People With Liver Cirrhosis

PubMed Central

Reis, Renata Karina; da Silva, Patrícia Costa dos Santos; Silva, Ana Elisa Bauer de Camargo; Atila, Elisabeth

2016-01-01

The aim of this study was to describe the process of developing a nursing assessment tool for hospitalized adult patients with liver cirrhosis. A descriptive study was carried out in three stages. First, we conducted a literature review to develop a data collection tool on the basis of the Conceptual Model of Wanda Horta. Second, the data collection tool was assessed through an expert panel. Third, we conducted the pilot testing in hospitalized patients. Most of the comments offered by the panel members were accepted to improve the tool. The final version was in the form of a questionnaire with open-closed questions. The panel members concluded that the tool was useful for accurate nursing diagnosis. Horta's Conceptual Model assisted with the development of this data collection tool to help nurses identify accurate nursing diagnosis in hospitalized patients with liver cirrhosis. We hope that the tool can be used by all nurses in clinical practice. PMID:26425862

Effects of nursing process-based simulation for maternal child emergency nursing care on knowledge, attitude, and skills in clinical nurses.

PubMed

Kim, Sunghee; Shin, Gisoo

2016-02-01

Since previous studies on simulation-based education have been focused on fundamental nursing skills for nursing students in South Korea, there is little research available that focuses on clinical nurses in simulation-based training. Further, there is a paucity of research literature related to the integration of the nursing process into simulation training particularly in the emergency nursing care of high-risk maternal and neonatal patients. The purpose of this study was to identify the effects of nursing process-based simulation on knowledge, attitudes, and skills for maternal and child emergency nursing care in clinical nurses in South Korea. Data were collected from 49 nurses, 25 in the experimental group and 24 in the control group, from August 13 to 14, 2013. This study was an equivalent control group pre- and post-test experimental design to compare the differences in knowledge, attitudes, and skills for maternal and child emergency nursing care between the experimental group and the control group. The experimental group was trained by the nursing process-based simulation training program, while the control group received traditional methods of training for maternal and child emergency nursing care. The experimental group was more likely to improve knowledge, attitudes, and skills required for clinical judgment about maternal and child emergency nursing care than the control group. Among five stages of nursing process in simulation, the experimental group was more likely to improve clinical skills required for nursing diagnosis and nursing evaluation than the control group. These results will provide valuable information on developing nursing process-based simulation training to improve clinical competency in nurses. Further research should be conducted to verify the effectiveness of nursing process-based simulation with more diverse nurse groups on more diverse subjects in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

Accuracy of nursing diagnoses for identifying domestic violence against children.

PubMed

Apostólico, Maíra Rosa; Egry, Emiko Yoshikawa; Fornari, Lucimara Fabiana; Gessner, Rafaela

2017-01-01

Objective Identify nursing diagnoses involving a hypothetical situation of domestic violence against a child and the respective degrees of accuracy. Method An exploratory, evaluative, case study was conducted using a quantitative and qualitative approach, with data collected using an online instrument from 26 nurses working in the Municipal Health Network, between June and August 2010, in Curitiba, and also during the first half of 2014 in São Paulo. Both of these cities are in Brazil. Nursing diagnoses and interventions from the International Classification of Nursing Practices in Collective Health were provided, and accuracy was verified using the Nursing Diagnosis Accuracy Scale. Results Thirty-nine nursing diagnoses were identified, 27 of which were common to both cities. Of these, 15 were scored at the null level of accuracy, 11 at high accuracy and 1 at medium accuracy. Conclusion The difficulty the nurses had in defining diagnoses may be associated with the fact that nursing care generally focuses on clinical problems, and signs expressing situations of domestic violence against children go unnoticed. The results demonstrated the difficulty of participants in selecting the appropriate nursing diagnosis for the case in question.

[Breastfeeding: nurses' practice under the perspective of the International Classification of Collective Health Nursing Practices].

PubMed

Chaves, Maria Marta Nolasco; de Senna Ávila Farias, Fabiana Costa; Apostólico, Maíra Rosa; Cubas, Marcia Regina; Egry, Emiko Yoshikawa

2011-03-01

This descriptive and exploratory study aimed to describe nursing diagnoses and interventions under the International Nursing Practice Classification in Collective Health--CIPESC®--in Women's Health Care, sub-theme Pre-Natal and Puerperium, correlating them to nurses' competences at Curitiba's Mother Program. Data used were diagnoses and interventions during nursing consultation from April to July/ 2005. Basic Statistics was used for data treatment. Proper Breastfeeding was the most frequent diagnosis and most interventions are related to strengthening the user to face the health-disease process (68.9%). In spite of nurses' practice during puerperium, such a competence is not part of the Program Protocol. In conclusion, minor adjustments are necessary in the analyzed diagnoses and the Protocol should be reviewed to entail nurses' competences that are developed in their practice in health services according to CIPESC' s registers.

Nursing phenomena in inpatient psychiatry.

PubMed

Frauenfelder, F; Müller-Staub, M; Needham, I; Van Achterberg, T

2011-04-01

Little is known about the question if the nursing diagnosis classification of North American Nursing Association-International (NANDA-I) describes the adult inpatient psychiatric nursing care. The present study aimed to identify nursing phenomena mentioned in journal articles about the psychiatric inpatient nursing care and to compare these phenomena with the labels and the definitions of the nursing diagnoses to elucidate how well this classification covers these phenomena. A search of journal articles took place in the databases MedLine, PsychInfo, Cochrane and CINAHL. A qualitative content analysis approach was used to identify nursing phenomena in the articles. Various phenomena were found in the articles. The study demonstrated that NANDA-I describes essential phenomena for the adult inpatient psychiatry on the level of labels and definitions. However, some apparently important nursing phenomena are not covered by the labels or definitions of NANDA-I. Other phenomena are assigned as defining characteristics or as related factors to construct nursing diagnoses. The further development of the classification NANDA-I will strengthen the application in the daily work of psychiatric nurses and enhance the quality of nursing care in the inpatient setting. © 2010 Blackwell Publishing.

Development and evaluation of evidence-based nursing (EBN) filters and related databases*

PubMed Central

Lavin, Mary A.; Krieger, Mary M.; Meyer, Geralyn A.; Spasser, Mark A.; Cvitan, Tome; Reese, Cordie G.; Carlson, Judith H.; Perry, Anne G.; McNary, Patricia

2005-01-01

Objectives: Difficulties encountered in the retrieval of evidence-based nursing (EBN) literature and recognition of terminology, research focus, and design differences between evidence-based medicine and nursing led to the realization that nursing needs its own filter strategies for evidence-based practice. This article describes the development and evaluation of filters that facilitate evidence-based nursing searches. Methods: An inductive, multistep methodology was employed. A sleep search strategy was developed for uniform application to all filters for filter development and evaluation purposes. An EBN matrix was next developed as a framework to illustrate conceptually the placement of nursing-sensitive filters along two axes: horizontally, an adapted nursing process, and vertically, levels of evidence. Nursing diagnosis, patient outcomes, and primary data filters were developed recursively. Through an interface with the PubMed search engine, the EBN matrix filters were inserted into a database that executes filter searches, retrieves citations, and stores and updates retrieved citations sets hourly. For evaluation purposes, the filters were subjected to sensitivity and specificity analyses and retrieval set comparisons. Once the evaluation was complete, hyperlinks providing access to any one or a combination of completed filters to the EBN matrix were created. Subject searches on any topic may be applied to the filters, which interface with PubMed. Results: Sensitivity and specificity for the combined nursing diagnosis and primary data filter were 64% and 99%, respectively; for the patient outcomes filter, the results were 75% and 71%, respectively. Comparisons were made between the EBN matrix filters (nursing diagnosis and primary data) and PubMed's Clinical Queries (diagnosis and sensitivity) filters. Additional comparisons examined publication types and indexing differences. Review articles accounted for the majority of the publication type differences

Assessment, Diagnosis, and Treatment of Binge Eating Disorder.

PubMed

Ambrogne, Janet A

2017-08-01

Binge eating disorder (BED) is the most prevalent eating disorder in the United States, believed to affect an estimated 2.8 million adults. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, BED was recognized as a separate diagnosis. The purpose of the current article is to provide an overview of BED including assessment, diagnosis, and current pharmacological and nonpharmacological treatment options. Implications for nursing are also addressed. [Journal of Psychosocial Nursing and Mental Health Services, 55(8), 32-38.]. Copyright 2017, SLACK Incorporated.

Mapping the Diagnosis Axis of an Interface Terminology to the NANDA International Taxonomy

PubMed Central

Juvé Udina, Maria-Eulàlia; Gonzalez Samartino, Maribel; Matud Calvo, Cristina

2012-01-01

Background. Nursing terminologies are designed to support nursing practice but, as with any other clinical tool, they should be evaluated. Cross-mapping is a formal method for examining the validity of the existing controlled vocabularies. Objectives. The study aims to assess the inclusiveness and expressiveness of the nursing diagnosis axis of a newly implemented interface terminology by cross-mapping with the NANDA-I taxonomy. Design/Methods. The study applied a descriptive design, using a cross-sectional, bidirectional mapping strategy. The sample included 728 concepts from both vocabularies. Concept cross-mapping was carried out to identify one-to-one, negative, and hierarchical connections. The analysis was conducted using descriptive statistics. Results. Agreement of the raters' mapping achieved 97%. More than 60% of the nursing diagnosis concepts in the NANDA-I taxonomy were mapped to concepts in the diagnosis axis of the new interface terminology; 71.1% were reversely mapped. Conclusions. Main results for outcome measures suggest that the diagnosis axis of this interface terminology meets the validity criterion of cross-mapping when mapped from and to the NANDA-I taxonomy. PMID:22830046

Mapping the Diagnosis Axis of an Interface Terminology to the NANDA International Taxonomy.

PubMed

Juvé Udina, Maria-Eulàlia; Gonzalez Samartino, Maribel; Matud Calvo, Cristina

2012-01-01

Background. Nursing terminologies are designed to support nursing practice but, as with any other clinical tool, they should be evaluated. Cross-mapping is a formal method for examining the validity of the existing controlled vocabularies. Objectives. The study aims to assess the inclusiveness and expressiveness of the nursing diagnosis axis of a newly implemented interface terminology by cross-mapping with the NANDA-I taxonomy. Design/Methods. The study applied a descriptive design, using a cross-sectional, bidirectional mapping strategy. The sample included 728 concepts from both vocabularies. Concept cross-mapping was carried out to identify one-to-one, negative, and hierarchical connections. The analysis was conducted using descriptive statistics. Results. Agreement of the raters' mapping achieved 97%. More than 60% of the nursing diagnosis concepts in the NANDA-I taxonomy were mapped to concepts in the diagnosis axis of the new interface terminology; 71.1% were reversely mapped. Conclusions. Main results for outcome measures suggest that the diagnosis axis of this interface terminology meets the validity criterion of cross-mapping when mapped from and to the NANDA-I taxonomy.

Inflammatory Bowel Disease: School Nurse Management

ERIC Educational Resources Information Center

Kitto, Lisa

2010-01-01

Initial symptoms and diagnosis of inflammatory bowel disease (IBD) usually occur between 10 and 20 years of age, although younger cases are reported. The complicated nature of IBD diagnosis and treatment can interfere with physical and emotional development that normally occurs in school-age children and adolescents. The school nurse should be…

Consensus-validation study identifies relevant nursing diagnoses, nursing interventions, and health outcomes for people with traumatic brain injuries.

PubMed

Lunney, Margaret; McGuire, Maria; Endozo, Nancy; McIntosh-Waddy, Dorothy

2010-01-01

A consensus-validation study used action research methods to identify relevant nursing diagnoses, nursing interventions, and patient outcomes for a population of adults with traumatic brain injury (TBI) in long-term care. In meetings totaling 159 hours to reach 100% consensus through group discussions, the three classifications of NANDA International's (NANDA-I's) approved nursing diagnoses, the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) were used as the basis for three nurses experienced in working with adults with TBI to select the elements of nursing care. Among almost 200 NANDA-I nursing diagnoses, 29 were identified as relevant for comprehensive nursing care of this population. Each nursing diagnosis was associated with 3-11 of the more than 500 NIC interventions and 1-13 of more than 300 NOC outcomes. The nurses became aware of the complexity and the need for critical thinking. The findings were used to refine the facility's nursing standards of care, which were to be combined with the interdisciplinary plan of care and included in future electronic health records.

Implementation of Free Text Format Nursing Diagnoses at a University Hospital's Medical Department. Exploring Nurses' and Nursing Students' Experiences on Use and Usefulness. A Qualitative Study

PubMed Central

Frigstad, Sigrun Aasen; Nøst, Torunn Hatlen; André, Beate

2015-01-01

Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses' and nursing students' experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses' use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis' appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process. PMID:26075091

Predictive factors for the Nursing Diagnoses in people living with Acquired Immune Deficiency Syndrome 1

PubMed Central

da Silva, Richardson Augusto Rosendo; Costa, Romanniny Hévillyn Silva; Nelson, Ana Raquel Cortês; Duarte, Fernando Hiago da Silva; Prado, Nanete Caroline da Costa; Rodrigues, Eduardo Henrique Fagundes

2016-01-01

Abstract Objective: to identify the predictive factors for the nursing diagnoses in people living with Acquired Immune Deficiency Syndrome. Method: a cross-sectional study, undertaken with 113 people living with AIDS. The data were collected using an interview script and physical examination. Logistic regression was used for the data analysis, considering a level of significance of 10%. Results: the predictive factors identified were: for the nursing diagnosis of knowledge deficit-inadequate following of instructions and verbalization of the problem; for the nursing diagnosis of failure to adhere - years of study, behavior indicative of failure to adhere, participation in the treatment and forgetfulness; for the nursing diagnosis of sexual dysfunction - family income, reduced frequency of sexual practice, perceived deficit in sexual desire, perceived limitations imposed by the disease and altered body function. Conclusion: the predictive factors for these nursing diagnoses involved sociodemographic and clinical characteristics, defining characteristics, and related factors, which must be taken into consideration during the assistance provided by the nurse. PMID:27384466

Nursing Diagnoses in Inpatient Psychiatry.

PubMed

Frauenfelder, Fritz; van Achterberg, Theo; Needham, Ian; Müller Staub, Maria

2016-01-01

This study explored how well NANDA-I covers the reality of adult inpatient psychiatric nursing care. Patient observations documented by registered nurses in records were analyzed using content analysis and mapped with the classification NANDA-I. A total of 1,818 notes were examined and contained 46 different patient responses. Twenty-nine patient responses were recognizable as NANDA-I diagnoses at the level of definitions, 15 as diagnoses-related factors, and 12 did not match with any NANDA-I diagnosis. This study demonstrates that NANDA-I describes the adult inpatient psychiatric nursing care to a large extent. Nevertheless, further development of the classification is important. The results of this study will spur nursing research and further classification development. © 2014 NANDA International, Inc.

A nursing diagnosis approach to the patient awaiting cardiac transplantation.

PubMed

Cardin, S; Clark, S

1985-09-01

The most common reason to perform cardiac transplantation is dilated cardiomyopathy. Alterations in cardiac output secondary to decreased contractility and increased preload and afterload will, over time, lead to progressive deterioration of the patient with this type of end-stage cardiac disease. Heart transplantation is now an accepted therapy for these patients. This article focused on the patient in the period awaiting cardiac transplantation. Five pertinent nursing diagnoses were identified and discussed. A case study approach was utilized to highlight patient problems and nursing interventions.

A Delphi study to identify the core components of nurse to nurse handoff.

PubMed

O'Rourke, Jennifer; Abraham, Joanna; Riesenberg, Lee Ann; Matson, Jeff; Lopez, Karen Dunn

2018-03-08

The aim of this study was to identify the core components of nurse-nurse handoffs. Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified. This lack of identification is a significant gap in moving towards a standardized approach for nurse-nurse handoff. Mixed methods design using the Delphi technique. From May 2016 - October 2016, using a series of iterative steps, a panel of handoff experts gave feedback on the nurse-nurse handoff core components and the content in each component to be passed from one nurse to the next during a typical unit-based shift handoff. Consensus was defined as 80% agreement or higher. After three rounds of participant review, 17 handoff experts with backgrounds in clinical nursing practice, academia and handoff research came to consensus on the core components of handoff: patient summary, action plan and nurse-nurse synthesis. This is the first study to identify the core components of nurse-nurse handoff. Subsequent testing of the core components will involve evaluating the handoff approach in a simulated and then actual patient care environment. Our long-term goal is to improve patient safety outcomes by validating an evidence-based handoff framework and handoff curriculum for pre-licensure nursing programmes that strengthen the quality of their handoff communication as they enter clinical practice. © 2018 John Wiley & Sons Ltd.

The developmental processes for NANDA International Nursing Diagnoses.

PubMed

Scroggins, Leann M

2008-01-01

This study aims to provide a step-by-step procedural guideline for the development of a nursing diagnosis that meets the necessary criteria for inclusion in the NANDA International and NNN classification systems. The guideline is based on the processes developed by the Diagnosis Development Committee of NANDA International and includes the necessary processes for development of Actual, Wellness, Health Promotion, and Risk nursing diagnoses. Definitions of Actual, Wellness, Health Promotion, and Risk nursing diagnoses along with inclusion criteria and taxonomy rules have been incorporated into the guideline to streamline the development and review processes for submitted diagnoses. A step-by-step procedural guideline will assist the submitter to move efficiently and effectively through the submission process, resulting in increased submissions and enhancement of the NANDA International and NNN classification systems.

Surgical Oncology Nursing: Looking Back, Looking Forward.

PubMed

Crane, Patrick C; Selanders, Louise

2017-02-01

To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

Influence of nutritional status in the diagnosis of sarcopenia in nursing home residents.

PubMed

Lardiés-Sánchez, Beatriz; Sanz-París, Alejandro; Pérez-Nogueras, Javier; Serrano-Oliver, Antonio; Torres-Anoro, María E; Cruz-Jentoft, Alfonso J

2017-09-01

Malnutrition and sarcopenia frequently coexist in elderly patients. The aim of this study was to assess the effect of nutritional status in the diagnosis of sarcopenia in nursing home residents. A cross-sectional study was performed with data collected from 339 elderly patients living in five nursing homes. Sarcopenia was defined according to the consensus definition of the European Working Group on Sarcopenia in Older People. Body mass composition was assessed using bioimpedance analysis, handgrip strength using a dynamometer, and physical performance by 5-m gait speed test. The nutritional status of residents was assessed using the Mini Nutritional Assessment (MNA). Of 436 patients, 339 (77.8%) were included. The mean age of participants was 84.9 y and 64.3% were women. More than one-third (38.1%) of the population had sarcopenia, with a higher prevalence in women (39.4%). According to the MNA, 32.4% of participants were at risk for malnutrition and 42.5% were malnourished. When analyzed together, the presence of malnutrition plus malnutrition risk, there was no difference between individuals with or without sarcopenia. However, the presence of malnutrition was statistically higher in individuals with sarcopenia compared with those without it. The prevalence of malnutrition was highest in individuals with low handgrip strength (62.8%), and in participants with severe sarcopenia. There were no significant differences in calf circumference between sarcopenic and nonsarcopenic participants. In the multivariate logistic regression analysis, body mass index <22 kg/m 2 and age >80 y remained predictive of sarcopenia status after adjustment. Prevalence of sarcopenia and malnutrition were significant in this population, especially in women. Approximately two-thirds of sarcopenic individuals were malnourished. A low body mass index may be a better predictor of sarcopenia in this population than a small calf circumference (<1 cm). Copyright © 2017 Elsevier Inc. All

Guide for Instructors of Practical Nursing in South Carolina, Phase 2.

ERIC Educational Resources Information Center

Clemson Univ., SC. Vocational Education Media Center.

The South Carolina Department of Education has printed an instruction manual for teacher use in schools of nursing. The guide covers the areas of medical surgical nursing, diagnosis of disease, dealing with the surgical patient, care of the aged, rehabilitation and chronic illness, nursing the cancer patient, gynecological disorders, respiratory…

Enhancement on infectious diseases nursing plan information system.

PubMed

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

2009-01-01

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

An investigation into the description of patients' problems by nurses using two different needs-based nursing models.

PubMed

Griffiths, P

1998-11-01

This paper describes an investigation into how nurses describe patients' problems and the possible effects of an espoused nursing model on these descriptions. A descriptive study was conducted on two medical wards in a Welsh District General Hospital. Data collected were subjected to content analysis using Gordon's Functional Health Patterns to order the data. The two wards investigated, whilst being very similar in many ways, utilized different nursing models. Findings showed that the nurses studied, when describing patients' problems, most commonly used medical diagnoses or the medical reasons for admission. Patients' problems identified predominately addressed bio-physical needs with scant attention given to psycho-social needs. Despite the use of two different nursing models the language and emphasis of problem description were very similar and there was no evidence of the application of the conceptual underpinnings of the two models. It is suggested that although the use of a ready-made nursing language may have drawbacks, the British nurse should understand and assess the value of the North American Nursing Diagnosis Association's (NANDA) nursing diagnoses. Without such involvement this system may be implemented in the United Kingdom (UK) without the input and influence of practising nurses.

Depression in nursing homes: prevalence, recognition, and treatment.

PubMed

Kramer, Dietmar; Allgaier, Antje-Kathrin; Fejtkova, Sabina; Mergl, Roland; Hegerl, Ulrich

2009-01-01

Depression is very common in people above 65 years living in long-term care. However, little is known about how well depression is recognized and how adequately it is treated. Therefore, the present study aimed at assessing accuracy of the unaided clinical diagnosis of the attending physicians, and the medical treatment situation in nursing home residents. A random sample of 97 residents of 10 nursing homes in Munich was examined with the Section A "Affective Syndrome" of the Structured Clinical Interview (SCID) for DSM-IV to detect depression. Information concerning clinical diagnosis and medication was obtained from the subjects' medical records. 14.4% suffered acutely from major depression, 14.4% suffered from minor depression, and 18.6% were diagnosed as depressive according to the physician and nursing records. In total, 27.8% received antidepressants. Merely 42.9% of the subjects with acute major depression were diagnosed by their attending physicians as depressive, and only half of them received an antidepressant; 17.5% received antidepressants without a diagnosis of depression in their physician and nursing records. In accordance with the guidelines, 73.3% of the antidepressants prescribed were SSRIs or newer antidepressants. Only 20.0% were tricyclic antidepressants. Findings show that depression is relatively frequent in residents of nursing homes. Moreover, it is insufficiently recognized by physicians and is even more seldom adequately treated. Also, a significant proportion of residents receive antidepressants without a documented associated indication. Therefore, the recognition and guideline-based treatment of depression should be improved in this high-risk group.

[Utilization of nursing diagnosis according to Nanda's classification for the systematization of nursing care in breast feeding].

PubMed

Abrão, A C; de Gutiérrez, M R; Marin, H F

1997-04-01

The present study aimed at describing the reformulated instrument used in the puerperal woman nursing consultation based on the identified diagnoses classification according to the Taxonomy-I reviewed by NANDA, and the identification of the most frequent nursing diagnoses concerning maternal breastfeeding, based on the reformulated instrument. The diagnoses found as being over 50% were: knowledge deficit (100%); sleep pattern disturbance (75%), altered sexuality patterns (75%), ineffective breastfeeding (66.6%) and impaired physical mobility (66.6%).

Terms used by nurses to describe patient problems: can SNOMED III represent nursing concepts in the patient record?

PubMed Central

Henry, S B; Holzemer, W L; Reilly, C A; Campbell, K E

1994-01-01

OBJECTIVE: To analyze the terms used by nurses in a variety of data sources and to test the feasibility of using SNOMED III to represent nursing terms. DESIGN: Prospective research design with manual matching of terms to the SNOMED III vocabulary. MEASUREMENTS: The terms used by nurses to describe patient problems during 485 episodes of care for 201 patients hospitalized for Pneumocystis carinii pneumonia were identified. Problems from four data sources (nurse interview, intershift report, nursing care plan, and nurse progress note/flowsheet) were classified based on the substantive area of the problem and on the terminology used to describe the problem. A test subset of the 25 most frequently used terms from the two written data sources (nursing care plan and nurse progress note/flowsheet) were manually matched to SNOMED III terms to test the feasibility of using that existing vocabulary to represent nursing terms. RESULTS: Nurses most frequently described patient problems as signs/symptoms in the verbal nurse interview and intershift report. In the written data sources, problems were recorded as North American Nursing Diagnosis Association (NANDA) terms and signs/symptoms with similar frequencies. Of the nursing terms in the test subset, 69% were represented using one or more SNOMED III terms. PMID:7719788

[Nursing diagnoses and most common collaboration problems in high-risk pregnancy].

PubMed

Gouveia, Helga Geremias; Lopes, Maria Helena Baena de Moraes

2004-01-01

This study identified the demographic profile, obstetric and clinical diagnoses, nursing diagnosis and most common collaboration problem among pregnant women subject to high-risk at a hospital in São Paulo, Brazil. Data were collected by means of a form based on Gordon's Functional Health Patterns. Nursing diagnoses were determined on the basis of the NANDA (North American Nursing Diagnosis Association) taxonomy. The nursing diagnoses found in 50% or more of the pregnant women were: risk for infection (90.1%), altered health maintenance (84.5%), altered comfort (80.3%), risk of ineffective breastfeeding (59.2%), altered sexuality patterns (52.1%), fear (52.1%) and pain (50.7%). The collaboration problem found in 50% or more of the cases was: potential complication: preterm labor (62.0%), potential complication: maternal tachycardia (54,9%) and potential complication: hypotension (54,9%). Thus, these results will allow us to guide the nursing care rendered to these pregnant women.

A nursing data base for initial patient assessment.

PubMed

Hartman, D; Knudson, J

1991-01-01

The introduction of nursing diagnoses at Saddleback Memorial Medical Center, Laguna Hills, CA, resulted in the nursing process becoming the basis for the documentation system. However, the medical model or body system remained the organizational structure for nursing data collection and narrative charting. The need for a model that would aid in identification and treatment of illness and not negatively affect the nursing process was the impetus behind the selection of Gordon's functional health patterns as the assessment format. These patterns provide a standard method for data collection and a holistic approach to assessment and diagnosis.

Testing telehealth using technology-enhanced nurse monitoring.

PubMed

Grant, Leslie A; Rockwood, Todd; Stennes, Leif

2014-10-01

Technology-enhanced nurse monitoring is a telehealth solution that helps nurses with assessment, diagnosis, and triage of older adults living in community-based settings. This technology links biometric and nonbiometric sensors to a data management system that is monitored remotely by RNs and unlicensed support staff. Nurses faced a number of challenges related to data interpretation, including making clinical inferences from nonbiometric data, integrating data generated by three different telehealth applications into a clinically meaningful cognitive framework, and figuring out how best to use nursing judgment to make valid inferences from online reporting systems. Nurses developed expertise over the course of the current study. The sponsoring organization achieved a high degree of organizational knowledge about how to use these systems more effectively. Nurses saw tremendous value in the telehealth applications. The challenges, learning curve, and organizational improvements are described. Copyright 2014, SLACK Incorporated.

"Does one size fit all?" Exploring the cultural applicability of NANDA nursing diagnoses to Chinese nursing practice.

PubMed

Lai, Wei-Shu; Chao, Co-Shi Chantal; Yang, Wan-Ping; Liu, Hsiao-Ching; Chen, Ching-Huey

2013-01-01

East Asia has historically unique concepts of health and well-being and thus is an appropriate setting for exploring the multicultural applicability of the North American Nursing Diagnosis Association's Nursing Diagnoses (NANDA ND) system. This study aimed to explore how NANDA ND affect the growth and quality of professional nursing from the perspective of Taiwanese nurses. Grounded theory was employed in this interview-based investigation of 53 Taiwan-licensed nursing professionals at various hospitals in Taiwan. Data were analyzed using constant comparative analysis until theoretical saturation was reached. The core concept, Struggling with (the NANDA ND notion that) One Size Fits All, emerged after ongoing analysis of the effects of NANDA ND on good nursing, patient welfare, and professional development. The preliminary theoretical framework developed from this study provides evidence that NANDA ND may be incompatible with the cultural beliefs of the traditional Chinese health care setting in Taiwan, which emphasize holistic harmony and balance.

[Nurses' Attitudes toward the “Advanced Nursing Process” before and after an educational intervention – a quasi-experimental study].

PubMed

Leoni-Scheiber, Claudia; Gothe, Raffaella Matteucci; Müller-Staub, Maria

2016-02-01

The attitude of nurses influences their application of the Advanced Nursing Process. Studies reveal deficits in the application of the Advanced Nursing Process that is based on valid assessments and nursing classifications. These deficits affect decision-making and – as a result – nursing care quality. In German speaking countries nurses' attitudes towards nursing diagnoses as part of the Advanced Nursing Process were not yet measured. The aim of this study was to evaluate the effects of an educational intervention on nurses' attitude. A quasi-experimental intervention study was carried out in Austria and Germany. Before and after a standardised educational intervention 51 nurses estimated their attitude with the instrument Positions on Nursing Diagnosis (PND). Analyses were performed by Wilcoxon- and U-tests. Before the educational intervention the average attitude score of the Austrian nurses was more positive than in the German group. After the study intervention both groups regarded nursing diagnostics statistically significant more convincing and better understandable. However, both groups still described the application of the Advanced Nursing Process as difficult and demanding to perform. In the future, more attention should be given to the reflexion and development of nurses' attitude towards the Advanced Nursing Process because attitudes lead nurses' actions. In further studies influencing organizational and structural factors in diverse settings will be analysed.

[Therapeutic nursing: a systematic review].

PubMed

Lautenschläger, S; Müller, C; Immenschuh, U; Muser, J; Behrens, J

2014-08-01

For some years therapeutic service catalogues have been established in medical rehabilitation which have broadened our previous understanding of nursing actions. Currently, therapeutic nursing plays a prominent role in neurological early rehabilitation because the operations and procedures coding system (OPS) 8-552 within the DRG-System (Diagnosis Related Groups) states that therapeutic nursing must be carried out by specially trained nursing personnel. This requirement leads to inconsistencies in nursing practice and the medical service of the health insurance (MDK) since a definition of therapeutic nursing is lacking. A previous review of therapeutic nursing in 2003 focused primarily on the development of the therapeutic nursing role, but not on therapeutic nursing itself. The following article contains the first systematic review of the current state of research regarding a definition of therapeutic nursing. For this purpose, a systematic study was conducted to examine if there are, nationally or internationally, any definitions of therapeutic nursing and to identify what the therapeutic aspects of nursing are. The research included following database; Medline, Cinahl and Embase. Additionally, a research by hand of several German journals as well as textbooks and specialized literature was carried out. 5 studies were selected which define the term "therapeutic nursing". Among these are one review, one primary study, one theoretical discussion and one dissertation. Further twenty four studies were identified which do not define the term, but are closely related to the subject, and use or characterize the term in various contexts. The publications examined provided indications of duties, interventions and roles nurses should perform, but not how to carry these out, nor what is therapeutic about the nursing. At the same time, the low number of studies reveals that therapeutic nursing has barely been examined and demonstrates the lack of theoretically grounding

Prevalence of intimate partner abuse among nurses and nurses' aides in Mexico.

PubMed

Díaz-Olavarrieta, C; Paz, F; de la Cadena, C G; Campbell, J

2001-01-01

Nurses are the health professionals most frequently involved in the diagnosis and treatment of victims of family violence (FV). Understanding their personal experience with victimization is the key to shaping an appropriate role as advocates for medical recognition of FV and as integral members of the screening teams. We sought to determine the lifetime prevalence of intimate partner abuse among them and identify its risk factors. In our cross-sectional study, 1,150 registered nurses and nurses' aides at 11 urban hospitals in Mexico City self-administered an anonymous survey. We calculated descriptive statistics, Fisher exact tests, and multivariate logistic regression models to analyze physical, sexual, and emotional abuse during adulthood. Physical/sexual abuse during adulthood was 13% for nurses' aides and 18% for nurses. Similar proportions (13% of nurses' aides and 14% of nurses) also reported childhood physical/sexual abuse. Additional respondents (39% nurses' aides, 42% nurses) reported emotional abuse during adulthood. Detecting no significant differences in abuse patterns between the two groups, we combined occupations for all subsequent analyses. Being separated or divorced (vs. married) (Apr = 3.41, 95% confidence interval (CI): 1.81-6.44) and having suffered physical/sexual abuse during childhood (Apr = 3.39, 95% CI: 2.26-5.08) were associated with physical/sexual abuse in adulthood. The same variables were associated with adult emotional abuse (separated/divorced: Apr = 5.33, 95% CI: 2.61-10.85, and childhood physical/sexual abuse: Apr = 2.58, 95% CI: 1.79-3.75). Younger women (between the ages of 23 and 28 years) reported more emotional abuse (Apr = 2.10, 95% CI: 1.48-2.98). Counseling for abused nursing staff may help break the cycle. Physical/sexual partner abuse among nurses appears lower than among the general Mexican population, but remains worrisome. Battling childhood abuse might prevent intimate partner violence.

Strategies for innovative energy-based nursing practice: the Healing Touch program.

PubMed

Kelley, Mari

2002-01-01

The purpose of this article is to share professional knowledge, practice, and educational opportunities related to energy-based nursing in order to broaden and improve the delivery of health care services. The holistic, theory-based approach places a patient's perceived needs first, and cares for the human body as well as the spirit. Energy medicine is an intricate part of the patient's expectation for health care. Watson's transpersonal-caring-healing model is explored (Watson, 1999). This model expands the view of the person to one that embodies energy that is comprised of spirit, a universal mind, and consciousness. The North American Nurses Diagnosis Association (NANDA) recognizes energy therapy as an intervention representing a specific theory: human energy field theory (HEFT). This therapy is related to the approved nursing diagnosis of energy field disturbance 1.8 (NANDA, 1995/1996). Healing touch (HT) is an energy-based therapeutic approach to healing that emphasizes caring for the whole person based on the HEFT. It is used in the nursing profession to influence changes in the human energy system; HT affects physical, emotional, mental, and spiritual health. The nursing process is evident throughout the curriculum. Nurse researchers report positive patients outcomes. The holistic nursing concept of energetic healing returns nurse professionals to the essence of nursing. Spinal cord injury (SCI) nurses will benefit by increasing their knowledge and awareness of energy therapy to increase patient satisfaction and improve outcomes for persons with SCI.

[Nursing care systematization at the intensive care unit (ICU) based on Wanda Horta's theory].

PubMed

Amante, Lúcia Nazareth; Rossetto, Annelise Paula; Schneider, Dulcinéia Ghizoni

2009-03-01

The purpose of this study was to implement the Nursing Care Systematization--Sistematização da Assistência de Enfermagem (SAE)--with Wanda Aguiar Horta's Theory of Basic Human Necessities and the North American Nursing Diagnosis Association's (NANDA) Nursing Diagnosis as its references. The starting point was the evaluation of the knowledge of the nursing team about the SAE, including their participation in this process. This is a qualitative study, performed in the Intensive Care Unit in a hospital in the city of Brusque, Santa Catarina, from October, 2006 to March, 2007. It was observed that the nursing professionals know little about SAE, but they are greatly interested in learning and developing it in their daily practice. In conclusion, it was possible to execute the healthcare systematization in an easy way, with the use of simple brochures that provided all the necessary information for the qualified development of nursing care.

Deep vein thrombosis: diagnosis and treatment.

PubMed

Bonner, Lynda; Johnson, Jacqueline

2014-01-28

This article aims to give nurses an insight into proximal deep vein thrombosis (DVT). DVT is relatively common and is associated with significant morbidity and mortality. Complications such as post-thrombotic syndrome, venous leg ulcers, recurrent venous thromboembolism (VTE) - pulmonary embolism (PE) or DVT - and pulmonary hypertension can develop following DVT diagnosis. There is also a risk that a large PE could prove fatal. While VTE prevention is a clinical priority, nurses should also have appropriate skills and knowledge to care for patients with suspected DVT. Nurses need to be aware of the signs and symptoms of DVT, common diagnostic tests, pharmacological and mechanical treatments, and the follow-up investigations patients should be offered.

Using vignettes to study nurse practitioners' performance in suspected domestic violence situations.

PubMed

Gagan, M J

2000-01-01

Vignettes have often been used to evaluate students or collect data in nursing research. The format is familiar to most nursing students as well as nurses and nurse researchers. This article presents the development and testing of the Nurse Practitioner Performance Tool (NPPT) which used vignettes as an approach to nurse practitioner performance evaluation. In this example, vignettes were used in a quasi-experimental design to collect data from Adult and Family Nurse Practitioners (A/FNP). The focus was on the diagnosis and intervention performance of the A/FNPs when addressing suspected cases of domestic violence.

[Standardisation of nursing care amongst patients in prison].

PubMed

Martínez-Delgado, M M

2014-01-01

To develop the Standardized Nursing Care Process format amongst patients in a prison. Observational, descriptive study, conducted on a sample of thirty patients in Soria Prison between March and June 2011. We collected information via a review of medical records and conducted an interview of nursing assessments using functional patterns. Subsequent nursing diagnoses and interrelated problems were obtained using NANDA taxonomy. The subsequent use of NIC and NOC taxonomy marked the activities and performance criteria for each diagnosis, in the same way as for interrelated problems. The nursing diagnoses found in the patient sample analyzed, and the frequency thereof, reveal peculiarities in terms of the health care needs of the prison population, which makes it possible to standardize nursing care plans for the population under study.

Nurses' Attitudes toward Gay and Hemophiliac Patients with AIDS.

ERIC Educational Resources Information Center

Strasser, Judith A.; Damrosch, Shirley

A sample of nurses (N=183) enrolled in a School of Nursing's master degree program was randomly assigned to read one of six vignettes about a patient who differed only in terms of diagnosis and lifestyle. Possible diagnoses were Acquired Immune Deficiency Syndrome (AIDS), AIDS acquired by a hemophiliac through blood therapy, and leukemia; possible…

Features of standardized nursing terminology sets in Japan.

PubMed

Sagara, Kaoru; Abe, Akinori; Ozaku, Hiromi Itoh; Kuwahara, Noriaki; Kogure, Kiyoshi

2006-01-01

This paper reports the features and relationships between standardizes nursing terminology sets used in Japan. First, we analyzed the common parts in five standardized nursing terminology sets: the Japan Nursing Practice Standard Master (JNPSM) that includes the names of nursing activities and is built by the Medical Information Center Development Center (MEDIS-DC); the labels of the Japan Classification of Nursing Practice (JCNP), built by the term advisory committee in the Japan Academy of Nursing Science; the labels of the International Classification for Nursing Practice (ICNP) translated to Japanese; the labels, domain names, and class names of the North American Nursing Diagnosis Association (NANDA) Nursing Diagnoses 2003-2004 translated to Japanese; and the terms included in the labels of Nursing Interventions Classification (NIC) translated to Japanese. Then we compared them with terms in a thesaurus dictionary, the Bunrui Goihyo, that contains general Japanese words and is built by the National Institute for Japanese Language. 1) the level of interchangeability between four standardized nursing terminology sets is quite low; 2) abbreviations and katakana words are frequently used to express nursing activities; 3) general Japanese words are usually used to express the status or situation of patients.

An Interactive Diagnosis Approach for Supporting Clinical Nursing Courses

ERIC Educational Resources Information Center

Wei, Chun-Wang; Lin, Yi-Chun; Lin, Yen-Ting

2016-01-01

Clinical resources in nursing schools are always insufficient for satisfying the practice requirements of each student at the same time during a formal course session. Although several studies have applied information and communication technology to develop computer-based learning tools for addressing this problem, most of these developments lack…

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

PubMed

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

2016-01-01

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

Causation and Validation of Nursing Diagnoses: A Middle Range Theory.

PubMed

de Oliveira Lopes, Marcos Venícios; da Silva, Viviane Martins; Herdman, T Heather

2017-01-01

To describe a predictive middle range theory (MRT) that provides a process for validation and incorporation of nursing diagnoses in clinical practice. Literature review. The MRT includes definitions, a pictorial scheme, propositions, causal relationships, and translation to nursing practice. The MRT can be a useful alternative for education, research, and translation of this knowledge into practice. This MRT can assist clinicians in understanding clinical reasoning, based on temporal logic and spectral interaction among elements of nursing classifications. In turn, this understanding will improve the use and accuracy of nursing diagnosis, which is a critical component of the nursing process that forms a basis for nursing practice standards worldwide. © 2015 NANDA International, Inc.

Understanding HIV-related stigma among Indonesian nurses.

PubMed

Waluyo, Agung; Culbert, Gabriel J; Levy, Judith; Norr, Kathleen F

2015-01-01

Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country's policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses' HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses' stigmatizing attitudes toward PLWH. Four hundred nurses recruited from four hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

[Development and validation of an instrument for initial nursing assessment].

PubMed

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

2012-12-01

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.

[To represent needs of nursing care using nursing diagnoses: potentials and restrictions of the NANDA classification and ICNP].

PubMed

Schilder, Michael

2005-03-01

Nursing diagnoses represent individual reactions to existing or potential changes in one's state of health. They are result of a diagnostic process, which is part of the dynamic nursing care process in its whole. Thus, as a basis of nursing interventions diagnoses have to be proved continuously. The classification of the North American Nursing Diagnosis Association (NANDA) as well as the International Classification for Nursing Practice (ICNP) can be account to the international well-known classifications of nursing diagnoses. Comparing their structures, some fundamental differences between both classifications become obvious. While the NANDA classification represents a systematic structured body of nursing knowledge with regard to human health reactions patterns, the ICNP reflects a more comprehensive part of the nursing reality, since it also contains nursing interventions and outcomes. Until the latest changes by establishing the taxonomy II, NANDA diagnoses have primarily focused deficits. But in contrast to the diagnoses of the ICNP they also comprise etiological factors. To prove the applicability of both classifications to nursing practice, they have been applied to a case study of a female resident living in a nursing home. The results of analysis show that because of their different structures the NANDA classification and ICNP have their own possibilities and limitations in covering the resident's individual needs of nursing care. These characteristic potentials and restrictions have to be taken into account when one of the classification systems is going to be implemented into nursing practice.

Outcomes of Planned Home Visits of Intern Public Health Nurses: An Example from Turkey.

PubMed

Ozkan, Ozlem; Ozdemir, Saadet

This study aimed at evaluating the outcomes of planned home visits of intern public health nurses enrolled to a school of health over 8 educational years. The descriptive research consisted of 181 families (N = 745 individuals) who received primary services through the planned home visits undertaken by 431 intern public health nurses at Kocaeli province in Turkey. The data were collected from Family Nursing Process Records and Family Health Achievement Forms. Both of these data collection forms were classified according to North American Nursing Diagnosis Association (NANDA) Taxonomy II. Intern public health nurses provided primary health services to 181 families (N = 745 persons) with a total of 8771 planned home visits undertaken over 802 days and 14.874 student/practice days. A total of 1539 nursing diagnoses were identified and 1677 achievements about these diagnoses were reported. Nursing diagnosis per family and per individual turned out to be 8.50 and 2.1, respectively, and achievements were 9.3 per family and 2.3 per individual. Among the nursing diagnosis domains, health promotion (20.3%), safety/protection (16.8%), and activity/rest (16.0%) were the top 3 domains identified. The most common diagnoses turned out to be ineffective health maintenance (47.4%) in health promotion domain and risk for trauma (18.2%) in safety/protection domain. The achievements were reported most in health promotion (37.9%), activity/rest (17.6%), and safety/protection (9.6%), respectively. Planned and continuous home visits by intern public health nurses resulted in positive health achievements in families, especially for women and children. Copyright © 2016. Published by Elsevier Inc.

Cardiovascular genomics: implications for acute and critical care nurses.

PubMed

Quinn Griffin, Mary T; Klein, Deborah; Winkelman, Chris

2013-01-01

As genomic health care becomes commonplace, nurses will be asked to provide genomic care in all health care settings including acute care and critical care. Three common cardiac conditions are reviewed, Marfan syndrome, bicuspid aortic valve, and hypertrophic cardiomyopathy, to provide acute care and critical care nurses with an overview of these pathologies through the lens of genomics and relevant case studies. This information will help critical care nursing leaders become familiar with genetics related to common cardiac conditions and prepare acute care and critical care nurses for a new phase in patient diagnostics, with greater emphasis on early diagnosis and recognition of conditions before sudden cardiac death.

Emergency nurses' knowledge of pain management principles.

PubMed

Tanabe, P; Buschmann, M

2000-08-01

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

[Implementation of the nursing process in a patient with hepatic cirrhosis using the standardized terminologies NANDA, NIC and NOC].

PubMed

Vargas, Rosimeire da Silva; França, Fabiana Cláudia de Vasconcelos

2007-01-01

This case study aimed at describing the implementation the implementation of the Nursing Process to a patient with hepatic cirrhosis, and report the difficulties found on the implementation of the assistance. The conceptual model of Horfa was used, NANDA--Nursing Diagnosis, Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) were also applied in care composition. The present study was developed in a public hospital of Distrito Federal, in September 2005, at the Emergency Unit. Among the identified nursing diagnosis was included: acute confusion, constipation and knowledge deficit. Among the pointed difficulties, it was detached: the disinterest of the nursing team and of the pacient, knowledge deficit and unpreparedness of the professionals, lack of human and material resources to deliver the care.

Discharge of Non-Acute Coronary Syndrome Chest Pain Patients From Emergency Care to an Advanced Nurse Practitioner-Led Chest Pain Clinic: A Cross-Sectional Study of Referral Source and Final Diagnosis.

PubMed

Ingram, Shirley J; McKee, Gabrielle; Quirke, Mary B; Kelly, Niamh; Moloney, Ashling

Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge. Referrals were by the advanced nurses during consult hours and out-of-hours were by the ED physicians. Data were extracted from case notes. This was a 1-site cross-sectional study of patients attending the chest pain clinic over 2 years. Confirmed coronary disease was diagnosed in 24% of patients. Of the 1041 patients, 45% were referred by the advanced nurses, who referred significantly more patients who were older (56.5 years/52.3 years), had positive exercise stress test results (21%/12%), and were diagnosed with stable coronary artery disease (19%/11%) and less patients with musculoskeletal diagnosis (5%/13%) and other noncardiac pain (36%/45%). The study fills a gap in the literature on the follow up of non-ACS patients who present to ED and used advanced cardiology nursing expertise in the ED and chest pain clinic. The advanced nurse referred more patients who were diagnosed with coronary disease, reflecting the expertise, experience, and efficiency of the advanced cardiology nurse-led service.

[The contribution of oncology nursing to the Swiss Research Agenda for Nursing - SRAN].

PubMed

Shaha, Maya; Schmid-Büchi, Silvia; Abt, Judith; Mathis-Jäggi, Franziska; Holdener, Eveline; Riederer, Evelyn; Stoll, Hans Ruedi; Fliedner, Monica; Imhof, Lorenz

2008-12-01

Worldwide, cancer remains the second most frequent cause of death in adults and children. A cancer diagnosis often marks the beginning of therapies that may continue over months and years. These therapies frequently consist in surgical interventions in combination with chemotherapy and radiotherapy. For all healthcare professionals involved, cancer also signifies a very complex illness with high demands. It is therefore important to identify research priorities in order to successfully and comprehensively address these demands and to provide high quality patient care. In order to identify research priorities in oncology care in Switzerland, a systematic review of literature was conducted. A total of 30 research priorities emerged from the literature. In accordance with SRAN guidelines, 25 were passed on to the SRAN. The systematic identification of research priorities in oncology nursing has, for the first time, resulted in a list of topics in need of investigation in Switzerland. Completing the list of research priorities for oncology nursing with an updated systematic review of literature and presenting it to a larger and more representative group of oncology nurses, experts, and nurse scientists with oncology nursing experience for assessment and valuation, will be crucial for any future revision of the SRAN. In the future, it will be indispensable to include patients and their families in the process.

A Comparison of Nurses’ Activities Under Two Models of Administration

DTIC Science & Technology

1985-08-01

Angela Sheehan, "Innovation in Cancer Nursing and the Role of the Nurse in Clinical Trials," Progress in Clinical and Biological Research 121 (1983): 87...by Diagnosis-Related Groups,* Annals of Internal Medicine 100 (April 1984): 576. 12Tony DeCrosta, " Megatrends in Nursing: 10 New Directions that are...in Clinical Trials." Progress in Clinical and Biological Research 121 (1983): 87-92. Beyers, Marjorie: Byre, Calvin: Levy, Paul: Mallin, Katherine

Adoption of innovations by specialised nurses: personal, work and organisational characteristics.

PubMed

van der Weide, Marian; Smits, Jeroen

2004-04-01

To gain insight in the factors that influence the adoption of professional information by specialised nurses, we studied the effects of individual, work and organisational characteristics on the extent to which continence nurses gained knowledge and made use of a book on nursing diagnosis and interventions for patients with urinary incontinence, which they received as a present. Subjects were all members of the Dutch Association of Continence Nurses. Data collection took place via a postal questionnaire with closed questions. In total, 109 valid questionnaires (78%) were received back. Stepwise selected ordered logit models were estimated with reading the book and knowledge and use of five selected parts of it as dependent variables and individual, work and organisational characteristics as independent variables. The most important factors found to promote reading of the book and taking knowledge of the parts of it were a personal characteristic of the nurses called "information directedness" (or eagerness to acquire professional information from other sources), the presence of an "innovative atmosphere" at the department, and "relevance" of the information for daily nursing practice. The most important factors found to promote the use of the book are (again) information directedness, working at a (relatively) small department and having experience with nursing diagnosis. Results suggest that nurses differ in the degree to which they are open to innovations and that information directedness might be a useful indicator of this characteristic. In addition, the degree of innovativeness of the atmosphere at the department and the relevance of the innovation for nursing practice are important factors influencing the success or failure of innovations in nursing practice.

Content Validity of a Psychotherapeutic Intervention Model in Nursing: A Modified e-Delphi Study.

PubMed

Sampaio, Francisco Miguel Correia; Sequeira, Carlos; Lluch Canut, Teresa

2017-04-01

To estimate the content validity of a psychotherapeutic intervention model in nursing. Mental health nurses encounter great extrinsic difficulties when it comes to providing psychotherapeutic interventions due to the fact that they are not allowed to perform such practice in some countries. In this light, the pursuit of a psychotherapeutic intervention model in nursing seems germane to guide the professionals' psychotherapeutic practice, contributing hereof to increase mental health nurses' professional autonomy. Modified e-Delphi. Data were collected from October 2015 to January 2016 by means of three rounds of online questionnaires. The initial questionnaire was structured into five sections: general structure of the model, patients' exclusion criteria, assessment framework, nursing diagnoses, and nursing psychotherapeutic interventions. From the 42 experts invited, at least twenty (20) participated in each round. The experts achieved consensus with regard to the conclusion that nursing psychotherapeutic interventions should always seek to address a nursing diagnosis. These defined furthermore that a psychotherapeutic intervention model in nursing should be exercised by means of 3 to 12 sessions using Nursing Interventions Classification (NIC) as a resource. Finally, experts deemed that the model should follow the principles of integrative psychotherapy, so that techniques from different schools of psychotherapy could therefore be used in conjunction to promote the resolution of a nursing diagnosis. Achieving consensus about the structure of a psychotherapeutic intervention model in nursing is imperative to guide nurses in the provision of nursing psychotherapeutic interventions and to enable an effective evaluation of the health gains associated with its implementation. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of nurse attitudes on psychiatric patient compliance with pharmacotherapy.

PubMed

Gajski, Anita; Karlović, Dalibor

2008-09-01

The aim of the study was to assess the opinion of nurses employed at a psychiatry department about compliance with pharmacotherapy in patients they provide care for on a daily basis, i.e. assessment of the nurse's role in patient compliance with prescribed medication and how much the nurse can contribute to better patient compliance with pharmacotherapy. Thirty-nine nurses, i.e. 2/3 of nurses employed at University Department of Psychiatry, Sestre milosrdnice University Hospital, participated in the study Data were collected through a structured survey/questionnaire for nurses, which is used to assess the nurses' opinion of patient compliance with pharmacotherapy. Study results confirmed the belief that nurses recognize the importance of patient compliance in daily work and are aware that this compliance depends on the patient himself, his diagnosis, the medicine he receives, his family and medical professionals involved in his medical care.

Return to Work for Nurses With Hand Dermatitis.

PubMed

Chen, Jennifer; Gomez, Pilar; Kudla, Irena; DeKoven, Joel; Holness, D Linn; Skotnicki, Sandra

2016-01-01

Occupational skin disease is common in healthcare workers. If the healthcare worker develops moderate to severe dermatitis, return to work (RTW) may be challenging. The study objectives were to review the impact of an RTW program on the work status of nurses with occupational hand dermatitis and to identify successful intervention methods and strategies. Nurses who received RTW services at a tertiary occupational medicine clinic were identified, and information related to their diagnosis and RTW was abstracted from their charts. Eighteen nurses with irritant hand dermatitis who received RTW services were identified. Twelve nurses (67%) were performing administrative duties because of their skin condition when admitted to the RTW program, and others were performing patient care with modifications. A graduated RTW trial was commonly implemented with optimized skin care management and monitoring by physicians and the RTW coordinator. Upon discharge, 14 nurses (78%) had returned to their nursing roles with direct patient care, 3 (17%) were working as nurses in non-patient care roles, and 1 (6%) was on permanent disability. A graduated RTW trial to reduce cumulative irritant exposure is a crucial strategy to facilitate nurses' transition back to work and to maintain direct patient care nursing roles.

Using standardized nursing languages: a case study exemplar on management of diabetes mellitus.

PubMed

Fischetti, Natalie

2008-01-01

This case study illustrates the characteristics of the nursing diagnosis readiness for enhanced self health management. Published literature, experience, and expertise of the author were utilized as data sources. The standardized nursing languages of NANDA International, Nursing Outcomes Classification, Nursing Interventions Classification, and interventions related to the client's management of diabetes were derived for the case study. The use of standardized nursing languages with interventions related to the management of type 2 diabetes provided a framework for nurses to support clients with enhanced self-management to improve their outcomes. The use of standardized nursing language in the management of type 2 diabetes can improve client outcomes.

Diagnostic Reasoning and Cognitive Biases of Nurse Practitioners.

PubMed

Lawson, Thomas N

2018-04-01

Diagnostic reasoning is often used colloquially to describe the process by which nurse practitioners and physicians come to the correct diagnosis, but a rich definition and description of this process has been lacking in the nursing literature. A literature review was conducted with theoretical sampling seeking conceptual insight into diagnostic reasoning. Four common themes emerged: Cognitive Biases and Debiasing Strategies, the Dual Process Theory, Diagnostic Error, and Patient Harm. Relevant cognitive biases are discussed, followed by debiasing strategies and application of the dual process theory to reduce diagnostic error and harm. The accuracy of diagnostic reasoning of nurse practitioners may be improved by incorporating these items into nurse practitioner education and practice. [J Nurs Educ. 2018;57(4):203-208.]. Copyright 2018, SLACK Incorporated.

[NURSING DIAGNOSES AND MIGRATION: PHENOMENOLOGICAL STUDY FROM THE IMMIGRANT'S POINT OF VIEW].

PubMed

Rifà Ros, M Rosa; Pallarés Martí, Àngela; Pérez Pérez, Isabel; Ferré Grau, Carme; Espinosa Fresnedo, Carme; Rodríguez Monforte, Míriam

2015-12-01

The objective of this research is to identify nursing diagnosis NANDA which is predominant within the immigrant community, linked to the migratory process and part of the framework of the Outcome Present State Test (OPT) of Pesut and Herman's critical awareness. Keeping in mind the objectives of this research, this approaches the quality-based paradigm and follows the proposals of phenomenology research. The study was carried out using an individual semi-structured interview of 30 immigrants. A categorization of the data has been applied in accordance with the domains of NANDA for the identification of nursing diagnosis and its analysis has been carried with computer support with Atlas-ti 6.0. Twenty three diagnoses were identified in nine out of thirteen taxonomy NANDA domains. Analysis of their interrelationships according to the OPT model were carried out and a clinical reasoning net was created. The main diagnoses achieved in our study was: Readiness for Enhanced Coping. NANDA taxonomy doesn't include the migratory process in the characteristics and related factors of this nursing diagnosis. We consider that nursing taxonomy should be reassessed in order to describe more in depth the specific responses derived from the migratory experience so it can lead to a high quality health care.

Open referral policy within a nurse-led memory clinic: patient demographics, assessment scores, and diagnostic profiles.

PubMed

Minstrell, Melinda; Bentley, Michael; Bucher, Hazel; Morrissey, Martin; Higgs, Carl; Robinson, Andrew; Stirling, Christine

2015-06-01

Memory clinics, typically led by multidisciplinary teams and requiring health professional referral, are one means of providing diagnosis and care coordination for dementia. Nurse-led clinics may provide an effective and alternative means to dementia diagnosis, and open referral policies may minimize existing barriers to accessing a diagnosis, but evidence is needed. Patients attending a one-day per week nurse-led memory clinic over a 25-month period during 2011-2013 (n = 106) completed comprehensive cognitive assessments and were diagnosed by an aged care nurse practitioner. Descriptive statistics detail the demographics, assessment scores, and diagnostic profiles of patients. Comparable data from published literature was identified, and the differences were analyzed qualitatively. One hundred and six patients were assessed with the key differences from other data sets being history of falls more common, higher mean Mini-Mental State Examination scores, and fewer dementia diagnoses. Sixty-four patients (60%) were self-referred to the nurse-led memory clinic, of which 19 (30%) were diagnosed with mild cognitive impairment (MCI) or dementia. Overall, forty-eight patients (45%) received diagnoses of MCI or dementia. An open referral policy led to a high proportion of patients being self-referred, and nearly a third of these were diagnosed with cognitive impairment or dementia. Open referral policies and nurse-led services may overcome some of the barriers to early diagnosis that are currently experienced. Considering an aging population worldwide and the associated increases in cognitive impairment, which benefits from early identification and intervention, this paper provides an alternative model of nurse-led assessment.

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

PubMed

Pobocik, Tamara

2015-01-01

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

Transfer-of-Care Communication: Nursing Best Practices.

PubMed

Chard, Robin; Makary, Martin A

2015-10-01

The successful and safe transfer of the patient from one phase of care to another is contingent on optimal communication by all team members. Nurses are often in a natural leadership position to improve safe practices during hand overs. A holistic understanding of the patient allows the perioperative nurse the opportunity to identify issues and choose a nursing diagnosis based on key elements of a patient's needs and goals--information that should be relayed during patient transfers. This article reviews best practices in transfer-of-care communication to enable perioperative RNs to take an active, leading role in hand-over processes. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Prevalence, Defining Characteristics, and Related Factors of the Nursing Diagnosis of Anxiety in Hospitalized Medical-Surgical Patients.

PubMed

Sanson, Gianfranco; Perrone, Annalisa; Fascì, Adriana; D'Agostino, Fabio

2018-03-01

To document the prevalence of the nursing diagnosis of anxiety in hospital patients, based on its level of severity, defining characteristics (DCs), and other related factors, and to identify the key DCs that serve as predictors of clinically significant anxiety (CSA). Cross-sectional study. We enrolled 116 consecutive adult patients hospitalized from October 10 to 16, 2016, in medical-surgical wards within the first 48 hr of admission. The potential DCs and related factors of anxiety were collected based on the NANDA International terminology. Anxiety was considered clinically significant when presenting at moderate, severe, or panic level. The differences in DC prevalence among patients having or not having CSA were analyzed by unpaired student's t-test. Multivariate analysis was used to examine the independent association between the DCs and CSA. The prevalence of CSA was 36.2% and was significantly higher in patients who were older, female, and taking anxiolytic drugs, and among those who had cancer. The most frequent related factor for CSA was major change in health status. In the logistic regression, the presence of the DCs helplessness, altered attention or concentration, and anguish independently increased the odds of having CSA, whereas subjects presenting with Diminished ability to problem-solve had about a 96% reduction in the likelihood to suffer from such a condition. A high prevalence of CSA among medical-surgical patients was shown. Furthermore, a critical cluster of DCs useful to identify CSA was found. The ability to accurately diagnose CSA should help prescribe and deliver the appropriate nursing interventions. © 2018 Sigma Theta Tau International.

[Neurologically critical patient. Nurses' care].

PubMed

López Díaz, Cristina

2009-12-01

Handling a neurologically critical patient requires some necessary knowledge and aptitudes in order to avoid risks and complications which could worsen a patient's prognosis. To that end, in this article the author deals with two important points nursing personnel need to bear in mind: the distinct methods and catheters which can be used to monitor intracranial pressure, obtaining an important parameter for evaluation purposes and therapeutic follow-up on these patients, placing special emphasis on ventricular drainage and nursing care, and the operations nurses take when dealing with patients who present a risk of intracranial hypertension, setting up a protocol based on seven necessities in the Virginia Henderson model: breathing, elimination, temperature, hygiene and skin, feeding and hydration, mobility and safety. In each of these necessities, the author studies the problems these patients present, identifying them with a series of diagnoses according to NANDA (North American Nursing Diagnosis Association), and defining the care or nursing activities for each of them, which will prove essential to prevent cerebral ischemia after suffering a primary cerebral injury due to a "TCE"(Cranial Encephalic Trauma) hemorrhage, etc. Nurses' role in caring for neurologically critical patients proves to be of vital importance since these professionals must be capable of evaluating, preventing, controlling and identifying those risk situations which neurologically critical patients could present, avoiding possible complications, aiding their recuperation, and providing quality health care.

A retrospective study of nursing diagnoses, outcomes, and interventions for patients with mental disorders.

PubMed

Escalada-Hernández, Paula; Muñoz-Hermoso, Paula; González-Fraile, Eduardo; Santos, Borja; González-Vargas, José Alonso; Feria-Raposo, Isabel; Girón-García, José Luis; García-Manso, Manuel

2015-05-01

The aim of this study is to describe the most frequent NANDA-I nursing diagnoses, NOC outcomes, and NIC interventions used in nursing care plans in relation to psychiatric diagnosis. Although numerous studies have described the most prevalent NANDA-I, NIC and NOC labels in association with medical diagnosis in different specialties, only few connect these with psychiatric diagnoses. This multicentric cross-sectional study was developed in Spain. Data were collected retrospectively from the electronic records of 690 psychiatric or psychogeriatric patients in long and medium-term units and, psychogeriatric day-care centres. The most common nursing diagnoses, interventions and outcomes were identified for patients with schizophrenia, organic mental disorders, mental retardation, affective disorders, disorders of adult personality and behavior, mental and behavioural disorders due to psychoactive substance use and neurotic, stress-related and somatoform disorders. Results suggest that NANDA-I, NIC and NOC labels combined with psychiatric diagnosis offer a complete description of the patients' actual condition. Copyright © 2014 Elsevier Inc. All rights reserved.

Nurses' perceptions of usefulness of nursing information system: module of electronic medical record for patient care in two university hospitals of iran.

PubMed

Kahouei, Mehdi; Baba Mohammadi, Hassan; Askari Majdabadi, Hesamedin; Solhi, Mahnaz; Parsania, Zeinab; Said Roghani, Panoe; Firozeh, Mehri

2014-02-01

For almost fifteen years, the application of computer in hospitals increasingly has become popular. Nurses' beliefs and attitudes towards computer is one of the most important indicators of the application of nursing information system. The purpose of this study was to investigate the perceptions of nurses on the usefulness of nursing information system for patient care. Here, a descriptive study was carried out. Sample was consisted of 316 nurses working in teaching hospitals in an urban area of Iran. This study was conducted during 2011 to 2012. A reliable and valid questionnaire was developed as a data collection tool. The collected data was analyzed using descriptive and inferential statistics. It was not believed that nursing information system was useful for patient care. However, it was mentioned that nursing information system is useful in some aspects of patient care such as expediting care, making early diagnosis and formulating diet plan. A significant association was found between the demographic background of sample and their perceptions of the usefulness of nursing information system (P<0.05). Totally, it can be concluded that nursing information system has a potential for improving patient care in hospital settings. Therefore, policy makers should consider implementing nursing information system in teaching hospitals.

A new assessment model and tool for pediatric nurse practitioners.

PubMed

Burns, C

1992-01-01

This article presents a comprehensive assessment model for pediatric nurse practitioner (PNP) practice that integrates familiar elements of the classical medical history, Gordon's Functional Health Patterns, and developmental fields into one system. This model drives the diagnostic reasoning process toward consideration of a broad range of disease, daily living (nursing diagnosis), and developmental diagnoses, which represents PNP practice better than the medical model does.

[Development and application of a computerized nursing process program for orthopedic surgery inpatients-- NANDA, NOC, and NIC linkages].

PubMed

Kim, Hye-Suk

2005-10-01

The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain (28.4%), Impaired physical mobility (15.6%), Impaired walking (8.7%), Chronic pain (5.5%) and Risk for disuse syndrome (5.0%). The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (95.2%), Comfort level (35.5%) and Pain level (17.7%). The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (71.0%), Splinting (24.2%) and Analgesic administration (17.7%). In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. It is expected that this program will help nurses perform their nursing processes more efficiently.

Translation and integration of CCC nursing diagnoses into ICNP.

PubMed

Matney, Susan A; DaDamio, Rebecca; Couderc, Carmela; Dlugos, Mary; Evans, Jonathan; Gianonne, Gay; Haskell, Robert; Hardiker, Nicholas; Coenen, Amy; Saba, Virginia K

2008-01-01

The purpose of this study was to translate and integrate nursing diagnosis concepts from the Clinical Care Classification (CCC) System Version 2.0 to DiagnosticPhenomenon or nursing diagnostic statements in the International Classification for Nursing Practice (ICNP) Version 1.0. Source concepts for CCC were mapped by the project team, where possible, to pre-coordinated ICNP terms. The manual decomposition of source concepts according to the ICNP 7-Axis Model served to validate the mappings. A total of 62% of the CCC Nursing Diagnoses were a pre-coordinated match to an ICNP concept, 35% were a post-coordinated match and only 3% had no match. During the mapping process, missing CCC concepts were submitted to the ICNP Programme, with a recommendation for inclusion in future releases.

Diagnosis and management of myasthenia gravis.

PubMed

Barber, Christopher

2017-06-21

Myasthenia gravis is a rare long-term neurological condition that is characterised by fluctuating skeletal muscle weakness and fatigue, as well as respiratory difficulties. It is both an acquired autoimmune disease and a chronic neuromuscular disorder. Because of its rarity, myasthenia gravis is relatively unknown and may be unfamiliar to many nurses. While there are various types of myasthenia, this article focuses on myasthenia gravis, exploring its symptoms, diagnosis and treatment, and examining the nurse's role in managing the condition. The symptoms of myasthenic crisis and cholinergic crisis are also explained, and the experience of patients with myasthenia gravis in hospital and community settings is illustrated using case studies.

Challenges facing the distribution of an artificial-intelligence-based system for nursing.

PubMed

Evans, S

1985-04-01

The marketing and successful distribution of artificial-intelligence-based decision-support systems for nursing face special barriers and challenges. Issues that must be confronted arise particularly from the present culture of the nursing profession as well as the typical organizational structures in which nurses predominantly work. Generalizations in the literature based on the limited experience of physician-oriented artificial intelligence applications (predominantly in diagnosis and pharmacologic treatment) must be modified for applicability to other health professions.

Acute hospital admissions among nursing home residents: a population-based observational study

PubMed Central

2011-01-01

Background Nursing home residents are prone to acute illness due to their high age, underlying illnesses and immobility. We examined the incidence of acute hospital admissions among nursing home residents versus the age-matched community dwelling population in a geographically defined area during a two years period. The hospital stays of the nursing home population are described according to diagnosis, length of stay and mortality. Similar studies have previously not been reported in Scandinavia. Methods The acute hospitalisations of the nursing home residents were identified through ambulance records. These were linked to hospital patient records for inclusion of demographics, diagnosis at discharge, length of stay and mortality. Incidence of hospitalisation was calculated based on patient-time at risk. Results The annual hospital admission incidence was 0.62 admissions per person-year among the nursing home residents and 0.26 among the community dwellers. In the nursing home population we found that dominant diagnoses were respiratory diseases, falls-related and circulatory diseases, accounting for 55% of the cases. The median length of stay was 3 days (interquartile range = 4). The in-hospital mortality rate was 16% and 30 day mortality after discharge 30%. Conclusion Acute hospital admission rate among nursing home residents was high in this Scandinavian setting. The pattern of diagnoses causing the admissions appears to be consistent with previous research. The in-hospital and 30 day mortality rates are high. PMID:21615911

Simulation: The Effects of Simulation on High Stakes Testing in Undergradute Nursing Education

ERIC Educational Resources Information Center

Walters, Linda

2014-01-01

Many nursing programs use standardized testing packages in order to evaluate students' content mastery as well as predict probability of passing the National Council Licensure for Registered Nurses (NCLEX-RN). Instead of a diagnosis for weak content areas, programs implement testing policies in the belief that such policies ensure student success…

The classification systems of nursing practice--the historical and practical perspective.

PubMed

Górajek-Jóźwik, Jolanta

2003-01-01

The contribution into activities connected with the development of the quality of nursing care is closely combined with the process of systematic recording of accumulated data, of undertaken activities and achieved results. This in turn constitutes the essence of the 31st Aim of WHO which speaks not only about the need to continue the rational contribution towards the increase in the nursing care quality but also the application of adequate computer technologies to improve this quality. The aim of this work is to demonstrate the scope and character of the activities that have been over years undertaken by the nursing community towards the development of the classification systems which are comparable with those used in medicine. The focus has been specifically put on the taxonomy of diagnosis used by the North American Nursing Diagnosis Association (NANDA) and the European International Classification of Nursing Practice (ICNP). The analysis of the reference sources constitutes the methodological foundation applied in this work. It has allowed to show the pioneering contribution of the American Nursing Association (ANA) into the process of recording and coding of the data that are essential in care delivery as well as their value for the development of ICNP. The latter one is a systematic and multi-axial structure which uses unified terminology and numeric codes for the three categories of variables: the recognized conditions, the undertaken activities and the achieved results.

Antidepressant treatment of depression in rural nursing home residents.

PubMed

Kerber, Cindy Sullivan; Dyck, Mary J; Culp, Kennith R; Buckwalter, Kathleen

2008-09-01

Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by their primary care provider than women. Depression detected by nurses through the Minimum Data Set was treated at a lower rate with antidepressants, which generates issues related to interprofessional communication, nursing staff communication, and the need for geropsychiatric role models in nursing homes.

Nurses' performance on primary care in the National Health Service in England.

PubMed

Toso, Beatriz Rosana Gonçalves de Oliveira; Filippon, Jonathan; Giovanella, Ligia

2016-01-01

To analyze the expansion of nursing roles in primary care in the English National Health Service and the implications for professional practice. qualitative research in case study format, held in London, England, in six primary care units. Data were obtained through interviews with nine nurses. After the thematic data analysis, two units emerged: the nurses' performance characteristics and effects of the expansion of nursing roles. expansion of nurses' roles: consultation, diagnosis and drug therapy, case management and monitoring of chronic conditions. Repercussions: for the user, there was improved access, communication and comprehensive care, increased duration of consultations, resulting in greater adherence; for nurses, there was the expansion of professional skills, knowledge and professional recognition; to the health care system, it resulted in cost savings. benefits in expanding nursing roles, were visible, contributing to primary care quality.

Apply creative thinking of decision support in electrical nursing record.

PubMed

Hao, Angelica Te-Hui; Hsu, Chien-Yeh; Li-Fang, Huang; Jian, Wen-Shan; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Chang, Her-Kung

2006-01-01

The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with.

Use of Mobile Apps Among Medical and Nursing Students in Iran.

PubMed

Sheikhtaheri, Abbas; Kermani, Farzaneh

2018-01-01

Mobile technologies have a positive impact on patient care and cause to improved decision making, reduced medical errors and improved communication in care team. The purpose of this study was to investigate the use of mobile technologies by medical and nursing students and their tendency in future. This study was conducted among 372 medical and nursing students of Tehran University of Medical Science. Respectively, 60.8% and 62.4% of medical and nursing students use smartphone. The most commonly used apps among medical students were medical dictionary, drug apps, medical calculators and anatomical atlases and among nursing students were medical dictionary, anatomical atlases and nursing care guides. Also, the use of decision support systems, remote monitoring, patient imagery and remote diagnosis, patient records documentation, diagnostic guidelines and laboratory tests will be increased in the future.

Conceptual definitions of indicators for the nursing outcome "Knowledge: Fall Prevention".

PubMed

Luzia, Melissa de Freitas; Argenta, Carla; Almeida, Miriam de Abreu; Lucena, Amália de Fátima

2018-01-01

to construct conceptual definitions for indicators of nursing outcome Knowledge: Fall Prevention, selected for evaluation of hospitalized patients with the nursing diagnosis Risk for falls. integrative literature review performed in the LILACS, MEDLINE and Web of Science databases, comprising articles published in English, Spanish and Portuguese languages from 2005 to 2015. the final sample of the study was composed of 17 articles. The conceptualizations were constructed for 14 indicators of nursing outcome Knowledge: Fall Prevention focused on hospitalized patients. the theoretical support of the Nursing Outcomes Classification (NOC), through the process of constructing the conceptual definitions of the indicators of its results, allows nurses to accurately implement this classification in clinical practice and to evaluate the effectiveness of their interventions through the change of the patients' status over time.

[Management and Nursing care for a patient with Lynch syndrome: A case report].

PubMed

Pacheco-Pérez, Luis Arturo; Guevara Valtier, Milton Carlos

2016-01-01

Colorectal cancer is one of the leading causes of death from cancer worldwide. Main interventions to reduce the impact are aimed to enhance prevention and early detection. Results of several studies show that tests such as the fecal occult blood test and colonoscopy are effective for early diagnosis. There are hereditary syndromes such as Lynch Syndrome that can lead to certain types of cancers, including bowel neoplasms, therefore early detection needs to be included as part of the treatment. In these cases, family genetic testing is recommended if the bowel cancer is diagnosed before 50 years old. A care plan including the NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification) and NIC (Nursing Interventions Classification) was developed for a patient with suspected Lynch Syndrome. Nurses should be qualified to identify potential cases of cancer associated with this syndrome, and thus, reduce the likelihood that family members develop the disease, through genetic counseling and education of environmental risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Encopresis: a guide for psychiatric nurses.

PubMed

Hardy, Lyons T

2009-10-01

Encopresis is an elimination disorder that involves symptoms of fecal incontinence in children. It affects an estimated 1.5% to 7.5% of children ages 6 to 12 and accounts for approximately 3% to 6% of psychiatric referrals. The etiology of encopresis is thought to be related to physiologic problems such as constipation; however, it is also a psychiatric diagnosis and anecdotally may have some association with psychiatric problems. Publications on this association and publications directed toward psychiatric nurses are limited. Encopresis is typically treated with nutritional and medical management along with behavioral modification. Psychiatric nurses working with patients who have encopresis in inpatient settings will have unique concerns and challenges. This article gives an overview of published literature from the past 10 years on the etiology and treatment of encopresis. Specific suggestions for inpatient psychiatric nurses based on published literature and the author's professional experience are provided.

[Glioblastoma and nursing care in neurosurgery].

PubMed

Lefort, Mathilde

2017-02-01

Nurses in neurosurgical departments play a critical role as they are involved in the first stages of the care pathway of patients with glioblastoma. Indeed, surgery enables a definitive histopathological diagnosis to be established and the size of the tumour to be significantly reduced, thereby improving the prognosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Nursing diagnoses in patients with cerebral vascular accident: an integrative review.

PubMed

Lima, Ana Carolina Maria Araújo Chagas Costa; Silva, Aurilene Lima da; Guerra, Débora Rodrigues; Barbosa, Islene Victor; Bezerra, Karine de Castro; Oriá, Mônica Oliveira Batista

2016-01-01

to verify the nursing diagnoses in patients affected by CVAs. this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: "Enfermagem", "Acidente Vascular Cerebral", "Diagnóstico de Enfermagem"; and "Nursing", "Stroke", and "Nursing Diagnosis". we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: "Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs" and "Application of the nursing process on subjects affected by CVAs". we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.

Perceptions of nurses with regard to doctor-patient communication.

PubMed

Angeles-Llerenas, A; Alvarez del Río, A; Salazar-Martínez, E; Kraus-Weissman, A; Zamora-Muñoz, S; Hernández-Avila, M; Lazcano-Ponce, E

The objective of this study was to evaluate nurses' perceptions of communication between doctors and patients with cancer, AIDS and rheumatoid arthritis. A cross-sectional study was conducted with 741 nurses in 12 hospitals. Nurses received a self-questionnaire that included questions on personal value and attitudes. The answers were used in constructing affective variables (religious beliefs, attitude towards death, paternalism). The prevalence of explicit communication in 'nurse perception of doctor-patient communication' in the case of cancer was 4.5%, with AIDS 30%, and with rheumatoid arthritis 41.8%. When the value of communication was evaluated, it became evident that the likelihood of a nurse perceiving explicit communication in reference to a diagnosis of cancer was 6.5 time greater when communication was considered to be of greater value (CI 95% 2.6-6.6). For nurses who accept the possibility of death, the likelihood of perceiving explicit communication in the case of AIDs was 7.4 times greater than for nurses who deny this possibility (CI 95% 3.7-14.7), and when nurses displayed a deeply religious attitude, the likelihood of perceiving explicit communication was 80% greater than for nurses without this attitude (CI 95% 1.1-2.9). Nurses participate actively in the process of attending to patients with cancer and other disabling illnesses. Thus, there is a need for health professionals who provide compassionate attention, which will improve the various interrelationships between nurses and patients.

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

PubMed

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

2016-01-01

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

Genetic discoveries and nursing implications for complex disease prevention and management.

PubMed

Frazier, Lorraine; Meininger, Janet; Halsey Lea, Dale; Boerwinkle, Eric

2004-01-01

The purpose of this article is to examine the management of patients with complex diseases, in light of recent genetic discoveries, and to explore how these genetic discoveries will impact nursing practice and nursing research. The nursing science processes discussed are not comprehensive of all nursing practice but, instead, are concentrated in areas where genetics will have the greatest influence. Advances in genetic science will revolutionize our approach to patients and to health care in the prevention, diagnosis, and treatment of disease, raising many issues for nursing research and practice. As the scope of genetics expands to encompass multifactorial disease processes, a continuing reexamination of the knowledge base is required for nursing practice, with incorporation of genetic knowledge into the repertoire of every nurse, and with advanced knowledge for nurses who select specialty roles in the genetics area. This article explores the impact of this revolution on nursing science and practice as well as the opportunities for nursing science and practice to participate fully in this revolution. Because of the high proportion of the population at risk for complex diseases and because nurses are occupied every day in the prevention, assessment, treatment, and therapeutic intervention of patients with such diseases in practice and research, there is great opportunity for nurses to improve health care through the application (nursing practice) and discovery (nursing research) of genetic knowledge.

Psychometric properties of the Spanish Burnout Inventory among staff nurses.

PubMed

Gil-Monte, P R; Manzano-García, G

2015-12-01

The burnout syndrome contributes to the deterioration in the quality of personal life as well as lower quality practice in healthcare personnel. Researchers have been concerned about the psychometric limitations of some previous questionnaires designed to evaluate burnout. The Spanish Burnout Inventory was developed to address the problems associated with other instruments, but it has not yet been validated in staff nurses. This study provides evidence that the Spanish Burnout Inventory has adequate psychometric properties to estimate burnout in staff nurses. The Spanish Burnout Inventory offers a theoretical proposal to explain the different components of burnout. The Spanish Burnout Inventory provides researchers and practitioners with an expanded conceptualization of the burnout syndrome, which can facilitate the diagnosis and treatment of nursing professionals. Researchers have been concerned about the psychometric limitations of the some previous questionnaires designed to evaluate burnout. To address these problems associated with previous instruments, the Spanish Burnout Inventory (SBI) was developed. The instrument has not yet been validated in staff nurses. The purpose of this paper was to evaluate the psychometric properties of the SBI. The sample consisted of 720 staff nurses from two Spanish general hospitals. The instrument is composed of 20 items distributed in four dimensions: Enthusiasm towards the job (five items), Psychological exhaustion (four items), Indolence (six items) and Guilt (five items). Data were subjected to confirmatory factor analysis. To assess the factorial validity of the SBI, four alternative models were tested. Results show that the four-factor model of the SBI has adequate psychometric properties for the study of burnout in staff nurses. This model fitted the data better than the alternative models. The study provides evidence of the adequate psychometric properties of a measure to evaluate burnout in nursing professionals. The

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

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in

Getting eHealth into basic nursing education: report of the RCN information in nursing project.

PubMed

Clark, June; Baker, Bernice; Baker, David

2009-01-01

This paper reports the results of a project undertaken in 2008 by the Royal College of Nursing's Information in Nursing Forum. The project, undertaken by the RCN IN Forum in association with the RCN Education Forum and the RCN Association of Nursing Students, was in two parts. The first part consisted of an on-line survey of nursing students to discover their "readiness" for working in an electronic environment. The second part consisted of a workshop for invited stakeholders - organisations responsible for commissioning and providing basic nursing education, regulators, nurse teachers, and nursing students themselves - the objective of which was to consider the results of the survey and other information, in order to develop a consensus on how best to incorporate eHealth issues into basic nursing education. The survey was undertaken during April 2008 via the RCN website. Students were asked how well they felt their nursing education had prepared them for competencies set out in a previously published model curriculum. 1,120 students responded. 565 students who had used electronic patient records during their most recent clinical placement were asked about their experience. Students rated their basic computer skills much higher than their understanding of eHealth. While they felt competent to document assessments and care plans using paper records, few felt competent to do so using electronic records. Few know anything about telehealth (remote diagnosis and delivery of healthcare) or telecare (assistive technology in people's homes). Among those who had used computers in their most recent clinical placement there were clear breaches of the protocols designed to ensure security and confidentiality. Twenty seven invited participants attended the workshop held in October 2008, plus 12 members of the participating Forums and relevant RCN staff. Following presentation and discussion of the findings of the survey, participants worked in three groups to identify and

Capturing Key NANDA-I Nursing Diagnoses From Actual Clinical Data for Patients With Heart Failure.

PubMed

Park, Hyejin; Tucker, Denise A

2017-01-01

The purpose of the study was to identify key nursing diagnoses with related factors and signs/symptoms using NANDA-I for patients with heart failure (HF). A retrospective descriptive design was used to address the research questions. Data were obtained from the records of patients discharged for 1 year with the medical diagnoses of HF from a Midwestern community hospital. A total of 272 inpatient records were analyzed to describe the frequency and percentage of NANDA-I diagnosis with related factors and signs/symptoms. The top 10 NANDA-I diagnoses associated with related factors and signs/symptoms were identified. Further research related to standardized nursing terminologies such as NANDA-I using large clinical databases from health information systems is needed to support evidence-based nursing diagnosis decision making. © 2015 NANDA International, Inc.

Knowledge of Toxoplasmosis among Doctors and Nurses Who Provide Prenatal Care in an Endemic Region

PubMed Central

da Silva, Laura Berriel; de Oliveira, Raquel de Vasconcelos Carvalhaes; da Silva, Marizete Pereira; Bueno, Wendy Fernandes; Amendoeira, Maria Regina Reis; Neves, Elizabeth de Souza

2011-01-01

Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC) transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy. PMID:21747644

Use of personal phones by senior nursing students to access health care information during clinical education: staff nurses' and students' perceptions.

PubMed

Wittmann-Price, Ruth A; Kennedy, Lynn D; Godwin, Catherine

2012-11-01

Research indicates that having electronic resources readily available increases learners' ability to make clinical decisions and confidence in patient care. This mixed-method, descriptive pilot study collected data about senior prelicensure nursing students using smartphones, a type of mobile electronic device (MED), in the clinical area. The smartphones contained nursing diagnosis, pharmacology, and laboratory information; an encyclopedia; and the MEDLINE database. Student (n = 7) data about smartphone use during a 10-week clinical rotation were collected via student-recorded usage logs and focus group recordings. Staff nurses' (n = 5) perceptions of students' use of smartphones for clinical educational resources were collected by anonymous survey. Both the focus group transcript and staff surveys were evaluated and the themes summarized by content analysis. Positive results and barriers to use, such as cost and technological comfort levels, are discussed. The results may help nurse educators and administrators initiate further research of MEDs as a clinical resource. Copyright 2012, SLACK Incorporated.

The role of nurse practitioners in health sector reform in Iran (2011).

PubMed

Vatankhah, Soudabe; Khalesi, Nader; Ebadifardazar, Farbod; Ferdousi, Masoud; Naji, Homayon; Farahabadi, Seyed Mohammad Ehsaan

2013-09-01

Most countries use educated nurses called "nurse practitioners" (NPs) besides the family physicians for diagnosis, treatment, and specifically health education of the family. The main goal of this study was to redefine the role of NPs for better use of their capabilities in the so-called "family physician reform" in Iran. This is a qualitative and comparative study carried out in three stages (triangulation method) in 2011. In the first stage, we conducted a literature review to design a conceptual framework. The second stage was a comparative study on four countries. In this study, we focused on the role of NPs, which in turn helped to redefine this role in the health sector reform of Iran. In the third stage, two expert panels were involved and the suggested roles were confirmed. In the United States, NPs are licensed by the state in which they practice and have a national board certification. In Canada, nurses involved in clinics should participate in specific training course of diagnosis and management of health care after registration. In Austria, nurses in Nursing homes and maternity do some of the medical procedures under the supervision of the physicians. In the United Kingdom, NPs increasingly substitute for GPs in the care of minor illness and routine management of chronic diseases. There is still debate in nursing and medical circles about what the focus of the NP roles should be. In Iran, whereas a noticeable reform toward "family physician" is ongoing, redefining the nurses' role is essential. They can perform more active roles in associating with GPs in the clinics of family physicians, both in urban and rural areas, even with higher degrees of autonomy.

Manual for monitoring the quality of nursing home care records.

PubMed

Barbosa, Silvia Freitas; Tronchin, Daisy Maria Rizatto

2015-01-01

to build and validate an instrument aimed at monitoring the quality of nursing records in the Home Care Program (HCP) of a university hospital. methodological study involving the elaboration of a manual, whose content was later submitted to six experts for validation, reaching a ≥ 80% consensus. The data collection process was carried out in 2012 by means of a questionnaire comprised of the following issues: nursing evolution, nursing diagnosis, and nursing prescription, and standards for the nursing team recommended by the Regional Nursing Council of São Paulo and by the assessed institution. Manual items were judged according to the following variables: relevance, pertinence, clarity and simplicity. of the 39 propositions, 100% achieved ≥ 80% agreement in the relevance, pertinence and clarity variables; 92.3% in the simplicity variable. Sleep/rest, Mobility and Check-out variables did not reach a favorable minimum consensus in the prescribed activities and were improved following suggestions from the experts. we believe that the instrument will enable the improvement of the HCP's work process.

Exploring communication difficulties in pediatric hematology: oncology nurses.

PubMed

Citak, Ebru Akgun; Toruner, Ebru Kilicarslan; Gunes, Nebahat Bora

2013-01-01

Communication plays an important role for the well being of patients, families and also health care professionals in cancer care. Conversely, ineffective communication may cause depression, increased anxiety, hopelessness and decreased of quality life for patients, families and also nurses. This study aimed to explore communication difficulties of pediatric hematology/oncology nurses with patients and their families, as well as their suggestions about communication difficulties. It was conducted in a pediatric hematology/oncology hospital in Ankara, Turkey. Qualitative data were collected by focus groups, with 21 pediatric hematology/oncology nursing staff from three groups. Content analysis was used for data analysis. Findings were grouped in three main categories. The first category concerned communication difficulties, assessing problems in responding to questions, ineffective communication and conflicts with the patient's families. The second was about the effects of communication difficulties on nurses and the last main category involved suggestions for empowering nurses with communication difficulties, the theme being related to institutional issues. Nurses experience communication difficulties with children and their families during long hospital stays. Communication difficulties particularly increase during crisis periods, like at the time of first diagnosis, relapse, the terminal stage or on days with special meaning such as holidays. The results obtained indicate that pediatric nurses and the child/family need to be supported, especially during crisis periods. Feeling of empowerment in communication will improve the quality of care by reducing the feelings of exhaustion and incompetence in nurses.

Assessment of nursing care using indicators generated by software.

PubMed

Lima, Ana Paula Souza; Chianca, Tânia Couto Machado; Tannure, Meire Chucre

2015-01-01

to analyze the efficacy of the Nursing Process in an Intensive Care Unit using indicators generated by software. cross-sectional study using data collected for four months. RNs and students daily registered patients, took history (at admission), performed physical assessments, and established nursing diagnoses, nursing plans/prescriptions, and assessed care delivered to 17 patients using software. Indicators concerning the incidence and prevalence of nursing diagnoses, rate of effectiveness, risk diagnoses, and rate of effective prevention of complications were computed. the Risk for imbalanced body temperature was the most frequent diagnosis (23.53%), while the least frequent was Risk for constipation (0%). The Risk for Impaired skin integrity was prevalent in 100% of the patients, while Risk for acute confusion was the least prevalent (11.76%). Risk for constipation and Risk for impaired skin integrity obtained a rate of risk diagnostic effectiveness of 100%. The rate of effective prevention of acute confusion and falls was 100%. the efficacy of the Nursing Process using indicators was analyzed because these indicators reveal how nurses have identified patients' risks and conditions, and planned care in a systematized manner.

Resourse Use and Disease Couse in dementia - Nursing Home (REDIC-NH), a longitudinal cohort study; design and patient characteristics at admission to Norwegian nursing homes.

PubMed

Røen, Irene; Selbæk, Geir; Kirkevold, Øyvind; Engedal, Knut; Testad, Ingelin; Bergh, Sverre

2017-05-22

Earlier studies of nursing home patients show a high prevalence of dementia, neuropsychiatric symptoms (NPS), pain, and dependency in activities of daily living. The REDIC-NH cohort was set up to study the disease course and the resources used in patients with dementia in Norway. The aim of this paper was to describe the methods and the data collection, and to present selected data about patients at admission to a nursing home. We included 696 patients at admission to a nursing home and followed them with biannual assessments until death. Baseline data were collected between March 2012 and November 2014. In October 2016, patients had either completed an 18-month follow-up (n = 349), passed 18 months without assessments (n = 22), or left the study (n = 324). Data on demographics, cognition, NPS, activities of daily living (ADL) functioning, physical health, medication, Quality of Life (QoL), resource use, and caregiver burden, in addition to DNA samples were collected. Mean age of the participants at inclusion was 84.5 years (SD 7.5, range 50 - 105), 63.9% were women. According to data collected in the study, 83.8% had dementia, but only 55.9% of them had a diagnosis of dementia registered in their records. The most frequent dementia diagnosis was Alzheimer's disease, which was present in 71% of those with dementia. Patients with dementia more often experienced delusions, hallucinations, agitation, anxiety, disinhibition, irritability, and aberrant motor behaviour compared to patients without dementia. Depression and anxiety were the most common NPS symptoms. Dementia and NPS were highly prevalent among persons admitted to nursing homes. Only 55.9% of the patients with dementia had a diagnosis of dementia registered in their records.

Diabetes management: optimizing roles for nurses in insulin initiation

PubMed Central

Levich, Bridget R

2011-01-01

Type 2 diabetes is a major public health concern. Screening and early diagnosis followed by prompt and aggressive treatment interventions can help control progression of diabetes and its complications. Nurses are often the first healthcare team members to interact with patients and are being called on to apply their specialized knowledge, training, and skills to educate and motivate patients with diabetes about insulin use and practical ways to achieve treatment goals. Clinical nurse specialists possess specific training and skills to provide this level of care, while staff or office-based nurses may be trained by physicians to fulfill a task-specific role. This manuscript reviews the benefits of intensive glycemic control in type 2 diabetes, therapeutic goals and guidelines, advances in insulin therapy, and contribution of nurses in overcoming barriers to insulin initiation and related aspects of diabetes care. Nurses are particularly well positioned to fill the gap and improve efficiency in diabetes-related healthcare by assisting patients with insulin initiation and other aspects of glycemic self-management. PMID:21468244

Understanding HIV-related stigma among Indonesian nurses

PubMed Central

Waluyo, Agung; Culbert, Gabriel J.; Levy, Judith; Norr, Kathleen

2014-01-01

Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country’s policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses’ HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses’ stigmatizing attitudes toward PLWH. Four hundred nurses recruited from 4 hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale (NAAS) to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. PMID:24759060

[Nursing diagnoses related to breastfeeding in a rooming-in unit].

PubMed

da Silva, Evilene Pinto; Alves, Albertisa Rodrigues; Macedo, Ana Ruth Monteiro; Bezerra, Regina Maria de Sá Barreto; de Almeida, Paulo César; Chaves, Edna Maria Camelo

2013-01-01

The study aimed to identify, in a Rooming-in unit, diagnoses related to the phenomenon of breastfeeding according to the NANDA-I Taxonomy II. It was conducted a descriptive exploratory study involving 83 mothers and their babies in the period of February to April 2011. Data were collected by means of an instrument based on the Theory of Basic Human Needs and, after statistical analysis, presented in tables. The results showed that the most frequent nursing diagnosis was Effective breastfeeding, identified in 65 (78.3%) cases. It is estimated that the nursing diagnoses related to breastfeeding can contribute to nursing care so that it can be more targeted, in order to promote a more qualified, effective and human care.

Nurses who work outside nursing.

PubMed

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

2004-09-01

The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.

Nurse practice issues regarding sperm banking in adolescent male cancer patients.

PubMed

Reebals, Jeri F; Brown, Richard; Buckner, Ellen B

2006-01-01

The impressive increase in the survival rate of childhood cancer patients has produced increased interest in quality of life issues. This research addresses nurse practice issues in determining whether the newly diagnosed adolescent male patient is offered the option of sperm banking before undergoing chemotherapy treatment. Questionnaires were distributed to nurses and nurse practitioners on 3 inpatient and outpatient units who care for adolescent male cancer patients at the time of diagnosis, during chemotherapy, and during follow-up care. Findings indicate that 96.3% of respondents agreed that all male patients undergoing cancer treatment with infertility as a potential side effect should be offered sperm banking. Respondents viewed oncologists and nurse practitioners as appropriate professionals to discuss the option. Lack of knowledge regarding sperm banking could be limiting nurses' willingness to introduce the topic, and education regarding cryopreservation may improve their knowledge and practice.

Treatment decisions on antidepressants in nursing homes: a qualitative study.

PubMed

Iden, Kristina Riis; Hjørleifsson, Stefan; Ruths, Sabine

2011-12-01

To explore decision-making on treatment with antidepressants among doctors and nurses in nursing homes. A qualitative study based on interviews with three focus groups comprising eight physicians engaged full time, eight physicians engaged part time, and eight registered nurses, respectively. The interview guide comprised questions on initiating, evaluating, and withdrawing treatment with antidepressants. The interviews were audio-recorded, transcribed, and analysed by systematic text condensation. The first theme was the diagnostic process. The informants expressed difficulty in differentiating between depression and sorrow resulting from loss in old age. Further, the doctors reported that they relied on nurses' observations and rarely carried out systematic diagnostic work and follow-up of patients with depression. The second theme was treatment. Antidepressants were usually the only type of treatment provided, and patients were kept on medication even though staff felt uncertain whether this was effective. The third theme was who really determines the treatment. Registered nurses reported that unskilled and auxiliary nursing staff requested drug treatment, and doctors felt some pressure from the nurses to prescribe antidepressants. This study suggests that the quality of diagnosis and treatment for depression in nursing homes needs to be improved in Norway. Doctors should be more available and take responsibility and leadership in medical decisions.

Advances in assessment, diagnosis, and treatment of hyperthyroidism in children.

PubMed

Amer, Kim Siarkowski

2005-04-01

The thyroid gland is responsible for regulating multiple complex metabolic processes that affect most organs. Physical growth and cognitive development are dependent on proper levels of thyroid hormone. This article will review common challenges in the diagnosis of hyperthyroidism in children, the approaches to treatment, and the nursing interventions guided toward child and family responses to thyroid disease. A comparison of signs and symptoms of hypothyroidism and hyperthyroidism is also included. The nursing interventions addressed in the article integrate the biological, psychological, social, and environmental stresses and adaptations necessary to cope with hyperthyroid disease.

A randomized controlled trial of a nursing psychotherapeutic intervention for anxiety in adult psychiatric outpatients.

PubMed

Sampaio, Francisco Miguel Correia; Araújo, Odete; Sequeira, Carlos; Lluch Canut, María Teresa; Martins, Teresa

2018-05-01

To evaluate the short-term efficacy of a psychotherapeutic intervention in nursing on Portuguese adult psychiatric outpatients with the nursing diagnosis "anxiety." Several efficacious forms of treatment for anxiety are available, including different forms of psychotherapy and pharmacotherapy. However, literature tends to favour findings from studies on the efficacy of psychotherapies and therapies provided by nurses to the detriment of those arising from studies on the efficacy of nursing psychotherapeutic interventions (interventions which are classified, for instance, on Nursing Interventions Classification). Randomized controlled trial. The study was performed, between November 2016 - April 2017, at a psychiatry outpatient ward. Participants were randomly allocated to an intervention group (N = 29) or a treatment-as-usual control group (N = 31). Patients in the intervention group received psychopharmacotherapy with interventions integrated in the Nursing Interventions Classification for the nursing diagnosis "anxiety." A treatment-as-usual control group received only psychopharmacotherapy (if applicable). Anxiety level and anxiety self-control were the primary outcomes. Patients from both groups had reduced anxiety levels, between the pre-test and the posttest assessment; however, according to analysis of means, patients in the intervention group displayed significantly better results than those of the control group. Furthermore, only patients in the intervention group presented significant improvements in anxiety self-control. This study demonstrated the short-term efficacy of this psychotherapeutic intervention model in nursing in the decrease of anxiety level and improvement of anxiety self-control in a group of psychiatric outpatients with pathological anxiety. NCT02930473. © 2017 John Wiley & Sons Ltd.

Effectiveness of nurse-led cardiac clinics in adult patients with a diagnosis of coronary heart disease.

PubMed

Page, Tamara; Lockwood, Craig; Conroy-Hiller, Tiffany

2005-02-01

Background  Coronary heart disease is the major cause of illness and death in Western countries and this is likely to increase as the average age of the population rises. Consumers with established coronary heart disease are at the highest risk of experiencing further coronary events. Lifestyle measures can contribute significantly to a reduction in cardiovascular mortality in established coronary heart disease. Improved management of cardiac risk factors by providing education and referrals as required has been suggested as one way of maintaining quality care in patients with established coronary heart disease. There is a need to ascertain whether or not nurse-led clinics would be an effective adjunct for patients with coronary heart disease to supplement general practitioner advice and care. Objectives  The objective of this review was to present the best available evidence related to nurse-led cardiac clinics. Inclusion criteria  This review considered any randomised controlled trials that evaluated cardiac nurse-led clinics. In the absence of randomised controlled trials, other research designs such as non-randomised controlled trials and before and after studies were considered for inclusion. Participants were adults (18 years and older) with new or existing coronary heart disease. The interventions of interest to the review included education, assessment, consultation, referral and administrative structures. Outcomes measured included adverse event rates, readmissions, admissions, clinical and cost effectiveness, consumer satisfaction and compliance with therapy. Results  Based on the search terms used, 80 papers were initially identified and reviewed for inclusion; full reports of 24 of these papers were retrieved. There were no papers included that addressed cost effectiveness or adverse events; and none addressed the outcome of referrals. A critical appraisal of the 24 remaining papers identified a total of six randomised controlled trials that

Lying to patients with dementia: Attitudes versus behaviours in nurses.

PubMed

Cantone, Daniela; Attena, Francesco; Cerrone, Sabrina; Fabozzi, Antonio; Rossiello, Riccardo; Spagnoli, Laura; Pelullo, Concetta Paola

2017-01-01

Using lies, in dementia care, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. In this article, we report results about the attitude and the behaviour of nurses towards the use of lies to patients with dementia. An epidemiological cross-sectional study was conducted between September 2016 and February 2017 in 12 elderly residential facilities and in the geriatric, psychiatric and neurological wards of six specialised hospitals of Italy's Campania Region. In all, 106 nurses compiled an attitude questionnaire (A) where the main question was 'Do you think it is ethically acceptable to use lies to patients with dementia?', instead 106 nurses compiled a behaviour questionnaire (B), where the main question was 'Have you ever used lies to patients with dementia?' Ethical considerations: Using lies in dementia care, although topic ethically still controversial, reveals a common practice far beyond the diagnosis and prognosis, extending to the entire care process. Only a small percentage of the interviewed nurses stated that they never used lies/that it is never acceptable to use lies (behaviour 10.4% and attitude 12.3%; p = 0.66). The situation in which nurses were more oriented to use lies was 'to prevent or reduce aggressive behaviors'. Indeed, only the 6.7% in the attitude group and 3.8% in the behaviour group were against using lies. On the contrary, the case in which the nurses were less oriented to use lies was 'to avoid wasting time giving explanations', in this situation were against using lies the 51.0% of the behaviour group and the 44.6% of the attitude group. Our results, according to other studies, support the hypothesis of a low propensity of nurses to ethical reflection about use of lies. In our country, the implementation of guidelines about a correct use of lie in the relationship between health operators and patients would be desirable.

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

PubMed

Semachew, Ayele

2018-03-13

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

Melanoma in the skin of a nurse shark (Ginglymostoma cirratum).

PubMed

Waldoch, Jennifer A; Burke, Sandy S; Ramer, Jan C; Garner, Michael M

2010-12-01

A female nurse shark, Ginglymostoma cirratum, estimated at 27 yr of age had a 5.5-yr history of a 6-cm black, raised nodular skin lesion located on the right side of the proximal tail. The lesion was diagnosed on biopsy as a slow-growing melanoma of the skin with no vascular invasion. The nurse shark was euthanized for systemic illness approximately 4.5 mo after diagnosis of the dermal melanoma. No evidence of metastasis was found on histopathologic evaluation of the skin and viscera.

Nurse Managers Speak Out About Disruptive Nurse-to-Nurse Relationships.

PubMed

Moore, Linda Weaver; Sublett, Cynthia; Leahy, Cathy

2017-01-01

The purpose of this study is to explore nurse managers' (NMs') perceptions regarding disruptive nurse-to-nurse relationships. Nurse managers play a pivotal role in creating and sustaining healthy practice environments. They must understand how to recognize and confront disruptive nurse relationships that can threaten the health of their units. A qualitative study design using researcher-participant interviews of 13 NMs from 5 institutions provided data regarding NMs' views on nurse relationships. Nurse managers reported how they became aware of disruptive nurse relationships, their strategies for dealing with those relationships, and the impact that confronting disruptive relationships had on them personally. Findings can be helpful to NMs who are faced with addressing disruptive nurse-to-nurse relationships as they endeavor to create and sustain healthy work environments.

Caring for people with dementia and challenging behaviors in nursing homes: A needs assessment geriatric nursing.

PubMed

Daly, Jeanette M; Bay, Camden P; Levy, Barcey T; Carnahan, Ryan M

2015-01-01

An estimated 50% of nursing home residents have a dementia diagnosis. The purpose of this research was to conduct a needs assessment of directors of nursing (DON) in Iowa nursing homes in relation to caring for patients with Behavioral and Psychological Symptoms of Dementia. DON responses were linked to Online Survey Certification and Reporting/Certification and Survey Provider Enhanced Reporting (OSCAR/CASPER) data to examine how facility characteristics may be associated with use of and confidence in non-drug management strategies. From 431 questionnaires mailed to DONs, 160 (37%) were returned. Regression analysis showed that those who were more confident in managing challenging behavior were more likely to have satisfaction with current training on managing challenging behaviors and had a psychiatrist available to visit the facility. Facilities with a larger proportion of patients with challenging behaviors being treated with non-drug approaches instead of antipsychotics had DONs who were more likely to be confident in non-drug management strategies and have knowledge about the FDA antipsychotic medications risks. Copyright © 2015 Elsevier Inc. All rights reserved.

[Gender violence: Knowledge and attitudes of nurses in Primary Care].

PubMed

Valdés Sánchez, Carmen Ana; García Fernández, Carla; Sierra Díaz, Ángela

2016-12-01

To determine the knowledge and attitudes of nurses in Primary Care as regards gender violence and their relationship with socio-demographic factors and cases detected. Cross-sectional, descriptive study. Urban health centres. A total of 167 nurses working in Primary Care. A questionnaire was used that included questions related to knowledge, knowledge perception and attitudes to gender violence attitudes. Variables such as age, gender, marital status, work place and health area were also analysed. The response rate was 114 (68.26%). The percentage of correct responses in the knowledge questions was 62.2%, with a medium level of knowledge being observed. Married nurses or couples living in a stable relationship obtained a higher score (95.2%, P=.077). The low detection (29%) is associated with marital status (P=.004), low knowledge (P=0,008), low knowledge perception (P=.001), lack of training (P=.03) and non-implementation of the gender violence protocol (P=.001). Nurses with low self-perception of their knowledge implement the protocol less often (OR=0.26; 95% CI: 0.1-0.7), and they consider that the lack of training is the main problem in determining the diagnosis (OR=11.24; 95% CI: 1.5-81.1). The level of knowledge was adequate. Nurses have a lack of confidence in terms of their knowledge about gender violence. The detection and diagnosis attitudes are more related to self-perception of levels of knowledge than their real knowledge. Marital status influences the level of knowledge. Professionals state that the lack of training is the main problem to give an efficient healthcare response. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Breaking bad news: issues relating to nursing practice.

PubMed

Warnock, Clare

2014-07-15

The breaking of bad news was traditionally regarded to be the time when a doctor and nurse sat down with a patient and family members to provide information about, for example, a life-limiting diagnosis or a poor prognosis. However, breaking bad news is now generally accepted as a process, not a one-off event, and is considered to refer to any bad, sad or difficult information that alters patients' perceptions of their present and future. Nurses have an important role in the process of providing information and helping patients prepare for, receive, understand and cope with the bad news they have been given. This article aims to help nurses understand the process of breaking bad news and discuss the challenges and difficulties that nurses can face when they are involved with patients who have been given bad news. It also provides guidance with regard to preparing for breaking bad news, giving difficult information, responding to possible reactions, and supporting patients and their relatives after they have received bad news.

What patients' problems do nurses e-chart? Longitudinal study to evaluate the usability of an interface terminology.

PubMed

Juvé-Udina, Maria Eulàlia

2013-12-01

The nurses' ability to document patient's status, problems and progress is an important issue in patients' safety. Nursing terminologies are intended to support nursing practice but as any other clinical tool, they should be evaluated to assure quality and warrant effective written communication among clinicians. This study was aimed to evaluate the usability of the diagnosis axis of an interface terminology by assessing its completeness and the frequency of use of its concepts. Observational, longitudinal, multicentre study. A total of 8 hospitals representing 162 acute medical-surgical, obstetric and mental health nursing wards, step-down units and home in-patient units were included. Overall, 246,400 electronic care plans were studied; 53.5% from male patients; 14.6% paediatrics and 33.7% from patients elder than 70 years old. Most were admitted due to cardiocirculatory, respiratory, digestive or musculoskeletal conditions (50.5%), other acute medical or surgical disorders (29.8%) and obstetrics (19.3%). The main outcome measures were: the use of nursing diagnoses from the interface terminology evaluated and their accumulated frequency, analysed over a 3-year retrospective review of the electronic nursing care plans. The analysis of data included descriptive statistics with a confidence level of 95% for confidence intervals. Most of the diagnostic concepts from the interface terminology were used (92.3%) by nurses to illustrate patients' problems in the electronic care plans. Their frequency of use widely varied, from some very frequent diagnoses like Risk for haemorrhage (51.4%; CI 95%: 51.25-51.65) or Acute pain (49.6%; CI: 49.49-49.88) to others used only in exceptional cases like Faecal impaction or Extravasation. The first nursing diagnosis related to family or caregiver emerges in the 32nd place of the ranking. Results for outcome measures oriented that the diagnosis axis of this interface terminology meets the usability criterion of completeness when

Nurse experiences as cancer survivors: part II--professional.

PubMed

Picard, Carol; Agretelis, Joan; DeMarco, Rosanna F

2004-05-01

To uncover dimensions of nurses' professional experiences of cancer survivorship. Interpretive, phenomenologic. Metropolitan area in the northeastern United States. 25 RNs diagnosed with cancer. Average age was 50 years, and 20 participants were less than five years from initial diagnosis. Interviews. Data were analyzed using the methodology of Newman (1994, 1999) and VanManen (1990). Nurses' professional experiences of cancer survivorship. Professional experiences of cancer survivorship fell into five themes: (a) role ambiguity, (b) a deepening level of compassion for patients and others, (c) self-disclosure as a therapeutic intervention, (d) becoming an advocate for change, and (e) volunteerism. Cancer survivorship was a factor in reshaping participants' clinical practice. Experiencing the role of the patient affirmed the necessity of compassionate care for these participants. Nurses experienced a deepening level of compassion for patients and used self-disclosure as a therapeutic intervention. During and shortly after treatment, role ambiguity (being both patient and nurse) could cause difficulties. Nurses took action to change their clinical environment through their influence on colleagues and the healthcare system and by working through other organizations to improve patient care. Nurse cancer survivors can benefit from the support of colleagues and healthcare providers and an appreciation of the challenge of being both a professional and a patient. The invitation for dialogue as they return to work may help with the challenges of role ambiguity as nurse cancer survivors. Based on this study, nurses value the opportunity to enhance care environments with their two-world knowledge through compassionate care, disclosure, advocacy, and volunteering, and coworkers need to appreciate each nurse's unique response to this potentially life-changing process. Nurses in all settings can learn from their cancer survivor colleagues who have been the recipients of care to

Diagnostic frameworks and nursing diagnoses: a normative stance.

PubMed

Zanotti, Renzo; Chiffi, Daniele

2015-01-01

Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective. The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false-positive and false-negative outcomes, leading to probabilistic judgements; and (2) non-epistemic values when related to ideas such as well-being, normality, illness, etc, as idealized norms or ideal points of reference. It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks - the taxonomies of Gordon and NANDA - in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value-based judgements in which both epistemic and non-epistemic values may coexist. © 2014 John Wiley & Sons Ltd.

Profile of nursing diagnoses in patients with respiratory disorders.

PubMed

Alves dos Santos, Naftale; Frota Cavalcante, Tahissa; de Oliveira Lopes, Marcos Venícios; Bezerra Gomes, Emiliana; de Oliveira, Célida Juliana

2015-01-01

Identify the profile of nursing diagnoses in patients with respiratory disorders. A descriptive and cross-sectional study involving 38 patients with respiratory problems, of referral hospitals, in a city in northeastern Brazil, in the period from August to October, 2012. Data collection was performed using a form and diagnostic inference was made according with the Taxonomy II of NANDA I. The average age of the patients was 46 years and males predominated (60.5%). The most frequent nursing diagnoses were: Risk for infection (97.3%), Acute pain (68.4%), Poor knowledge (68.4%), Sedentary lifestyle (65.7%), Ineffective airway clearance (65.7%), Risk-prone health behavior (63.1%), Activity intolerance (52.6%) and Disturbed sleep pattern (33.3%). Evaluated patients exhibited an average of 8.6 nursing diagnoses (SD = 2.8). With respect to the defining characteristics and related factors the average per person was 7.2 and 9.3, respectively. In this group of patients the most frequent diagnoses were the domain activity/rest. Knowledge of nursing diagnoses profile presented by people with respiratory disorders is important, because it is part of the Nursing Process and nurses who take care of such patients should exercise them in their care practice. Knowledge of the mains nursing diagnosis presented by patients with respiratory disorders are important for the practice of nurses who care for these patients, because it allows the choice of responses to problems of their clientele.

Nursing, Nursing Education, and Anxiety.

ERIC Educational Resources Information Center

Biggers, Thompson; And Others

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

Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey.

PubMed

Kang, Yu; Meng, Hongdao; Miller, Nancy A

2011-12-01

To evaluate the impact of rural geographic location on nursing home quality of care in the United States. The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics. Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident. Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities.

[Nursing methodology applicated in patients with pressure ulcers. Clinical report].

PubMed

Galvez Romero, Carmen

2014-05-01

The application of functional patterns lets us to make a systematic and premeditated nursing assessment, with which we obtain a lot of relevant patient data in an organized way, making easier to analize them. In our case, we use Marjory Gordon's functional health patterns and NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification), NIC (Nursing Intervention Classification) taxonomy. The overall objective of this paper is to present the experience of implementation and development of nursing methodology in the care of patients with pressure ulcers. In this article it's reported a case of a 52-year-old female who presented necrosis of phalanxes in upper and lower limbs and suffered amputations of them after being hospitalized in an Intensive Care Unit. She was discharged with pressure ulcers on both heels. GENERAL ASSESSMENT: It was implemented the nursing theory known as "Gordon's functional health patterns" and the affected patterns were identified. The Second Pattern (Nutritional-Metabolic) was considered as reference, since this was the pattern which altered the rest. EVOLUTION OF THE PATIENT: The patient had a favourable evolution, improving all the altered patterns. The infections symptoms disappeared and the pressure ulcers of both heels healed completely. The application of nursing methodology to care patients with pressure ulcers using clinical practice guidelines, standardized procedures and rating scales of assessment improves the evaluation of results and the performance of nurses.

As Patient Navigation Expands and Evolves, Nurses Assume Many Roles

Cancer.gov

It can be difficult to access care in our labyrinthine health care system. Oncology nurses are joining the ranks of patient navigators—a diverse group of people who help patients at all stages of cancer care, from screening and diagnosis to treatment and survivorship.

Rehabilitation services after the implementation of the nursing home prospective payment system: differences related to patient and nursing home characteristics.

PubMed

Murray, Patrick K; Love, Thomas E; Dawson, Neal V; Thomas, Charles L; Cebul, Randall D

2005-11-01

The prospective payment system (PPS) for nursing homes was designed to curtail the rapid expansion of Medicare costs for skilled nursing care. This study examines the changes that occurred in nursing home patients and rehabilitation services following the PPS. Free-standing Medicare and/or Medicaid certified nursing homes in Ohio. The percent of new admissions receiving therapy and the amount of rehabilitation therapy provided. A total of 7006 first admissions in 1994-6 (pre-PPS) and 61,569 first admissions in 2000-1 (post-PPS). A logistic model predicting likelihood of rehabilitation was developed and validated in pre-PPS admissions and applied to the post-PPS patients. Rehabilitation services were compared in the pre-PPS and post-PPS cohorts overall, stratified by quintile of predicted score, diagnosis group, and by nursing home profit status. Post-PPS patients had less cognitive impairment, more depression, and more family support. The amount of rehabilitation services declined the most in the higher quintiles of predicted likelihood of rehabilitation and among patients with stroke. The percent of patients receiving rehabilitation services increased the most in the lowest quintile and among patients with medical conditions. These changes were greater in for-profit nursing homes. The implementation of the PPS in nursing homes has been associated with a decrease in the amount of rehabilitation services, targeted at those predicted to receive higher amounts and an increased frequency of providing services targeted at those predicted to be less likely to receive them. The outcomes of the changes deserve further study.

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

PubMed

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

2017-07-01

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

Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.

PubMed

Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong

2016-11-01

As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nursing practice environment and registered nurses' job satisfaction in nursing homes.

PubMed

Choi, JiSun; Flynn, Linda; Aiken, Linda H

2012-08-01

 Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes.   The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes.   Controlling for individual and nursing home characteristics, staff RNs' participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs' job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied.   A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction.

A Guide to Screening for the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) Under Medicaid.

ERIC Educational Resources Information Center

Frankenburg, William K.; North, A. Frederick, Jr.

The manual was designed to help public officials, physicians, nurses, and others to plan and implement an Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program under Medicaid. Procedures for carrying out components of an EPSDT program are recommended. Part 1 discusses organization and administration of screening, diagnosis, and…

Mortality and nursing home placement of dementia patients in rural and urban areas: a cohort study from the Swedish Dementia Registry.

PubMed

Roheger, Mandy; Zupanic, Eva; Kåreholt, Ingemar; Religa, Dorota; Kalbe, Elke; Eriksdotter, Maria; Garcia-Ptacek, Sara

2018-04-14

Life in rural and urban areas differs in regard to social support and health care. Our aim was to examine the association between nursing home placement and survival of patients with dementia living in urban vs. rural areas. We performed a longitudinal cohort study of patients with dementia at time of diagnosis (n = 58 154) and at first follow-up (n = 21 522) including patients registered from 2007 through 2014 in the Swedish Dementia Registry (SveDem). Descriptive statistics are shown. Odds ratios with 95% CI are presented for nursing home placement and hazard ratios for survival analysis. In age- and sex-adjusted analyses, patients living in urban areas were more likely to be in nursing homes at the time of dementia diagnosis than patients in rural areas (1.49, 95% CI: 1.29-1.73). However, there were no differences in rural vs urban areas in either survival after dementia diagnosis (urban: 0.99, 0.95-1.04, intermediate: 1.00, 0.96-1.04), or nursing home placement at first follow-up (urban: 1.00, 0.88-1.13; intermediate: 0.95, 0.85-1.06). Persons with dementia living in rural areas are less likely to live in a nursing home than their urban counterparts at the time of dementia diagnosis, but these differences disappear by the time of first follow-up. Differences in access to nursing homes between urban and rural settings could explain these findings. Results should be considered in the future healthcare decisions to ensure equality of health care across rural and urban areas. © 2018 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Capability of Using Clinical Care Classification System to Represent Nursing Practice in Acute Setting in Taiwan

PubMed Central

Feng, Rung-Chuang; Tseng, Kuan-Jui; Yan, Hsiu-Fang; Huang, Hsiu-Ya; Chang, Polun

2012-01-01

This study examines the capability of the Clinical Care Classification (CCC) system to represent nursing record data in a medical center in Taiwan. Nursing care records were analyzed using the process of knowledge discovery in data sets. The study data set included all the nursing care plan records from December 1998 to October 2008, totaling 2,060,214 care plan documentation entries. Results show that 75.42% of the documented diagnosis terms could be mapped using the CCC system. A total of 21 established nursing diagnoses were recommended to be added into the CCC system. Results show that one-third of the assessment and care tasks were provided by nursing professionals. This study shows that the CCC system is useful for identifying patterns in nursing practices and can be used to construct a nursing database in the acute setting. PMID:24199066

Nursing: What's a Nurse Practitioner?

MedlinePlus

... nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification in their ... Nurse Practitioners (NAPNAP) and through local hospitals or nursing schools. Also, many doctors share office space with ...

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

PubMed

Gray, Linda R; Shirey, Maria R

2013-01-01

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

Smoking Cessation Interventions in Cancer Care: Opportunities for Oncology Nurses and Nurse Scientists

PubMed Central

Cooley, Mary E.; Lundin, Rebecca; Murray, Lyndsay

2016-01-01

Smoking cessation is essential after the diagnosis of cancer to improve clinical outcomes. The purpose of this chapter is to provide a systematic review of research on smoking cessation in the context of cancer care with an emphasis on nursing contributions to the field. Data sources included research reports of smoking cessation interventions conducted in people with cancer. Nineteen primary studies were reviewed. High intensity interventions, targeting multiple behaviors, and/or using a multicomponent intervention that included pharmacotherapy, behavioral counseling, and social support were characteristics of the most successful treatments for tobacco dependence. The majority of interventions were conducted in adults with smoking-related malignancies during acute phases of illness. The most striking finding was that more than one half of the studies tested the efficacy of nurse-delivered interventions. Conceptual and methodological issues that can be improved in future studies include: using theoretical frameworks to specify how the intervention will affect outcomes, ensuring adequate sample sizes, using biochemical verification to monitor smoking outcomes, and using standardized outcome measures of abstinence. Although effective interventions are available for healthy populations, further research is needed to determine if tailored cessation interventions are needed for patients with cancer. To provide optimal quality care it is imperative that delivery of evidence-based smoking cessation interventions be integrated into the cancer treatment trajectory. Multiple barriers, including patient and nurse attitudes toward smoking and lack of knowledge related to tobacco treatment, prevent translating evidence-based tobacco dependence treatment into clinical practice. Further nursing research is needed to address these barriers. PMID:20192107

Overview of depression: epidemiology and implications for community nursing practice.

PubMed

Lazarou, Chrystalleni; Kouta, Christiana; Kapsou, Margarita; Kaite, Charis

2011-01-01

Depressive disorders are among the most common psychological conditions currently affecting individuals living in the Westernized world. Yet, available data indicate that fewer than one third of adults with depression obtain appropriate professional treatment. This is attributed, among other reasons, to the under-recognition of the problem by health professionals, including district nurses. In order to improve recognition of the problem, it is imperative for nurses and especially those working in community settings, to appreciate the importance of prompt diagnosis which presumes both an understanding and knowledge of basic aspects of the problem and, an understanding of their role in dealing with depression. This overview presents epidemiological data and identifies the potential consequences of depression on daily functioning and other aspects of life among adults in Westernized countries, aiming to raise awareness and sensitize district nurses about the issue The article discusses how the role of district nurses can be enhanced to improve recognition rates.

An international study of hospitalized cancer patients' health status, nursing care quality, perceived individuality in care and trust in nurses: A path analysis.

PubMed

Charalambous, Andreas; Radwin, Laurel; Berg, Agneta; Sjovall, Katarina; Patiraki, Elisabeth; Lemonidou, Chryssoula; Katajisto, Jouko; Suhonen, Riitta

2016-09-01

Providing high quality nursing care for patients with malignancies is complex and driven by many factors. Many of the associations between nursing care quality, trust, health status and individualized care remain obscure. To empirically test a model of association linking hospitalized cancer patients' health status, nursing care quality, perceived individuality in care and trust in nurses. A cross-sectional, exploratory and correlational study design was used. This multi-site study was conducted in cancer care clinics, in-patient wards of five tertiary care hospitals in Cyprus, Finland, Greece and Sweden. Out of 876 hospitalized patients with a confirmed histopathological diagnosis of cancer approached to participate in the study in consecutive order, 599 (response rate 68%) agreed to participate and the data from 590 were used for path analysis. Data were collected in 2012-2013 with the Individualized Care Scale-Patient (ICS-Patient), the Oncology Patients' Perceptions of Quality Nursing Care Scale (OPPQNCS), the Euro-Qol (EQ-5D-3L) and the Trust in Nurses Scale. Data were analysed statistically using descriptive and inferential statistics. Mplus version 7.11 was used to determine the best Trust model with path analysis. Although the model fit indices suggested that the hypothesized model did not perfectly to the data, a slightly modified model which includes the reciprocal path between individualized care and nursing care quality demonstrated a good fit. A model of trust in nurses was developed. Health status, individualized care, and nursing care quality were found to be associated with trust. The model highlights the complexity of caring for cancer patients. Trust in nurses is influenced by the provision of individualized care. Generating and promoting trust requires interventions, which promote nursing care quality, individuality and patients' health status. Copyright © 2016 Elsevier Ltd. All rights reserved.

American Nurses Association Nursing World

MedlinePlus

... ANA » My ANA » Shop » ANA Nursing Knowledge Center Nursing Insider News 10/13/2017 American Nurses Association ... 17 ANA Enterprise CEO Weston Announces Resignation More Nursing Insider News Upcoming Events 10/17/2017 - 10/ ...

Emotional reaction to diagnosis of infertility in Kuwait and successful clients' perception of nurses' role during treatment

PubMed Central

2010-01-01

Background The unfulfilled desire of millions of infertile couples worldwide to have their own biological children results in emotional distress. This study evaluated the emotional reactions of couples attending a combined infertility clinic in Kuwait and successful clients' perception of nurses. Methods Quantitative and qualitative methods were used. The first phase was by structured interview using two standardized psychological scales: the 25-item Hopkins Symptom Checklist and Modified Fertility Adjustment Scale. Data were collected from 268 couples attending the combined infertility clinic, between October 2002 and September 2007. The second phase was a semi-structured interview of 10 clients who got pregnant following treatment. The interview explored their feelings and perception of the nurses' role. Interviews were transcribed verbatim and analyzed. Results The average duration of infertility was 4 years; 65.7% of the women and 76.1% of men suffered from primary infertility. Emotional reactions experienced were: anxiety in women (12.7%) and men (6%), depression in women (5.2%) and men (14.9%) and reduced libido in women (6.7%) and men (29.9%). Also in men, 14.9% experienced premature ejaculation, 5.2% weak ejaculation and 7.9% had impotence although 4.9% were transient. In the semi-structured interviews, the emotions expressed were similar and in addition to anger, feelings of devastation, powerlessness, sense of failure and frustration. In the survey, 12.7% of the men were found to show more anxiety than women (6%). Although all the 10 women interviewed confirmed they were anxious; only 4 of their partners were reported to be sad or anxious. Successful clients' perception of nurses' roles included nurses carrying out basic nursing procedures, communicating, educating about investigative and treatment procedures, providing emotional support by listening, encouraging, reassuring and being empathetic. Conclusions This study illuminates the emotional reactions

Accuracy of Home-Based Ultrasonographic Diagnosis of Obstetric Risk Factors by Primary-Level Health Workers in Rural Nepal

PubMed Central

Kozuki, Naoko; Mullany, Luke C.; Khatry, Subarna K.; Ghimire, Ram K.; Paudel, Sharma; Blakemore, Karin; Bird, Christine; Tielsch, James M.; LeClerq, Steven C.; Katz, Joanne

2016-01-01

Objective To assess the feasibility of task shifting by estimating the accuracy at which primary-level health care workers can perform community-based third trimester ultrasound diagnosis for selected obstetric risk factors in rural Nepal. Methods Three auxiliary nurse midwives received two one-week ultrasound trainings at Tribhuvan University Teaching Hospital in Kathmandu. In our study site in rural Nepal, women who were ≥32 weeks in gestational age were enrolled and received ultrasound examinations from the auxiliary nurse midwives during home visits. Each auxiliary nurse midwife screened for non-cephalic presentation, multiple gestation, and placenta previa. All de-identified images were stored and uploaded onto an online server, where certified sonologists and sonographers reviewed the images and made their own diagnoses for the three conditions. Accuracy of auxiliary nurse midwife diagnoses was then calculated. Results We enrolled 804 women in the study. Each auxiliary nurse midwife’s kappa statistic for diagnosis of non-cephalic presentation was above 0.90 compared with the sonogram reviewers. Sensitivity, specificity, positive and negative predictive values were between 90–100% for all auxiliary nurse midwives For multiple gestation, the auxiliary nurse midwives were in perfect agreement with both the sonogram reviewers and maternal postpartum self-report. Two placenta previa cases were detected, and the sonogram reviewers agreed with both. Conclusion With limited training, primary-level health care workers in rural Nepal can accurately diagnose selected third trimester obstetric risk factors using ultrasonography. PMID:27500343

Effectiveness of communication skills training of nurses on the quality of life and satisfaction with healthcare professionals among newly diagnosed cancer patients: a preliminary study.

PubMed

Fukui, Sakiko; Ogawa, Keiko; Yamagishi, Akemi

2011-12-01

The importance of effective communication skills to sustain the cancer patient quality of life (QOL) and their satisfaction with healthcare professionals is well documented. This study aims to assess the effectiveness of communication skills training (CST) of nurses for patient QOL and their satisfaction with healthcare professionals just after being diagnosed with cancer. This is a secondary analysis of a randomized controlled trial. Eight nurses, who mainly provide psychological and informational support for patients soon after they were informed of their cancer diagnosis by physicians at a cancer screening center, were randomly assigned to an experimental group attending a CST program (four nurses) or to a control group (four nurses). Eighty-nine patients with gastric, colorectal, or breast cancer were supported and assessed by either group of nurses during the study period. The effectiveness for patient QOL and their satisfaction with healthcare professionals was assessed by administering the Short Form-8 Health Survey (SF-8) and a single-item VAS three times (1 week after diagnosis: T1; 1 month after diagnosis: T2; and 3 months after diagnosis: T3). Repeated measures analysis of variance showed a group-by-time significant increase of the mental aspects of SF-8 (F=3.48; P=0.03) and satisfaction with the nurse (F=3.18; p=0.04). Our findings underscore the importance of CST for healthcare professionals to improve the QOL of patients as well as their satisfaction with these professionals. Copyright © 2010 John Wiley & Sons, Ltd.

Using a Web-Based e-Visit Simulation to Educate Nurse Practitioner Students.

PubMed

Merritt, Lisa Schaeg; Brauch, Allison N; Bender, Annah K; Kochuk, Daria

2018-05-01

The purpose of this pilot study was to develop and implement a Web-based, e-Visit simulation experience for nurse practitioner students and evaluate student satisfaction and perceived learning. The convenience sample consisted of 26 senior-level Master of Science in Nursing students in the Pediatric Nurse Practitioner and Adult-Gerontology Nurse Practitioner programs. A Likert survey was used for evaluation that measured items from 1 (strongly disagree) to 5 (strongly agree). Students reported that the simulation cases closely resembled real-world patients (97%; M = 4.42, SD = 0.69), providing them with a better understanding of complaints commonly addressed via telehealth services (96%; M = 4.46, SD = 0.57). Accuracy of diagnosis and treatment on first attempt was 95%. A Web-based, e-Visit simulation can be a useful learning experience for nurse practitioner students with knowledge gained that is transferable to real clinical situations. [J Nurs Educ. 2018;57(5):304-307.]. Copyright 2018, SLACK Incorporated.

Building Care Bridges between Acute and Long-Term Care with Nursing Diagnosis.

ERIC Educational Resources Information Center

Taylor, Carol A.

The increasing age of the American population and the current emphasis on cost containment in health care make the 1980s an ideal time for building bridges to span the health care needs of elderly persons in acute care and long-term care. While hospitals often discharge patients to nursing homes as an intermediate step between hospitalization and…

People with dementia in nursing home research: a methodological review of the definition and identification of the study population.

PubMed

Palm, Rebecca; Jünger, Saskia; Reuther, Sven; Schwab, Christian G G; Dichter, Martin N; Holle, Bernhard; Halek, Margareta

2016-04-05

There are various definitions and diagnostic criteria for dementia, leading to discrepancies in case ascertainment in both clinical practice and research. We reviewed the different definitions, approaches and measurements used to operationalize dementia in health care studies in German nursing homes with the aim of discussing the implications of different approaches. We conducted a systematic search of the MEDLINE and CINAHL databases to identify pre-2016 studies conducted in German nursing homes that focused on residents with dementia or cognitive impairment. In- or exclusion of studies were consented by all authors; data extraction was independently carried out by 2 authors (RP, SJ). The studies' sampling methods were compared with respect to their inclusion criteria, assessment tools and methods used to identify the study population. We summarized case ascertainment methods from 64 studies. Study participants were identified based on a diagnosis that was evaluated during the study, or a recorded medical dementia diagnosis, or a recorded medical diagnosis either with additional cognitive screenings or using screening tests exclusively. The descriptions of the diagnostics that were applied to assess a diagnosis of dementia were not fully transparent in most of the studies with respect to either a clear reference definition of dementia or applied diagnostic criteria. If reported, various neuropsychological tests were used, mostly without a clear rationale for their selection. Pragmatic considerations often determine the sampling strategy; they also may explain the variances we detected in the different studies. Variations in sampling methods impede the comparability of study results. There is a need to consent case ascertainment strategies in dementia studies in health service research in nursing homes. These strategies should consider resource constraints and ethical issues that are related to the vulnerable population of nursing home residents. Additionally

[The new methods to define the staffing requirements for doctors,
nurses and nurses aides: an example of their implementation in an Italian hospital].

PubMed

Laquintana, Dario; Pazzaglia, Silvia; Demarchi, Antonia

2017-01-01

. The new methods to define the staffing requirements for doctors, nurses and nurses aides: an example of their implementation in an Italian hospital. The Italian government, after the transposition of European Union legislation on working hours, made a declaration of commitment to increase the number of staff of the National Health Service (NHS). The method for assessing the staffing needs innovates the old one that dated back a few decades. To implement the method proposed by the Ministry of Health to an Italian hospital and assess its impact on staffing and costs. The model was implemented on all the wards, multiplying the minutes of care expected in 2016, dividing the result by 60 to obtain the hours of care, and further dividing by the number of yearly hours of work of a nurse (1418). Same was done for nurses aides. The minutes of care were related to mean weight of the Diagnosis Related Groups of the ward and the results obtained compared to the actual staffing of nurses and nurses aides. The costs of the differences were calculated. The implementation of the model produced an excess of 23 nurses and a scarcity of 95 nurses aides compared to the actual staffing, with an increase of the costs of € 1.828.562,00. The results obtained and the criticisms received so far show the need of major changes. The data from international studies that associate staffing and patients outcomes and the nurse/patient ratio are macro-indicators already available that may orient choices and investments on the health care professions.

Nursing students assess nursing education.

PubMed

Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert

2005-01-01

This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.

Men student nurses: the nursing education experience.

PubMed

Meadus, Robert J; Twomey, J Creina

2011-01-01

This study explored the phenomenon of being a male in a predominately female-concentrated undergraduate baccalaureate nursing program. Men remain a minority within the nursing profession. Nursing scholars have recommended that the profile of nursing needs to change to meet the diversity of the changing population, and the shortfall of the worldwide nursing shortage. However, efforts by nursing schools and other stakeholders have been conservative toward recruitment of men. Using Giorgi's method, 27 students from a collaborative nursing program took part in this qualitative, phenomenological study. Focus groups were undertaken to gather data and to develop descriptions of the experience. Five themes highlighted men students' experience of being in a university nursing program: choosing nursing, becoming a nurse, caring within the nursing role, gender-based stereotypes, and visible/invisible. The experiences of the students revealed issues related to gender bias in nursing education, practice areas, and societal perceptions that nursing is not a suitable career choice for men. Implications for nurse educators and strategies for the recruitment and retention of men nursing students are discussed. © 2011 Wiley Periodicals, Inc.

Nurse migration: the effects on nursing education.

PubMed

Hancock, P K

2008-09-01

This paper is an opinion piece based on experience and supported where possible with literature, which addresses an issue of both national and international interest. It focuses on one aspect of the multifaceted social phenomenon of nurse migration, i.e. nurse education. Much has been written about the direct effects of nurse migration on the nurse migrant, the delivery of health care in the countries that supply the nurses, and the countries that receive them. However, there is little information regarding the direct effects of migration on nurse education within the literature. The aim of this paper is to raise awareness of the positive and negative effects of nurse migration on nurse education both in the countries that supply nurses and those which receive them. Both scholarly and 'grey' literature is used to support the discussion on the 'real' challenges faced by nurse educators and clinical nurses in those countries that supply or receive nurses. In addition, practical recommendations for nurse educators are presented. Furthermore, the nursing profession is challenged to become politically active, to become involved and to take responsibility for the decisions made about nurse education in order to protect the integrity of nurse education and patient safety. The quality of nurse education in many countries has been undermined as a result of rapid, mass migration. There is an urgent need to take practical steps to maintain the integrity of nurse education and the nurse's preparation for practice in order to protect patients' safety.

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

PubMed

Caspers, Barbara A; Pickard, Beth

2013-01-01

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

Using a human patient simulator to study the relationship between communication and nursing students' team performance.

PubMed

Hirokawa, Randy Y; Daub, Katharyn; Lovell, Eileen; Smith, Sarah; Davis, Alice; Beck, Christine

2012-11-01

This study examined the relationship between communication and nursing students' team performance by determining whether variations in team performance are related to differences in communication regarding five task-relevant functions: assessment, diagnosis, planning, implementation, and evaluation. The study results indicate a positive relationship between nursing students' team performance and comments focused on the implementation of treatment(s) and the evaluation of treatment options. A negative relationship between nursing students' team performance and miscellaneous comments made by team members was also observed. Copyright 2012, SLACK Incorporated.

Nursing shortages and international nurse migration.

PubMed

Ross, S J; Polsky, D; Sochalski, J

2005-12-01

The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

Screening physical health? Yes! But...: nurses' views on physical health screening in mental health care.

PubMed

Happell, Brenda; Scott, David; Nankivell, Janette; Platania-Phung, Chris

2013-08-01

To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Qualitative exploratory study. Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a

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

PubMed Central

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

2016-01-01

Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses’ areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not. PMID:27594906

An analysis of nursing diagnoses for patients undergoing procedures in a Brazilian interventional radiology suite.

PubMed

Viegas, Liza de Souza; Turrini, Ruth Natalia Teresa; da Silva Bastos Cerullo, Josinete Aparecida

2010-05-01

Innovations in minimally invasive surgery have led to more procedures being performed in the interventional radiology suite. It, therefore, is essential that nurses in radiology departments be competent to care for all types of patients. Use of nursing classification systems can improve care by providing standardized language for documentation. We conducted a project that involved 25 patients undergoing interventional radiology procedures between August and October 2006 in São Paulo, Brazil, to identify the most frequent North American Nursing Diagnosis Association (NANDA) nursing diagnoses used and then compared the NANDA diagnoses to Perioperative Nursing Data Set diagnoses. The most frequent nursing diagnoses in the participants were anxiety, chronic pain, inefficient tissue perfusion-peripheral, deficient knowledge, and risk for falls. These results are similar to diagnoses that have been reported in outpatient centers. The NANDA and Perioperative Nursing Data Set diagnoses were found to be similar. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Prospective payment based on case mix: will it work in nursing homes?

PubMed

Rosko, M D; Broyles, R W; Aaronson, W E

1987-01-01

This article evaluates the potential efficacy of implementing a prospective payment system based on case mix in the nursing home industry. The analysis of structural differences between the nursing home and hospital industries suggests that the mechanism of compensating long-term care facilities should be based on functional health status rather than on diagnosis and that incentives to improve quality and access should be strengthened. The article assesses several systems of classifying patients that have been proposed as the basis for implementing a prospective payment system in the nursing home industry. The article concludes with a discussion of policy issues related to the appropriate unit of payment and the scope of regulatory authority.

From diagnosis to birth: parents' experience when expecting a child with congenital anomaly.

PubMed

Askelsdóttir, Björk; Conroy, Sherrill; Rempel, Gwen

2008-12-01

Of 350,000 Canadian children born each year, 2% to 3% will have a serious congenital anomaly. Because of recent ultrasound diagnostic improvements and increased frequency of prenatal scans, many anomalies are determined prenatally, with more parents receiving disturbing, unanticipated news of an anomaly. This article highlights the experiences, concerns, and healthcare needs of parents who receive a prenatal diagnosis of congenital anomaly during routine ultrasound and choose to continue with the pregnancy. Examples from parent interviews describing their experience complement the sparse literature dealing with this phenomenon. Parents describe their experience from antenatal diagnosis and preparation for the child's birth and subsequent admission to the neonatal intensive care unit. Attention is paid to how neonatal nurses can positively influence this process by attending to parents' feelings or moods. The conclusion includes recommendations for neonatal nursing care for these vulnerable parents.

Nurses who do not nurse: factors that predict non-nursing work in the U.S. registered nursing labor market.

PubMed

Black, Lisa; Spetz, Joanne; Harrington, Charlene

2010-01-01

Registered nurses (RNs) who work outside of nursing have seldom been examined. This aim of this study was to compare the 122,178 (4%) of RNs who are employed outside of nursing to those who work in nursing jobs in terms of sociodemographic, market, and political variables to determine if these groups are substantively different from one another. Using a logit regression model, wages were a significant predictor of working outside of nursing for unmarried nurses but not for married nurses. Married and unmarried male nurses were more likely to work outside of nursing. Baccalaureate education, children under age 6, higher family income, and years since graduation increased the odds of working outside of nursing for married nurses. Ultimately, identifying characteristics on which these groups differ may inform future policy directions that could target nurses who may leave nursing at a time when retention efforts might be effective to alter their trajectory away from the profession.

Important knowledge for parents of children with heart disease: parent, nurse, and physician views.

PubMed

Daily, Joshua; FitzGerald, Mike; Downing, Kimberly; King, Eileen; del Rey, Javier Gonzalez; Ittenbach, Richard; Marino, Bradley

2016-01-01

Parental understanding of their children's heart disease is inadequate, which may contribute to poor health outcomes. The purpose of this study was to determine what parental knowledge is important in the care of children with heart disease from the perspective of parents, nurses, and physicians. Focus groups were formed with parents of children with single ventricle congenital heart disease (CHD), biventricular CHD, and heart transplantation, and with nurses and physicians who provide care for these children. A nominal group technique was used to identify and prioritise important parental knowledge items and themes. The voting data for each theme were reported by participant type--parent, nurse, and physician--and patient diagnosis--single ventricle CHD, biventricular CHD, and heart transplantation. The following three themes were identified as important by all groups: recognition of and response to clinical deterioration, medications, and prognosis and plan. Additional themes that were unique to specific groups included the following: medical team members and interactions (parents), tests and labs (parents), neurodevelopmental outcomes and interventions (physicians), lifelong disease requiring lifelong follow-up (physicians and nurses), and diagnosis, physiology, and interventions (single ventricle and biventricular CHD). Parents, nurses, and physicians have both common and unique views regarding what parents should know to effectively care for their children with single ventricle CHD, biventricular CHD, or heart transplantation. Specific targeted parental education that incorporates these findings should be provided to each group. Further development of questionnaires regarding parental knowledge with appropriate content validity is warranted.

Patients' needs following colorectal cancer diagnosis: where does primary care fit in?

PubMed

Browne, Susan; Dowie, Al; Mitchell, Elizabeth; Mitchell, Liz; Wyke, Sally; Ziebland, Sue; Campbell, Neil; Macleod, Una

2011-11-01

Colorectal cancer is the third most common cancer in the UK. Patients with colorectal cancer spend most of their time in the community, but the role of primary care in their management and follow-up is unclear. To explore colorectal cancer patients' experiences of psychosocial problems and their management in primary and specialist care. Longitudinal qualitative study of participants recruited from three hospitals in the west of Scotland and interviewed in their own homes. In-depth interviews with 24 participants with a new diagnosis of colorectal cancer, and then follow-up interviews 12 months later. Participants' needs following a diagnosis for colorectal cancer included physical, psychological, and social issues. GPs played a key role in diagnosis, after which they were less involved. Participants valued GPs making unsolicited contact and offering support. Participants described being well supported by clinical nurse specialists who are expert in the illness, and who provide continuity of care and psychological support. A year after diagnosis, when there was less contact with GPs and clinical nurse specialists, participants still faced challenges associated with the ongoing impact of colorectal cancer. While some patients enjoyed straightforward recoveries from surgery, others experienced longer-term implications from their disease and treatment, particularly bowel-function issues, fatigue, anxiety, and sexual problems. The potential for primary care to contribute more to the ongoing care of colorectal cancer patients was identified.

Concept analysis: nurse-to-nurse lateral violence.

PubMed

Embree, Jennifer L; White, Ann H

2010-01-01

The purpose of this paper is to examine the concept of nurse-to-nurse lateral violence (LV). Published literature--LV among nurses is significant and results in social, psychological, and physical consequences, negative patient and nursing outcomes, and damaged relationships. An extensive review of literature through Health Source, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest health, and Medical Complete was used to determine agreement and disagreement across disciplines and emerging trends. This concept analysis demonstrates that nurse-to-nurse LV is nurse-to-nurse aggression with overtly or covertly directing dissatisfaction toward another. Origins include role issues, oppression, strict hierarchy, disenfranchising work practices, low self-esteem, powerlessness perception, anger, and circuits of power. The result of this analysis provides guidance for further conceptual and empirical research as well as for clinical practice. Organizations must learn how to eliminate antecedents and provide nurses with skills and techniques to eradicate LV to improve the nursing work environment, patient care outcomes, and nurse retention.

Student nurses as school nurse extenders.

PubMed

Rossman, Carol L; Dood, Florence V; Squires, Darcy A

2012-12-01

The severe underuse of school nurses leaves students with unaddressed health needs that impact their safety and learning ability. An undergraduate pediatric clinical focusing on nursing students and the role of a school nurse in an elementary school setting can be a unique approach to combining the needs of school children and educating student nurses. One school of nursing created such a project to help address these needs and collect data on the activities student nurses performed in school nurse role and their impact on student health. This project serves as both a practice improvement project and an innovation in pediatric clinical education. The purposes of this project were to quantify baccalaureate nursing student activities related to the school nurse role and to evaluate the results that have the potential to impact on student health in an urban elementary school. Copyright © 2012 Elsevier Inc. All rights reserved.

Acute medical bed usage by nursing home residents.

PubMed

Beringer, T R; Flanagan, P

1999-05-01

An increasing number of elderly patients in nursing home care appears to be presenting to hospital for acute medical admission. A survey of acute hospital care was undertaken to establish accurately the number and character of such admissions. A total of 1300 acute medical beds was surveyed in Northern Ireland in June 1996 and January 1997 on a single day using a standardised proforma. Demographic details, diagnosis and length of admission were recorded. A total of 84 patients over the age of 65 (mean 79.5 years) admitted from nursing home care was identified in June 1996 and a total of 125 (mean 83.3 years) in January 1997. A total of 88 (70%) of admissions in 1997 were accompanied by a general practitioner's letter. The assessing doctor judged that 12 (9.6%) of admissions in 1997 could have had investigations and or treatment reasonably instituted in a nursing home. The proportion of acute medical beds occupied by nursing home residents was 6% in June 1996 rising to 10% in January 1997. The study accurately identifies the significant contribution of nursing home patients to acute medical admissions and the low proportion in whom admission was unnecessary. Closure of long stay hospital facilities should be accompanied by investment in community medical services and also reinvestment in acute hospital care for elderly people.

Congruence between nursing problems in nursing care plans and NANDA nursing diagnoses.

PubMed

Varsi, Cecilie; Ruland, Cornelia M

2009-01-01

This study abstracted nursing problems documented in cancer patients' nursing care plans to analyze (1) which nursing problems were documented and (2) the degree of congruence between the abstracted problems and NANDA nursing diagnoses. 236 unique nursing problems were identified and could be mapped to 32 NANDA nursing diagnoses. However, only 4.3% had a precise match with NANDA, Thirty-eight percent were classified as similar and the rest were broader, narrower or no match. Thus NANDA only partially covered problems written by nurses in the care plans for this group of patients.

Nurses', nursing students', and nursing instructors' perceptions of professional values: A comparative study.

PubMed

Bijani, Mostafa; Tehranineshat, Banafsheh; Torabizadeh, Camellia

2017-01-01

In order to prove their commitment to the nursing profession, nurses need to base their professional activities on certain acknowledged values. Although a large number of studies have addressed professional values in nursing, only a few studies are available on the identification and comparison of nurses', nursing students', and nursing instructors' understanding of such values. The study aims to compare nurses', nursing students', and nursing instructors' perception of nursing professional values. In this descriptive-comparative study, data were collected using Weis and Schank's Nurses' Professional Values Scale-Revised. The data were analyzed using the SPSS statistical software (v 22). Participants and research context: A total of 299 nurses, 341 nursing students, and 100 nursing instructors from multisite, 20 different wards from 3 university hospitals and associated nursing schools located in the cities of Shiraz, Fasa, and Jahrom in Fars province, participated in 2016. Ethical considerations: The Institutional Review Board of the researchers' primary university has verified that the study complies with research ethics. The total mean scores of the nurses', nursing students', and nursing instructors' perception were found to be 4.23 (0.44), 3.92 (0.50), and 4.34 (0.35), respectively, in the domain of justice-this domain was the subjects' top priority-and 3.40 (0.56), 3.29 (0.49), and 3.55 (0.36), respectively, in the domain of activism-this domain was attached the least importance by the subjects. There were significant differences across the three groups' perception in all of the dimensions of professional values ( p < 0.001). The three study groups' overall mean scores fall within the range of relatively important or important. Several studies show the same results, but there are still controversies in this regard. There is need for plans to increase nurses' awareness of certain professional duties and improve their professional performance in all areas

Nursing in Malawi: nursing theory in the movement to professionalize nursing.

PubMed

Bultemeier, Kaye I

2012-04-01

Nursing in Malawi has been predominately a technical trade and only recently has begun the transition to a profession with autonomy and advanced degree preparation. Nursing theories provide a framework for the evolution of nursing to an independent profession. Theories provide a means for the articulation of the nursing role to other members of the healthcare team including consumers. Healthcare and human needs are basic and the guidance provided by nursing theories, including Nightingale's, gives language and structure to the education of nurses as the profession moves into advanced practice in a developing country.

Individual and contextual determinants of resident-on-resident abuse in nursing homes: a random sample telephone survey of adults with an older family member in a nursing home.

PubMed

Schiamberg, Lawrence B; von Heydrich, Levente; Chee, Grace; Post, Lori A

2015-01-01

Few empirical investigations of elder abuse in nursing homes address the frequency and determinants of resident-on-resident abuse (RRA). A random sample of 452 adults with an older adult relative, ≥65 years of age, in a nursing home completed a telephone survey regarding elder abuse experienced by that elder family member. Using a Linear Structural Relations (LISREL) modeling design, the study examined the association of nursing home resident demographic characteristics (e.g., age, gender), health and behavioral characteristics (e.g., diagnosis of Alzheimer's Disease, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), types of staff abuse (e.g., physical, emotional), and factors beyond the immediate nursing home setting (e.g., emotional closeness of resident with family members) with RRA. Mplus statistical software was used for structural equation modeling. Main findings indicated that resident-on-resident mistreatment of elderly nursing home residents is associated with the age of the nursing home resident, all forms of staff abuse, all ADLs and IADLs, and emotional closeness of the older adult to the family. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Nurse Bullying: Impact on Nurses' Health.

PubMed

Sauer, Penny A; McCoy, Thomas P

2017-12-01

Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center.

PubMed

Basu, Mohua; Linebarger, Jared; Gabram, Sheryl G A; Patterson, Sharla Gayle; Amin, Miral; Ward, Kevin C

2013-07-15

A patient navigation process is required for accreditation by the National Accreditation Program for Breast Centers (NAPBC). Patient navigation has previously been shown to improve timely diagnosis in patients with breast cancer. This study sought to assess the effect of nurse navigation on timeliness of care following the diagnosis of breast cancer by comparing patients who were treated in a comprehensive cancer center with and without the assistance of nurse navigation. Navigation services were initiated at an NAPBC-accredited comprehensive breast center in July 2010. Two 9-month study intervals were chosen for comparison of timeliness of care: October 2009 through June 2010 and October 2010 through June 2011. All patients with breast cancer diagnosed in the cancer center with stage 0 to III disease during the 2 study periods were identified by retrospective cancer registry review. Time from diagnosis to initial oncology consultation was measured in business days, excluding holidays and weekends. Overall, 176 patients met inclusion criteria: 100 patients prior to and 76 patients following nurse navigation implementation. Nurse navigation was found to significantly shorten time to consultation for patients older than 60 years (B = -4.90, P = .0002). There was no change in timeliness for patients 31 to 60 years of age. Short-term analysis following navigation implementation showed decreased time to consultation for older patients, but not younger patients. Further studies are indicated to assess the long-term effects and durability of this quality improvement initiative. © 2013 American Cancer Society.

Variability of nursing care by APR-DRG and by severity of illness in a sample of nine Belgian hospitals.

PubMed

Pirson, Magali; Delo, Caroline; Di Pierdomenico, Lionel; Laport, Nancy; Biloque, Veronique; Leclercq, Pol

2013-10-10

As soon as Diagnosis related Groups (DRG) were introduced in many hospital financing systems, most nursing research revealed that DRG were not very homogeneous with regard to nursing care. However, few studies are based on All Patient refined Diagnosis related Groups (APR-DRGs) and few of them use recent data. Objectives of this study are: (1) to evaluate if nursing activity is homogeneous by APR-DRG and by severity of illness (SOI) (2) to evaluate the outlier's rate associated with the nursing activity and (3) to compare nursing cost homogeneity per DRG and SOI. Study done in 9 Belgian hospitals on a selection of APR-DRG with more than 30 patients (7 638 inpatient stays). The evaluation of the homogeneity is based on coefficients of variation (CV). The 75th percentile + 1.5 × inter-quartile range was used to select high outliers. 25th percentile -1.5 × inter-quartile range was used to select low outliers. Nursing costs per ward were distributed on inpatient stays of each ward following two techniques (the LOS vs. the number of nursing care minutes per stay). The homogeneity of LOS by DRG and by SOI is relatively good (CV: 0.56). The homogeneity of the nursing activity by DRG is less good (CVs between 0.36 and 1.54) and is influenced by nursing activity outliers (high outliers' rate: 5.19%, low outliers' rate: 0.14%). The outlier's rate varies according to the studied variable. The high outliers' rate is higher for nursing activity than for LOS. The homogeneity of nursing costs is higher when costs are based on the LOS of patients than when based on minutes of nursing care (CVs between 0.26 and 1.46 for nursing costs based on LOS and between 0.49 and 2.04 for nursing costs based on minutes of nursing care). It is essential that the calculation of nursing cost by stay and by DRG for hospital financing purposes was based on nursing activity data, that more reflect resources used in wards, and not on LOS data. The only way to obtain this information is

Variability of nursing care by APR-DRG and by severity of illness in a sample of nine Belgian hospitals

PubMed Central

2013-01-01

Background As soon as Diagnosis related Groups (DRG) were introduced in many hospital financing systems, most nursing research revealed that DRG were not very homogeneous with regard to nursing care. However, few studies are based on All Patient refined Diagnosis related Groups (APR-DRGs) and few of them use recent data. Objectives of this study are: (1) to evaluate if nursing activity is homogeneous by APR-DRG and by severity of illness (SOI) (2) to evaluate the outlier’s rate associated with the nursing activity and (3) to compare nursing cost homogeneity per DRG and SOI. Methods Study done in 9 Belgian hospitals on a selection of APR-DRG with more than 30 patients (7 638 inpatient stays). The evaluation of the homogeneity is based on coefficients of variation (CV). The 75th percentile + 1.5 × inter-quartile range was used to select high outliers. 25th percentile −1.5 × inter-quartile range was used to select low outliers. Nursing costs per ward were distributed on inpatient stays of each ward following two techniques (the LOS vs. the number of nursing care minutes per stay). Results The homogeneity of LOS by DRG and by SOI is relatively good (CV: 0.56). The homogeneity of the nursing activity by DRG is less good (CVs between 0.36 and 1.54) and is influenced by nursing activity outliers (high outliers’ rate: 5.19%, low outliers’ rate: 0.14%). The outlier’s rate varies according to the studied variable. The high outliers’ rate is higher for nursing activity than for LOS. The homogeneity of nursing costs is higher when costs are based on the LOS of patients than when based on minutes of nursing care (CVs between 0.26 and 1.46 for nursing costs based on LOS and between 0.49 and 2.04 for nursing costs based on minutes of nursing care). Conclusions It is essential that the calculation of nursing cost by stay and by DRG for hospital financing purposes was based on nursing activity data, that more reflect resources used in wards, and not on LOS

Nursing regulation, the nurse licensure compact, and nurse administrators: working together for patient safety.

PubMed

Poe, Laura

2008-01-01

Maintaining the concept of states rights, boards of nursing responded to the need for removal of barriers in meeting nursing manpower needs. One mechanism to accomplish this end was the development of the Nurse Licensure Compact, a multistate nurse license structured in much the same way as driver's license compacts. Representatives of State Boards of Nursing developed model compact structure and rules which allow nurses licensed in their state of residence to practice in other participating states without having to obtain additional licenses. Monitoring of nurse licensure and disciplinary information is facilitated through Nursys (nurse system). Nurses, nurse administrators, and the public benefit from the experiences of the 23 states that have implemented the Nurse Licensure Compact.

Development of the Austrian Nursing Minimum Data Set (NMDS-AT): the third Delphi Round, a quantitative online survey.

PubMed

Ranegger, Renate; Hackl, Werner O; Ammenwerth, Elske

2015-01-01

A Nursing Minimum Data Set (NMDS) aims at systematically describing nursing care in terms of patient problems, nursing activities, and patient outcomes. In an earlier Delphi study, 56 data elements were proposed to be included in an Austrian Nursing Minimum Data Set (NMDS-AT). To identify the most important data elements of this list, and to identify appropriate coding systems. Online Delphi-based survey with 88 experts. 43 data elements were rated as relevant for an NMDS-AT (strong agreement of more than half of the experts): nine data elements concerning the institution, patient demographics, and medical condition; 18 data elements concerning patient problems by using nursing diagnosis; seven data elements concerning nursing outcomes, and nine data elements concerning nursing interventions. As classification systems, national classification systems were proposed besides ICNP, NNN, and nursing-sensitive indicators. The resulting proposal for an NMDS-AT will now be tested with routine data.

The cost of nurse-sensitive adverse events.

PubMed

Pappas, Sharon Holcombe

2008-05-01

The aim of this study was to describe the methodology for nursing leaders to determine the cost of adverse events and effective levels of nurse staffing. The growing transparency of quality and cost outcomes motivates healthcare leaders to optimize the effectiveness of nurse staffing. Most hospitals have robust cost accounting systems that provide actual patient-level direct costs. These systems allow an analysis of the cost consumed by patients during a hospital stay. By knowing the cost of complications, leaders have the ability to justify the cost of improved staffing when quality evidence shows that higher nurse staffing improves quality. An analysis was performed on financial and clinical data from hospital databases of 3,200 inpatients. The purpose was to establish a methodology to determine actual cost per case. Three diagnosis-related groups were the focus of the analysis. Five adverse events were analyzed along with the costs. A regression analysis reported that the actual direct cost of an adverse event was dollars 1,029 per case in the congestive heart failure cases and dollars 903 in the surgical cases. There was a significant increase in the cost per case in medical patients with urinary tract infection and pressure ulcers and in surgical patients with urinary tract infection and pneumonia. The odds of pneumonia occurring in surgical patients decreased with additional registered nurse hours per patient day. Hospital cost accounting systems are useful in determining the cost of adverse events and can aid in decision making about nurse staffing. Adverse events add costs to patient care and should be measured at the unit level to adjust staffing to reduce adverse events and avoid costs.

Nursing patients with epilepsy in secondary care settings.

PubMed

Welsh, Rebecca; Kerley, Sarah

This article gives a brief overview of epilepsy and how a diagnosis is made. It highlights the importance of good observation and communication in its ongoing management. Long-term management of the condition and the acute management of seizures are considered. The article emphasises the effect on the individual, family and carers, identifies the key legislation and highlights the crucial role of secondary care nurses.

Evidence-based nursing-sensitive indicators for patients hospitalized with depression in Thailand.

PubMed

Thapinta, Darawan; Anders, Robert L; Mahatnirunkul, Suwat; Srikosai, Soontaree

2010-12-01

The aim of this study was to develop and validate nursing-sensitive indicators for patients hospitalized with depression in Thailand. The initial draft, consisting of 12 categories with 37 subcategories, was then evaluated by experts in the US and Thailand. Hospital records were then utilized to evaluate the feasibility and efficacy of the indicators. The finalized instrument consisted of 11 categories with 43 items with a validity of .98 and internal consistency of .88. This is the first set of indicators developed to evaluate nursing-sensitivity for patients hospitalized with a diagnosis of depression in Thailand. Having nursing indicators for depressed patients provides nurses with concrete tools to evaluate their work with depressed patients, allowing these staff to assess their work in a very specific, methodical, and consistent manner. When problems are discovered, both the staff and administration can work to address these issues through training, procedural changes, and departmental shifts.

Nursing diagnoses, interventions, and patient outcomes for hospitalized older adults with pneumonia.

PubMed

Head, Barbara J; Scherb, Cindy A; Reed, David; Conley, Deborah Marks; Weinberg, Barbara; Kozel, Marie; Gillette, Susan; Clarke, Mary; Moorhead, Sue

2011-04-01

A study was conducted by academic and community hospital partners with clinical information systems that included the standardized nursing language classifications of the North American Nursing Diagnosis Association International (NANDA-I), Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC). The aim of the study was to determine the frequency of NANDA-I, NIC, and NOC (NNN) terms documented for older adults with pneumonia who were discharged from three hospitals during a 1-year period. NNN terms were ranked according to frequency for each hospital, and then the rankings were compared with previous studies. Similarity was greater across hospitals in rankings of NANDA-I and NOC terms than in rankings of NIC terms. NANDA-I and NIC terms are influenced by reimbursement and regulatory factors as well as patient condition. The 10 most frequent NNN terms for each hospital accounted only for a small to moderate percentage of the terms selected.

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

PubMed

Demarré, Liesbet; Vanderwee, Katrien; Defloor, Tom; Verhaeghe, Sofie; Schoonhoven, Lisette; Beeckman, Dimitri

2012-05-01

To gain insight into the knowledge and attitudes of nurses and nursing assistants and to study the correlation between knowledge, attitudes and the compliance with the pressure ulcer prevention guidelines provided to residents at risk of pressure ulcers in nursing homes. There is a lack of evidence on knowledge and attitudes of nurses and nursing assistants towards pressure ulcer prevention in nursing homes. A cross-sectional multi-centre study. A convenience sample of nine Belgian nursing homes, representing 18 wards was chosen in the study. In total, 145 nurses and nursing assistants were included. The compliance with the guidelines was evaluated in 615 residents, and data were collected using validated instruments. Fully compliant prevention was found in only 6·9% of the residents at risk. The mean knowledge score of the nurses was 29·3 vs. 28·7% for the nursing assistants. The overall attitude score was 74·5%, and attitude scores were significantly different between nurses and nursing assistants. Nurses showed to have a more positive attitude towards pressure ulcer prevention than nursing assistants, respectively 78·3 and 72·3%. A more positive attitude was a significant predictor of pressure ulcer prevention compliance with the guidelines provided to residents at risk of pressure ulcers in nursing homes. Knowledge about pressure ulcer prevention of both nurses and nursing assistants in nursing homes was low. Attitudes were a significant predictor of the application of fully compliant prevention in residents at risk. Pressure ulcer prevention is an important aspect in daily care for residents at risk in nursing homes. These insights will contribute to evidence-based practice in this area of care and will form the basis for the development of an education strategy for pressure ulcer prevention and management in nursing homes. © 2011 Blackwell Publishing Ltd.

Benign Episodic Unilateral Mydriasis in a Flight Nurse.

PubMed

Schiemer, Anthony

2017-05-01

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

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

ERIC Educational Resources Information Center

Wise, Vanessa

2013-01-01

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

Nursing students' attitudes about home health nursing.

PubMed

Prestia, Mindy; Murphy, Susan; Yoder, Marian

2008-09-01

In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

Nursing Practice Environment and Outcomes for Oncology Nursing

PubMed Central

Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

2012-01-01

Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping: nurses' communication with patients just after being diagnosed with cancer.

PubMed

Fukui, Sakiko; Ogawa, Keiko; Ohtsuka, Masao; Fukui, Naoshi

2008-09-15

Although studies have shown the usefulness of improving health professionals' communication skills by training, to the authors' knowledge none have demonstrated the efficacy of communication skill training (CST) for health professionals in terms of improving patient outcomes. This study aimed to assess the efficacy of CST for nurses in improving psychologic distress and coping among patients after being informed of a cancer diagnosis. Nurses who mainly provide patients with psychologic and informational support after being informed of their cancer diagnosis by physicians at a cancer screening center were randomly assigned to either an experimental or a control group; patients were supported by either group of nurses. Patient selection criteria were: age >18 years with gastric, colorectal, or breast cancer that was not in advanced stage. Intervention consisted of 3 1-on-1 nurses' interviews (on the day of, 1 week after, and 1 month after diagnosis). Efficacy was assessed through patients' psychologic distress and coping by administering the Hospital Anxiety and Depression Scale (HADS) and Mental Adjustment to Cancer scale (MAC), at 3 time points (1 week, 1 month, and 3 months after diagnosis). Eighty-nine patients participated. Repeated measures analysis of variance demonstrated a significant group-by-time decrease in patients' psychologic distress on HADS (P = .03), and significant group-by-time increase in fighting spirit and decrease of fatalism (P = .01 and P = .04, respectively), in addition to significant between-group difference of anxious preoccupation on the MAC (P = .003). Support by nurses who completed the CST program was found to reduce psychologic distress and improved coping long term among patients informed of their cancer diagnosis. (c) 2008 American Cancer Society.

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

PubMed Central

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

2014-01-01

Objectives to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers. Method a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014. Results the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance. Conclusion the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue. PMID:26107833

Caring for patients with cancer in non-specialist wards: the nurse experience.

PubMed

Mohan, S; Wilkes, L M; Ogunsiji, O; Walker, A

2005-07-01

This study aims to describe the experiences of nurses caring for cancer patients in non-specialist wards. The study was conducted in a large (420 beds) and small (32 beds) hospital in an area health service with urban and rural populations in the west of Sydney. A qualitative descriptive approach was utilized to collect data from the nurses. Data were collected using a survey and in-depth interviews of nurses working in non-specialist cancer wards. Transcribed data were managed with Nudist Vivo software and analysed for common themes using process of constant comparison and contrast. Twenty-five surveys were returned and five nurses volunteered to be interviewed. The six major themes that emerged from analysis of data were: emotional nature of care, lack of time, lack of knowledge of cancer treatment, family support, environment not conducive to proper care and dealing with patient's non-acceptance of cancer diagnosis. The nurses in this study wished to provide quality supportive care for cancer patients and their families but the inconducive environment and inadequate relevant training hindered the nurses' efforts. This then presents further need of relevant training for nurses in cancer care and time management, to meet up with these challenges.

Nurse administrators' intentions and considerations in recruiting inactive nurses.

PubMed

Yu, Hsing-Yi; Tang, Fu-In; Chen, I-Ju; Yin, Teresa J C; Chen, Chu-Chieh; Yu, Shu

2016-07-01

To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit. Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses. A census survey collected data from 392 nurse administrators via a mailing method. Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence. Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health. Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence. © 2016 John Wiley & Sons Ltd.

Revisioning a clinical nurse specialist curriculum in 3 specialty tracks.

PubMed

Arslanian-Engoren, Cynthia; Sullivan, Barbara-Jean; Struble, Laura

2011-01-01

The objective of the present study was to revise 3 clinical nurse specialist (CNS) educational tracks with current National Association of Clinical Nurse Specialist core competencies and educational expectations. National curricula recommendations include core competencies by the 3 spheres of influence. Advanced practice registered nurses consensus model educational requirements include a minimum of 500 faculty-supervised clinical hours; separate graduate courses in pharmacology, pathophysiology, and advanced physical assessment; and content in differential diagnosis disease management, decision making, and role preparation. This educational initiative was designed to (1) align with core competencies and advanced practice registered nurse consensus model recommendations, (2) create an innovative learning environment, (3) meet the needs of diverse student populations, (4) align with emerging doctor of nursing practice programs, (5) create a high-efficiency and high-quality environment to manage human and fiscal resources, and (6) reduce duplication of efforts. Courses were revised that did not meet current CNS educational preparation expectations. A total of 11 didactic and clinical sequences courses were developed for the 3 tracks to (1) ensure minimum numbers of clinical hours; (2) expand content on health promotion and risk reduction, advanced practice nurse role, and the healthcare delivery system; (3) consolidate clinical courses; and (4) resequence foundational content before beginning clinical courses. Revisioning a CNS curriculum in 3 specialty tracks is challenging but doable using innovative and creative approaches. The innovative process used to revise our CNS curriculum will assist nurse educators faced with similar program delivery challenges to meet future directions for educating CNS students in advanced nursing practice. Copyright © 2011 Lippincott Williams & Wilkins.

Revolution as a care plan: ethnography, nursing and somatic solidarity in Honduras.

PubMed

Pine, Adrienne

2013-12-01

While diagnosis is not within the biomedical scope of a nurse's work, assessment-an inherently ethnographic exercise-is. In Honduras, as in the United States, nurses' proximity with patients, in terms of both time spent at the bedside and shared class identification (embodied as habitus), mean that nurses are often more effective than physicians in assessment and healing. Following the 2009 coup that brought a violently repressive regime to power in Honduras, subjectivation as citizen healers brought many nurses to assess patient health as a function of neoliberal and political violence. This assessment framed radical struggle that required nurses to block political violence with their own bodies as being a necessary part of patient care. Similarly, as ethnographer, I came to share with nurses and other Hondurans certain violent processes of subjectivation (albeit from a privileged subject position) that strengthened my solidarity with them as well as my deeply embodied investment in their care plan of organizing for radical social change. This paper examines the politicizing impact of the 2009 coup on Honduran auxiliary and professional nurses and the ways in which nurse assessment and ethnographic analysis can overlap and combine in somatic and political solidarity with patients and others resisting state and political violence through their bodies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Transcultural nursing practice described by registered nurses and baccalaureate nursing students.

PubMed

Baldonado, A; Beymer, P L; Barnes, K; Starsiak, D; Nemivant, E B; Anonas-Ternate, A

1998-01-01

Using Leininger's Theory of Culture Care Diversity and Universality as a framework, this research examined transcultural practices of nurses and students. A survey was administered to a convenience sample of registered nurses and senior baccalaureate students with 767 usable questionnaires returned. Neither group expressed confidence in their ability to care for culturally-diverse patients. Registered nurses (RNs) reported assessing cultural factors and modifying practices more frequently than did students. Respondents reported their beliefs about transcultural nursing were influenced by being with people of other cultures, their own personal values, and education. Analysis of the open-ended questions revealed two major themes. First, both nurses and students perceive an overwhelming need for transcultural nursing. Second, nurses and students respond to cultural challenges by modifying their care. Modifications are based on language and communication, pain perception and relief, religious and spiritual dimensions, gender and family roles, and other values. Results suggest that nurses and students are aware of culture, recognize that culture influences the care they provide, and modify their health teaching and nursing care based on culture. The use of a conceptual framework to help make modifications in care was not mentioned.

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

PubMed

Jooste, Karien; Cairns, Lindi

2014-05-01

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

Asthma history, job type and job changes among US nurses.

PubMed

Dumas, Orianne; Varraso, Raphaëlle; Zock, Jan Paul; Henneberger, Paul K; Speizer, Frank E; Wiley, Aleta S; Le Moual, Nicole; Camargo, Carlos A

2015-07-01

Nurses are at increased risk of occupational asthma, an observation that may be related to disinfectants exposure. Whether asthma history influences job type or job changes among nurses is unknown. We investigated this issue in a large cohort of nurses. The Nurses' Health Study II is a prospective study of US female nurses enrolled in 1989 (ages 24-44 years). Job status and asthma were assessed in biennial (1989-2011) and asthma-specific questionnaires (1998, 2003). Associations between asthma history at baseline (diagnosis before 1989, n=5311) and job type at baseline were evaluated by multinomial logistic regression. The relations of asthma history and severity during follow-up to subsequent job changes were evaluated by Cox models. The analytic cohort included 98 048 nurses. Compared with nurses in education/administration (likely low disinfectant exposure jobs), women with asthma history at baseline were less often employed in jobs with likely high disinfectant exposure, such as operating rooms (odds ratio 0.73 (95% CI 0.63 to 0.86)) and emergency room/inpatient units (0.89 (0.82 to 0.97)). During a 22-year follow-up, nurses with a baseline history of asthma were more likely to move to jobs with lower exposure to disinfectants (HR 1.13 (1.07 to 1.18)), especially among those with more severe asthma (HR for mild persistent: 1.13; moderate persistent 1.26; severe persistent: 1.50, compared with intermittent asthma, p trend: 0.004). Asthma history was associated with baseline job type and subsequent job changes among nurses. This may partly reflect avoidance of tasks involving disinfectant use, and may introduce bias in cross-sectional studies on disinfectant exposure and asthma in nurses. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Nursing Practice Environment and Registered Nurses' Job Satisfaction in Nursing Homes

ERIC Educational Resources Information Center

Choi, JiSun; Flynn, Linda; Aiken, Linda H.

2012-01-01

Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…

Ventilator-associated pneumonia: clinical significance and implications for nursing.

PubMed

Grap, M J; Munro, C L

1997-01-01

Pneumonia is the second most common nosocomial infection in the United States and the leading cause of death from nosocomial infections. Intubation and mechanical ventilation greatly increase the risk of bacterial pneumonia. Ventilator-associated pneumonia (VAP) occurs in a patient treated with mechanical ventilation, and it is neither present nor developing at the time of intubation; it is a serious problem--with significant morbidity and mortality rates. Aspiration of bacteria from the oropharynx, leakage of contaminated secretions around the endotracheal tube, patient position, and cross-contamination from respiratory equipment and health care providers are important factors in the development of VAP. Nurses caring for patients treated with mechanical ventilation must recognize risk factors and include strategies for reducing these factors as part of their nursing care. This article summarizes the literature related to VAP: its incidence, associated factors, diagnosis, and current therapies, with an emphasis on nursing implications in the care of these patients.

Opinions of Nurses About the Evaluation of Risk of Falling Among Inpatients.

PubMed

Atay, Selma; Vurur, Sevda; Erdugan, Necla

Patient falls and fall-related injuries are an important problem for patients, relatives, caregivers, and the health system at large. This study aims to identify opinions of nurses about the risk of falling among patients staying in hospitals. This study uses a qualitative descriptive design and employs a semistructured interview method to identify the opinions and experiences of nurses about patient falls. This study evaluated the opinions of a total of 12 staff nurses. It was found that nurses consider patients in the postoperative period to be most prone to falls. They think that most falls take place during transfers and that the medical diagnosis of the patient plays a crucial role in fall incidents. The most important problem associated with patient falls was symptoms of traumatic brain injury. According to the participating nurses, the risk of fall for every patient should be evaluated upon admission. Measures that the nurses take against patient falls include raising the bed's side rails and securing the bed brakes. The findings of this research suggest that in-service training programs about the evaluation of the risk of falling should be organized for nurses. Guidelines should be developed for patients with different levels of risk of falling. It is suggested that nurses should be in charge of training patients who are conscious, their relatives, and caregiver personnel. The training of nurses and caregivers helps to prevent the falls of inpatients.

Quality nursing care in the words of nurses.

PubMed

Burhans, Linda Maas; Alligood, Martha Raile

2010-08-01

This paper is a report of a study of the meaning of quality nursing care for practising nurses. Healthcare quality continues to be a subject of intense criticism and debate. Although quality nursing care is vital to patient outcomes and safety, meaningful improvements have been disturbingly slow. Analysis of quality care literature reveals that practising nurses are rarely involved in developing or defining improvement programs for quality nursing care. Therefore, two major study premises were that quality nursing care must be meaningful and relevant to nurses and that uncovering their meaning of quality nursing care could facilitate more effective improvement approaches. Using van Manen's hermeneutic phenomenology, meaning was revealed through analysis of interviews to answer the research question 'What is the lived meaning of quality nursing care for practising nurses?' Twelve nurses practising on medical or surgical adult units at general or intermediate levels of care within acute care hospitals in the United States of America were interviewed. Emerging themes were discovered through empirical and reflective analysis of audiotapes and transcripts. The data were collected in 2008. The revealed lived meaning of quality nursing care for practising nurses was meeting human needs through caring, empathetic, respectful interactions within which responsibility, intentionality and advocacy form an essential, integral foundation. Nurse managers could develop strategies that support nurses better in identifying and delivering quality nursing care reflective of responsibility, caring, intentionality, empathy, respect and advocacy. Nurse educators could modify education curricula to model and teach students the intrinsic qualities identified within these meanings of quality nursing care.

The influence of nursing care integration services on nurses' work satisfaction and quality of nursing care.

PubMed

Ryu, Jeong-Im; Kim, Kisook

2018-06-20

To investigate differences in work satisfaction and quality of nursing services between nurses from the nursing care integration service and general nursing units in Korea. The nursing care integration service was recently introduced in Korea to improve patient health outcomes through the provision of high quality nursing services and to relieve the caregiving burden of patients' families. In this cross-sectional study, data were collected from a convenience sample of 116 and 156 nurses working in nursing care integration service and general units, respectively. The data were analysed using descriptive statistics, t tests and one-way analysis of variance. Regarding work satisfaction, nursing care integration service nurses scored higher than general unit nurses on professional status, autonomy and task requirements, but the overall scores showed no significant differences. Scores on overall quality of nursing services, responsiveness and assurance were higher for nursing care integration service nurses than for general unit nurses. Nursing care integration service nurses scored higher than general unit nurses on some aspects of work satisfaction and quality of nursing services. Further studies with larger sample sizes will contribute to improving the quality of nursing care integration service units. These findings can help to establish strategies for the implementation and efficient operation of the nursing care integration service system, for the improvement of the quality of nursing services, and for successfully implementing and expanding nursing care integration service services in other countries. © 2018 John Wiley & Sons Ltd.

Electronic health records and improved nursing management of chronic obstructive pulmonary disease.

PubMed

Liu, Fengping; Zou, Yeqing; Huang, Qingmei; Zheng, Li; Wang, Wei

2015-01-01

This paper identifies evolving trends in the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), and recommends the integration of nursing strategies in COPD management via widespread implementation of electronic health records. COPD is a complex lung disease with diverse origins, both physical and behavioral, manifested in a wide range of symptoms that further increase the patient's risk for comorbidities. Early diagnosis and effective management of COPD require monitoring of a dizzying array of COPD symptoms over extended periods of time, and nurses are especially well positioned to manage potential progressions of COPD, as frontline health care providers who obtain, record, and organize patient data. Developments in medical technology greatly aid nursing management of COPD, from the deployment of spirometry as a diagnostic tool at the family practice level to newly approved treatment options, including non-nicotine pharmacotherapies that reduce the cravings associated with tobacco withdrawal. Among new medical technologies, electronic health records have proven particularly advantageous in the management of COPD, enabling providers to gather, maintain, and reference more patient data than has ever been possible before. Thus, consistent and widespread implementation of electronic health records facilitates the coordination of diverse treatment strategies, resulting in increased positive health outcomes for patients with COPD.

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

PubMed

Finnema, Evelyn; Dröes, Rose-Marie; Ettema, Teake; Ooms, Marcel; Adèr, Herman; Ribbe, Miel; van Tilburg, Willem

2005-04-01

To examine the effect of integrated emotion-oriented care on nursing home residents with dementia and nursing assistants. A multi-site randomized clinical trial with matched groups, and measurements at baseline and after seven months. Sixteen psychogeriatric wards in fourteen nursing homes in the Netherlands. One hundred and forty-six elderly residents with the diagnosis dementia of the Alzheimer (DAT) type, mixed DAT and vascular dementia, and dementia syndrome (NAO) and 99 nursing assistants. Integrated emotion-oriented care and usual care. MESUREMENTS: Demented elderly: Behaviour and mood related to adaptation to the illness and the institutionalization. Nursing assistants: General health as measured by feelings of stress, stress reactions, feeling of competence and illness. Positive effects in favour of the integrated emotion-oriented care were found in mild to moderately demented residents on two adaptive tasks: maintaining an emotional balance (less anxiety) and preserving a positive self-image (less dissatisfaction). In the trained group of nursing assistants fewer stress reactions were found only in those who perceived improvement in their emotion-oriented care skills after training. Emotion-oriented care is more effective with regard to the emotional adaptation in nursing homes of persons with a mild to moderate dementia. For the severely demented elderly we did not find this surplus value. This outcome is of clinical importance for elderly persons with dementia who are cared for in nursing homes. With respect to the nursing assistants it is concluded that emotion-oriented care has a positive influence on stress reactions in some of them. Copyright 2005 John Wiley & Sons, Ltd.

Use of the Internet by Patients: Not a Threat to Nursing, but an Opportunity?

ERIC Educational Resources Information Center

Timmons, Stephen

2001-01-01

Patients' use of Internet health information raises concerns about reliability, access to information meant for clinicians, and self-diagnosis and treatment. Nurses should become informed and undertake patient education about consumer health informatics. (Contains 25 references.) (SK)

Determinants of hospital-to-nursing home placement delays: a pilot study.

PubMed Central

Weissert, W G; Cready, C M

1988-01-01

Estimates of hospital-to-nursing home placement delays have always been varied, and given Medicare's new Prospective Payment System (PPS) based on diagnosis-related groups (DRGs), they are likely to have changed again. Theory and previous research suggest that four patient characteristics are the main causes of delays: Medicaid as the patient's nursing home payer source; need for heavy care due to major physical or mental problems; admission to the hospital from a nursing home; and lack of social support. A pilot study of all 1,016 elderly awaiting nursing home placement in two admission cohorts (pre- and post-PPS) from the three largest hospitals in the county surrounding Charlotte, North Carolina--where nursing home beds are in short supply--indicates that other factors are more important. While most placements were delayed, delays were short. Multiple regression results show that Medicaid patients' delays were only about a day longer than those of private-pay patients. Of the many heavy-care conditions studied, only three were associated with delay. Patients without social support and patients admitted from a nursing home, discharged to a hospital-affiliated facility, or placed after PPS had shorter delays. Long delays were found among patients who had applied for Medicaid coverage but had not yet been certified as financially eligible. Nonwhites and males were also delayed. These findings, if replicated in other areas with perceived nursing home bed shortages, appear to have important implications not only for the usefulness of nursing home case-mix reimbursement and subacute levels of nursing home care, but for nursing home bed-need estimates, too, as well as for Medicaid eligibility determination practices and civil rights law enforcement. PMID:3060449

Identifying critical thinking indicators and critical thinker attributes in nursing practice.

PubMed

Chao, Shu-Yuan; Liu, Hsing-Yuan; Wu, Ming-Chang; Clark, Mary Jo; Tan, Jung-Ying

2013-09-01

Critical thinking is an essential skill in the nursing process. Although several studies have evaluated the critical thinking skills of nurses, there is limited information related to the indicators of critical thinking or evaluation of critical thinking in the context of the nursing process. This study investigated the potential indicators of critical thinking and the attributes of critical thinkers in clinical nursing practice. Knowledge of these indicators can aid the development of tools to assess nursing students' critical thinking skills. The study was conducted between September 2009 and August 2010. In phase 1, a literature review and four focus groups were conducted to identify the indicators of critical thinking in the context of nursing and the attributes of critical thinkers. In phase 2, 30 nursing professionals participated in a modified Delphi research survey to establish consensus and the appropriateness of each indicator and attribute identified in phase 1. We identified 37 indicators of critical thinking and 10 attributes of critical thinkers. The indicators were categorized into five subscales within the context of the nursing process toreflect nursing clinical practice: assessment, 16 indicators of ability to apply professional knowledge and skills to analyze and interpret patient problems; diagnosis, five indicators of ability to propose preliminary suppositions; planning, five indicators of ability to develop problem-solving strategies; implementation, five indicators of ability to implement planning; and evaluation, six indicators of ability to self-assess and reflect. The study operationalized critical thinking into a practical indicator suitable for nursing contexts in which critical thinking is required for clinical problem solving. Identified indicators and attributes can assist clinical instructors to evaluate student critical thought skills and development-related teaching strategies.

Classification systems in nursing: formalizing nursing knowledge and implications for nursing information systems.

PubMed

Goossen, W T; Epping, P J; Abraham, I L

1996-03-01

The development of nursing information systems (NIS) is often hampered by the fact that nursing lacks a unified nursing terminology and classification system. Currently there exist various initiatives in this area. We address the question as to how current initiatives in the development of nursing terminology and classification systems can contribute towards the development of NIS. First, the rationale behind the formalization of nursing knowledge is discussed. Next, using a framework for nursing information processing, the most important developments in the field of nursing on formalization, terminology and classification are critically reviewed. The initiatives discussed include nursing terminology projects in several countries, and the International Classification of Nursing Practice. Suggestions for further developments in the area are discussed. Finally, implications for NIS are presented, as well as the relationships of these components to other sections of an integrated computerized patient record.

Botulism in the ICU: Nursing care plan.

PubMed

Zariquiey-Esteva, G; Galeote-Cózar, D; Santa-Candela, P; Castanera-Duro, A

Botulism is a rare disease in Europe, caused by the bacterium Clostridium botulinum, notifiable, non-transmissible person-to-person and potentially fatal (between 5 and 10%) if not treated quickly. The favourable opinion of the Clinical Research Ethics Committee was obtained. We present the nursing care plan of a 49-year-old man with a diagnosis of bacterial intoxication caused by Clostridium botulinum, secondary to ingestion of beans in poor condition, who was admitted to the ICU for a total of 35 days. Holistic nursing evaluation during the first 24hours, with prioritisation of the systems that were deteriorating fastest: neurological and respiratory. Nine diagnoses were prioritised according to the NANDA taxonomy: Risk for allergy response, Ineffective breathing pattern, impaired oral mucous membrane, Impaired physical mobility, Risk for disuse syndrome, Risk for dysfunctional gastrointestinal motility, Impaired urinary elimination, Risk for acute confusion and Risk for caregiver role strain. The nursing care plan, standardised and organised with the NANDA taxonomy and prioritised with the outcome-present state-test (OPT) model, guaranteed the best care based on evidence, as the NOC scores improvement demonstrated. It was impossible to compare the nursing intervention with other case reports. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

Promotion or marketing of the nursing profession by nurses.

PubMed

Kagan, I; Biran, E; Telem, L; Steinovitz, N; Alboer, D; Ovadia, K L; Melnikov, S

2015-09-01

In recent years, much effort has been invested all over the world in nurse recruitment and retention. Issues arising in this context are low job satisfaction, the poor public image of nursing and the reluctance of nurses to promote or market their profession. This study aimed to examine factors explaining the marketing of the nursing profession by nurses working at a general tertiary medical centre in Israel. One hundred sixty-nine registered nurses and midwives from five clinical care units completed a structured self-administered questionnaire, measuring (a) professional self-image, (b) job satisfaction, (c) nursing promotional and marketing activity questionnaire, and (d) demographic data. The mean scores for the promotion of nursing were low. Nurses working in an intensive cardiac care unit demonstrated higher levels of promotional behaviour than nurses from other nursing wards in our study. Nurse managers reported higher levels of nursing promotion activity compared with first-line staff nurses. There was a strong significant correlation between job satisfaction and marketing behaviour. Multiple regression analysis shows that 15% of the variance of promoting the nursing profession was explained by job satisfaction and job position. Nurses are not inclined to promote or market their profession to the public or to other professions. The policy on the marketing of nursing is inadequate. A three-level (individual, organizational and national) nursing marketing programme is proposed for implementation by nurse leadership and policy makers. Among proposed steps to improve marketing of the nursing profession are promotion of the image of nursing by the individual nurse in the course of her or his daily activities, formulation and implementation of policies and programmes to promote the image of nursing at the organizational level and drawing up of a long-term programme for promoting or marketing the professional status of nursing at the national level. © 2015

Anaemia and iron deficiency in cardiac patients: what do nurses and allied professionals know?

PubMed

Verheijden Klompstra, Leonie; Jaarsma, Tiny; Moons, Philip; Norekvål, Tone M; Smith, Karen; Martensson, Jan; Thompson, David R; De Geest, Sabina; Lenzen, Mattie; Strömberg, Anna

2012-03-01

Cardiac nurses and allied professionals often take care of patients who also have anaemia or iron deficiency. To deliver optimal care, professionals should be knowledgeable about the prevalence, diagnosis, pathophysiology, and therapeutic management of these conditions. We therefore set out a survey to get a first impression on the current knowledge of nurses and allied professionals on anaemia and iron deficiency. A questionnaire was designed for this study by the Undertaking Nursing Interventions Throughout Europe (UNITE) Study Group. Data were collected from 125 cardiovascular nurses and allied professionals visiting the 11th Annual Spring Meeting of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology. Most respondents had general knowledge on the definition of anaemia and iron deficiency and 54% of the respondents rated anaemia and iron deficiency as important when evaluating a cardiac patient. Specific knowledge regarding anaemia and more prominently of iron deficiency was not optimal. Although cardiac nurses and allied professionals have basic knowledge of anaemia and iron deficiency, they would benefit from additional knowledge and skills to optimally deliver patient care.

Effect of nurse case management on the treatment of older women with breast cancer.

PubMed

Goodwin, James S; Satish, Shiva; Anderson, Elizabeth T; Nattinger, Ann B; Freeman, Jean L

2003-09-01

To evaluate the effect of nurse case management on the treatment of older women with breast cancer. Randomized prospective trial. Sixty surgeons practicing at 13 community and two public hospitals in southeast Texas. Three hundred thirty-five women (166 control and 169 intervention) aged 65 and older newly diagnosed with breast cancer. Women seeing surgeons randomized to the intervention group received the services of a nurse case manager for 12 months after the diagnosis of breast cancer. The primary outcome was the type and use of cancer-specific therapies received in the first 6 months after diagnosis. Secondary outcomes were patient satisfaction and arm function on the affected side 2 months after diagnosis. More women in the intervention group received breast-conserving surgery (28.6% vs 18.7%; P=.031) and radiation therapy (36.0% vs 19.0%; P=.003). Of women undergoing breast-conserving surgery, greater percentages in the case management group received adjuvant radiation (78.3% vs 44.8%; P=.001) and axillary dissection (71.4% vs 44.8%; P=.057). Women in the case management group were also more likely to receive more breast reconstruction surgery (9.3% vs 2.6%, P=.054), and women in the case management group with advanced cancer were more likely to receive chemotherapy (72.7% vs 30.0%, P=.057). Two months after surgery, higher percentages of women in the case manager group had normal arm function (93% vs 84%; P=.037) and were more likely to state that they had a real choice in their treatment (82.2% vs 69.9%, P=.020). Women with indicators of poor social support were more likely to benefit from nurse case management. Nurse case management results in more appropriate management of older women with breast cancer.

The role of resilience and mindful leadership in oncology nursing.

PubMed

Rishel, Cindy J

2015-03-01

When oncology nurses think of the word resilient, they often describe the term in the context of the patients and families they care for each day. When patients face a diagnosis of cancer, their lives have suddenly been altered in a frightening manner. Everything changes, and they must find a way to navigate the troubled waters ahead. 
.

How do nursing students perceive substance abusing nurses?

PubMed

Boulton, Martha A; Nosek, Laura J

2014-02-01

Substance abuse among nurses was recognized by nurse leaders and professional nursing organizations as a growing threat to patient safety and to the health of the abusing nurse more than 30years ago. Although numerous studies on nurse impairment were published in the 1980s and 1990s, there was minimal focus on student nurses' perceptions about impaired nurses and less research has been published more recently, despite a growing rate of substance abuse. A quasi-experimental study to explore the perceptions of student nurses toward nurses who are chemically dependent was conducted using a two-group, pretest-posttest design. The Perception of Nurse Impairment Inventory (PNII) was completed by student nurses at the beginning of their junior course work, prior to formal education about substance abuse. The PNII was repeated after the students received substance abuse education. The PNII was also completed by a control group of sophomore student nurses who did not receive the formal substance abuse education. A repeated measures analysis of variance was used to measure the differences between the two groups of students. Students who received the education chose more compassionate responses on the PNII and were more likely to respond that an impaired nurse's supervisor is responsible for supporting and guiding the impaired nurse to access professional care. Discrepancies in study findings about the efficacy of education for effecting positive attitudes of student nurses toward impaired nurses may be related to the length and type of the education. © 2014.

Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia.

PubMed

Hughes, Linda; Adair, Jean; Feng, Feng; Maciejewski, Stephanie; Sharma, Harsha

2016-01-01

In the United States, fibromyalgia affects 2%-5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010. The purpose of this study was to evaluate nurse practitioners' education and awareness of fibromyalgia and to evaluate nurse practitioners' practices for the management of fibromyalgia. Sixty-six nurse practitioners voluntarily completed an online survey regarding their education, diagnosis, and treatment options for patients with fibromyalgia. The majority of participants reported that they always or occasionally had difficulty diagnosing fibromyalgia and worried about labeling their patients as having fibromyalgia. The most commonly used agents were nonsteroidal anti-inflammatory drugs (70%), serotonin norepinephrine reuptake inhibitors (61%), selective serotonin reuptake inhibitors (51%), and muscle relaxants (44%). Nondrug therapies included exercise (88%), cognitive behavior therapy (58%), and nutrition (56%). Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.

Finnish nurses' and nursing students' pharmacological skills.

PubMed

Grandell-Niemi, Heidi; Hupli, Maija; Leino-Kilpi, Helena; Puukka, Pauli

2005-07-01

PURPOSES AND OBJECTIVES: The purposes of this study were to investigate the pharmacological skills of Finnish nurses and graduating nursing students, to determine how pharmacological skills are related to background factors and to identify differences between nurses and students and, finally, to examine how the instrument used, the Medication Calculation Skills Test, works. Pharmacology is a relevant and topical subject. In several studies, however, pharmacological skills of nurses and nursing students have been found insufficient. In addition, pharmacology as a subject is found to be difficult for both nursing students and nurses. The study was evaluative in nature; the data were collected using the Medication Calculation Skills Test, developed for the purposes of this study. The instrument was used to gather information on background factors and self-rated pharmacological and mathematical skills and to test actual skills in these areas. Results concerning pharmacological skills are reported in this paper. The maximum Medication Calculation Skills Test score was 24 points. The mean score for nurses was 18.6 and that for students 16.3. Half of (50%) the students attained a score of 67% and 57% of nurses attained a score of 79%. Nurses and students had some deficiencies in their pharmacological skills. Nurses had better pharmacological skills than students according to both self-ratings and actual performance on the test. It is vitally important that nurses have adequate pharmacological skills to administer medicines correctly. This study showed that the Medication Calculation Skills Test seems to work well in measuring pharmacological skills, even though it needs further evaluation. Findings from this study can be used when planning the nursing curriculum and further education for Registered Nurses.

[Innovative culture and diagnosis related groups in a high complexity hospital, Colombia].

PubMed

Gorbanev, Iouri; Agudelo-Londoño, Sandra; Cortes, Ariel; Yepes, Francisco J

2016-04-01

Objectives To characterize the perception of Diagnosis-Related Groups (DRGs) as an innovation among physicians, nurses and administrative staff in a hospital in Colombia. Methods A case study of innovative culture in a hospital. Surveys and focus groups were carried out with the medical, nursing and administrative staff. Descriptive statistics were calculated for the perceptions of innovative culture. Comparative analysis was done between professional groups. The results of the focus groups were transcribed and analyzed to deepen the findings of the surveys. Results Significant differences were found in perceptions of the innovative culture. The nursing staff were more enthusiastic than doctors when evaluating the innovative culture and leadership. Physicians felt more autonomy when discussing professional issues. Administrative staff assessed the Hospital's disposition to acquire new medical technologies as higher than that of physicians. The three groups know little about DRG's. Conclusions When implementing a health innovation it is advisable to analyze its effect on the professionals who participate in the implementation. Physicians perceive DRGs as a threat to their professional autonomy, while nurses see it as a pro-innovation force. It is important to involve nursing and administrative staff when implementing this kind of innovation.

Nurses' attitudes toward substance misusers. III. Emergency room nurses' attitudes, nurses' attitudes toward impaired nurses, and studies of attitudinal change.

PubMed

Howard, M O; Chung, S S

2000-08-01

Emergency room nurses generally regard alcohol and drug misusers as troublesome patients and dislike caring for them. Surveys of nurses' and nurse managers' attitudes toward impaired nurses, all published in recent years, suggest that they are generally supportive of impaired nurses and sanguine about their prospects for recovery; nonetheless, a substantial minority oppose the return to work of a formerly substance-misusing nurse colleague. Programs designed to change nurses' attitudes toward substance misusers are generally ineffective, although significant gains in substance-related knowledge are commonly reported.

Nurses take ownership of rads discrepancies.

PubMed

2010-02-01

The ED at Catawba Valley Medical Center in Hickory, NC, has improved its responses to radiology discrepancies by redesigning its process and giving ownership of that process to two nurses. Here are some of the key aspects of the process: every day the coordinators check the computer system, into which discrepancies are entered by radiology. Diagnosis and treatment are reviewed with one of the ED physicians. If the patient has been discharged, the coordinator will contact the patient via phone or follow-up letter.

Should I stay or should I go? Nurses' wishes to leave nursing homes and home nursing.

PubMed

Bratt, Christopher; Gautun, Heidi

2018-04-30

This study investigates the prevalence of nurses' wishes to leave work in elderly care services and aims to explain differences between younger and older nurses. Health-and-care services, and specifically elderly care services, experience problems recruiting and retaining nurses. A nationwide survey among nurses in Norway with 4,945 nurses aged 20-73 (mean age = 41.8), 95% female. Structural equation modelling was used, analysing the whole sample as well as analysing younger and older nurses as separate groups. Of the nurses surveyed, 25% wanted to work outside elderly care services and 25% were uncertain. The wish to leave was much more frequent among younger nurses. Reported working conditions were a strong predictor of the wish to leave, and a much stronger predictor among younger nurses than older nurses in nursing homes. Working conditions are a major predictor of nurses' wishes to leave elderly care services, especially among younger nurses in nursing homes. Attempts to reduce turnover in elderly care services need to address the working conditions for younger nurses, for instance by reducing the time young nurses work in isolation. © 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

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

PubMed

Chang, Fang-Mei; Lee, Ting-Ting

2013-04-01

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

Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents.

PubMed

Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

2015-01-01

to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. the development of this tool used to document the nursing actions will contribute to decision-making and quality of care.

Leading nurses in dire straits: head nurses' navigation between nursing and leadership roles.

PubMed

Sørensen, Erik E; Delmar, Charlotte; Pedersen, Birthe D

2011-05-01

The present study reports selected findings from a doctoral study exploring the negotiation between nursing and leadership in hospital head nurses' leadership practice. The importance of bringing a nursing background into leadership is currently under debate. In spite of several studies of nursing and clinical leadership, it is still unclear how nurses' navigate between nursing and leadership roles. An 11-month-long ethnographic study of 12 head nurses' work: five worked at a first line level and seven at a department level. At the first line level, leadership practices were characterized by an inherent conflict between closeness and distance to clinical practice; at the department level practises were characterized by 'recognition games'. On both levels, three interactive roles were identified, that of clinician, manager and a hybrid role. Where clinician or manager roles were assumed, negotiation between roles was absent, leading to reactive, adaptive and isolated practices. The hybrid role was associated with dialectical negotiation of roles leading to stable and proactive practices. Nursing leadership practises depend on leaders' negotiation of the conflicting identities of nurse and leader. Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

Nurses' contributions to the resolution of ethical dilemmas in practice.

PubMed

Barlow, Nichola Ann; Hargreaves, Janet; Gillibrand, Warren P

2018-03-01

Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Four major themes emerged: 'best for the patient', 'accountability', 'collaboration and conflict' and 'concern for others'. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing

Mental health nurses' attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review.

PubMed

Dickens, Geoffrey L; Lamont, Emma; Gray, Sarah

2016-07-01

To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses' attitudes have had limited success. Systematic, integrative literature review. Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses' attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Forty studies were included. Only one used direct observation of clinical practice. Nurses' knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals' and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Mental health nurses' responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working

Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

PubMed

Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

2017-10-01

A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

Neonatal nurse practitioners: identity as advanced practice nurses.

PubMed

Beal, J A; Maguire, D; Carr, R

1996-06-01

To define how neonatal nurse practitioners (NNPs) perceive their identity as advanced practice nurses. Non-experimental descriptive and correlational survey. Nationwide random sample drawn from NNPs certified by the National Certification Corporation. Two hundred fifty-eight neonatal nurse practitioners practicing in neonatal intensive-care units across the United States. Neonatal Nurse Practitioners indicated on a visual analogue scale at which point their philosophy of practice fell on a continuum from nursing to medicine and specified on a 5-point bipolar Likert scale how various role socialization factors influenced their identity. The NNPs predominantly were certificate-prepared and aligned themselves with a medical philosophy. Those NNPs who were master's-prepared (p < .01), precepted by another NNP (p < .05), espoused a philosophy of nursing (p < .001), belonged to a professional nursing organization (p < .05), and had an NNP role model (p < .001) were more likely to have a strong nursing identity (95% confidence interval). The issues of role differentiation, socialization, and identity of advanced practice nurses in tertiary care need further exploration. These data support the American Nurses' Association mandate of graduate nursing education for advanced nurse practitioners.

Emergency nurses' knowledge, attitude and clinical decision making skills about pain.

PubMed

Ucuzal, Meral; Doğan, Runida

2015-04-01

Pain is the most common reason that patients come to the emergency department. Emergency nurses have an indispensable role in the management of this pain. The aim of this study was to examine emergency nurses' knowledge, attitude and clinical decision-making skills about pain. This descriptive study was conducted in a state and a university hospital between September and October 2012 in Malatya, Turkey. Of 98 nurses working in the emergency departments of these two hospitals, 57 returned the questionnaires. The response rate was 58%. Data were collected using the Demographic Information Questionnaire, Knowledge and Attitude Questionnaire about Pain and Clinical Decision Making Survey. Frequency, percentage, mean and standard deviation were used to evaluate data. 75.4% of participant nurses knew that patients' own statement about their pain was the most reliable indicator during pain assessment. Almost half of the nurses believed that patients should be encouraged to endure the pain as much as possible before resorting to a pain relief method. The results also indicate that most of nurses think that a sleeping patient does not have any pain and pain relief should be postponed as it can influence the diagnosis negatively. It is determined that the pain scale was not used frequently. Only 35.1% of nurses reported keeping records of pain. Despite all the recommendations of substantial past research the results of this study indicate that emergency nurses continue to demonstrate inadequate knowledge, clinical decision-making skills and negative attitudes about pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Nutrition for Nurses: Nursing 245.

ERIC Educational Resources Information Center

Palermo, Karen R.

A description is presented of "Nutrition for Nurses," a prerequisite course for students anticipating entrance into the junior level of a state university registered nursing program. Introductory material highlights the course focus (i.e., the basics of good nutrition; nutrition through the life cycle; nursing process in nutritional care; and…

Taking personal responsibility: Nurses' and assistant nurses' experiences of good nursing practice in psychiatric inpatient care.

PubMed

Gabrielsson, Sebastian; Sävenstedt, Stefan; Olsson, Malin

2016-10-01

Therapeutic nurse-patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values. © 2016 Australian College of Mental Health Nurses Inc.

Use of Narrative Nursing Records for Nursing Research

PubMed Central

Park, Hyeoun-Ae; Cho, InSook; Ahn, Hee-Jung

2012-01-01

To explore the usefulness of narrative nursing records documented using a standardized terminology-based electronic nursing records system, we conducted three different studies on (1) the gaps between the required nursing care time and the actual nursing care time, (2) the practice variations in pressure ulcer care, and (3) the surveillance of adverse drug events. The narrative nursing notes, documented at the point of care using standardized nursing statements, were extracted from the clinical data repository at a teaching hospital in Korea and analyzed. Our findings were: the pediatric and geriatric units showed relatively high staffing needs; overall incidence rate of pressure ulcer among the intensive-care patients was 15.0% and the nursing interventions provided for pressure-ulcer care varied depending on nursing units; and at least one adverse drug event was noted in 53.0% of the cancer patients who were treated with cisplatin. A standardized nursing terminology-based electronic nursing record system allowed us to explore answers to different various research questions. PMID:24199111

Sexual harassment of nurses and nursing students.

PubMed

Bronner, Gila; Peretz, Chava; Ehrenfeld, Mally

2003-06-01

Nursing has dealt with sexual harassment long before the term was coined during the 1970s. The current study investigated sexual harassment of nurses and nursing students in Israel following new legislation against sexual harassment in the workplace. A self-report questionnaire was administered to 281 nurses and 206 nursing students (80% women) from five medical centres in Israel. Seven types of sexual harassment behaviour patterns were evaluated. Frequency of sexual harassment decreased as the behaviour became more intimate and offensive. Ninety percent of subjects reported experiencing at least one type of sexual harassment and 30% described at least four types. A significant difference was found between nurses and nursing students. Furthermore, "severe" types of behaviour were experienced by 33% of nurses, in comparison with 23% of nursing students. Women were significantly more exposed than men to "mild" and "moderate" types of sexual harassment, while 35% of men vs. 26% of women were exposed to "severe" types of harassment. However, women responded significantly more assertively than men to "severe" sexual harassment. Particular attention is needed when sexual harassment occurs to male students and nurses because they may be subjected to the more offensive sexual conducts and at the same time may lack the ability to respond assertively.

[Nursing service certification. Norm UNE-EN-ISO 9001-2008].

PubMed

Salazar de la Guerra, R; Ferrer Arnedo, C; Labrador Domínguez, M J; Sangregorio Matesanz, A

2014-01-01

To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process. The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements. The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%. The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Quality Evaluation of Nursing Observation Based on a Survey of Nursing Documents Using NursingNAVI.

PubMed

Tsuru, Satoko; Omori, Miho; Inoue, Manami; Wako, Fumiko

2016-01-01

We have identified three foci of the nursing observation and nursing action respectively. Using these frameworks, we have developed the structured knowledge model for a number of diseases and medical interventions. We developed this structure based NursingNAVI^® contents collaborated with some quality centred hospitals. Authors analysed the nursing care documentations of post-gastrectomy patients in light of the standardized nursing care plan in the "NursingNAVI^®" developed by ourselves and revealed the "failure to observe" and "failure to document", which leaded to the volatility of the patients' data, conditions and some situation. This phenomenon should have been avoided if nurses had employed a standardized nursing care plan. So, we developed thinking process support system for planning, delivering, recording and evaluating in daily nursing using NursingNAVI^® contents. It is important to identify the problem of the volatility of the patients' data, conditions and some situation. We developed a survey tool of nursing documents using NursingNAVI^® Content for quality evaluation of nursing observation. We recommended some hospitals to use this survey tool. Fifteen hospitals participated the survey using this tool. It is estimated that the volatilizing situation. A hospital which don't participate this survey, knew the result. So the hospital decided to use NursingNAVI^® contents in HIS. It was suggested that the system has availability for nursing OJT and time reduction of planning and recording without volatilizing situation.

Clinical findings associated with radiographic pneumonia in nursing home residents.

PubMed

Mehr, D R; Binder, E F; Kruse, R L; Zweig, S C; Madsen, R W; D'Agostino, R B

2001-11-01

Subtle presentation and the frequent lack of on-site physicians complicate the diagnosis of pneumonia in nursing home residents. We sought to identify clinical findings (signs, symptoms, and simple laboratory studies) associated with radiographic pneumonia in sick nursing home residents. This was a prospective cohort study. The residents of 36 nursing homes in central Missouri and the St. Louis area with signs or symptoms suggesting a lower respiratory infection were included. We compared evaluation findings by project nurses with findings reported from chest radiographs. Among 2334 episodes of illness in 1474 nursing home residents, 45% of the radiograph reports suggested pneumonia (possible=12%; probable or definite = 33%). In 80% of pneumonia episodes, subjects had 3 or fewer respiratory or general symptoms. Eight variables were significant independent predictors of pneumonia (increased pulse, respiratory rate =30, temperature =38 degrees C, somnolence or decreased alertness, presence of acute confusion, lung crackles on auscultation, absence of wheezes, and increased white blood count). A simple score (range = -1 to 8) on the basis of these variables identified 33% of subjects (score > or =3) with more than 50% probability of pneumonia and an additional 24% (score of 2) with 44% probability of pneumonia. Pneumonia in nursing home residents is usually associated with few symptoms. Nonetheless, a simple clinical prediction rule can identify residents at very high risk of pneumonia. If validated in other studies, physicians could consider treating such residents without obtaining a chest radiograph.

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

PubMed

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

2014-03-01

The Basic Documentation for Psycho-Oncology (PO-Bado) is a semi-directive instrument for assessing psychosocial difficulties in cancer patients. It is based on subjective status and not on degree of symptom severity. Our objectives were to assess whether use of the PO-Bado during post-cancer-diagnosis consultations improves the quality of communication by establishing a supportive relationship between nurses and patients and to assess nurses' satisfaction of their communication skills. Data were collected from post-diagnosis 'bad-news' consultations across four Cancer treatment centres in South West France. Eleven nurses who had never used the PO-Bado ('inexperienced group') received training on the instrument (short-form). Twenty-one pre-training consultations without the PO-Bado were recorded and compared with 21 post-training consultations with the PO-Bado. Twenty consultations with four nurses with experience using the PO-Bado ('experienced group') were included for between-group comparisons. Nurses' satisfaction was evaluated through semi-directive consultations at the end of the study and completed by a visual analogue scale. We transcribed and analysed 62 consultations. We observed greater use of techniques encouraging patient expression in consultations with PO-Bado-experienced nurses (p < 0.01); after PO-Bado training for 'inexperienced' nurses (p < 0.05) and less use of non-encouraging techniques after PO-Bado training for 'inexperienced' nurses (p < 0.01). Nurses felt more satisfied with their communications skills after PO-Bado training and stated that they felt more competent, particularly for referrals to psychologists. The PO-Bado is beneficial for the quality of the communication between nurses and patients at bad-news delivery consultations and for the satisfaction of nurses with regard to their relational skills. Copyright © 2013 John Wiley & Sons, Ltd.

The diagnosis of depression and use of antidepressants in nursing home residents with and without dementia.

PubMed

van Asch, Iris F M; Nuyen, Jasper; Veerbeek, Marjolein A; Frijters, Dinnus H M; Achterberg, Wilco P; Pot, Anne Margriet

2013-03-01

To compare the prevalence of diagnosed depressive disorders, depressive symptoms and use of antidepressant medication between nursing home residents with and without dementia. This cross-sectional study used Minimal Data Set of the Resident Assessment Instrument 2.1 data collected in seven nursing homes located in an urbanized region in the Netherlands. Trained nurse assistants recorded all medical diagnoses made by a medical specialist, including dementia and depressive disorder, and medication use. Depressive symptoms were measured with the Depression Rating Scale. Multivariate logistic regression analysis was used to compare data between residents with and without dementia. Included in the study were 1885 nursing home residents (aged 65 years or older), of which 837 had dementia. There was no significant difference in the prevalence of diagnosed depressive disorder between residents with (9.6%) and without dementia (9.8%). Residents with dementia (46.4%) had more depressive symptoms than residents without dementia (22.6%). Among those with depressive symptoms, residents with dementia had the same likelihood of being diagnosed with a depressive disorder as residents without dementia. Among residents with a diagnosed depressive disorder, antidepressant use did not differ significantly between residents with dementia (58.8%) and without dementia (57.3%). The same holds true for residents with depressive symptoms, where antidepressant use was 25.3% in residents with dementia and 24.6% in residents without dementia. Regarding the prevalence rates of diagnosed depressive disorder and antidepressant use found in this study, our findings demonstrate that there is room for improvement not only for the detection of depression but also with regard to its treatment. Copyright © 2012 John Wiley & Sons, Ltd.

[Nursing care of pulmonary embolism in out-of-hospital emergencies].

PubMed

Carrión-Martínez, Aurora; Rivera-Caravaca, José Miguel

2016-01-01

Pulmonary embolism is one of the most severe venous thromboembolic diseases, both in mortality and the high number of associated complications and their impact on quality of life. The early hours are critical and proper management during this period can determine future sequels. Therefore, in the outpatient setting, nurses must have adequate knowledge and tools to act quickly and efficiently. In this paper, we present a case of a 77 year-old male in his home that after being discharged from a knee replacement surgery starts with symptoms compatible with pulmonary thromboembolism. A Nursing Care Process is performed, according to the functional patterns of Margory Gordon and a care plan is developed based on NNN taxonomy (NANDA, NOC, NIC). As main nursing diagnosis 'ineffective breathing pattern' is selected and as possible potential complication of the pulmonary embolism the 'pulmonary infarction' is chosen. The results obtained after conducting the care plan are satisfactory, improving the signs and symptoms presented by the patient, hence why we believe it is useful for nurses when facing similar clinical situations. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Undergraduate nursing students' compatibility with the nursing profession

PubMed Central

Adib-Hajbaghery, Mohsen; Dianati, Mansur

2005-01-01

Background The high rate of attrition among nursing students has caused some nursing leaders to think about the necessity of considering students' personality during the process of admission into nursing schools. Due to the lack of studies on Iranian nursing students' personality traits, this study was designed to assess freshmen nursing students' personality characteristics and their compatibility with the demands of the nursing profession. Methods A descriptive study was conducted at Tehran and kashan medical universities and one of the branches of Azad University. Convenience sampling was used and 52 freshmen nursing students were assessed using Holland's Vocational Interests Inventory. Results From the total participants 63.5% were females and 36.5% were males. Based on the Holland's Vocational Interests Inventory 44% did not have appropriate personality characteristics for the nursing profession. 77% of the nursing students participating in the study reported that they lacked information about nursing. Conclusion It seems that personality tests can help to select the best students for nursing schools from those who show good academic capabilities. This would decrease the rate of attrition and could improve the quality of care. PMID:16011800

Nursing Home Work Practices and Nursing Assistants' Job Satisfaction

ERIC Educational Resources Information Center

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

2009-01-01

Purpose: To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Design and Methods: Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey,…

Using appreciative inquiry to transform student nurses' image of nursing.

PubMed

Chauke, Motshedisi E; Van Der Wal, Dirk; Botha, Annalie

2015-08-19

Literature provides adequate evidence of a poor perception of nursing within the profession, resulting in high rates of attrition of student nurses and newly qualified nurses. The nursing profession, in particular nurse educators, has an ethical and professional responsibility to find innovative strategies to promote the positive image of nursing amongst student nurses. The purpose of the study was to explore the potential of appreciative inquiry (AI) as an intervention teaching strategy to transform student nurses' image of nursing. A quantitative, quasi-experimental, explorative-descriptive design comprising the pretest, appreciative inquiry as intervention, and the post-test was used. Convenience sampling was used to select third and fourth year college and university student nurses in the Gauteng province of South Africa for the pre- and the post-test respectively. Data were collected by means of a questionnaire and analysed by SPSS version 20.0. The pretest results revealed a mix of positive and negative perceptions of the image of nursing amongst student nurses. The negative perceptions of the image of nursing that needed intervention included the working conditions of nurses, and the perception of nursing as a profession that was not respected and appreciated. The post-test results showed a significant and positive change in the student nurses' perception of the image of nursing as a respected and appreciated profession. Although AI resulted in a negative to positive change in some aspects of student nurses' image of nursing, the negative perceptions of the working conditions of nurses remained and became more negative. The positive image of gender in nursing was enhanced following the implementation of AI. Appreciative inquiry demonstrated potential as a teaching strategy to produce a positive nursing image change and positive orientation towards nursing amongst student nurses.

Disparities in Nursing Home Use and Quality Among African American, Hispanic, and White Medicare Residents With Alzheimer's Disease and Related Dementias.

PubMed

Rivera-Hernandez, Maricruz; Kumar, Amit; Epstein-Lubow, Gary; Thomas, Kali S

2018-04-01

This article examines differences in nursing home use and quality among Medicare beneficiaries, in both Medicare Advantage and fee-for-service, newly admitted to nursing homes with Alzheimer's disease and related dementias (ADRD). Retrospective, national, population-based study of Medicare residents newly admitted to nursing homes with ADRD by race and ethnic group. Our analytic sample included 1,302,099 nursing home residents-268,181 with a diagnosis of ADRD-in 13,532 nursing homes from 2014. We found that a larger share of Hispanic Medicare residents that are admitted to nursing homes have ADRD compared with African American and White beneficiaries. Both Hispanics and African Americans with ADRD received care in segregated nursing homes with fewer resources and lower quality of care compared with White residents. These results have implications for targeted efforts to achieve health care equity and quality improvement efforts among nursing homes that serve minority patients.

Convergence: How Nursing Unions and Magnet are Advancing Nursing.

PubMed

Johnson, Joyce E; Billingsley, Molley

2014-01-01

Historically, unions and professional associations such as the American Nurses Association have been adversaries in the fight to represent the best interests of the nursing profession. We reviewed the literature on the evolution of nursing unions, nursing's historical unease about unions, the Magnet designation in nursing, the tensions between the unions and Magnet, the core values and commonalities they share, and the obligations of nursing as a profession. Refocusing on the advancement of our profession provides a positive pathway in which the collective efforts of nursing unions and professional initiatives such as the Magnet designation converge during these turbulent times for our profession. The single, central organizing idea of nursing-where nursing unions and Magnet converge-is the pivotal role of nurses in delivering high-quality patient care. The often-maligned dialectic between unions and Magnet has advanced and not hindered the nursing profession. © 2014 Wiley Periodicals, Inc.

Workplace culture in psychiatric nursing described by nurses.

PubMed

Kurjenluoma, K; Rantanen, A; McCormack, B; Slater, P; Hahtela, N; Suominen, T

2017-12-01

This study looks to describe the workplace culture from the viewpoints of stress, job satisfaction and practice environment. Data were collected from nurses (n = 109) using a web-based survey, The Person-Centred Nursing Index, from two purposefully selected hospital districts in Finland. Data were statistically analysed. Nurses described their workplace culture in slightly positive terms. Nurses only occasionally experienced stress (mean = 2.56, SD = 0.55) and were fairly satisfied with their job (mean = 4.75, SD = 0.66) and their practice environment (mean = 4.42, SD = 0.81). Demographic variables such as the nurses' age, length of time in nursing, time at their present hospital, working shifts and their use of patient restriction were more frequently associated with their perceived workplace culture. Older nurses and those with a longer work history in the nursing profession tended to be more satisfied with their workplace culture in psychiatric nursing. Young and/or newly graduated nurses felt more negatively on their workplace culture; this issue should be recognised and addressed with appropriate support and mentoring. Nurses who used restrictive measures were more often less satisfied with their workplace culture. Continuous efforts are needed to reduce the use of coercive measures, which challenge also the managers to support nursing practice to be more person-centred. © 2017 Nordic College of Caring Science.

Nurse retention and satisfaction in Ecuador: implications for nursing administration.

PubMed

Palmer, Sheri P

2014-01-01

This study explores the characteristics of professional nursing work environments that may affect nursing turnover and satisfaction within a large Ecuadorian hospital. Nursing turnover is a challenge and may compromise patient care. Work dissatisfaction contributes to high turnover. Improving nurse satisfaction can contribute to better patient outcomes. Eighty-eight nurses participated in a quantitative and qualitative survey focusing on nursing satisfaction, turnover and selected organisation characteristics. Issues that may affect nurse satisfaction and turnover were identified using questions from the Nursing Work Index: pay, insufficient number of nurses, undervaluing of nurses by public and the medical team, limited advancement opportunities, lack of autonomy and inflexibility in schedule. Other themes identified from qualitative data are reported. The top factor of decreased satisfaction was low pay as indicated by the Nursing Work Index. The qualitative results showed that low pay was the factor for nurse turnover. Additional factors related to nursing satisfaction can be addressed to improve nurse retention. Along with increasing nursing pay, strategies to consider in decreasing turnover and increasing satisfaction included: providing opportunities for nursing advancement, promoting the value of nursing, creating clinical protocols and enhancing autonomy. This study adds to knowledge about nursing needs and satisfaction in South America. © 2013 John Wiley & Sons Ltd.

Using Nursing Languages in School Nursing Practice. Second Edition

ERIC Educational Resources Information Center

Denehy, Janice

2010-01-01

The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…

Genome Sequencing Technologies and Nursing: What Are the Roles of Nurses and Nurse Scientists?

PubMed

Taylor, Jacquelyn Y; Wright, Michelle L; Hickey, Kathleen T; Housman, David E

Advances in DNA sequencing technology have resulted in an abundance of personalized data with challenging clinical utility and meaning for clinicians. This wealth of data has potential to dramatically impact the quality of healthcare. Nurses are at the focal point in educating patients regarding relevant healthcare needs; therefore, an understanding of sequencing technology and utilizing these data are critical. The objective of this study was to explicate the role of nurses and nurse scientists as integral members of healthcare teams in improving understanding of DNA sequencing data and translational genomics for patients. A history of the nurse role in newborn screening is used as an exemplar. This study serves as an exemplar on how genome sequencing has been utilized in nursing science and incorporates linkages of other omics approaches used by nurses that are included in this special issue. This special issue showcased nurse scientists conducting multi-omic research from various methods, including targeted candidate genes, pharmacogenomics, proteomics, epigenomics, and the microbiome. From this vantage point, we provide an overview of the roles of nurse scientists in genome sequencing research and provide recommendations for the best utilization of nurses and nurse scientists related to genome sequencing.

A cluster of unexplained deaths in a nursing home in Florida.

PubMed Central

Sacks, J J; Herndon, J L; Lieb, S H; Sorhage, F E; McCaig, L F; Withum, D G

1988-01-01

In the two-week period November 13-27, 1984, 12 patients died in a 54-bed nursing home in Florida; based on previous mortality patterns, 2.5 deaths would have been expected for the whole month. There was no similar increase in deaths in November 1984 and no comparable monthly death rate for any of 69 nursing homes in the same county from 1976-84. Comparison of the 12 deaths in November with 28 deaths that occurred during the previous 10 months and with 31 surviving patients who were continuously present in the nursing home between November 12-28, 1984 revealed that the patients who died in November were more likely to have had onset of the terminal event during the night shift, had a recent visitor, and had an admitting diagnosis of organic brain syndrome. The abrupt increase in the death rate for November 1984 was not associated with a measurable change in population characteristics, an outbreak of infectious disease, or changes in procedures or the environment. Reviews of employee schedules revealed a consistent and strong association between the duty times of two nurses and the onsets of the terminal episode and the times of patient deaths. Continuing epidemiologic surveillance of adverse outcomes in nursing homes is recommended. PMID:3381956

Nurse work engagement impacts job outcome and nurse-assessed quality of care: model testing with nurse practice environment and nurse work characteristics as predictors.

PubMed

Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik

2014-01-01

To explore the mechanisms through which nurse practice environment dimensions, such as nurse-physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Cross-sectional survey. Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Nurse practice environment dimensions predicted nurses' ratings of job outcome variables as well as quality of care. Features of nurses' work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses' perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services.

Nursing and Nursing Education: Public Policies and Private Actions.

ERIC Educational Resources Information Center

Institute of Medicine (NAS), Washington, DC.

Results are presented of a study of nursing and nursing education that focused on the need for continued federal support of nursing education, ways to attract nurses to medically underserved areas, and approaches to encourage nurses to stay in the profession. Findings are presented on whether the aggregate supply of generalist nurses will be…

Development of nurses with specialties: the nurse administrators' perspective.

PubMed

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

2008-10-01

This study clarified how Japanese nurse administrators consider the current status and future prospects of development and utilization of nurses with specialties. The demand for specialized nurses is not satisfied throughout the country. Nine nurse administrators participated in three focus-group discussions. Data were analyzed using qualitative content analysis technique. On development of specialized nurses, four categories were abstracted: offering opportunities for career development; establishing an environment of life-term continuous learning; providing well-balanced support for the needs of organizations and individual nurses; and support for career development as a specialist. To develop specialized nurses effectively it is important to focus more attention on qualitative aspects of nurses' professional experience in in-service education and to support appropriate personnel for strategic human resource development. Facilitating frequent contacts between specialized and general nurses should be highly valued as making an environment where nurses can face career goals daily leads to steady preservation of human resources. It is necessary for nurse administrators to keep human resources quantitatively and to clarify the developmental process after nurses obtain special roles to plan for continuous education.

[Beginnings of nursing education and nurses' contribution to nursing professional development in Serbia].

PubMed

Vlaisavljević, Željko; Čolović, Nataša; Perišić, Mirjana

2014-01-01

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 is Serbia. Dušica Spasić was a medical nurse that died at her workplace, when aged 23 years, nursing the sick from variola.

Nurse learners--do nurse tutors know them?

PubMed

Moule, P

1995-04-01

Research was undertaken to establish the social profile of Project 2000 (Diploma) learners, and to determine when, and with whose influence, learners make decisions to enter nursing. The image of nursing held by the group was sought and nurse tutors perceptions of the group were obtained, using a questionnaire method. Results analysed using statistical measures and content analysis showed that the majority of learners came from middle socio-economic backgrounds, generally decided to enter nursing whilst at school, and were influenced by nursing role models and the media. The learners perceptions and expectations of nursing were influenced by their experiences and showed some differences when compared with tutor responses. The findings from this small study imply the need for the dissemination of accurate and appropriate recruitment information to school personnel and career advisors. Effective marketing which addresses influences of the media and nursing role models should be employed, and finally nurse tutors need to be conversant with course content and learner expectations to facilitate effective recruitment policies and curriculum development.

Changes in nurse education: being a nurse teacher.

PubMed

Carr, Graham

2007-11-01

The aim of this study is to examine changes in nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty, which took place between August 2003 and March 2004 and totalled 34.4h or 305,736 words. There were thirty female and seven male participants, who between them shared 1015 years of nursing experience, averaging at 27.4 years (min7-max 42). These nursing years included 552 years of teaching practice, the average time being 15 years spent in a formal teaching role (min 0.5-max 29). Each interview was subjected to a process of thematic content analysis as described by Miles and Huberman. This paper identifies how nurse teachers try to combine teaching with a nursing role. The Government, the NHS, the Universities and the Nursing and Midwifery Council all articulate contradictory visions of the nurse teacher role, which raises the question of what additional value (if any) is gained from combining nursing practice and its teaching. This tension has led to a default situation where the longer a nurse works as a teacher the less likely it is that they will maintain any nursing practice.

Nurse managers' role in older nurses' intention to stay.

PubMed

Armstrong-Stassen, Marjorie; Freeman, Michelle; Cameron, Sheila; Rajacic, Dale

2015-01-01

The purpose of this paper is to propose and test a model of the underlying mechanisms linking perceived availability of human resource (HR) practices relevant to older nurses and older nurses' intentions to stay with their hospitals. Quantitative data were collected from randomly selected older registered nurses (N=660) engaged in direct patient care in hospitals in Canada. Structural equation modelling was used to test the hypothesized model. The relationship between perceptions of HR practices (performance evaluation, recognition/respect) and intentions to stay was mediated by the perceived fairness with which nurse managers managed these HR practices and nurse manager satisfaction. When nurse managers were perceived to administer the HR practices fairly (high perceived procedural justice), older nurses were more satisfied with their nurse manager and, in turn, more likely to intend to stay. The cross-sectional research design does not allow determination of causality. It is important that nurse managers receive training to increase their awareness of the needs of older nurses and that nurse managers be educated on how to manage HR practices relevant to older nurses in a fair manner. Equally important is that hospital administrators and HR managers recognize the importance of providing such HR practices and supporting nurse managers in managing these practices. The findings increase the understanding of how HR practices tailored to older nurses are related to the intentions of these nurses to remain with their hospital, and especially the crucial role that first-line nurse managers play in this process.

Supporting new graduate nurses making the transition to rural nursing practice: views from experienced rural nurses.

PubMed

Lea, Jackie; Cruickshank, Mary

2015-10-01

To present the findings from the experienced rural nurse participants of a larger study that explored the transitional experiences of newly graduated nurses making the role transition in rural health care facilities in Australia. There are specific and unique aspects of rural nursing practice that influence the nature and timing of support for new graduate nurses that have not been explored or acknowledged as influencing the new graduate nurses' experience of transition. Specifically, the difficulties and challenges that experienced rural nurses face in providing effective and timely support for new graduate nurses who are making the transition to rural nursing practice is yet to be explored. Using a qualitative case study framework, this study specifically aimed to investigate and describe the nature and timing of support required during the transition to nursing practice that is specific for the rural context and capacity. Individual in-depth interviews were conducted with 16 experienced rural nurses who, at the time of the study, worked with new graduate nurses in the rural practice environment. The findings from this study showed that the provision of timely on-ward support for new graduates making the transition to rural nursing practice is affected and influenced by the skill mix and staffing allocation within the rural environment. As well, there is a lack of awareness by rural nurses of how to meet the on-ward support needs of new graduate nurses. This study has identified the specific and unique aspects of the rural nurse's role and responsibilities for which the new graduate nurse requires incremental learning and intensive clinical support. The findings can be used by rural health services and experienced rural registered nurses to assist in implementing adequate and timely support for new graduate nurses. © 2015 John Wiley & Sons Ltd.

A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations.

PubMed

Priebe, Åsa; Wiklund Gustin, Lena; Fredriksson, Lennart

2018-04-01

The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously-used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self-esteem is restored. When synthesized, these themes gave rise to a main theme - a sanctuary of safety - where suffering is alleviated and dignity and self-esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients' recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self-esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses' caring expertise. © 2017 Australian College of Mental Health Nurses Inc.

Triumph and adversity: Exploring the complexities of consumer storytelling in mental health nursing education.

PubMed

Happell, Brenda; Bennetts, Wanda

2016-12-01

Consumer participation in the education of health professionals is increasing, particularly in mental health nursing education and storytelling remains the most frequent approach to consumer involvement. The use of story has tended to be accepted as a legitimate educational tool with limited critique or consideration of its potential consequences presented within the academic literature. A qualitative exploratory research study was undertaken with mental health nurse academics (n = 34) and consumer educators and academics (n = 12), to investigate the perceptions and experiences of mental health nurses and consumers regarding the involvement of consumers in mental health nursing education. Data were analysed thematically. Story was a major theme to emerge from consumer participants and received some attention from nurse academics. Consumers and nurses both referred to the power of story to convey the human experience of mental illness diagnosis and service use; and the vulnerability that can result from storytelling. Consumers also described: story as expectation; preparation and support; and the politics of story. All participants supported the value of storytelling in mental health nursing education. Consumers had considered the complexities in far greater detail. The ongoing value of story as an educational technique requires further research. Equally important is considering a broader range of educational roles for mental health consumers. © 2016 Australian College of Mental Health Nurses Inc.

Nurse-Led Interventions for Hypertension: A Scoping Review With Implications for Evidence-Based Practice.

PubMed

Spies, Lori A; Bader, Susan Gerding; Opollo, Jackline G; Gray, Jennifer

2018-06-14

Hypertension is the leading preventable contributor to cardiovascular morbidity and mortality, affecting 1 billion people globally. Low- and middle-income countries have increasing rates of hypertension, much of it undiagnosed. The purpose of the project is to review studies of nurse-led hypertension interventions that have been implemented in East Africa and to inform hypertension interventions in low-resource settings. A scoping review was conducted following Arksey and O'Malley's (2005) format. An electronic search in six databases for citations was conducted by the medical librarian author. The parameters for this scoping review were nurse interventions related to hypertension in East Africa. Fourteen full-text articles were identified that met inclusion criteria. Nurse-led interventions for hypertension were found to increase access to care and be cost- effective. Medication Adherence Clubs were an innovative intervention that increased the retention of patients in care. This scoping review provides evidence from studies of nurse-led hypertension interventions in East Africa relevant to implementing or improving hypertension screening, diagnosis, and treatment. Nurses provide 80% of health care in East Africa, and nurse-led hypertension interventions are critically needed to ameliorate the significant hypertension-related increases in morbidity and mortality globally. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.

Nursing home work practices and nursing assistants' job satisfaction.

PubMed

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

2009-10-01

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

Embracing healthcare technology - What is the way forward for nurse education?

PubMed

McCabe, Catherine; Timmins, Fiona

2016-11-01

Digital technology is regarded as increasingly important in the provision of safe, consistent and optimal health care in the future. However considerable challenges exist in relation to how it can best be used and integrated to support, transform and facilitate user engagement and provide individualised care. Many forms of digital health technology exist already that have improved diagnosis and treatment in terms of early diagnosis and treatment. That said, healthcare, and nursing in particular, remains largely at the periphery of the digital technology transformation and as a result is failing to capitalise on its potential for improving health care and services. Awareness of the level of change in terms of professional and cultural ideology is needed when introducing technology in health care. Participation in the introduction, adaptation and acceptance process by all staff using soft and hard data to create a vision, set clear goals and develop a mutually agreed implementation strategy is essential for success. A positive approach by management towards the use and benefits of digital technology for improving and transforming healthcare in conjunction with education support has been effective in some UK and US projects. Education needs to commence at undergraduate level and continue across the nursing career trajectory. This will help nurses to re-conceptualise how both patients and health care professionals can benefit and that technology can serve to enhance and support patient centred communication rather than limit it. Copyright © 2016. Published by Elsevier Ltd.

Genome Sequencing Technologies and Nursing: What Are the Roles of Nurses and Nurse Scientists?

PubMed Central

Taylor, Jacquelyn Y.; Wright, Michelle L.; Hickey, Kathleen T.; Housman, David

2016-01-01

Background Advances in DNA sequencing technology have resulted in an abundance of personalized data with challenging clinical utility and meaning for clinicians. This wealth of data has potential to dramatically impact the quality of healthcare. Nurses are at the focal point in educating patients regarding relevant healthcare needs; therefore, an understanding of sequencing technology and utilizing these data are critical. Aim The objective of this paper is to explicate the role of nurses and nurse scientists as integral members of healthcare teams in improving understanding of DNA sequencing data and translational genomics for patients. Approach A history of the nurse role in newborn screening is used as an exemplar. Discussion This paper serves as an exemplar on how genome sequencing has been utilized in nursing science and incorporates linkages of other omics approaches used by nurses that are included in this special issue. This special issue showcased nurse scientists conducting multi-omic research from various methods, including targeted candidate genes, pharmacogenomics, proteomics, epigenomics and the microbiome. From this vantage point, we provide an overview of the roles of nurse scientists in genome sequencing research and provide recommendations for the best utilization of nurses and nurse scientists related to genome sequencing. PMID:28252579

Evaluation of nursing manpower allocation in a nursing home.

PubMed

Chen, Chun-Hsi; Tsai, Wen-Chen; Chang, Wei-Chieh

2007-03-01

The subjects of this study encompassed the nursing staffs (nurses and nursing aids) and residents of a public hospital-based nursing home. By intensive sampling, this study explored the differences in actual times that nurses spent caring for residents. We assessed the functional status of nursing home residents of various illness severities as well as measured the actual nursing manpower needed to meet the residents' care needs using Typology of the Aged with Illustration (TAI). Results showed that current nursing manpower levels in nursing homes was adequate, although some units had excessive manpower allocation. As a result, this study suggests the establishment of a resident classification system for use in long-term care (LTC) facilities to assist with manpower allocation and reasonable utilization of resources within the facility. Adequate nurse staffing will enhance the quality and accessibility of care for the residents with severe illnesses in LTC facilities.

Undergraduate nursing students' attitudes toward mental health nursing.

PubMed

Thongpriwan, Vipavee; Leuck, Susan E; Powell, Rhonda L; Young, Staci; Schuler, Suzanne G; Hughes, Ronda G

2015-08-01

The purpose of this study was to describe undergraduate nursing students' attitudes toward mental health nursing and how these attitudes influenced their professional career choices in mental health nursing. A descriptive, online survey was utilized to examine students' perceptions of mental health nursing. A total of 229 junior and senior nursing students were recruited from eight nursing colleges in Midwestern United States to participate in this survey. Students of different ages, genders, ethnicities, and nursing programs did not report significantly different perceptions of: (a) knowledge of mental illness; (b) negative stereotypes; (c) interest in mental health nursing as a future career; and (d), and beliefs that psychiatric nurses provide a valuable contribution to consumers and the community. Negative stereotypes were significantly different between students who had mental health nursing preparation either in class (p=0.0147) or in clinical practice (p=0.0018) and students who had not. There were significant differences in anxiety about mental illness between students who had classes on mental health nursing (p=.0005), clinical experience (p=0.0035), and work experience in the mental health field (p=0.0012). Significant differences in an interest in a future career in mental health nursing emerged between students with and without prior mental health experience and between students with and without an interest in an externship program with p-values of 0.0012 and <0.0001, respectively. The more exposure that students have to mental health nursing through clinical experiences, theory classes, and previous work in the field, the more prepared they feel about caring for persons with mental health issues. Published by Elsevier Ltd.

Feelings about Nursing Assistants that Enhance the Work Motivation of Japanese Registered Nurses and Licensed Practical Nurses.

PubMed

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

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

Bias in the nursing workplace: implications for Latino(a) nurses.

PubMed

Moceri, Joane T

2012-01-01

The nursing shortage coupled with health inequities makes it imperative to retain nurses from diverse backgrounds in the workplace. Since Latinos are the fastest growing racial/ethnic group in the U.S., the issue is of particular importance. Thus, the purpose of this study was to measure the prevalence of bias in the nursing workplace as experienced by Latino(a) nurses. This descriptive study of Latino(a) nurses measured the prevalence of bias, its relationship to nurse retention in the nursing workplace, and additional factors in the workplace that were associated with bias. Results included that Latino(a) nurses both experienced and witnessed bias on a regular basis, along with negative comments by peers about their ethnicity. Significant correlations were found between experiences of bias and the study variables of witnessing bias, perceived levels of support, and time planning to remain in the workplace. As the nursing shortage continues and increases in severity, retaining nurses becomes as important as creating new nurses. Nurse managers, hospital administrators, and nurse educators must develop strategies to educate staff and promote non-biased interactions between nurses in the workplace, as well as to support nurses from diverse backgrounds.

An Integrative Review of Engaging Clinical Nurses in Nursing Research.

PubMed

Scala, Elizabeth; Price, Carrie; Day, Jennifer

2016-07-01

To review the literature for best practices for engaging clinical nurses in nursing research. Review of the research and nonresearch papers published between 2005 and 2015 that answered the evidence-based practice (EBP) question: what are the best practices for engaging clinical nursing staff in nursing research? PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, and Cochrane were searched using a combination of controlled vocabulary and key words. Nineteen papers that answered the EBP question were selected for review. It can be difficult to involve clinical nurses in research. There are multiple factors to consider when nursing leadership looks to engage clinical nurses in nursing research. Nurse leaders can take many approaches to engage clinical nurses in research. Each organization must perform its own assessment to identify areas of opportunity. Nursing leadership can take these areas of opportunity to structure a multifaceted approach to support clinical staff in the conduct and dissemination of nursing research. The evidence from this review offers EBP recommendations as well as reports on the gaps in the literature related to best practices for engaging clinical nurses in nursing research. © 2016 Sigma Theta Tau International.

Nursing diagnoses in patients with immune-bullous dermatosis.

PubMed

Brandão, Euzeli da Silva; Santos, Iraci Dos; Lanzillotti, Regina Serrão; Ferreira, Adriano Menis; Gamba, Mônica Antar; Azulay-Abulafia, Luna

2016-08-15

identify nursing diagnoses in patients with immune-bullous dermatosis. a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology. identificar diagnósticos de enfermagem em clientes com dermatoses imunobolhosas. pesquisa quantitativa e descritiva, realizada em três instituições localizadas no Rio de Janeiro e no Mato Grosso do Sul-Brasil, aplicando o Protocolo de Avaliação do Cliente em Dermatologia, durante consulta de enfermagem. Utilizou-se a estatística descritiva simples para análise dos dados. participaram do estudo 14 sujeitos, nove com diagnóstico médico de pênfigo vulgar, dois de foliáceo e três de penfigoide bolhoso. A idade variou entre 27 e 82 anos, predominando 11 pessoas do sexo feminino. Foram discutidos 14 diagnósticos de enfermagem

Empowering Staff Nurses as Primary Educators to Children with Type 1 Diabetes.

PubMed

Sy, Virginia

2016-01-01

Patient and family education is a critical element of diabetes management. Manychildren with new onset type 1 diabetes present with symptoms of diabeticketoacidosis (DKA) and are hospitalized at diagnosis. These children and theirfamilies receive their initial education in the hospital setting. As soon as bloodglucose levels are stabilized and the acidosis is corrected, the patient is dischargedhome, usually within three days (Nettles, 2005). There is little time toprovide the skills and education, as well as emotional support, for a smooth transitionto home. It is a challenge to achieve these goals if the only resource personfor diabetes education is the clinical nurse specialist (CNS). The CNS for a 14-bed pediatric unit sought to expand the role of the bedside nurse to being the primaryeducator of patients with diabetes through education and support. All nursesattended an eight-hour workshop on diabetes. A DKA protocol was developedthrough multidisciplinary collaboration, and nurses were educated on this protocol.Additionally, the CNS organized a diabetes resource cart that contains thetools for diabetes education. The protocol and education materials wereuploaded in the Pediatric SharePoint site to make them accessible to nurses. Most importantly, the CNS developed a structured patient education plan that isoutcome-oriented, and based on review of current literature and practices in theunit. This initiative resulted in an increase in nursing confidence and expertiserelated to diabetes care as demonstrated by competencies met by nurses andanecdotal evidence from nurses and patients’ caregivers.

Nurses' perceptions of nurse-led healthy lifestyle clinics.

PubMed

Marshall, Bob; Floyd, Sue; Forrest, Rachel

2011-12-01

Nineteen Nurse-Led Healthy Lifestyle Clinics (NLHLCs) were implemented and targeted Maori, Pacific and people living in high deprivation areas. The general focus of the clinics was on lifestyle issues and much of the nursing was educative and preventative care. The aim of this project was to assess nurses' experiences and opinions of their participation in the clinics. Nurses participating in the clinics were asked to complete a monthly narrative report over five reporting periods, and these were collated and evaluated for emergent themes. Sixteen nurses were subsequently interviewed and the transcripts analysed to identify major themes and sub-themes. In total, 167 narrative reports were collected from 53 of the 115 participating nurses. Almost all the nurses either strongly agreed or agreed that they enjoyed working in an NLHLC. This enjoyment was the result of: increased time for in-depth consultations, being able to provide enhanced holistic patient care, developing knowledge, gaining experience, receiving positive patient feedback and the satisfaction of seeing patient improvements. Nurses reported that the opportunity and responsibility of providing holistic nursing care, and the skills and knowledge gained from participating in the project, were extremely valuable. NLHLCs provide benefits for both patient and nurse. For the nurse, job satisfaction is increased through positive patient feedback, opportunities for professional development and a greater feeling of empowerment.

[The prevalence of intestinal parasites in four different special daytime nursing homes and day-centers in Antakya.].

PubMed

Culha, Gülnaz; Canpolat, Asutay; Gülbol, Gülay