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Sample records for advanced neonatal nurse

  1. Evaluating the Outcomes of Advanced Neonatal Nurse Practitioner Programmes.

    ERIC Educational Resources Information Center

    Redshaw, Margaret; Hart, Bev; Harvey, Merryl; Harris, Anne

    The outcomes of advanced neonatal nurse practitioner (ANNP) programs in the United Kingdom were examined. The different programs of education currently available for nurses wishing to become ANNPs were compared, and the outcomes of ANNP programs, as demonstrated in the levels of performance of practitioners undertaking different programs, were…

  2. Neonatal nursing: an unmet challenge in India.

    PubMed

    Kalyan, Geetanjli; Vatsa, Manju

    2014-11-01

    Nurses comprise a key component to maternal and newborn health care delivery, including the care of 'at-risk' or sick newborns. However, the efficiency and effectiveness of services rely heavily on adequate numbers of highly skilled neonatal nurses. Currently, in India, a significant shortage of trained nurses in the field of newborn care is contributing to poor neonatal outcomes. Specifically, nurses caring for newborns lack the competency and experience needed to ensure optimal care. This deficiency has been linked to a lack of expert faculty, standardized training and minimal or no exposures to newborn clinical care areas during pre service education. Moreover, in addition to a lack of operational research in the area, nurses who provide care for newborns are often faced with numerous system related issues that impede their ability to provide optimal care. Most notably, frequent changes of work place, poor wages, and lack of continuing education, skill maintenance, recognition, and collaborative team culture further compromise the nursing care. All these lead to poor motivation and competency. To meet this challenge, it is essential that emphasis be placed on the identification and support of nursing faculty with expertise in newborn and neonatal care who are able to ensure that nurses receive standardized education for pre-service, in-service and ongoing care. In addition, importance should be placed on encouraging newborn nursing research as well as on governmental increases in salary compensation. Lastly, given the shortage of physicians to take care of sick neonates in remote areas, the creation of a cadre of Neonatal nurse practitioner/ advanced practice nurses would be an invaluable solution in developing countries. Furthermore, centralized oversight of newborn education and training would be best served, if responsibility was placed with Reproductive maternal newborn child health (RMNCH) workers and district level officers. PMID:25278279

  3. Global health and neonatal nursing: a personal journey.

    PubMed

    Kenner, Carole; Boykova, Marina

    2012-09-01

    The need for improvement of neonatal nursing care is a global issue. Neonatal nurses have an important role in optimizing these health outcomes for neonates and their families. This article describes the personal journey of one nurse and her mentee. It describes how a passion for neonates led to global policy work. PMID:22895204

  4. The neonatal nurse: advocating for breastfeeding mothers.

    PubMed

    Darby, Colm; Nurse, Sharon

    2016-02-01

    Accurate information and support from healthcare professionals as well as respect for parental choice are all factors which contribute to effective breastfeeding in the neonatal unit; with this in mind, Colm Darby and Sharon Nurse discuss the potential problems in expressing breast milk and the interventions which might be effective in avoiding them. Advocacy is an inherent part of neonatal nurses' role whilst caring for sick, vulnerable babies. Colm Darby is a male neonatal nurse working in a predominantly female environment and passionately believes in supporting and advocating for mothers who want to provide breast milk for their babies. In this article, CoIm uses Borton's model of reflection to discuss how he acted as an effective advocate for such a mother. PMID:27008754

  5. Legal and ethical issues in neonatal nursing.

    PubMed

    2016-09-12

    Neonatal nurses regularly face complex legal and ethical dilemmas. This article discusses the hypothetical case of Jack, a two-day-old infant, born at 39 weeks' gestation, and diagnosed with trisomy 13 (syndrome), a life-limiting condition and being cared for in a neonatal intensive care unit. Jack's prognosis is poor and he is not expected to live past two weeks of age. PMID:27615591

  6. Nursing supports neonatal porcine testicular development.

    PubMed

    Rahman, K M; Lovich, J E; Lam, C; Camp, M E; Wiley, A A; Bartol, F F; Bagnell, C A

    2014-07-01

    The lactocrine hypothesis suggests a mechanism whereby milk-borne bioactive factors delivered to nursing offspring affect development of neonatal tissues. The objective of this study was to assess whether nursing affects testicular development in neonatal boars as reflected by: (1) Sertoli cell number and proliferation measured by GATA-4 expression and proliferating cell nuclear antigen immunostaining patterns; (2) Leydig cell development and steroidogenic activity as reflected by insulin-like factor 3 (INSL3), and P450 side chain cleavage (scc) enzyme expression; and (3) expression of estrogen receptor-alpha (ESR1), vascular endothelial growth factor (VEGF) A, and relaxin family peptide receptor (RXFP) 1. At birth, boars were randomly assigned (n = 6-7/group) to nurse ad libitum or to be pan fed porcine milk replacer for 48 h. Testes were collected from boars at birth, before nursing and from nursed and replacer-fed boars at 50 h on postnatal day (PND) 2. Sertoli cell proliferating cell nuclear antigen labeling index increased (P < 0.01) from birth to PND 2 in nursed, but not in replacer-fed boars. Sertoli cell number and testicular GATA-4 protein levels increased (P < 0.01) from PND 0 to PND 2 only in nursed boars. Neither age nor nursing affected testicular INSL3, P450scc, ESR1, or VEGFA levels. However, testicular relaxin family peptide receptor 1 (RXFP1) levels increased (P < 0.01) with age and were greater in replacer-fed boars on PND 2. Results suggest that nursing supports neonatal porcine testicular development and provide additional evidence for the importance of lactocrine signaling in pigs. PMID:24906933

  7. Preparation for Advanced Nursing Practice.

    ERIC Educational Resources Information Center

    Frik, Seigina M.; Pollock, Susan E.

    1993-01-01

    Lehman College's graduate nursing program uses theory-based courses to prepare advanced nurse practitioners. Students increase scholarly inquiry skills and clinical decision making; use of nursing conceptual models helped them plan and evaluate their practice. (SK)

  8. Advanced practice registered nurse certification.

    PubMed

    Alleman, Kim; Houle, Katherine

    2013-01-01

    Advanced practice registered nurses (APRNs) in nephrology began to be certified through the Nephrology Nursing Certification Commission (NNCC) in 2006. Since that time, the APRN Consensus Model has been developed, which addresses licensure, accreditation, certification, and education and which strongly recommends specialty certification for advanced practice nurses. This article discusses NNCC certification for advanced practice in nephrology nursing and describes the major components of the APRN Consensus Model. PMID:23923801

  9. Japan and its healthcare challenges and potential contribution of neonatal nurse practitioners.

    PubMed

    Eklund, Wakako

    2010-01-01

    Challenge has the potential to create opportunities for innovation. This applies to new developments aimed at enhancing existing systems of healthcare delivery. The development of the neonatal nurse practitioner's role in the United States is undoubtedly 1 such example of an innovation that was made in response to the challenge in neonatal healthcare delivery. This challenge and concomitant change was generated by a significant increase in neonatal patient needs, survival of smaller and sicker neonates, a rising acuity level, and the accompanying need to elevate the standard of healthcare for neonates. Nursing has faced such challenges more than once and been called upon to change the scope of practice not only in the United States but also globally. Japanese nursing is at a new historic moment since the end of World War II. There is an increased interest in expanding the role of nursing in collaboration with physicians to meet the complex needs of a growing neonatal intensive care population. However, for a nation where traditionally physician-led medicine was believed to maintain patient safety, nursing role advancement is met with significant opposition. This article will first describe the differences between neonatal intensive care unit workforce in Japan and in the United States and then introduce recent neonatal healthcare issues and the nation's response including an exploration of the neonatal nurse practitioner's (NNP's) role. Various barriers against nurse practitioner's role development are explained to better describe the context of NNP. This article focuses on the current status and direction of the NNP movement and efforts that are being made in Japan. PMID:20442612

  10. Call for neonatal nursing specialization in developing countries.

    PubMed

    Premji, Shahirose S; Spence, Kaye; Kenner, Carole

    2013-01-01

    In an attempt to reach Millennium Development Goals, health facility births, which are births occurring in health centers, facilities, or institutions under the care of a skilled birth attendant, are increasing in developing countries. We examined the state of neonatal nursing care in the context of issues related to the capacity of these health facilities to provide quality care and the high facility mortality rates in those neonates admitted to hospital. Neonatal nursing as a specialty within a community-hospital-community network system is proposed as an effective scaling-up strategy to improve neonatal survival. Establishment of international competency standards for neonatal nursing together with regulatory processes with mechanisms to facilitate specialty education forms the basis for the specialty of neonatal nursing. We have identified a strategy to mobilize financial resources for the development of the specialty of neonatal nursing. Evaluation of trends in mortality and identification of process indicators will facilitate examination of the effectiveness of the introduction of the specialty of neonatal nursing as a scaling-up strategy. PMID:23792874

  11. Advances in Neonatal Pulmonary Hypertension.

    PubMed

    Steinhorn, Robin H

    2016-01-01

    Persistent pulmonary hypertension of the newborn (PPHN) is a surprisingly common event in the neonatal intensive care unit, and affects both term and preterm infants. Recent studies have begun to elucidate the maternal, fetal and genetic risk factors that trigger PPHN. There have been numerous therapeutic advances over the last decade. It is now appreciated that oxygen supplementation, particularly for the goal of pulmonary vasodilation, needs to be approached as a therapy that has risks and benefits. Administration of surfactant or inhaled nitric oxide (iNO) therapy at a lower acuity of illness can decrease the risk of extracorporeal membrane oxygenation/death, progression of disease and duration of hospital stay. Milrinone may have specific benefits as an 'inodilator', as prolonged exposure to iNO plus oxygen may activate phosphodiesterase (PDE) 3A. Additionally, sildenafil and hydrocortisone may benefit infants exposed to hyperoxia and oxidative stress. Continued investigation is likely to reveal new therapies such as citrulline and cinaciguat that will enhance NO synthase and soluble guanylate cyclase function. Continued laboratory and clinical investigation will be needed to optimize treatment and improve outcomes. PMID:27251312

  12. Nurses Behave Differentially to Neonates in Terms of Their True Gender Compared to Their Ascribed Gender.

    ERIC Educational Resources Information Center

    Hollenbeck, Albert R.; And Others

    Response patterns of 24 female nurses to 2-day-old neonates who had been arbitrarily labeled male or female were studied. A total of 17 reliable behaviors of nurses were scored from videotapes of nurse-infant interaction. Nurses responded differentially to neonates based on true gender rather than ascribed gender. Nurses held boys more by their…

  13. Adversity and advancing nursing knowledge.

    PubMed

    Reed, Pamela G

    2008-04-01

    This column reports the theme of adversity addressed in reference to theoretical and metatheoretical considerations for advancing nursing knowledge. The development and content of three classic nursing theories are presented by Neuman representatives, and by theorists King and Roy. Topics for continued dialogue are identified as derived from the interface between philosophy of science issues and these theories. PMID:18378823

  14. Neonatal nurses' attitudes, beliefs, and feelings toward the care and management of fetal-infants.

    PubMed

    Richey, D A

    1988-01-01

    Neonatal intensive care nurses must handle on a regular basis the complex dilemmas that accompany the rapid advances in knowledge and technology that have enabled the survival of fetal-infants. Little literature addresses the attitudes and feelings of neonatal nurses regarding the moral, ethical, legal, economic, and social issues surrounding fetal-infants. The purpose of this investigation, therefore, was to examine the attitudes, beliefs, and feelings held by neonatal nurses towards these issues as they relate to the care and management of fetal-infants. The research design of this study was a nonexperimental approach. The sample was drawn from a roster of subscribers to a neonatal nursing journal. The tool that was used in this study is an attitudinal assessment questionnaire developed by the investigator. Data obtained were described and synthesized by use of measures of central tendency, variability, frequency, and the chi square statistic. Comments to the questionnaire almost overwhelmingly referred to the participants' difficulty in responding as the issues were felt to be dependent on the particular fetal-infant, family, and circumstances involved. Respondents strongly supported the need for situational ethics in cases involving fetal-infants. PMID:3193266

  15. Training Advanced Practice Palliative Care Nurses.

    ERIC Educational Resources Information Center

    Sherman, Deborah Witt

    1999-01-01

    Describes the role and responsibilities of advanced-practice nurses in palliative care and nursing's initiative in promoting high-quality care through the educational preparation of these nurses. (JOW)

  16. Age and nursing affect the neonatal porcine uterine transcriptome

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The lactocrine hypothesis for maternal programming of neonatal development was proposed to describe a mechanism through which milk-borne bioactive factors, delivered from mother to nursing offspring, could affect development of tissues, including the uterus. Porcine uterine development, initiated be...

  17. The NNP/DNP shortage: transforming neonatal nurse practitioners into DNPs.

    PubMed

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Neonatal nurse practitioners (NNPs) represent a high-demand specialty practice that is especially targeted for US secondary and tertiary care neonatal intensive care units (NICUs). NNPs make primary decisions about the caregiving of high-risk newborns at the time of admission, throughout hospitalization, at transfer, and at discharge that require an advanced knowledge base in neonatology as well as NICU clinical experience. NNPs prepared at the master's level are currently in very short supply, with some estimates suggesting that for each NNP who graduates, there are 80 positions open across the country. Even with the present shortage, due to the high cost of NNP education, NNP programs are diminishing and those that are remaining are not graduating a sufficient number of new NNPs each year to keep up with the demand. To add to the basic shortage problem, in 2004 the American Association of Colleges of Nursing decided that by 2015, the terminal degree for all nurse practitioners should move from the master's degree to the doctor of nursing practice (DNP) degree. That decision added a minimum of 12 months of full-time education to the advanced education requirements for nurse practitioners. What impact will the decision to require a DNP degree have on NNP specialty practice? Will even more NNP programs close because of faculty shortages of NNPs prepared at the DNP level? If a worse shortage occurs in the number of NNPs prepared to practice in NICUs, will physician assistants or other nonphysician clinicians who meet the need for advanced neonatal care providers replace NNPs? What steps, if any, can nursing take to ensure that NNP specialty practice is still needed and survives after supplementing the DNP requirement to NNP education? PMID:19704297

  18. Effectiveness of a nurse educational oral feeding programme on feeding outcomes in neonates: protocol for an interrupted time series design

    PubMed Central

    Touzet, Sandrine; Beissel, Anne; Denis, Angélique; Pillet, Fabienne; Gauthier-Moulinier, Hélène; Hommey, Sophie; Claris, Olivier

    2016-01-01

    Introduction Oral feeding is a complex physiological process. Several scales have been developed to assess the ability of the neonate to begin suck feedings and assist caregivers in determining feeding advancement. However, feeding premature neonates remains an ongoing challenge and depends above all on caregivers' feeding expertise. We will evaluate the effect of a nurse training programme on the achievement of full oral feeding with premature neonates. Methods and analysis The study design will be an interrupted time series design with 3 phases: (1) A 6-month baseline period; (2) a 22-month intervention period and (3) a 6-month postintervention period. The intervention will consist of an educational programme, for nurses and assistant nurses, on feeding patterns in neonates. The training modules will be composed of a 2-day conference, 2 interactive multidisciplinary workshops, and routine practice nurse coaching. A total of 120 nurses and 12 assistant nurses, who work at the neonatal unit during the study period, will participate in the study. All premature neonates of <34 weeks postmenstrual age (PMA) will be included. The primary outcome will be the age of tube withdrawal PMA and chronological age are taken into account. The secondary outcomes will be the transition time, length of hospital stay, competent suckle feeding without cardiorespiratory compromise, rate of neonates presenting with feeding issues or feeding rejection signs, and current neonatal pathologies or deaths during hospital stay. A segmented regression analysis will be performed to assess the impact of the programme. Ethics and dissemination Approval for the study was obtained from the Hospital Ethics Committee, and the Institutional Review Board, as well as the French Data Protection Agency. The findings from the study will be disseminated through peer-reviewed journals, national and international conference presentations and public events. Trial registration number NCT02404272 (https

  19. The need to nurse the nurse: emotional labor in neonatal intensive care.

    PubMed

    Cricco-Lizza, Roberta

    2014-05-01

    In this 14-month ethnographic study, I examined the emotional labor and coping strategies of 114, level-4, neonatal intensive care unit (NICU) nurses. Emotional labor was an underrecognized component in the care of vulnerable infants and families. The nature of this labor was contextualized within complex personal, professional, and organizational layers of demand on the emotions of NICU nurses. Coping strategies included talking with the sisterhood of nurses, being a super nurse, using social talk and humor, taking breaks, offering flexible aid, withdrawing from emotional pain, transferring out of the NICU, attending memorial services, and reframing loss to find meaning in work. The organization had strong staffing, but emotional labor was not recognized, supported, or rewarded. The findings can contribute to the development of interventions to nurse the nurse, and to ultimately facilitate NICU nurses' nurturance of stressed families. These have implications for staff retention, job satisfaction, and delivery of care. PMID:24675967

  20. An ontological view of advanced practice nursing.

    PubMed

    Arslanian-Engoren, Cynthia; Hicks, Frank D; Whall, Ann L; Algase, Donna L

    2005-01-01

    Identifying, developing, and incorporating nursing's unique ontological and epistemological perspective into advanced practice nursing practice places priority on delivering care based on research-derived knowledge. Without a clear distinction of our metatheoretical space, we risk blindly adopting the practice values of other disciplines, which may not necessarily reflect those of nursing. A lack of focus may lead current advanced practice nursing curricula and emerging doctorate of nursing practice programs to mirror the logical positivist paradigm and perspective of medicine. This article presents an ontological perspective for advanced practice nursing education, practice, and research. PMID:16350595

  1. Historical Trends in Neonatal Nursing: Developmental Care and NIDCAP.

    PubMed

    Kaye, Spence

    2016-01-01

    The focus of neonatal nursing has shifted from a highly technical approach to one of supportive interventions and a more individualized developmental approach. Developmental care is described as a philosophy of care that requires rethinking the relationships between infants, families, and healthcare professionals. Various models of developmental care exist; however, they all include a variety of activities designed to manage the environment and individualize the care provided to premature and/or sick infants. PMID:27465465

  2. Ethical challenges in the neonatal intensive care units: perceptions of physicians and nurses; an Iranian experience.

    PubMed

    Kadivar, Maliheh; Mosayebi, Ziba; Asghari, Fariba; Zarrini, Pari

    2015-01-01

    The challenging nature of neonatal medicine today is intensified by modern advances in intensive care and treatment of sicker neonates. These developments have caused numerous ethical issues and conflicts in ethical decision-making. The present study surveyed the challenges and dilemmas from the viewpoint of the neonatal intensive care personnel in the teaching hospitals of Tehran University of Medical Sciences (TUMS) in the capital of Iran. In this comparative cross-sectional study conducted between March 2013 and February 2014, the physicians' and nurses' perceptions of the ethical issues in neonatal intensive care units were compared. The physicians and nurses of the study hospitals were requested to complete a 36-item questionnaire after initial accommodations. The study samples consisted of 284 physicians (36%) and nurses (64%). Content validity and internal consistency calculations were used to examine the psychometric properties of the questionnaire. Data were analyzed by Pearson's correlation, t-test, ANOVA, and linear regression using SPSS v. 22. Respecting patients' rights and interactions with parents were perceived as the most challenging aspects of neonatal care. There were significant differences between sexes in the domains of the perceived challenges. According to the linear regression model, the perceived score would be reduced 0.33 per each year on the job. The results of our study showed that the most challenging issues were related to patients' rights, interactions with parents, communication and cooperation, and end of life considerations respectively. It can be concluded, therefore, that more attention should be paid to these issues in educational programs and ethics committees of hospitals. PMID:26839675

  3. Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.

    PubMed

    Lavoie-Tremblay, Mélanie; Feeley, Nancy; Lavigne, Geneviève L; Genest, Christine; Robins, Stéphanie; Fréchette, Julie

    2016-01-01

    There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork. PMID:27455363

  4. High-Fidelity Simulation for Neonatal Nursing Education: An Integrative Review of the Literature.

    PubMed

    Cooper, Allyson

    2015-01-01

    The lack of safe avenues to develop neonatal nursing competencies using human subjects leads to the notion that simulation education for neonatal nurses might be an ideal form of education. This integrative literature review compares traditional, teacher-centered education with high-fidelity simulation education for neonatal nurses. It examines the theoretical frameworks used in neonatal nursing education and outlines the advantages of this type of training, including improving communication and teamwork; providing an innovative pedagogical approach; and aiding in skill acquisition, confidence, and participant satisfaction. The importance of debriefing is also examined. High-fidelity simulation is not without disadvantages, including its significant cost, the time associated with training, the need for very complex technical equipment, and increased faculty resource requirements. Innovative uses of high-fidelity simulation in neonatal nursing education are suggested. High-fidelity simulation has great potential but requires additional research to fully prove its efficacy. PMID:26803016

  5. Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units.

    PubMed

    Duxbury, M L; Armstrong, G D; Drew, D J; Henly, S J

    1984-01-01

    Leadership style has been defined as a two-factor construct composed of "consideration" and "initiating structure." Research has suggested that these factors affect the behavior and attitude of subordinates. This study's purpose was to quantify the relationships of head nurse leadership style with self-reported staff nurse burnout and job satisfaction in Neonatal Intensive Care Units (NICUs). Three instruments--the Minnesota Satisfaction Questionnaire, the Tedium Scale, and the Leadership Opinion Questionnaire--were voluntarily completed by 283 registered nurses employed by 14 level-III NICUs in the United States. The leadership dimensions of consideration and structure were distinct (r = -.10). Staff nurse satisfaction and burnout were related (r = -.41). Head nurse consideration was clearly related to staff nurse satisfaction (r = -.55) and to a lesser extent to burnout (r = -.29). Initiating structure alone was not related to satisfaction or burnout. Aggregate perceptions of head nurse leadership were ranked across NICUs in order to classify the head nurses on consideration and structure. The 14 head nurses were separated into four groups: high consideration-high structure, high consideration-low structure, low consideration-high structure, and low consideration-low structure. Satisfaction and burnout of staff nurses in each of the leadership-style groups were then compared. Analysis of variance for satisfaction (F(3,279) = 3.10, p = .03) and burnout (F(3,279) = 3.90, p = .01) were both significant. For both satisfaction and burnout, the head nurse leadership classification of low consideration-high structure was most deviant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6560431

  6. Lessons learned from advanced practice nursing payment.

    PubMed

    Sullivan-Marx, Eileen M

    2008-05-01

    For more than 25 years, advanced practice nurses have been incrementally included as a part of the health care financing structure. Following physician payment revisions at the federal level, advanced practice nurses were overtly recognized as Medicare providers and have participated in the establishment of current procedural terminology codes and the subsequent relative work values associated with payment. Success in this regard has been the result of business, political, and policy savvy that has important lessons for moving forward in any health care restructuring for both nurses and advanced practice nurses. Principles of valuing nurse work, time, and intensity in the Resource-Based Relative Value Scale are discussed with implications for future opportunities of measuring nursing work and any potential relationship to quality outcomes of care. PMID:18650417

  7. Tobacco cessation education for advanced practice nurses.

    PubMed

    Whitehead, Diane; Zucker, Steven B; Stone, Jennifer

    2014-01-01

    The predicted shortfall of primary care physicians and the millions of newly insured beginning in 2014 call for an increase in the number of advanced practice nurses (APRNs). Advanced practice nurses can significantly improve their clients' quality of life and increase their life expectancy through tobacco cessation education. The purpose of this study was to educate APRN students on smoking information and techniques to assist clients with quitting smoking in the primary care setting. PMID:24867074

  8. Advanced Practice Nursing Education: Challenges and Strategies

    PubMed Central

    Fitzgerald, Cynthia; Kantrowitz-Gordon, Ira; Katz, Janet; Hirsch, Anne

    2012-01-01

    Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change. PMID:22220273

  9. Neonatal nursing care issues following a natural disaster: lessons learned from the Katrina experience.

    PubMed

    Orlando, Susan; Bernard, Marirose L; Mathews, Pamela

    2008-01-01

    The massive evacuation of sick and at-risk infants from a large metropolitan area following a natural disaster provides many lessons for neonatal nurses. Planning and education are of utmost importance, and disaster education and training are essential for all nurses. Unit-specific disaster plans can serve as a guide for nurses but the real test occurs during and after the event. Nurses must learn to adapt neonatal care to the rapidly changing environment during a disaster. Supporting high-risk infants without the aid of technology requires a back-to-the-basics approach. The ability to maintain communication and facilitate transportation of neonates out of a disaster area is essential. Nurses must also consider their own well-being in the aftermath of a disaster. Planning for future disasters should include lessons learned from the past events. This article addresses nursing care issues and lessons learned from the events that unfolded in the New Orleans area neonatal units during and after Hurricane Katrina, and guidance in support of disaster education for neonatal nurses. PMID:18496075

  10. The Nature of Advanced Practice Nursing.

    ERIC Educational Resources Information Center

    Oberle, Kathleen; Allen, Marion

    2001-01-01

    Advanced practice nurses are situated between general knowledge (knowing why, what, and how) and particular knowledge (knowing who--personal knowledge of patients). Integration of the two assists in knowing when a particular action would be most helpful. This practical wisdom is the hallmark of advanced practice. (Contains 45 references.) (SK)

  11. The neonatal nurse's role in preventing abusive head trauma.

    PubMed

    Allen, Kimberly A

    2014-10-01

    Abusive head trauma in infants occurs in 24.6 to 39.8 per 100,000 infants in developed countries. Abusive head trauma refers to any type of intentional head trauma an infant sustains, as a result of an injury to the skull or intracranial contents from a blunt force and/or violent shaking. The clinical question was: what evidence-based interventions have been implemented by neonatal nurses to prevent abusive head trauma in infants? PubMed was searched to obtain English language publications from 2005 to May 2014 for interventions focused on preventing abusive head trauma using the key term "shaken baby syndrome." A total of 10 studies were identified that met the inclusion criteria. All of the interventions targeted prevention of abusive head trauma with information about abusive head trauma/shaken baby syndrome and the "normal" infant crying behaviors. Interventions taught parents why infants cried, how to calm the infants, ways to cope with inconsolable infants, and how to develop a plan for what to do if they could not cope anymore. Parents who participated in the interventions were consistently able to explain the information and tell others about the dangers of shaking infants compared to the control parents. Only 2 studies calculated the preintervention abusive head trauma rate and the postintervention frequency of abusive head trauma. Each found significant differences in abusive head trauma. PMID:25137601

  12. The Enigma of Graduate Nursing Education: Advanced Generalist? Specialist?

    ERIC Educational Resources Information Center

    Reed, Suellen B.; Hoffman, Sharon E.

    1986-01-01

    To pin down the appropriate parameters for graduate nursing education, the authors say we must explore the meanings of advanced generalist and specialist. They discuss the focus, scope, and depth of the community health major, psychiatric mental health nursing, nursing care of children, maternity nursing, medical-surgical nursing, and nursing…

  13. The Effect of Endotracheal Tube Suctioning Education of Nurses on Decreasing Pain in Premature Neonates

    PubMed Central

    Hadian, Zahra S.; Sabet, Raheleh S

    2013-01-01

    Objective Endotracheal tube suctioning (ETS) is a painful and invasive procedure. Studies have shown that the performance of nurses in this procedure is weak, so we conducted a study to evaluate the effect of ETS education for nurses on neonates’ pain in neonatal intensive care units (NICUs). Methods In a quasi-experimental study, performance of 25 nurses working in NICU was assessed before and after ETS education by a checklist. In addition pain score of 50 neonates was measured using pain assessment tool (PIPP) one minute before, during and 5 minutes after ETS. The neonates had a gestational age of less than 37 weeks and were intubated (at least for 8 hours and up to 24 hours). A P. value of less than 0.05 was considered as statistically significant. Findings Mean scores of nurses’ performance were significantly different before and after education (P≤0.001) by Wilcoxon test. Friedman test revealed that PIPPs before, during and after ETS were significantly different before and after education (P≤0.05). Mann-Whitney test showed no significant differences between PIPPs before ETS, before and after education (P=0.2), but PIPPs during and after ETS were significantly different (P≤0.01). Conclusion ETS causes moderate to severe pain in neonates. Education improved performance of nurses and decreased pain in neonates during and after ETS. Despite education, neonates will experience mild pain during ETS, so other interventions need to be considerate. PMID:23795259

  14. A gap between Need and Reality: Neonatal Nursing Staff Requirements on a German Intensive Care Unit.

    PubMed

    Patry, Christian; Schindler, Monika; Reinhard, Julia; Hien, Steffen; Demirakca, Süha; Böhler, Thomas; Schaible, Thomas

    2014-02-17

    Recently, new staffing rules for neonatal nurses in intensive care units (ICU) were issued in Germany, using categories of care of the British Association of Perinatal Medicine as blueprint. Neonates on intensive care require a nurse-to-patient ratio of 1:1, on intensive surveillance (high dependency care) of 1:2. No requirements exist for special care, transitional care, and pediatric ICU patients. Using these rules, nursing staff requirement was calculated over a period of 31 consecutive days once a day in a combined pediatric and neonatal ICU of a metropolitan academic medical center in southwest Germany. Each day, 18.9±0.98 patients (mean±standard deviation) were assessed (14.26±1.21 neonatal, 4.65±0.98 pediatric). Among neonates, 9.94±2.56 received intensive therapy, 3.77±1.85 intensive surveillance, and 0.65±0.71 special care. Average nursing staff requirement was 12.10±1.81 full time equivalents (FTE) per shift. Considering additional pediatric patients in the ICU and actual nursing staff availability (8.97±0.87 FTE per shift), this ICU seems understaffed. PMID:24711913

  15. [Promoting affective attachment at the neonatal intensive care unit: a challenge for nurses].

    PubMed

    Conz, Claudete Aparecida; Merighi, Miriam Aparecida Barbosa; de Jesus, Maria Cristina Pinto

    2009-12-01

    The study was motivated by observations of the routine at neonatal intensive care units (NICU), thoughts about the dichotomy between theory, discourse, and the practice of many nurses towards the newborns' parents. The objectives were to learn about nurses' experiences regarding neonatal care to newborns and their parents, and to understand how nurses experience the process of affective attachment between newborns hospitalized at NICUs and their parents. This study was developed according to the social phenomenology approach of Alfred Schütz. Study subjects were eight practical nurses who had worked at NICU of public and private hospitals. Categories of experience emerged from the discourses, including Human Contact. The analysis revealed that nurses see themselves as the connection between parents and children, and believe they play an important role in creating the affective attachment between parent and child. PMID:20085155

  16. Advanced or advancing nursing practice: what is the future direction for nursing?

    PubMed

    Gray, Alastair

    Advanced nursing practice roles have emerged over the last 25 years in response to two major challenges: first, the significant reduction in available doctors; and, second, the rise in numbers of patients with complex health needs. It is suggested that, with a major drive to respond to the first problem, with its emphasis on the development of medical skills, the development of advanced nursing practice (which has the potential to have a significant impact on the second challenge of the rise in long-term conditions) has very much taken second place. Moreover, advanced nursing practice roles have become so medically focused that not only is advanced nursing practice not evident, but neither are the recognised sub-roles that are fundamental to advancing practice. These include innovation, education, research and clinical leadership. This article argues that in the current climate it is essential that advanced nurse practitioners not only demonstrate advanced practice, but also actively embrace the concept of 'advancing' nursing practice as the dominant feature of new roles. PMID:26768039

  17. Technological Advances in Psychiatric Nursing: An update.

    PubMed

    Bostrom, Andrea C

    2016-06-01

    Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. PMID:27229272

  18. Population-based advanced practice nursing: where does oncology fit in?

    PubMed

    Lattimer, Jennie Greco

    2013-12-01

    A national work group met in 2004 to discuss the future of advanced practice nursing. The representatives were nursing education, certification, accreditation, and regulation experts, and the goal was to develop a consensus model for advanced practice nursing regulation (Nevidjon et al., 2010). As a result, a set of recommendations was published in an article that defined a new consensus model for advanced practice registered nurse (APRN) regulation (APRN Consensus Workgroup, 2008; Goudreau, 2009). The new model included six population-based focuses of practice (i.e., family and individual across the lifespan, adult and gerontology, neonatal, pediatrics, women's health- and gender-related, and psychiatric and mental health) (Johnson, Dawson, & Brassard, 2010). A goal of the new model was to standardize the licensure, certification, and regulation of nurse practitioners into specific focuses. State boards were facing an increasing number of requests to recognize nurse practitioner specialties (e.g., organ specific, body systems, diseases) (Johnson et al., 2010). The new model helped standardize education programs, which may help certifying agencies set up curriculum review processes to ensure appropriate credentials for APRNs (Johnson et al., 2010). It also supported the mission of nursing to meet future healthcare needs of the public and to protect the public (Johnson et al., 2010). Some advantages exist to delineating into population-based focuses, but the new model leaves out many specialties (e.g., oncology) that encompass the whole person as well as concentrate on certain diseases. PMID:24305476

  19. Advanced nursing practice: old hat, new design.

    PubMed

    De Grasse, C; Nicklin, W

    2001-01-01

    Advanced practice nurses positively impact the delivery of healthcare and client outcomes. However, in the past these positions have been seen to have variable value and were often vulnerable during budget cuts. Lack of a clear advanced nursing practice (ANP) framework probably contributed to the compromised effectiveness of these roles and evolution of roles with different titles, scopes of practice and reporting structures. To build the foundation for developing an ANP framework, a task force at The Ottawa Hospital (TOH) conducted a literature review related to ANP roles and completed a review of all clinical nursing roles at TOH. In addition, focus groups with nurses and other health professionals elicited ANP perceptions. The ANP framework includes a standardized job description that details competencies under five role components: clinical practice; consultation; research; education; and, leadership. Recommendations for assessment, implementation and evaluation of ANP roles are identified. The process undertaken by our ANP task force proved to be thorough and sound in developing a framework within which to move forward with ANP role implementation throughout TOH. This article, describing the process, may assist other organizations in defining ANP roles to better meet patient needs in changing health care environments. PMID:11803945

  20. Materials on Nursing in the Clearinghouse: Bibliography #16, and Neonatal Intensive Care Units: Bibliography #17.

    ERIC Educational Resources Information Center

    Illinois Public Health Association, Springfield.

    The first of the two bibliographies in this document contains 38 entries on neonatal nursing, including books and journal articles (originally published from 1973 to 1986) dealing with such topics as high-risk pregnancy and delivery, home care of developmentally disabled newborns, and family dynamics. The second bibliography, titled "Neonatal…

  1. Educational outcomes associated with providing a comprehensive guidelines program about nursing care of preterm neonates receiving total parenteral nutrition.

    PubMed

    Al-Rafay, Safy S; Al-Sharkawy, Sabah S

    2012-05-01

    Poor understanding or practice of Total Parenteral Nutrition (TPN) causes devastating complications. Therefore, good Neonatal Intensive Care Unit (NICU) nursing care for preterm neonates and close monitoring of complications is essential for successful TPN therapy. The study was conducted in NICU at Ain Shams University Hospital in Cairo, Egypt, using a quasi-experimental research design with prepost intervention assessments. Data was collected using a self-administered questionnaire sheet and an observation checklist (prepost format) and developed a comprehensive guidelines program about nursing care of TPN of preterm neonates. Results revealed that the program had a significant positive impact on nurses' knowledge and practice outcomes. PMID:21828243

  2. Neonatal ethical issues: viability, advance directives, family centered care.

    PubMed

    Sudia-Robinson, Tanya

    2011-01-01

    Ethical issues in perinatal and NICU settings can arise from a variety of situations. This article focuses on issues surrounding viability and the incorporation of advance directives and family-centered care. Prenatal education about infant viability, probable scenarios, and parental involvement in decision-making are addressed. Considerations for advance directives for complex births and critical decisions at the time of birth are also discussed. Implications for nurses and suggested dialogue strategies are provided. PMID:21407121

  3. Clinical practice: new challenges for the advanced practice nurse.

    PubMed

    Bartel, J C; Buturusis, B

    2000-12-01

    This report describes the challenges for advanced practice nurses (APNs) relative to supply and demand issues. The article also includes opportunities with the Balanced Budget Act, physician acceptance of Advanced Practice Nurses, and expanding practice opportunities. The challenges include the nursing shortage (both in nursing students and faculty), the aging of the nursing workforce, and a lag in nursing salaries; increased demand for nursing based on aging baby boomers, increasing patient acuity and technology, and new arenas for practice. The Balanced Budget Act of 1997 provided new opportunities for advanced practice nurses, including enhanced autonomy to provide services and bill independently of physicians. With these changes come new opportunities for advanced practice nurse entrepreneurs in the areas of independent practice, including opportunities to positively impact the health of families and communities in alignment with the Federal government's vision for "Healthy People 2010." As physician acceptance of advanced practice nurses continues to grow and in light of the changes in medical practice and education (residency reduction), opportunities to expand collaborative practice arrangements also exist. APNs are best suited to make the most of these changes. One example of an opportunity for independent practice, a Community Wellness Center, is developed as an entrepreneurial venture benefiting both the APN and the health of a community. Who better than registered nurses (RNs), especially those practicing at the advanced level, can ensure that these opportunities and challenges are addressed in an ethical manner and focused on the needs and health of the community? PMID:12029667

  4. Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Lang, Norma M.; Evans, Lois K.; Swan, Beth Ann

    2002-01-01

    The Penn School of Nursing and the Macy Foundation established a comprehensive institute and technical assistance program to help nursing schools advance academic nursing practice. The Penn School consulted with 21 participating schools, providing institutes, conferences, a listserv and a web-based knowledge center focused on integrating research,…

  5. The Future of Nursing: Leading Change, Advancing Health

    ERIC Educational Resources Information Center

    National Academies Press, 2011

    2011-01-01

    "The Future of Nursing" explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single…

  6. Antimicriobial resistance patterns of colonizing flora on nurses' hands in the neonatal intensive care unit

    PubMed Central

    Cook, Heather A.; Cimiotti, Jeannie P.; Della-Latta, Phyllis; Saiman, Lisa; Larson, Elaine L.

    2007-01-01

    Background The Centers for Disease Control and Prevention recommends the use of an alcohol-based handrub for health care worker hand hygiene. The purpose of this study was to examine effects of hand hygiene product and skin condition on the antimicrobial resistance patterns of colonizing hand flora among nurses. Methods Colonizing hand flora of 119 nurses working in 2 neonatal intensive care units was compared during a 22-month crossover study using alcohol handrub or antiseptic soap. Results Altogether, 1442 isolates from 834 hand cultures (mean, 7 cultures/nurse) were obtained. In 3 of 9 regression analyses modeling for resistant staphylococcal flora, the use of antiseptic soap was a significant predictor of resistance, and nurses with damaged skin were 2.79 times more likely to carry Staphylococcus warneri isolates resistant to gentamicin. Conclusion Hand hygiene product and skin condition may influence resistance patterns of hand flora of care providers. PMID:17482994

  7. Neonatal peripherally inserted central catheter team. Evolution and outcomes of a bedside-nurse-designed program.

    PubMed

    Linck, Deborah A; Donze, Ann; Hamvas, Aaron

    2007-02-01

    Percutaneously inserted central venous catheters (PICCs) have been used to provide central venous access for more than 25 years. Although these lines initially were placed by physicians, currently there are many adult, pediatric, and neonatal nurse-based PICC teams. This article describes the inception and growth of 1 team which, during the last 14 years, has placed more than 3400 catheters and trained more than 50 bedside nurses to insert PICCs. It highlights the development of the team, including details of how team members were selected and trained. Management of ongoing issues was handled by a self-directed nurse team organized into a committee structure composed of an oversight committee and education, guideline, qualifications, and quality improvement subcommittees. This team set and achieved the goals of training bedside nurses to place PICCs, providing consistent management of PICCs, and closely monitoring outcomes. PMID:17536330

  8. A burden of knowledge: A qualitative study of experiences of neonatal intensive care nurses' concerns when keeping information from parents.

    PubMed

    Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

    2015-12-01

    Improved life-sustaining technology in the neonatal intensive care has resulted in an increased probability of survival for extremely premature babies. In the neonatal intensive care, the condition of a baby can deteriorate rapidly. Nurses and parents are together for long periods at the bedside and so form close and trusting relationships. Neonatal nurses as the constant caregivers may be presented with contradictory demands in attempting to meet the baby's needs and being a patient and family advocate. This article aims to explore the issues arising for neonatal nurses when holding information about changes to a condition of a baby that they are unable to share with parents. Data were collected via interviews with 24 neonatal nurses in New South Wales, Australia. A qualitative approach was used to analyse the data. The theme 'keeping secrets' was identified and comprised of three sub-themes 'coping with potentially catastrophic news', 'fear of inadvertent disclosure' and 'a burden that could damage trust'. Keeping secrets and withholding information creates internal conflict in the nurses as they balance the principle of confidentiality with the parent's right to know information. The neonatal nurses experienced guilt and shame when they were felt forced by circumstances to keep secrets or withhold information from the parents of extremely premature babies. PMID:24821077

  9. Postpartum and neonatal nursing care during the 2009 H1N1 influenza pandemic.

    PubMed

    Zapata, Lauren B; Ruch-Ross, Holly S; Williams, Jennifer L; Ruhl, Catherine

    2013-01-01

    We describe select influenza infection control policies and practices related to postpartum and newborn care during the 2009 H1N1 pandemic. In an online survey of obstetric and neonatal nurses, significantly more nurses indicated a written hospital policy supporting each of the practices during versus before the pandemic. The two practices least often implemented were temporary separation of healthy newborns from ill mothers (37.7 percent) and testing newborns for influenza virus infection if signs of influenza were observed (31.4 percent). Presence of written hospital policies increased implementation of practices. Findings may be useful to guide planning for future pandemics or other public health emergencies. PMID:23957794

  10. Teaching Pediatric Nursing Concepts to Non-Pediatric Nurses Using an Advance Organizer

    ERIC Educational Resources Information Center

    Bell, Julie Ann

    2013-01-01

    Non-pediatric nurses in rural areas often care for children in adult units, emergency departments, and procedural areas. A half-day program about pediatric nursing using constructivist teaching strategies including an advance organizer, case studies, and simulation was offered at a community hospital in Western North Carolina. Nurses reported a…

  11. Sources of Stress for Nurses in Neonatal Intensive Care Units of East Azerbaijan Province, Iran

    PubMed Central

    Valizadeh, Leila; Farnam, Alireza; Zamanzadeh, Vahid; Bafandehzendeh, Mostafa

    2012-01-01

    Introduction: Stress is one of the main factors affecting one's efficiency as well as staff health and quality of nursing services. Neonatal intensive care units (NICUs) can be stressful environments for nurses, infants and families as well. Since there is no evidence in this regard in Iran, the present study aimed to determine stress levels related to care delivering in NICU from the viewpoint of nurses in NICUs of East Azerbaijan Province, Iran during 2011. Methods: This was a descriptive study including a purposive sample of 110 nurses working in NICUs of hospitals in East Azerbaijan Province. The data collection tool was a self-report questionnaire. The validity and reliability of the questionnaire were assessed by content validity and Cronbach's alpha coefficient (α = 0.84). Results: According to factor analysis, the stressors included environmental and nurse and human factors. Stress sources in total and separately in each category were reported as moderate. The mean and 95% confidence interval of the factors in the categories were 2.75 (0.84); 2.59-2.91 and 3.21 (0.72); 3.07-3.35, respectively. Therefore, human factors caused significantly higher levels of stress compared to environmental factors (p < 0.05). Conclusion: Stressors involved in NICU nursing include environmental and human factors. Planning to remove or reduce their impact can improve the quality of nursing services in intensive care units and, thus, decrease the adverse effects of stress on workers. PMID:25276702

  12. [Nursing interventions on the physical environment of Neonatal Intensive Care Units].

    PubMed

    Miquel Capó Rn, I

    2016-01-01

    The objectives of this study are to analyse nursing interventions regarding noise and lighting that influence neurodevelopment of the preterm infant in the Neonatal Intensive Care Unit. A review of the literature was performed using the databases: Cuiden Plus, PubMed, IBECS and Cochrane Library Plus. The inclusion and exclusion criteria were established in accordance with the objectives and limits used in each database. Of the 35 articles used, most were descriptive quantitative studies based on the measurement of sound pressure levels and lighting in the Neonatal Intensive Care Units. The countries included in this study are Brazil and the United States, and the variables analysed were the recording the times of light and noise. Based on the high levels of light and noise recorded in the Neonatal Intensive Care Units, nursing interventions that should be carried out to reduce them are described. The evidence indicates that after the implementation of these interventions, the high levels of both environmental stimuli are reduced significantly. Despite the extensive literature published on this problem, the levels of light and noise continue to exceed the recommended limits. Therefore, nurses need to increase and enhance their efforts in this environment, in order to positively influence neurodevelopment of premature newborn. PMID:27293033

  13. The myth of the miracle baby: how neonatal nurses interpret media accounts of babies of extreme prematurity.

    PubMed

    Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

    2015-09-01

    Improved life sustaining technology in the neonatal intensive care unit (NICU) has resulted in an increased probability of survival in extremely premature babies. Miracle baby stories in the popular press are a regular occurrence and these reports are often the first source from which the general public learn about extremely premature babies. The research from which this paper is drawn sought to explore the care-giving and ethical dilemmas of neonatal nurses when caring for extremely premature babies 24 weeks gestation and less. This current paper aims to outline the views of neonatal nurses on miracle baby stories in the media. Data were collected via a questionnaire to 760 Australian neonatal nurses with 414 returned, representing a response rate of 54.4%. Narrative was collected from semi-structured interviews with 24 experienced neonatal nurses in NSW, Australia. A qualitative approach utilising thematic analysis was utilised to analyse the data. The theme the myth of the miracle baby is seen as generating myths and unrealistic expectations on the part of vulnerable families and the public. Neonatal nurses, as the primary caregivers for tiny babies and their families, viewed popular media publications with suspicion, believing published reports to be incomplete, inaccurate and biased towards the positive. PMID:25824907

  14. Clinical Assessment of Nursing Care Regarding Hemovigilance in Neonatal Wards and Neonatal Intensive Care Units in Selected Hospitals Affiliated to Shahid Beheshti University of Medical Sciences (2013 - 2014)

    PubMed Central

    Tajalli, Saleheh; Nourian, Manijeh; Rassouli, Maryam; Baghestani, Ahmad Reza

    2015-01-01

    Background: Hemovigilance is a series of surveillance procedures encompassing the entire transfusion chain from the collection of blood and its components to the follow-up of its recipients. It is intended to collect and access information on unanticipated or adverse effects stemming from the therapeutic use of labile blood products. Blood transfusion, particularly in neonates, requires meticulous clinical assessment to ensure safety before, during, and after the procedure. Therefore, it is essential to investigate how nurses and other health care providers implement hemovigilance with a view to elevating the standards of care. Objectives: The aim of this study, conducted between 2013 and 2014, was to assess nursing care regarding hemovigilance in the neonatal wards and neonatal intensive care units (NICUs) of selected hospitals affiliated to Shahid Beheshti University of Medical Sciences. Materials and Methods: This descriptive study assessed nursing care concerning hemovigilance in 144 neonates. Data were collected using a checklist at the neonatal wards and NICUs of Mahdiyeh, Mofid, and Imam Hussain hospitals affiliated to Shahid Beheshti University of Medical Sciences. The checklist contained information on the standard of care in relation to neonatal hemovigilance in three components of request, transfusion, and documentation. Descriptive statistics with the Statistical Package for the Social Sciences (version 21) were used to analyze the collected data. Results: The rates of compliance with the hemovigilance guidelines in terms of request, transfusion, and documentation were 47%, 63.2%, and 68%, correspondingly, with a total score of 59.6% in all areas of research. Accordingly, compliance with hemovigilance guidelines was highest in documentation (68%), followed by transfusion (63.2%) and request (47%). Conclusions: The overall score of nursing care as regards adherence to the neonatal hemovigilance guidelines was 59.6% in the present study, indicating a lack

  15. Web Camera Use in the Neonatal Intensive Care Unit: Impact on Nursing Workflow

    PubMed Central

    Joshi, Aditya; Chyou, Po-Huang; Tirmizi, Zoya; Gross, Jody

    2016-01-01

    Background Many neonatal intensive care units (NICU) are using web camera systems to allow virtual visitation of the infant by family members. Generally, families appreciate the web camera and utilize this service. However, no one has looked into the change on nursing workload after implementation of a web camera. Objective This study was designed to explore the perception of nurses and their workflow and identify determinants that may disrupt or facilitate the use of a commercially available camera service. Our primary goal was to see if the camera system interferes with the nursing care. Study Design This was a prospective, questionnaire-based study conducted between March and September 2014. Parents were offered the camera service and signed a consent form before use. Parents who refused the camera were the group designated as “off camera.” There were two infant groups; one cared for using the cameras and the other not. The camera service was used continuously during the study period, except during procedures, baby care, and feedings. Demographic information on nursing staff and neonates was collected weekly. Questionnaires were placed at each bedside for nurses to complete on each shift for each infant once weekly. The questionnaires for infants off-camera did not have questions regarding the camera. However, the rest of the questions were similar regarding time spent interacting with family members, face to face, or on the phone. Data on time spent manipulating the camera per shift were also obtained. Results Surveys for 623 on-camera and 130 off-camera infants were completed by 42 nursing staff. Findings showed that caring for multiple infants while using the web camera increased nurses’ workload and stress, which they perceived as having an adverse effect on the ability to provide quality care. Family decisions not to utilize the camera service were mainly cultural, and noted among Mennonite, Amish, and Hmong families. Some families residing close to

  16. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team 1

    PubMed Central

    Tomazoni, Andréia; Rocha, Patrícia Kuerten; de Souza, Sabrina; Anders, Jane Cristina; de Malfussi, Hamilton Filipe Correia

    2014-01-01

    OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units. METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121. RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument. CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units. PMID:25493670

  17. An Infrastructure to Advance the Scholarly Work of Staff Nurses

    PubMed Central

    Parkosewich, Janet A.

    2013-01-01

    The traditional role of the acute care staff nurse is changing. The new norm establishes an expectation that staff nurses base their practice on best evidence. When evidence is lacking, nurses are charged with using the research process to generate and disseminate new knowledge. This article describes the critical forces behind the transformation of this role and the organizational mission, culture, and capacity required to support practice that is based on science. The vital role of senior nursing leaders, the nurse researcher, and the nursing research committee within the context of a collaborative governance structure is highlighted. Several well-known, evidence-based practice models are presented. Finally, there is a discussion of the infrastructure created by Yale-New Haven Hospital to advance the scholarly work of the nursing staff. PMID:23482435

  18. Advancing Nursing Research in Hospitals Through Collaboration, Empowerment, and Mentoring.

    PubMed

    Berger, Jill; Polivka, Barbara

    2015-12-01

    Meeting the Magnet Recognition Program® requirements for integrating research into practice can be daunting, particularly for nonacademic hospitals. The authors describe 1 healthcare system's approach to advancing nursing research in 5 hospitals through collaboration with a local university school of nursing and development of an infrastructure to support, empower, and mentor clinical nurses in the conduct of research. Outcomes include completed research, presentations, publications, practice change, and professional development. PMID:26565639

  19. Development of the role of director of advanced practice nursing.

    PubMed

    Rhodes, Catherine A; Fusilero, Jane; Williams, Christine M

    2010-01-01

    Advanced practice nurses (APNs) are integral to cost-effective delivery of health care in large health care organizations. Development of the leadership position of director of advanced practice nurses in a large teaching institution provides leadership to APNs in various settings, contributes to staff satisfaction, facilitates increased professional growth, and provides improved quality and fiscal outcomes. Job satisfaction, productivity, accountability, and communication may be enhanced through implementation of the role of director of advanced practice nursing and a committee structure of APNs, as was found in this academic health system. PMID:20306882

  20. Kangaroo Care in a Neonatal Context: Parents’ Experiences of Information and Communication of Nurse-Parents

    PubMed Central

    Lemmen, Desirée; Fristedt, Petra; Lundqvist, Anita

    2013-01-01

    Objective: Kangaroo Care (KC) is an evidence-based nursing practice with many benefits for infants and parents. The purpose of this study was to describe parents’ experience of information and communication mediated by staff nurses before and during KC at neonatal wards. Methodology and Participants: A qualitative study with semi-structured interviews was performed. The sample consisted of 20 parents. Results: The results show that the information and communication were experienced as both optimal and suboptimal including following categories: initially conflicting emotions in relation to KC, participation and confidence in KC is evolving, strengthening preparation and context is decisive as well as parental sense and caution. The overall theme was that good preparation will contribute to a positive experience of KC. Conclusion: The conclusion is that most of the parents had positive experiences of KC. The information and communication from the staff nurses encouraged and motivated the parents to practice KC, in a sense that it was a natural way to get to know the infant, when the staff nurses were well versed in the method and coherent and supportive. Conflicting emotions emerged when staff nurses practised KC as a routine without deeper knowledge and skills of the method and its advantages as well as without sensitivity to parents’ vulnerable situation. PMID:23802029

  1. Advanced practice politics and the Oregon nurses' trail.

    PubMed

    Bifano, L C

    1996-01-01

    As health care reform continues to evolve, it is important to consider the context of politics, practice, and power through an examination of nursing's recent history and participation in legislative events. Through a retrospective chronicle that includes interviews, recorded events, and article reviews, the political and legislative history of Oregon nurses in establishing advanced practice for nurse practitioners within the Oregon Nurse Practice Act is described. Prescriptive authority, hospital admitting privileges, and important elements contained in the Oregon Health Plan and Medicare reform are discussed. Questions are posed for the future of health care reform, such as the role of government in determining the quality of care in managed health care. PMID:8710224

  2. [Nurses' knowledge about the health care proxy and advance directives].

    PubMed

    Georget, Jean-Philippe; Cecire-Denoyer, Catherine

    2015-06-01

    The Basse-Normandie palliative care nurses' group carried out a survey regarding nurses' knowledge of the health care proxy and advance directives. The study revealed a lack of connection between these two arrangements, poor knowledge about advance directives but an understanding of the role of the health care proxy. How, therefore, can patients be effectively informed? How should they be supported in this process of determining themselves the conditions of their end of life? PMID:26146326

  3. Advance Care Planning in Nursing Homes: Correlates of Capacity and Possession of Advance Directives

    ERIC Educational Resources Information Center

    Allen, Rebecca S.; DeLaine, Shermetra R.; Chaplin, William F.; Marson, Daniel C.; Bourgeois, Michelle S.; Dijkstra, Katinka; Burgio, Louis D.

    2003-01-01

    Purpose: The identification of nursing home residents who can continue to participate in advance care planning about end-of-life care is a critical clinical and bioethical issue. This study uses high quality observational research to identify correlates of advance care planning in nursing homes, including objective measurement of capacity. Design…

  4. Advanced practice: the clinical nurse specialist.

    PubMed

    Sparacino, P

    1992-01-01

    Historically, the clinically expert nurse who wanted to continue in direct patient care had few career options. That dilemma is changing in response to the recognised need for greater knowledge and clinical expertise in the domain of patient care. The clinical nurse specialist role is an answer to this concern. The clinical nurse specialist practices within a framework of theoretically-based knowledge and combines that knowledge with clinical expertise. The role is also pivotal in the promotion of patient care focused scientific inquiry and in the generation and refinement of nursing theories. Career options are more versatile than for the educator, researcher, or administrator. While the clinical nurse specialist is an essential person in influencing quality care in the traditional practice settings, there are now opportunities with clientele and practice settings which have expanded beyond the conventional boundaries. PMID:1528295

  5. Skills Required for Nursing Career Advancement: A Qualitative Study

    PubMed Central

    Sheikhi, Mohammad Reza; Fallahi-Khoshnab, Masoud; Mohammadi, Farahnaz; Oskouie, Fatemeh

    2016-01-01

    Background Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement. Objectives This study aimed to identify the skills needed for nurses’ career advancement. Materials and Methods A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis. Results The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement. Conclusions The findings showed that personal, interpersonal, and functional skills can facilitate nurses’ career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies. PMID:27556054

  6. Factors enabling advanced practice nursing role integration in Canada.

    PubMed

    DiCenso, Alba; Bryant-Lukosius, Denise; Martin-Misener, Ruth; Donald, Faith; Abelson, Julia; Bourgeault, Ivy; Kilpatrick, Kelley; Carter, Nancy; Kaasalainen, Sharon; Harbman, Patricia

    2010-12-01

    Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper. PMID:21478695

  7. On the night shift: advanced nurse practice in emergency medicine.

    PubMed

    Jenkins, Jennifer

    2016-05-01

    Advanced nurse practitioners in the author's emergency department (ED) work autonomously and as part of a team to assess, diagnose and treat patients with unexplained and undiagnosed illnesses and injuries over a 24-hour cycle of care. The complexity of the role in EDs is often not fully understood, and expectations can vary between trusts and between different clinical areas within trusts. This article describes one night shift in the author's ED to explain the complexity of advanced nurse practitioners' roles in this environment. The article focuses on autonomous decision-making skills and the use of advanced clinical skills in the context of evidence-based practice. PMID:27165394

  8. The covered wagon journey: student chronicles in advanced holistic nursing.

    PubMed

    Purnell, Marguerite J; Lange, Bernadette; Bailey, Christie; Drozdowicz, Aleida; Eckes, Shirley; Kinchen, Elizabeth; Smith-Atkinson, Nikkisha

    2013-01-01

    This article recounts the experiences of a first cohort of graduate students in a newly implemented advanced holistic nursing (AHN) track, one of only a handful in the nation, and the first in Florida. The increasing popularity of complementary and alternative healing processes represents the insufficiency of a health system of fragmented care and a desire for holistic healing that is beyond mainstream allopathic care. Graduate holistic nurse education equips nurses to explore the commitment needed to advance the evolution of health care. The covered wagon journey is a metaphor for this meaningful participation. Students journaled their experiences as cotravelers in a lone wagon: embarking on a courageous journey, forging a path of discovery, and reaching their destination as pioneers. This cohort experience embodied the central tenets of holistic nursing, thus creating conscious change and unity within a learning community. The future of AHN is addressed in the context of the contemporary health care environment. PMID:23600022

  9. Advancing the education of nurses: a call for action.

    PubMed

    Zimmermann, Deborah T; Miner, Dianne Cooney; Zittel, Barbara

    2010-12-01

    The debate over the educational preparation of RNs has raged for over a century. In New York, chief nursing officers are partnering with academic colleagues and successfully implementing a model that standardizes education requirements, supports seamless transition from associate to baccalaureate degree programs, addresses financial barriers, and identifies expected outcomes of a more educated workforce. Nursing leaders are perfectly positioned to advance the educational standards of the profession in the United States. PMID:21084888

  10. Advancing the quality of oncology nursing care: Interlink Community Cancer Nurses' model for reflective practice.

    PubMed

    Howell, D; Pelton, B

    2001-01-01

    Since 1996, Interlink Community Cancer Nurses have been using reflective practice as a team to share knowledge and experience amongst peers. The use of reflective practice enables the nurse to examine decision-making in patient situations and uncover the knowledge and artistry that is embedded in nursing practice. This article describes how reflection is practised by specialist cancer nurses to advance the quality of caregiving. The use of a structured framework for reflection which incorporates ways of knowing in nursing is an essential feature of the Interlink model for reflection. The development of a process for reflection within the Interlink program has at times been challenging. However, the Interlink nurses' experience with reflection is believed to be critical to the ongoing development of the program and the individual nurse. Interlink nurses have found that guided reflection, the creation of an environmental milieu for reflection and personal knowing, and self-evaluation are critical to the process of becoming a self-reflective practitioner. PMID:11842450

  11. An overview of Medicare reimbursement regulations for advanced practice nurses.

    PubMed

    Frakes, Michael A; Evans, Tracylain

    2006-01-01

    The federal government spends nearly 15% of the budget on Medicare services annually, and advanced practice nurses are eligible for reimbursement from that pool. The regulations governing reimbursement are complex because of the social, political, and financial pressures involved in their development. Although economic viability and due diligence considerations make it incumbent on advanced practice nurses to understand the rules, the profession, as a whole, has knowledge deficits in this area. The essentials of regulatory development and structure are reviewed and considerations for optimizing reimbursement are described. PMID:16676748

  12. Advanced nursing practice and Newton's three laws of motion.

    PubMed

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries. PMID:18773586

  13. Kenya and distance education: a model to advance graduate nursing.

    PubMed

    Mutea, Naomi; Cullen, Deborah

    2012-08-01

    Africa is faced with a myriad of challenges, such as HIV/AIDS, malaria, tuberculosis, and a variety of political and historical complications that have affected the educational system for advanced nursing practice. In Kenya, the current situation in the higher education sector does not give nurses an opportunity to pursue graduate education after they have acquired the basic diploma in nursing due to limited government support and the type of education system existing in the country today. Although distance education has been available in Kenya for professionals such as teachers, in public universities, this kind of opportunity is unreachable for nurses who are working and need to further their education. Nurses desire to have access to advanced practice education to equip them with the relevant knowledge to cope and address the complex health issues arising in the management and care of patients. A collaborative model is presented as a potential solution for this need. Four major constituents are identified including hospitals and agencies, communities of interest, Kenyan universities and international education partners. Each has a part to play including contributions to information, communication of opinion and expertise, money and support, infrastructure and in-kind resources. Distance education is cost-effective and will help in building capacity at various levels of nursing including leadership in clinical practice, teaching, administration and research. PMID:22845642

  14. Nephrotoxicity and hepatotoxicity evaluation of Crocus sativus stigmas in neonates of nursing mice

    PubMed Central

    Bahmani, Mahmoud; Rafieian, Mortaza; Baradaran, Azar; Rafieian, Samira; Rafieian-kopaei, Mahmoud

    2014-01-01

    Background: Crocus sativus, known as saffron crocus, is best known for the spice saffron. Saffron use spans more than 3500 years, however, its toxicity on neonates during lactation has not yet evaluated. Objectives: This study was aimed to examine the acute toxicity of saffron on adult mice and its nephrotoxicity and hepatotoxicity on neonates of lactating mothers that used saffron during lactation. Materials and Methods: In this experimental study, following acute toxicity evaluation, 32 pregnant mice were randomly designated into four equal groups. Following delivery, the mothers of groups 1 to 4 were administered orally (by gavage) normal saline (control group), 500, 1000 or 2000 mg/kg/day of saffron for three weeks, respectively. The newborn’s kidney and liver parameters were assessed at the end of the study for possible nephrotoxicity and hepatotoxicity evaluation. The kidney and liver tissue samples of newborns were histopathologically studied after staining with Hematoxylin & Eosin. Data were analyzed using ANOVA and Scheffe’s tests Results: The LD50 value of saffron was calculated to be 4120±556 mg/kg in mice. To evaluate lactating toxicity, saffron was administered orally to the mothers once daily for 21 days, after delivery, during lactating period. Saffron increased serum urea nitrogen (p< 0.05). Histological studies indicated that saffron did not have any toxic effect on liver, however, histopathology changes were seen in the kidney of neonates. Conclusions: From the results of present study, it might be concluded that saffron is a nearly safe spice, however, nursing mothers should avoid high doses of this spice. PMID:24772401

  15. Specialty practice entrepreneur: the advanced practice nurse.

    PubMed

    Kowal, N

    1998-01-01

    There are many opportunities in the health care arena to make a difference. The structured sense of change is "old school." New "surfers" of the system will be entrepreneurial in spirit, energy, and flexibility. There is no job description for the perfect person, only a sense of excitement and innovation that gives one the feeling energetic change is about to happen. In nursing, the risk takers are abundant in the APN role. It is the reason why they walk the line of provider/nurse. Making a difference to patients is important. Riding the waves of clinical care is the excitement. The final results are "the big waves" of life--a patient's life. A provider who defines the reality of practice creates a vision and skillfully bridges the road between the two. Design the surfboard--catch the wave. PMID:9987328

  16. Missouri Responses to the Advanced Practice Nurse Role.

    ERIC Educational Resources Information Center

    Armer, Jane M.

    1997-01-01

    A randomly drawn statewide sample of 891 Missouri consumers revealed overall support for the advance practice nurse role to be greater than 75%. Seeking health care consumers' reactions to proposed alternatives is a crucial step in planning and implementing a program of health care reform that will meet current and future health needs. (Author)

  17. Advancing Your Career: Concepts of Professional Nursing. Second Edition.

    ERIC Educational Resources Information Center

    Kearney, Rose

    This textbook, intended for registered nurses (RN's) returning to school, is designed to provide practicing RN's with professional concepts to advance their careers. The book contains 22 chapters organized in five sections. Each chapter includes chapter objectives, key terms, key points, chapter exercises, references, and a bibliography. Section I…

  18. Educational Changes to Support Advanced Practice Nursing Education

    PubMed Central

    LeFlore, Judy L.; Thomas, Patricia E.

    2016-01-01

    Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system. PMID:27465446

  19. [Care provided by nursing students in a neonatal intensive care unit from the mother's point of view].

    PubMed

    Pacheco, S T; do Valle, E R; Simões, S M

    2001-01-01

    The objective of the present study is to investigate the perspective of mothers regarding the care given by academics of nursing to their newborn in a neonatal intensive therapy unit. This is a qualitative research based on a phenomenological approach which has as its philosophical framework the thought of Martin Heidegger expressed in his book Being and Time. The data used in the investigation were interviews given by ten mothers who had their newborns in a neonatal intensive therapy unit of a university hospital in the city of Rio de Janeiro. The interpretation of the data collected revealed that mothers viewed the nursing academics as solicitous beings regarding the care given to their newborns. They also acknowledged that these students were engaged in the assistance given and concerned with what was being done and to whom it was being done. PMID:12098862

  20. Nursing entrepreneurship: motivators, strategies and possibilities for professional advancement and health system change.

    PubMed

    Wall, Sarah

    2013-06-01

    In Canada, as well as internationally, efficiency-focused organizational restructuring in healthcare has resulted in stressful job change for nurses, although nurses continue to work in a system that values technology-based, physician-provided services. Employed nurses have had to participate in organizational activities that undermine their professional values and goals. Nursing entrepreneurship presents an opportunity to explore nursing's professional potential in nursing practice that is uniquely independent. In this study, a focused ethnographic approach was used to explore the experiences of self-employed nurses, who see themselves as leaders in advancing the profession of nursing and its contribution to healthcare. Key themes in the findings include the responses of self-employed nurses to health system change, expanded roles for nurses, the consequences of this non-traditional approach to nursing work and the possibilities for change that arise from nursing entrepreneurship. This research has implications for healthcare policy, professional advocacy and nursing education. PMID:23809640

  1. Transnationalism: A Framework for Advancing Nursing Research With Contemporary Immigrants.

    PubMed

    Rosemberg, Marie-Anne S; Boutain, Doris M; Mohammed, Selina A

    2016-01-01

    This article advances nursing research by presenting transnationalism as a framework for inquiry with contemporary immigrants. Transnationalism occurs when immigrants maintain relationships that transcend the geographical borders of their origin and host countries. Immigrants use those relationships to experience health differently within concurrent socioeconomic, political, and cultural contexts than national situated populations. Nurse researchers are called upon to consider these trans-border relationships when exploring the health of contemporary immigrants. Such consideration is needed to develop relevant research designs, methods, analysis, and dissemination strategies. PMID:26836998

  2. Developing advanced nursing skills for frail older people.

    PubMed

    Goldberg, Sarah; Cooper, Jo; Russell, Catherine

    2014-05-01

    Improving hospital care for frail older people requires expertise, leadership and resources as these patients have multiple complex needs. One innovative solution to providing the skilled care necessary is to train experienced nurses to become advanced nurse practitioners (ANPs). Such roles encompass activity previously undertaken by medical staff, together with leadership, teaching, research and service development. Skills specific to caring for older people, such as comprehensive geriatric assessment, are also required. This article discusses the need for ANPs in this clinical area, a pilot that is under way in one acute trust to develop these roles, and the potential benefits and challenges that may accompany this development. PMID:24787943

  3. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice

    PubMed Central

    Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

    2016-01-01

    Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. PMID:27508923

  4. The presence of family members during cardiopulmonary resuscitation: European federation of Critical Care Nursing associations, European Society of Paediatric and Neonatal Intensive Care and European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions Joint Position Statement.

    PubMed

    Fulbrook, Paul; Latour, Jos; Albarran, John; de Graaf, Wouter; Lynch, Fiona; Devictor, Denis; Norekvål, Tone

    2007-12-01

    This paper presents the European federation of Critical Care Nursing associations, the European Society of Paediatric and Neonatal Intensive Care, and the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions Joint Position Statement on The Presence of Family Members During Cardiopulmonary Resuscitation. PMID:17919981

  5. Advances in neonatal screening for primary immune deficiencies

    PubMed Central

    JIANG, TINGTING; LI, ZHENGUANG; ZHANG, QIULI

    2016-01-01

    The congenital disorders of immune competence are known as primary immunodeficiencies (PID) and are mainly characterized by a pathological susceptibility to infection. These infections are mostly of time repetitive and drug resistant in nature. The number of infected infants has reached over 200 and is on the increase. Additionally, clinical severity of the disease has been confirmed to be extensive. The increasing number of these severe PIDs is due to the lack of specific as well as efficient management avenues. New assays and concepts for newborn screening of severe primary immune deficiencies are being explored and the present review focused on these new upcoming strategies for improved screening of neonates. PMID:27168770

  6. Discovering the nature of advanced nursing practice in high dependency care: a critical care nurse consultant's experience.

    PubMed

    Fairley, Debra

    2005-06-01

    This paper describes how a critical care nurse consultant's clinical role has evolved within a surgical high dependency unit (SHDU) in a large teaching hospitals trust. In order to provide some background to role development, an overview of the research exploring the nature of advanced nursing practice in the context of critical care will be presented. From the outset, advanced nursing practice was not perceived as the acquisition and application of technical procedures usually undertaken by doctors, but possibly an integration of medicine and nursing where holistic nursing assessment is combined with symptom-focused physical examination. A reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation will be presented. A model of working that can be applied to high dependency units, integrating the role of the advanced nurse practitioner within the clinical team, will be described. PMID:15907666

  7. The Obstacles against Nurse-Family Communication in Family-Centered Care in Neonatal Intensive Care Unit: a Qualitative Study

    PubMed Central

    Hadian Shirazi, Zahra; Sharif, Farkhondeh; Rakhshan, Mahnaz; Pishva, Narjes; Jahanpour, Faezeh

    2015-01-01

    Introduction: Communication is one of the key principles in Family-Centered Care (FCC). Studies have shown some drawbacks in communication between families and nurses. Therefore, the present study aimed to recognize the obstacles against nurse-family communication in FCC in Neonatal Intensive Care Unit (NICU). Methods: This qualitative study was conducted on 8 staff nurses in 2 NICUs affiliated to Shiraz University of Medical Sciences selected through purposive sampling. The data were collected using 8 deep semi-structured interviews and 3 observations. Then, they were analyzed through inductive content analysis. Results: Data analysis resulted in identification of 3 main categories and 7 subcategories. The first category was organizational factors with 2 subcategories of educational domain (inadequate education, lack of a system for nursing student selection, and poor professionalization) and clinical domain (difficult working conditions, lack of an efficient system for ongoing education and evaluation, and authoritarian management). The second category was familial factors with socio-cultural, psychological, and economic subcategories. The last category was the factors related to nurses with socio-cultural and psycho-physical subcategories. Conclusion: Identification of the obstacles against nurse-family communication helps managers of healthcare systems to plan and eliminate the challenges of effective communication. Besides, elimination of these factors leads to appropriate strategies in NICUs for effective application of FCC. PMID:26464837

  8. Reflections on ethnocentrism and racism: a challenge for advanced practice nurses.

    PubMed

    Harris, S H; Cummings, S H

    1996-01-01

    As nurses and patient populations increasingly reflect the changing demographics of the United States, it will be necessary for nurses to address the critical issues surrounding a multicultural society. Nurses have been relatively quiet on the topic of ethnocentric and racist behavior. If advanced practice nurses are to be successful in assisting nurses and organizations to embrace cultural diversity, understanding ethnocentric and racist behaviors is key to developing strategies to facilitate the provision of culturally competent care. PMID:9447077

  9. [The strict sense nursing postgraduation in Brazil: advances and perspectives].

    PubMed

    Scochi, Carmen Gracinda Silvan; Munari, Denize Bouttelet; Gelbcke, Francine Lima; Erdmann, Alacoque Lorenzini; de Gutiérrez, Maria Gaby Rivero; Rodrigues, Rosalina Aparecida Partezani

    2013-09-01

    Nursing is a specific field of knowledge and social practice that has been consolidated and strengthened as science. In Brazil, it has been developed due to the increase and qualification of strict sense post-graduate programs. This study aims to present a historical review of the strict sense post-graduate nursing courses in Brazil and to reflect on their evolution, progress, challenges and future perspectives. It explores the creation of strict sense post-graduate courses, highlighting the movement to build a culture of academic and professional post-graduation in nursing. The historical path of their consolidation, expansion, conquest of excellence and international visibility over four decades, and the challenges and future perspectives are showed. It is found that the post-graduate programs in the field has contributed to the advancement and consolidation of scientific, technological knowledge and innovation in nursing and health care, having as philosophy the respect for diversity and the free exchange of ideas, the improvement of quality of life and health, and the effectiveness of citizenship. PMID:24092314

  10. [Advanced directives: nurses' and physicians' representations in 2012].

    PubMed

    Ledoux, Mathilde; Rhondali, Wadih; Monnin, Luc; Thollet, Catherine; Gabon, Patricia; Filbet, Marilène

    2013-10-01

    In cancer patients, decision-making process is crucial and patient's involvement is described as a central component. In 2005, a new tool appears to convey patient's opinion even if he is not able to communicate anymore: advanced directives (AD). Unfortunately, their documentation is marginal. The objective of this study was to investigate nurses' and physicians' representations towards AD. A questionnaire had been sent to hospitals, public health facilities and liberal practitioners during February 2012. We collected responses from 42/251 physicians (17 %) and 80/198 nurses (40 %). Sixty percent of participants reported that they were not familiar with the legislative framework for AD. For physicians, main barriers were patient cognitive impairment (P = 0.004) and lack of information on the clinical situation (P = 0.004). For nurses, difficulties were toward end of life and prognosis discussion (P = 0.002), clinical situation evolution since AD documentation (P = 0.008), time frame for AD application (P < 0.001) and the fact that final decision is made by physician alone (P = 0.015). AD should be part of a good medical practice and literature has highlighted the benefit of AD on patient's quality of life. End of life discussion therefore requires dedicated time and specific training for physicians and nurses to improve the rate of patients with AD. PMID:24077035

  11. Nursing during the first two days of life is essential for the expression of proteins important for growth and remodeling of the neonatal porcine cervix.

    PubMed

    Frankshun, Amy-Lynn; Chen, Joseph; Barron, Lauren A; Ho, Teh-Yuan; Miller, Dori J; Rahman, Kathleen M; Bartol, Frank F; Bagnell, Carol A

    2012-09-01

    The neonatal porcine cervix is sensitive to hormones, including relaxin (RLX), from birth. Whether nursing is required to establish the cervical developmental program or to determine cervical developmental trajectory is unknown. The objective of study 1 was to determine effects of age and nursing on expression of molecular markers and mediators of porcine cervical growth and remodeling from birth to postnatal day (PND) 2 and to document effects of RLX treatment during this period on expression of targeted gene products in nursed vs. replacer-fed gilts. Study 2 was conducted to determine effects of age at first nursing and duration of nursing from birth on expression of targeted transcripts or proteins at PND 14. Nursing supported cervical estrogen receptor-α, vascular endothelial growth factor, matrix metalloproteinase (MMP)9, and antiapoptotic B-cell lymphoma-2 protein expression on PND 2. These proteins were undetectable in replacer-fed gilts. Returning replacer-fed gilts to nursing after PND 2 did not restore cervical expression of these proteins by PND 14. RLX increased (P < 0.05) cervical estrogen receptor-α, vascular endothelial growth factor, and B-cell lymphoma-2 protein in nursed gilts, MMP2 protein in nursed and replacer-fed gilts, and decreased (P < 0.05) pro-MMP9 protein in nursed gilts, and RXFP1 mRNA levels in nursed and replacer-fed gilts at PND 2. Replacer feeding for 2 wk from birth increased (P < 0.05) RXFP1 mRNA levels on PND 14. Results support the lactocrine hypothesis for maternal programming of neonatal tissues. Nursing from birth is required to establish the neonatal cervical developmental program and to maintain cervical developmental trajectory to PND 14. PMID:22778228

  12. Using appreciative inquiry to bring neonatal nurses and parents together to enhance family-centred care: A collaborative workshop.

    PubMed

    Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

    2015-06-01

    Family-centred care (FCC) has been well recognised, accepted and reported in the literature as an optimised way of caring for hospitalised children. While neonatal units strive to adopt this philosophy, published research suggests there are difficulties implementing FCC principles in daily practice. Appreciative inquiry (AI) is a philosophy and methodology that offers a unique, strength-based approach to promoting organisational learning and positive organisational change. As a participatory approach, AI facilitates change from the ground up and lends itself to building effective partnerships or collaborations. This article reports the findings of a one-day workshop using an AI methodology to bring neonatal nurses and parents together to enhance the FCC within a neonatal intensive care unit in Sydney, Australia. Participants (n = 15) developed collaborative insights of optimal FCC that can be built upon to support neonates and their families in the future. Shared visions were formed, strategies identified and a development plan made for ongoing collaborations and partnerships. AI provides a flexible framework that enables the mandatory collaboration needed to develop action plans that can form the catalyst for organizational change in health-care research and practice. PMID:24270986

  13. Advanced dementia research in the nursing home: the CASCADE study.

    PubMed

    Mitchell, Susan L; Kiely, Dan K; Jones, Richard N; Prigerson, Holly; Volicer, Ladislav; Teno, Joan M

    2006-01-01

    Despite the growing number of persons with advanced dementia, and the need to improve their end-of-life care, few studies have addressed this important topic. The objectives of this report are to present the methodology established in the CASCADE (Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life) study, and to describe how challenges specific to this research were met. The CASCADE study is an ongoing, federally funded, 5-year prospective cohort study of nursing [nursing home (NH)] residents with advanced dementia and their health care proxies (HCPs) initiated in February 2003. Subjects were recruited from 15 facilities around Boston. The recruitment and data collection protocols are described. The demographic features, ownership, staffing, and quality of care of participant facilities are presented and compared to NHs nationwide. To date, 189 resident/HCP dyads have been enrolled. Baseline data are presented, demonstrating the success of the protocol in recruiting and repeatedly assessing NH residents with advanced dementia and their HCPs. Factors challenging and enabling implementation of the protocol are described. The CASCADE experience establishes the feasibility of conducting rigorous, multisite dementia NH research, and the described methodology serves as a detailed reference for subsequent CASCADE publications as results from the study emerge. PMID:16917187

  14. [Breast Care Nurses - nursing experts for breast cancer care. A path to "Advanced Nursing Practice" in Germany?].

    PubMed

    Gerlach, Anja; Wiedemann, Regina

    2010-12-01

    The role of Breast Care Nurses (BCNs) has been discussed since Breast Centres have been opened in Germany. This article introduces the concept of the Breast Care Nurses on a national and an international level in the context of Advanced Nursing Practice (ANP). Within a descriptive study, graduates of a German BCN-education programme were interrogated regarding their current work, their main activities as a BCN, about general conditions in their work environment, experienced barriers, and supporting factors. 122 questionnaires were evaluated. The return rate was 71 % (n = 171). Results showed that 58.1 % (n = 71) of the graduates were employed as a Breast Care Nurse, however only 28.1 % (n = 20) in a full-time and 35.2 % (n = 25) in a part-time position. This first German study about BCN-services showed a lack of basic work conditions, for example regarding a consultation room, access to literature, or templates for documentation. In the discussion part, the situation of the BCNs is reviewed in the German context and in relation to ANP concepts as well as regarding future demands for the position of a BCN. PMID:21154250

  15. Experiences of the advanced nurse practitioner role in acute care.

    PubMed

    Cowley, Alison; Cooper, Joanne; Goldberg, Sarah

    2016-05-01

    The aim of the service evaluation presented in this article was to explore the multidisciplinary team's (MDT) experiences and perception of the advanced nurse practitioner (ANP) role on an acute health care of the older person ward. A qualitative case study was carried out comprising semi-structured interviews with members of the MDT, exploring their experiences of the ANP role. An overarching theme of 'Is it a nurse? Is it a doctor? No, it's an ANP' emerged from the data, with three subthemes: the missing link; facilitating and leading holistic care; and safe, high quality care. The ANP role is valued by the MDT working with them and provides a unique skill set that has the potential to enhance care of older patients living with frailty. While there are challenges to its introduction, it is a role worth introducing to older people's wards. PMID:27125941

  16. Predictors of practice patterns for lymphedema care among oncology advanced practice nurses.

    PubMed

    Ryan, Joanne C; Cleland, Charles M; Fu, Mei R

    2012-09-01

    Lymphedema, a debilitating and chronic condition, is considered to be one of the most distressing adverse effects of cancer treatment. The purpose of this study was to understand the practice patterns in lymphedema care and identify predictors influencing those patterns among oncology nurses, with a focus on advanced practice nurses. Random and purposive sampling was utilized to recruit 238 oncology nurses who completed the Web-based study. Participants included advanced practice nurses (nurse practitioners and clinical nurse specialists), nurse navigators/case managers, staff nurses, and directors/managers/coordinators. Data focused on perceived knowledge of and perceived competence in risk reduction, treatment, and self-management of lymphedema and practice patterns in lymphedema care. Actual knowledge of lymphedema care was evaluated. Descriptive, comparative, and regression analyses were performed. The study showed that perceived knowledge and perceived competence were highly correlated. Perceived competence was a predictor of practicing lymphedema care. Advanced practice nurses scored in the midrange for perceived knowledge and perceived competence in risk reduction and self-management, but obtained lower scores in perceived knowledge and perceived competence for treatment. The odds of advanced practice nurses delivering lymphedema care were less than those of staff nurses. This study identifies gaps and opportunities for advanced practice nurses to play an important role in providing lymphedema care, an essential aspect of cancer survivorship. PMID:25031960

  17. Predictors of Practice Patterns for Lymphedema Care Among Oncology Advanced Practice Nurses

    PubMed Central

    Ryan, Joanne C.; Cleland, Charles M.; Fu, Mei R.

    2012-01-01

    Lymphedema, a debilitating and chronic condition, is considered to be one of the most distressing adverse effects of cancer treatment. The purpose of this study was to understand the practice patterns in lymphedema care and identify predictors influencing those patterns among oncology nurses, with a focus on advanced practice nurses. Random and purposive sampling was utilized to recruit 238 oncology nurses who completed the Web-based study. Participants included advanced practice nurses (nurse practitioners and clinical nurse specialists), nurse navigators/case managers, staff nurses, and directors/managers/coordinators. Data focused on perceived knowledge of and perceived competence in risk reduction, treatment, and self-management of lymphedema and practice patterns in lymphedema care. Actual knowledge of lymphedema care was evaluated. Descriptive, comparative, and regression analyses were performed. The study showed that perceived knowledge and perceived competence were highly correlated. Perceived competence was a predictor of practicing lymphedema care. Advanced practice nurses scored in the midrange for perceived knowledge and perceived competence in risk reduction and self-management, but obtained lower scores in perceived knowledge and perceived competence for treatment. The odds of advanced practice nurses delivering lymphedema care were less than those of staff nurses. This study identifies gaps and opportunities for advanced practice nurses to play an important role in providing lymphedema care, an essential aspect of cancer survivorship. PMID:25031960

  18. Neonatal amygdala lesions advance pubertal timing in female rhesus macaques

    PubMed Central

    Stephens, Shannon B.Z.; Raper, Jessica; Bachevalier, Jocelyne; Wallen, Kim

    2014-01-01

    Summary Social context influences the timing of puberty in both humans and nonhuman primates, such as delayed first ovulation in low-ranking rhesus macaques, but the brain region(s) mediating the effects of social context on pubertal timing are unknown. The amygdala is important for responding to social information and thus, is a potential brain region mediating the effects of social context on pubertal timing. In this study, female rhesus macaques living in large, species-typical, social groups received bilateral neurotoxic amygdala lesions at one month of age and pubertal timing was examined beginning at 14 months of age. Pubertal timing was affected in neonatal amygdala-lesioned females (Neo-A), such that they experienced significantly earlier menarche and first ovulation than did control females (Neo-C). Duration between menarche and first ovulation did not differ between Neo-A and Neo-C females, indicating earlier first ovulation in Neo-A females was likely a consequence of earlier menarche. Social rank of Neo-A females was related to age at menarche, but not first ovulation, and social rank was not related to either event in Neo-C females. It is more likely that amygdalectomy affects pubertal timing through its modulation of GABA-ergic mechanisms rather than as a result of the removal of a social-contextual inhibition on pubertal timing. PMID:25462903

  19. Recent Trends in Advance Directives at Nursing Home Admission and One Year after Admission

    ERIC Educational Resources Information Center

    McAuley, William J.; Buchanan, Robert J.; Travis, Shirley S.; Wang, Suojin; Kim, MyungSuk

    2006-01-01

    Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence of having any advance directive at admission declined…

  20. 78 FR 54255 - HRSA's Bureau of Health Professions Advanced Education Nursing Traineeship Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-03

    ... Education Nursing Traineeship Program AGENCY: Health Resources and Services Administration (HRSA), HHS... Education Nursing Traineeship (AENT) program. Effective fiscal year (FY) 2014, AENT support for part-time... practitioners and nurse midwives. FOR FURTHER INFORMATION CONTACT: Joan Wasserman, DrPH, RN, Advanced...

  1. Addressing Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Advanced Practice Nursing Education.

    ERIC Educational Resources Information Center

    Nokes, Kathleen M.; Stein, Gary L.

    1997-01-01

    A survey of 23 advanced practice nursing programs showed only 3 had HIV-specific graduate-level nursing courses. Recommendations were made for HIV-specific courses, integration of HIV content into other courses, use of Centers for Disease Control and Occupational Safety and Health Administration guidelines, and subspecialties in HIV nursing. (SK)

  2. Career advancement and educational opportunities: experiences and perceptions of internationally educated nurses.

    PubMed

    Salma, Jordana; Hegadoren, Kathleen M; Ogilvie, Linda

    2012-01-01

    The number of internationally educated nurses is increasing in the Canadian workforce. Recruitment of internationally educated nurses is often seen as a solution to ongoing nursing shortages. However, international recruitment needs to be accompanied by strategies to ensure long-term retention. One of the criteria for successful retention is the availability and accessibility of career advancement and educational opportunities. Little research exists on the opportunities for career advancement and education for internationally educated nurses in Canada. This interpretive descriptive study was conducted to look at the perceptions of internationally educated nurses regarding career advancement and educational opportunities in Alberta, Canada. Eleven internationally educated nurses, working as registered nurses in Alberta, were interviewed using semi-structured interviews. Five themes were identified: motherhood as a priority, communication and cultural challenges, process of skill recognition, perceptions of opportunity and need for mentorship. PMID:23010920

  3. Nurses' and Parents' Perceptions of Parental Guidance on Using Nonpharmacological Pain-Relieving Methods Among Neonates in the NICU.

    PubMed

    Pölkki, Tarja; Laukkala, Helena; Korhonen, Anne

    2016-08-01

    Despite growing knowledge of parents' important role in their infants' pain management, the extent to which nurses in neonatal intensive care units (NICUs) provide guidance to parents on nonpharmacological methods is unclear. This study aimed to describe and compare the perceptions of parental guidance in using nonpharmacological pain-relieving methods among neonates in NICUs from the viewpoints of nurses and parents, and to examine the participants' demographics related to the guidance. A cross-sectional, descriptive, correlational study using questionnaire surveys was conducted. Eight NICUs of 5 university hospitals in Finland. A total of 427 participants, including 294 nurses and 178 parents. The participants indicated that the methods of touching and holding were the most commonly introduced strategies in infants' pain alleviation, as they were given as an alternative "nearly always/always" (nurses 91%, 87% and parents 61%, 58%, respectively). In contrast, music and breast-feeding were the less commonly introduced nonpharmacological methods (nurses 11%, 6% and parents 1%, 6%, respectively). A significant difference (p < .001) was found between the parents' and nurses' perceptions of parental guidance; nurses reported providing more guidance about all nonpharmacological methods compared with parents. In addition, many demographic factors of the nurses, the parents, and their infants were related to the parental guidance. Our findings indicate that parental guidance should not be based on nurses' evaluations of their activities without taking into account parents' perspectives. When counseling parents to use nonpharmacological methods, neonatal nurses should actively interact with families and discuss parents' individual needs. PMID:27287760

  4. Advancing a program of research within a nursing faculty role.

    PubMed

    Nolan, Marie T; Wenzel, Jennifer; Han, Hae-Ra; Allen, Jerilyn K; Paez, Kathryn A; Mock, Victoria

    2008-01-01

    Doctoral students and new faculty members often seek advice from more senior faculty on how to advance their program of research. Students may ask whether they should choose the manuscript option for their dissertation or whether they should seek a postdoctoral fellowship. New faculty members wonder whether they should pursue a career development award and whether they need a mentor as they strive to advance their research while carrying out teaching, service, and practice responsibilities. In this article, we describe literature on the impact of selected aspects of pre- and postdoctoral training and faculty strategies on scholarly productivity in the faculty role. We also combine our experiences at a school of nursing within a research-intensive university to suggest strategies for success. Noting the scarcity of research that evaluates the effect of these strategies, we are actively engaged in collecting data on their relationship to the scholarly productivity of students and faculty members within our own institution. PMID:19022210

  5. Advancing a Program of Research within a Nursing Faculty Role

    PubMed Central

    Nolan, Marie T.; Wenzel, Jennifer; Han, Hae-Ra.; Allen, Jerilyn K.; Paez, Kathryn A.; Mock, Victoria

    2008-01-01

    Doctoral students and new faculty members often seek advice from more senior faculty on how to advance their program of research. Students may ask whether they should choose the manuscript option for their dissertation or whether they should seek a postdoctoral fellowship. New faculty members wonder whether they should pursue a career development (K) award and whether they need a mentor as they strive to advance their research while carrying out teaching, service, and practice responsibilities. In this paper, we describe literature on the impact of selected aspects of pre and postdoctoral training and faculty strategies on scholarly productivity in the faculty role. We also combine our experiences at a school of nursing within a research-intensive university to suggest strategies for success. Noting the scarcity of research that evaluates the effect of these strategies we are actively engaged in collecting data on their relationship to the scholarly productivity of students and faculty members within our own institution. PMID:19022210

  6. Spasm or transformation? Advanced practice psychiatric nursing education in the United States.

    PubMed

    Olson, Tom

    2004-08-01

    Psychiatric nursing graduate programs are in precipitous decline in the United States, leading many advanced practice psychiatric nurses to question the viability of their field. This article examines the current crisis in advanced practice psychiatric nursing education in the United States by identifying core concerns and exploring the reasons for these concerns. Suggestions for securing the future of this practice area are also discussed. These suggestions include identifying a more clearly focused role for advanced practice psychiatric nurses, development of realistic educational expectations, achievement of greater uniformity in curricula, and the establishment of a strong and rigorous process of accreditation. PMID:15468608

  7. Effectiveness of Advanced Illness Care Teams for Nursing Home Residents with Dementia

    ERIC Educational Resources Information Center

    Chapman, Dennis G.; Toseland, Ronald W.

    2007-01-01

    This study evaluated the effectiveness of advanced illness care teams (AICTs) for nursing home residents with advanced dementia. The AICTs used a holistic approach that focused on four domains: (1) medical, (2) meaningful activities, (3) psychological, and (4) behavioral. The authors recruited 118 residents in two nursing homes for this study and…

  8. Emerging areas of science: Recommendations for Nursing Science Education from the Council for the Advancement of Nursing Science Idea Festival.

    PubMed

    Henly, Susan J; McCarthy, Donna O; Wyman, Jean F; Heitkemper, Margaret M; Redeker, Nancy S; Titler, Marita G; McCarthy, Ann Marie; Stone, Patricia W; Moore, Shirley M; Alt-White, Anna C; Conley, Yvette P; Dunbar-Jacob, Jacqueline

    2015-01-01

    The Council for the Advancement of Nursing Science aims to "facilitate and recognize life-long nursing science career development" as an important part of its mission. In light of fast-paced advances in science and technology that are inspiring new questions and methods of investigation in the health sciences, the Council for the Advancement of Nursing Science convened the Idea Festival for Nursing Science Education and appointed the Idea Festival Advisory Committee (IFAC) to stimulate dialogue about linking PhD education with a renewed vision for preparation of the next generation of nursing scientists. Building on the 2005 National Research Council report Advancing The Nation's Health Needs and the 2010 American Association of Colleges of Nursing Position Statement on the Research-Focused Doctorate Pathways to Excellence, the IFAC specifically addressed the capacity of PhD programs to prepare nursing scientists to conduct cutting-edge research in the following key emerging and priority areas of health sciences research: omics and the microbiome; health behavior, behavior change, and biobehavioral science; patient-reported outcomes; big data, e-science, and informatics; quantitative sciences; translation science; and health economics. The purpose of this article is to (a) describe IFAC activities, (b) summarize 2014 discussions hosted as part of the Idea Festival, and (c) present IFAC recommendations for incorporating these emerging areas of science and technology into research-focused doctoral programs committed to preparing graduates for lifelong, competitive careers in nursing science. The recommendations address clearer articulation of program focus areas; inclusion of foundational knowledge in emerging areas of science in core courses on nursing science and research methods; faculty composition; prerequisite student knowledge and skills; and in-depth, interdisciplinary training in supporting area of science content and methods. PMID:26187079

  9. 'Something normal in a very, very abnormal environment' - Nursing work to honour the life of dying infants and children in neonatal and paediatric intensive care in Australia.

    PubMed

    Bloomer, Melissa J; Endacott, Ruth; Copnell, Beverley; O'Connor, Margaret

    2016-04-01

    The majority of deaths of children and infants occur in paediatric and neonatal intensive care settings. For nurses, managing an infant/child's deterioration and death can be very challenging. Nurses play a vital role in how the death occurs, how families are supported leading up to and after the infant/child's death. This paper describes the nurses' endeavours to create normality amidst the sadness and grief of the death of a child in paediatric and neonatal ICU. Focus groups and individual interviews with registered nurses from NICU and PICU settings gathered data on how neonatal and paediatric intensive care nurses care for families when a child dies and how they perceived their ability and preparedness to provide family care. Four themes emerged from thematic analysis: (1) respecting the child as a person; (2) creating opportunities for family involvement/connection; (3) collecting mementos; and (4) planning for death. Many of the activities described in this study empowered parents to participate in the care of their child as death approached. Further work is required to ensure these principles are translated into practice. PMID:26687773

  10. [Briefly summarized nursing card for patients with advanced cancer receiving out hospital management].

    PubMed

    Hayashi, Y; Andoh, M; Hioki, M; Sugitoh, Y; Hyoudoh, C

    1994-12-01

    Briefly summarized nursing card to perform adequate nursing for readmission patients with advanced cancer receiving outhospital management was developed and its clinical usefulness for nursing is discussed. The card is 18 cm x 13 cm, differential colored for diseases, and written only necessary summarized informations for adequate nursing at the patient's emergent readmission. By using this card for 24 patients, it was very useful because of its very selected, brief and summarized information. This card has much usefulness for nursing of such patients. PMID:7802460

  11. Advanced practice nursing in performing arts health care.

    PubMed

    Weslin, Anna T; Silva-Smith, Amy

    2010-06-01

    Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care. PMID:20644180

  12. Quality Nursing Care for Hospitalized Patients with Advanced Illness: Concept Development

    PubMed Central

    Izumi, Shigeko; Baggs, Judith G.; Knafl, Kathleen A.

    2011-01-01

    The quality of nursing care as perceived by hospitalized patients with advanced illness has not been examined. A concept of quality nursing care for this population was developed by integrating the literature on constructs defining quality nursing care with empirical findings from interviews of 16 patients with advanced illness. Quality nursing care was characterized as competence and personal caring supported by professionalism and delivered with an appropriate demeanor. Although the attributes of competence, caring, professionalism, and demeanor were identified as common components of quality care across various patient populations, the caring domain increased in importance when patients with advanced illness perceived themselves as vulnerable. Assessment of quality nursing care for patients with advanced illness needs to include measures of patient perceptions of vulnerability. PMID:20572095

  13. Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care.

    PubMed

    Fougère, Bertrand; Morley, John E; Decavel, Frédérique; Nourhashémi, Fati; Abele, Patricia; Resnick, Barbara; Rantz, Marilyn; Lai, Claudia Kam Yuk; Moyle, Wendy; Pédra, Maryse; Chicoulaa, Bruno; Escourrou, Emile; Oustric, Stéphane; Vellas, Bruno

    2016-09-01

    Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors and growing health care demand. The development of new nursing roles varies greatly from country to country. The United States and Canada established "nurse practitioners" (NPs) in the mid-1960s. The United Kingdom and Finland also have a long experience in using different forms of collaboration between doctors and nurses. In other countries, such as Australia, NPs were endorsed more recently in 2000. In France, Belgium, or Singapore, the formal recognition of advanced practice nurses is still in its infancy, whereas in other countries, such as Japan or China, advanced practice nurses are not licensed titles. The aims of this article were to define precisely what is meant by the term "advanced practice nurse (APN)," describe the state of development of APN roles, and review the main factors motivating the implementation of APN in different countries. Then, we examine the main factors that have hindered the development of APN roles. Finally, we explain the need for advanced practice roles in geriatrics. PMID:27321868

  14. Macrophage VLDL Receptor Promotes PAFAH Secretion in Mother’s Milk and Suppresses Systemic Inflammation in Nursing Neonates

    PubMed Central

    Du, Yang; Yang, Marie; Wei, Wei; Huynh, HoangDinh; Herz, Joachim; Saghatelian, Alan; Wan, Yihong

    2012-01-01

    Mother’s milk is widely accepted as nutritious and protective to the newborn mammals by providing not only macronutrients but also immune-defensive factors. However, the mechanisms accounting for these benefits are not fully understood. Here we show that maternal very-low-density-lipoprotein receptor (VLDLR) deletion in mice causes the production of defective milk containing diminished level of platelet-activating factor acetylhydrolase (PAFAH). As a consequence, the nursing neonates suffer from alopecia, anemia and growth retardation owing to elevated levels of pro-inflammatory platelet-activating factors (PAFs). VLDLR deletion significantly impairs the expression of phospholipase A2 group 7 (Pla2g7) in macrophages, which decreases PAFAH secretion. Exogenous oral supplementation of neonates with PAFAH effectively rescues the toxicity. These findings not only reveal a novel role of VLDLR in suppressing inflammation by maintaining macrophage PAFAH secretion, but also identify the maternal VLDLR as a key genetic program that ensures milk quality and protects the newborns. PMID:22910354

  15. Advanced practice nurse entrepreneurs in a multidisciplinary surgical-assisting partnership.

    PubMed

    DeCarlo, Linda

    2005-09-01

    CHANGES IN THE HEALTH CARE environment and reimbursement practices are creating opportunities for nurse entrepreneurs to be partners with other professional nurses and physicians. Advanced practice nurses (APNs) who want to step into an entrepreneurial role must have strong clinical expertise, specific personal characteristics, interpersonal skills, and business acumen. ESTABLISHING A MULTIDISCIPLINARY partnership for providing surgical assisting services has many benefits and presents many challenges. PMID:16309068

  16. Master’s programs in advanced nursing practice: new strategies to enhance course design for subspecialty training in neonatology and pediatrics

    PubMed Central

    Morgan, Colin; Barry, Catherine; Barnes, Katie

    2012-01-01

    The advanced nurse practitioner (ANP) role first developed in the USA in the 1960s in primary care. Since then, it has evolved in many different countries and subspecialties, creating a variety of challenges for those designing and implementing master’s programs for this valuable professional group. We focus on ANPs in the neonatal and pediatric intensive care setting to illustrate the complexity of issues faced by both faculty and students in such a program. We review the impact of limited resources, faculty recruitment/accreditation, and the relationship with the medical profession in establishing a curriculum. We explore the evidence for the importance of ANP role definition, supervision, and identity among other health professionals to secure a successful role transition. We describe how recent advances in technology can be used to innovate with new styles of teaching and learning to overcome some of the difficulties in running master’s programs for small subspecialties. We illustrate, through our own experience, how a thorough assessment of the available literature can be used to innovate and develop strategies to create an individual MSc programs that are designed to meet the needs of highly specialized advanced neonatal and pediatric nursing practice. PMID:23762011

  17. Neonatal drug exposure: assessing a specific population and services provided by visiting nurses.

    PubMed

    Mahony, D L; Murphy, J M

    1999-01-01

    Historically, community health nurses have provided nursing services to infants who were exposed to licit and illicit drugs in utero and their mothers. The charts of 145 infants whose mothers had a history of drug and alcohol abuse and who were referred to a visiting nurse agency between 1988 and 1994 were reviewed for this study. Of the infants who were reported to have been exposed to drugs in utero, 69% were exposed to cocaine, 11% to heroin, and 6% to marijuana. The average age of the mothers was 26 years; 83.4% were single; 82.1% received Aid for Families of Dependent Children (AFDC); 92.4% were on Medicaid; and 95.9% were involved with child protective services. The most frequent nursing problems identified were (a) maternal-child attachment, (b) sleep patterns, (c) infant feeding, and (d) infant development. Nursing interventions included nutritional management, physical assessment, monitoring growth and development, and education in parenting skills. Fifty percent of the infants increased their weight by at least one percentile and 31% increased two percentiles. Resolution of nursing problems occurred in 50% of the cases. PMID:10335247

  18. The 2015 NASN School Nurse Survey: Developing and Providing Leadership to Advance School Nursing Practice.

    PubMed

    Mangena, Anantha Sameera; Maughan, Erin

    2015-11-01

    This article summarizes the results of the 2015 NASN School Nurse Survey, identifies similarities and differences between this survey and the 2013 NASN School Nurse Survey, and evaluates the possible impacts of this data on the organization. PMID:26515570

  19. Role performance of psychiatric nurses in advanced practice: a systematic review of the literature.

    PubMed

    Fung, Y L; Chan, Z; Chien, W T

    2014-10-01

    This paper discusses findings from a systematic review of literature pertaining to the role performance of psychiatric nurses in advanced practice. A search of 11 electronic databases was conducted to identify research involving interventions by psychiatric (or mental health) nurses in advanced practice. A total of 14 studies were identified. In this review, the role performance of psychiatric nurses in advanced practice was categorized into three themes: (1) the provision of psychosocial interventions; (2) the provision of nurse-directed services in health-care contexts; and (3) the provision of psychiatric nursing consultation services. Our results document that psychiatric nurses in advanced practice perform multifaceted roles and provide mental health-care services in various contexts. This systematic review reveals that the nurses obtain significant results in managing clients with depression and psychological stress, and demonstrates their value when developing partnerships with non-mental health service providers. One study, however, showed that the nurses had insignificant results in performing transitional care for pre-discharged mental health service users. PMID:24299195

  20. Cost-effectiveness of a WOC Advanced Practice Nurse in the Acute Care and Outpatient Setting

    PubMed Central

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  1. Cost-effectiveness of a WOC advanced practice nurse in the acute care and outpatient setting.

    PubMed

    Medley, Jenny A

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  2. [Advanced nursing practice: a must for the quality of care and mental health services].

    PubMed

    Ricard, Nicole; Page, Claire; Laflamme, France

    2014-01-01

    New professional legislation and reorganization of mental health services have had a significant influence on mental health nursing practice. Many nurses have demonstrated clinical leadership and have been able to adapt their services to the needs of the population specially in the primary health care setting. However, many believe that the role of nurses is not sufficiently known and optimally utilized in mental health services. In this article we take a critical look at the mental health nursing practice in Quebec and at the essential requirements for its development. This review aims to: 1) describe current trends in the changing roles and the modernization of mental health nursing practice in Quebec, 2) provide an overview of the development of advanced nursing practice and its impact on the quality of mental health services; 3) clarify the concept of advanced nursing practice and position its development in Quebec and 4) propose various strategies for optimizing the role of nurses and their complementarity with other professionals providing mental health services. This review presents innovative practices developed by nurses in the context of the restructuring of mental health services. For example, new nursing roles have been developed to improve the collaboration with general practitioners groups in primary care settings and facilitate the evaluation and monitoring of patient presenting medical and psychological problems. Another interesting innovation was set up by nurses in developing a new service to allow timely access to integrated care for patients with substance abuse and mental health problems. The various testimonies reported in this article illustrate the potential contribution of these nursing innovations in improving the mental health services in Quebec. Also, in few countries, the reform of mental health services has been a good time to recognize this potential. Thus, some countries have repositioned the role of mental health nurses and

  3. Hospital clinical career advancement programs: comparing perceptions of nurse participants and nonparticipants.

    PubMed

    Thornhill, S K

    1994-09-01

    The study reported in this article describes nurse participants and nonparticipants in hospital clinical career advancement programs (clinical ladders) and compares perceptions in relation to program intrinsic outcomes, needs, and criteria for level advancement. A stratified random sample consisted of 120 participants and 480 nonparticipants drawn from 1,769 clinical nurses employed full time at five regional general hospitals. The findings suggest that nurses' demographic characteristics do not influence program participation status and that clinical advancement programs have limited impact upon job enrichment designed to recruit and retain clinical nurses providing direct patient care. Program participants (106; 88.3 percent) differed significantly at the .05 level from nonparticipants (385; 80.2 percent) on each factor area measuring perceptions of clinical advancement programs. PMID:10136982

  4. Online, directed journaling in community health advanced practice nursing clinical education.

    PubMed

    Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

    2004-04-01

    The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education. PMID:15098912

  5. Gerontological nursing leadership in the Advancing Excellence Campaign: moving interdisciplinary collaboration forward.

    PubMed

    Bakerjian, Debra; Beverly, Claudia; Burger, Sarah Greene; Carter, Diane; Dornberger, Sherrie; Eliopoulos, Charlotte; Remsburg, Robin

    2014-01-01

    Nursing was not a part of the coalition of multiple nursing home stakeholders at the roll out of the Advancing Excellence Campaign (AEC). In January 2007, several nurse organizations proactively approached the AEC leadership, were welcomed and immediately began to volunteer for leadership positions such as committee chairs and conference coordinators. This paper presents an exemplar of how a proactive stance, even when not initially included, allowed nurses to secure chairs at the decision making table of this quality campaign and contribute to improved resident outcomes. PMID:24970338

  6. [Necessary changes for advancing nursing as caring science].

    PubMed

    de Pires, Denise Elvira Pires

    2013-09-01

    The article aimed to reflect upon the challenges involved in strengthening Nursing as a caring science. It is founded on the sociological theory, connecting three approaches: the historical-dialectic materialism perspective about the working process in health care and nursing; the sociology of professions from a critical perspective; and the philosophy of science. The discussion is organized considering the aspects of Nursing as a discipline, work and health care profession. It sustains that knowledge production should be driven both by the purpose of Nursing work which is providing care to human beings with health needs and to advocate for the indispensable work conditions to a safe and responsible practice. It concludes that to strengthening Nursing it is necessary to produce knowledge to support nursing care and the political actions defending safe work conditions, the universal right to health as well safe and high quality care. PMID:24092308

  7. Applying the Advancing Excellence in America's Nursing Homes Circle of Success to improving and sustaining quality.

    PubMed

    Bakerjian, Debra; Zisberg, Anna

    2013-01-01

    Looking forward to the Quality Assurance Performance Improvement (QAPI) program to be implemented and required in 2014, and as nursing home staff provide care for residents with increasingly complex health issues, knowledge of how to implement quality improvement (QI) is imperative. The nursing home administrator and director of nursing (DON) provide overall leadership, but it is the primary responsibility of the DON and other registered nurse staff to implement and manage the day to day QI process. This article describes potential roles of nursing leaders and key components of a QI project using a pressure ulcer case study exemplar to illustrate a quality improvement process. The authors suggest specific methods that RN leaders can employ using the Advancing Excellence Campaign Circle of Success as an organizing framework along with evidence-based resources. Nursing home leaders could use this article as a guideline for implementing any clinical quality improvement process. PMID:23870372

  8. Advancing Nursing Informatics in the Next Decade: Recommendations from an International Survey.

    PubMed

    Topaz, Maxim; Ronquillo, Charlene; Peltonen, Laura-Maria; Pruinelli, Lisiane; Sarmiento, Raymond Francis; Badger, Martha K; Ali, Samira; Lewis, Adrienne; Georgsson, Mattias; Jeon, Eunjoo; Tayaben, Jude L; Kuo, Chiu-Hsiang; Islam, Tasneem; Sommer, Janine; Jung, Hyunggu; Eler, Gabrielle Jacklin; Alhuwail, Dari

    2016-01-01

    In the summer of 2015, the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA NISIG) Student Working Group developed and distributed an international survey of current and future trends in nursing informatics. The survey was developed based on current literature on nursing informatics trends and translated into six languages. Respondents were from 31 different countries in Asia, Africa, North and Central America, South America, Europe, and Australia. This paper presents the results of responses to the survey question: "What should be done (at a country or organizational level) to advance nursing informatics in the next 5-10 years?" (n responders = 272). Using thematic qualitative analysis, responses were grouped into five key themes: 1) Education and training; 2) Research; 3) Practice; 4) Visibility; and 5) Collaboration and integration. We also provide actionable recommendations for advancing nursing informatics in the next decade. PMID:27332175

  9. Using evidence-based practice for managing clinical outcomes in advanced practice nursing.

    PubMed

    Glanville, I; Schirm, V; Wineman, N M

    2000-10-01

    Preparation of advanced practice nurses to assume leadership positions for clinical decision making requires that traditional ways of solving clinical problems be augmented with information from relevant, research-derived evidence. In this article, the authors describe how one graduate program prepares advanced practice nurses to use the best scientific evidence with clinical expertise to influence patient outcomes. The assignments that students complete in their program provide examples of evidence-based practice that apply quality improvement principles and science-based nursing interventions to create best practices. PMID:11008434

  10. Preserving the Art and Science of Psychotherapy for Advance Practice Psychiatric Mental Health Nurses.

    PubMed

    Caughill, Ann

    2016-04-01

    Psychiatric Mental Health (PMH) Nurses are challenged to maintain the viability of their roles in today's healthcare climate as advances in research and complexity of mental healthcare needs of society continue to unfold. Today's mental health practice environment includes disciplines with marketable credentials. Roles for PMH nurses in recent decades are less clearly defined than for other disciplines, much of this related to changes in educational and practice settings. This article reviews literature on the topic of psychotherapy and a call for a renewed emphasis on this mode of treatment for psychiatric mental health advance practice nurses. PMID:27077508

  11. Enhancing Success in Advanced Practice Nursing: a grant-funded project.

    PubMed

    McNeal, Gloria J; Walker, Donita

    2006-01-01

    The Enhancing Success in Advanced Practice Nursing (ESAPN) Project is designed to improve access to a diverse and culturally competent and sensitive health professions workforce by increasing the number of Hispanic, African-American and Asian nurses recruited, enrolled in and graduated from the MSN program at the University of Medicine and Dentistry of New Jersey-School of Nursing (UMDNJ-SN). In addition, the project plan includes the development and implementation of a comprehensive program that incorporates academic support services, career advisement and mentoring activities to retain and graduate an increased number of culturally, racially and ethnically diverse advanced practice nurses for the State of New Jersey. The project also seeks to improve the quality of care by preparing advanced practice nurses to provide culturally competent and sensitive care by assuring that the MSN curriculum includes content and clinical experiences relevant to the development of cultural competence. Faculty participation in workshops, designed to increase knowledge of cultural competence, is a key component. The success of the project will be evaluated using a variety of measures that track increases in the number of diverse students recruited and enrolled, the number of students accessing services associated with the ESAPN program, and increased retention and graduation of Hispanic, African-American and Asian nurses prepared as advanced practice nurses. PMID:16696540

  12. [Domains in the clinical practice of Clinical Nursing Experts in Germany and their correspondence with the internationally described "Advanced Nursing Practice"].

    PubMed

    Mendel, Simon; Feuchtinger, Johanna

    2009-06-01

    In spite of a growing trend toward academic education and increasing numbers of "nursing experts" functioning as change agents in Germany, actual nursing experts as in the internationally described Advanced Nursing Practice (ANP) are scarce. Drawing from a ten-year experience in implementing the international concept, the University Hospital Freiburg (UKF), Germany, constitutes a notable exception, as it presently employs ten clinically practicing nursing experts. Based on this background of educating nursing experts, this presentation aims at describing the implementation of the nursing expert's role and its fit and conformance with the international ANP. A 3-stage Delphi design was used for interviewing all the nursing experts at the hospital (n = 10) about their expert opinions; in addition, all nursing managers (n = 7) as well as unit and team leaders (n = 49) were asked about their opinion to relevant functions and domains of nursing experts. The following clinical practice domains of nursing experts were identified: Direct patient care, patient education, support and supervision of nurses, maintenance and expansion of professional skills and knowledge of the nursing staff, counselling of managers, quality assurance and organizational development, theory to practice transfer, nursing research, maintenance of own professional skills and knowledge and continuing education, and publicity work. Additionally, a three-year nursing education, a longer lasting professional experience, a degree in nursing science or nursing education, and specialist skills in the respective area of expertise were identified as credentials for nursing expert practice. The nursing expert concept at UKF shows elements of the international ANP with similarities to the role of a Clinical Nurse Specialist. PMID:19496033

  13. Reaching for the stars: career advancement and the registered nurse.

    PubMed

    Walker, Kim

    2005-08-01

    Clinical nursing has long struggled to secure the place of primacy it deserves in the profession's hierarchy of importance and worth. It is ironic that, even at the beginning of the 21st century, a clinical nurse is generally not as well-recognized, rewarded or remunerated as a colleague working in nursing management, education or research. Until the profession recognizes and takes serious action to remedy this situation, the crisis of recruitment and retention in nursing currently ravaging the globe is likely to continue. In this paper, I present a discursive account of an exciting initiative by a leading private, acute-care hospital which addresses this very problem. A new ladder for clinical nurse specialists (CNSs) introduces a rigorous and systematic approach to the appointment of three classifications of CNS, each requiring evidence of successively higher levels of competency, and which are accompanied by fiscal reward and stronger peer recognition. PMID:15985097

  14. Emergency nurse practitioners' perceptions of their role and scope of practice: is it advanced practice?

    PubMed

    McConnell, Donna; Slevin, Oliver D; McIlfatrick, Sonja J

    2013-04-01

    There are multiple interpretations of the nurse practitioner role which appear to be shaped by discourses within and outside the profession and its regulatory body. This study aimed to explore and clarify the role and scope of practice of emergency nurse practitioners in a region in the United Kingdom and determine if they fulfil the proposed criteria for Advanced Nurse Practitioners. A survey approach using questionnaires (n=42) was adopted. The sample included all emergency nurse practitioners working in Accident and Emergency Departments and Minor Injury Units in the region. Statistical data was analysed using SPSS for Windows and qualitative data was content analysed for themes. Results revealed a variation in education. Investigation of role typology and scope of practice revealed a relatively homogenous group where the clinical aspect of the role dominated. The scope of practice was perceived to be influenced by internal factors such as competence; however protocol use, referral rights and prescribing authority could be considered ways that nursing management and medical staff indirectly control the role. Findings suggested that emergency nurse practitioners were working at a level significantly beyond registration, yet do not fulfil the Nursing and Midwifery Council proposed criteria for Advanced Nurse Practitioner. PMID:23615513

  15. Professional Nurse Coaching: Advances in National and Global Healthcare transformation

    PubMed Central

    Hess, Darlene

    2013-01-01

    Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)—the foundational philosopher of modern nursing—to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.1,2 The Institute of Medicine report3 and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing. PMID:24416681

  16. Advancing the Digital Health Discourse for Nurse Leaders.

    PubMed

    Remus, Sally

    2016-01-01

    Limited informatics competency uptake is a recognized nursing leadership challenge impacting digital practice settings. The health system's inability to reap the promised benefits of EHRs is a manifestation of inadequate development of informatics competencies by chief nurse executives (CNEs) and other clinicians. Through the application of Transformational Leadership Theory (TL), this discussion paper explains how informatics competencies enable CNEs to become transformational nursing leaders in digital health allowing them to meet their accountabilities to lead integrated, high-quality care delivery through evidence based practices (EBPs). It is proposed that successful CNE eHealth sponsors will be those armed with informatics competencies who can drive health organizations' investment in technology and innovation. Finally, some considerations are suggested in how nurse informaticists globally play a critical role in preparing our existing and future CNEs to fulfill their transformational leader roles in the digital age. PMID:27332233

  17. Advanced practice psychiatric nurses legislative update: State of the States, 2010.

    PubMed

    Oleck, Leslie G; Retano, Angela; Tebaldi, Christine; McGuinness, Teena M; Weiss, Steven; Carbray, Julie; Rodgers, Laura; Donelson, Emily E; Ashton, Lisa Lynn; Koehn, Darcy; McCoy, Patricia

    2011-01-01

    This article provides an update regarding individual state legislation for advanced practice psychiatric nursing, building on previous briefings. Specific attention is given to independent versus collaborative practice regulations, titling, and prescriptive authority. There is review of contemporary issues and focus on scope and standards of practice, workforce data, certification, and advanced practice regulatory models. PMID:21659307

  18. Education and Advance Care Planning in Nursing Homes: The Impact of Ownership Type.

    ERIC Educational Resources Information Center

    Walker, Leslie C.; Bradley, Elizabeth H.

    1998-01-01

    A study of 25 nonprofit and 87 for-profit nursing homes showed both types likely to offer education on advance care planning. However, nonprofits were more likely to have ongoing discussions that covered more than life support decisions and to have ethics committees to support advance care planning. (SK)

  19. [Brazilian technological output in the area of nursing: advances and challenges].

    PubMed

    Koerich, Micheline Henrique Araujo da Luz; Vieira, Raquel Heloisa Guedes; Silva, Daniela Eda; Erdmann, Alacoque Lorenzini; Meirelles, Betina Horner Shlindwein

    2011-12-01

    This article aims to analyze the patents registered in the nursing area, since these patents may be used as an indicator of the technological development in the area. It presents and discusses national technological productions, tracked through the "nursing" keyword, patented in the period from 1990-2009. This is a retrospective documental research, using, as a source, data from the National Industrial Property Institute (INPI). The information gathered is discussed in relation to the appropriation of the technologies, the incentive to develop them and register them as a source of knowledge in the nursing field, aiming the practice of care. Light and light hard technology productions are increasing in the nursing field. However, these are not registered and patented. The technological advance in the nursing field is emergent and needs policies for its development. PMID:22299276

  20. Communicating with patients who have advanced dementia: training nurse aide students.

    PubMed

    Beer, Laura E; Hutchinson, Susan R; Skala-Cordes, Kristine K

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students' perceptions of dementia and their ability to care for patients with dementia. The results indicated the training was effective regarding nurse aides' understanding of residual cognitive abilities and need for meaningful contact among patients with advanced dementia; however, the training was not successful in terms of nurse aides' comfort level or perceived skills in working with this population of patients. The findings suggest a need to transform how caregivers are trained in communication techniques. Incorporating this training into nurse aide education has the potential to increase quality of life for people with dementia. PMID:23095223

  1. Contemporary theories and contemporary nursing--advancing nursing care for those who are marginalized.

    PubMed

    Davis, K; Glass, N

    1999-06-01

    This paper critiques the topic of postmodernism and how it is represented in nursing and social science literature. This critique classified the debates into three identifiable constructs, those being: dissatisfaction; fragmentation and integration. The authors propose a solution from the integration debate by putting forward the notion of an 'integrated postmodern turn'. The 'solution' is situated within feminism and draws on modernist and postmodernist theory. The integrated model is grounded in nursing clinical examples which demonstrate the usefulness and workability of this approach when caring for those who are marginalized by nurses because of their ethnicity, gender, cultural and/or spiritual beliefs. PMID:11096793

  2. Advancing nursing leadership in long-term care.

    PubMed

    O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

    2010-05-01

    Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention. PMID:20463447

  3. Exploring Advance Care Planning from the Nephrology Nurse Perspective: A Literature Review.

    PubMed

    Haras, Mary S; Astroth, Kim S; Woith, Wendy L; Kossman, Susan P

    2015-01-01

    Advance care planning is a process that engages healthcare providers and patients to articulate wishes of patients as their illness progresses. Persons with chronic kidney disease require earlier and more frequent advance care planning conversations because they are faced with increased co-morbidities and a shortened lifespan. This literature review explores the phenomenon of advance care planning and the potential factors affecting nephrology nurse engagement in these discussions. PMID:26290915

  4. Implementing advance care planning: a qualitative study of community nurses' views and experiences

    PubMed Central

    2010-01-01

    Background Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by policy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. Methods An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach. Findings Nurses understood ACP to be an important part of practice and to have the potential to be a celebration of good nursing care. Nurses saw their roles in ACP as engaging with patients to elicit care preferences, facilitate family communication and enable a shift of care focus towards palliative care. They perceived challenges to ACP including: timing, how to effect team working in ACP, the policy focus on instructional directives which related poorly to patients' concerns; managing differences in patients' and families' views. Perceived barriers included: lack of resources; lack of public awareness about ACP; difficulties in talking about death. Nurses recommended the following to be included in education programmes: design of realistic scenarios; design of a flow chart; practical advice about communication and documentation; insights into the need for clinical supervision for ACP practice. Conclusions Nurses working in the community are centrally involved with patients with palliative care needs who may wish to set on record their views about future care and treatment. This study reveals some important areas for practice and educational development to enhance nurses' use and understanding of ACP. PMID:20377876

  5. Effects of an advanced surgical nursing module on clinical practice.

    PubMed

    Frost, J

    1994-04-01

    1. Innovation and changes in practice can be developed through continuing education. 2. By adapting appropriate change strategies, theories learned in class can be applied in practice. 3. Excellence in quality can be achieved by all qualified nurses by applying theory to practice. PMID:7513891

  6. Laptops and Learning: Evaluating Advances in Nurse Education.

    ERIC Educational Resources Information Center

    Geertshuis, Susan A.; Holmes, Mary E. A.; Thomas, A.; Sandercock, L.; Krayer, A.; Iphofen, R.; Allsup, D.; Godwin, M.

    2002-01-01

    Describes the use of information and communication technologies (ICT) in nurse education at the University of Wales Bangor. Explains the evaluation strategy for a longitudinal study of ICT, summarizes emerging trends in learning evaluation, discusses best practices in evaluation, and considers the expanding role of the evaluator. (Author/LRW)

  7. The Effects upon Advanced Placement Licensed Vocational Nursing Students When Integrated with Generic Students in the Second Year of a Registered Nursing Program.

    ERIC Educational Resources Information Center

    Balint, Marilyn

    A study was conducted to evaluate the effect of integrating advanced placement licensed vocational nursing (APLVN) students with generic students in the second year of the registered nursing program at Long Beach City College. It was hypothesized that the academic achievement of the APLVN students who were taught as a separate group for the first…

  8. Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

    PubMed

    Delaney, Colleen; Barrere, Cynthia

    2012-01-01

    The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented. PMID:22694866

  9. [How to develop advanced practice nursing in complex health care systems?].

    PubMed

    Lecocq, Dan; Mengal, Yves; Pirson, Magali

    2015-01-01

    Over the last few decades, advanced nursing practitioners (ANP) have developed new roles in health care systems and this tendency is continuing to grow. Postgraduate trainedANP interact directly with the person, i.e. the individual and his/her family - in many fields of practice and in a context of collaboration withfellow nurses and other health care professionals. The potential benefits of ANP interventions have been demonstrated in many fields. In particular, ANP are public health actors, able to participate in the interdisciplinary response to supportive care ofpatients with chronic diseases. However, the development of advanced practice nursing (APN) in a complex health care system requires a systemic approach coordinated with the various levels of training of nursing practitioners and other health care professionals. This is an essential prerequisite to allow ANPs to develop new roles adapted to their capacities (legal qualification, high level, specialist training, modalities of collaboration, etc.). To achieve an added value for patients, for the health care system in terms ofresults and to ensure adequate nursing conditions, the authors emphasize the importance of structured development of APN and propose an awareness phase comprising adoption of a conceptual model of APN and the establishment of a structured list of existing nursing practices in order to prepare a methodical implementation strategy. PMID:26168623

  10. Advance Care Planning in Norwegian nursing homes-Who is it for?

    PubMed

    Thoresen, Lisbeth; Ahlzén, Rolf; Solbrække, Kari Nyheim

    2016-08-01

    Advance care planning (ACP) is an international concept for improving patient autonomy and communication in the context of anticipated deterioration and end-of-life care. In a preparatory conversation, health care professionals facilitate one or more conversations where nursing home residents are invited to reflect on, and articulate wishes and preferences concerning future medical treatment and end-of-life care. Our aim with this study was to increase knowledge of existing ACP practices in Norwegian nursing homes. We wanted to know how nursing home residents, relatives and nursing home staff take part in the conversations, and to what extent these conversations can be regarded as promoting autonomy, legal rights and individual needs for the residents. We conducted participant observation of seven preparatory conversations, followed by interviews with health care staff (together) and resident and relative (together). In the result section, we present an informative case example of an ACP conversation where common and important characteristics running through our data are present. These are further elaborated under the following headings: Life critical questions, Residents' quiet participation in the conversations, the Dying phase - a clinical issue, Nurses and physicians; different domains and Timing. We find that nursing home staff in our study wants to contribute to open awareness, autonomy and a good death, but there are little reflections about the purpose and content of the conversations, how they should be carried out and when, and what frail nursing home residents are able to understand and express in ACP conversations. PMID:27531449

  11. [Therapeutic advances and nursing practices, 1914-1918].

    PubMed

    Debout, Christophe

    2014-06-01

    The production and transfer of knowledge in the healthcare field were key factors which enabled the fight against morbidity and mortality during the First World War to be carried out efficiently. The knowledge used to train nurses before the war soon became obsolete and had to be updated. Knowledge and practices were developed in order to meet as best as possible the specific needs of patients in the particular context of this war. PMID:25069355

  12. Development of advanced pulmonary vascular disease in D-transposition of the great arteries after the neonatal arterial switch operation.

    PubMed Central

    Rivenes, S M; Grifka, R G; Feltes, T F

    1998-01-01

    We report the case of a neonate with D-transposition of the great arteries who, after undergoing an uneventful arterial switch operation at the age of 4 days, was found at the age of 42 months to have developed advanced pulmonary vascular disease. Because the arterial switch operation was performed when our patient was only 4 days old, this case challenges the hypothesis that postnatal hemodynamics alone dictate the development of advanced pulmonary vascular disease in infants and children with transposition of the great arteries. Images PMID:9782561

  13. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention

    ERIC Educational Resources Information Center

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.

    2012-01-01

    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  14. Communicating with Patients Who Have Advanced Dementia: Training Nurse Aide Students

    ERIC Educational Resources Information Center

    Beer, Laura E.; Hutchinson, Susan R.; Skala-Cordes, Kristine K.

    2012-01-01

    The increase of dementia in older adults is changing how medical care is delivered. Recognizing symptoms of pain, managing behaviors, and providing quality of life for people who have advanced dementia requires a new skill set for caregivers. Researchers in this study targeted nurse aide students to test an educational module's effect on students'…

  15. Globalization and advances in information and communication technologies: the impact on nursing and health.

    PubMed

    Abbott, Patricia A; Coenen, Amy

    2008-01-01

    Globalization and information and communication technology (ICT) continue to change us and the world we live in. Nursing stands at an opportunity intersection where challenging global health issues, an international workforce shortage, and massive growth of ICT combine to create a very unique space for nursing leadership and nursing intervention. Learning from prior successes in the field can assist nurse leaders in planning and advancing strategies for global health using ICT. Attention to lessons learned will assist in combating the technological apartheid that is already present in many areas of the globe and will highlight opportunities for innovative applications in health. ICT has opened new channels of communication, creating the beginnings of a global information society that will facilitate access to isolated areas where health needs are extreme and where nursing can contribute significantly to the achievement of "Health for All." The purpose of this article is to discuss the relationships between globalization, health, and ICT, and to illuminate opportunities for nursing in this flattening and increasingly interconnected world. PMID:18922277

  16. Role of extrahepatic UDP-glucuronosyltransferase 1A1: Advances in understanding breast milk-induced neonatal hyperbilirubinemia.

    PubMed

    Fujiwara, Ryoichi; Maruo, Yoshihiro; Chen, Shujuan; Tukey, Robert H

    2015-11-15

    Newborns commonly develop physiological hyperbilirubinemia (also known as jaundice). With increased bilirubin levels being observed in breast-fed infants, breast-feeding has been recognized as a contributing factor for the development of neonatal hyperbilirubinemia. Bilirubin undergoes selective metabolism by UDP-glucuronosyltransferase (UGT) 1A1 and becomes a water soluble glucuronide. Although several factors such as gestational age, dehydration and weight loss, and increased enterohepatic circulation have been associated with breast milk-induced jaundice (BMJ), deficiency in UGT1A1 expression is a known cause of BMJ. It is currently believed that unconjugated bilirubin is metabolized mainly in the liver. However, recent findings support the concept that extrahepatic tissues, such as small intestine and skin, contribute to bilirubin glucuronidation during the neonatal period. We will review the recent advances made towards understanding biological and molecular events impacting BMJ, especially regarding the role of extrahepatic UGT1A1 expression. PMID:26342858

  17. Impact of new regulatory standards on advanced practice registered nursing: the APRN Consensus Model and LACE.

    PubMed

    Stanley, Joan M

    2012-06-01

    Advanced practice registered nurses (APRNs) represent a crucial resource to meeting growing health care needs. Such resources must be used to the full extent and in the most effective way possible. Through the development of the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education (LACE), nursing is assuming a leadership role within the health care system and participating as an equal partner in redesigning health care. When fully implemented, the Consensus Model will allow APRNs to practice to the full scope of their education and more easily move from one state to another, increasing access to quality health care for all populations. PMID:22579059

  18. Advancing the application of systems thinking in health: understanding the dynamics of neonatal mortality in Uganda

    PubMed Central

    2014-01-01

    Background Of the three million newborns that die each year, Uganda ranks fifth highest in neonatal mortality rates, with 43,000 neonatal deaths each year. Despite child survival and safe motherhood programmes towards reducing child mortality, insufficient attention has been given to this critical first month of life. There is urgent need to innovatively employ alternative solutions that take into account the intricate complexities of neonatal health and the health systems. In this paper, we set out to empirically contribute to understanding the causes of the stagnating neonatal mortality by applying a systems thinking approach to explore the dynamics arising from the neonatal health complexity and non-linearity and its interplay with health systems factors, using Uganda as a case study. Methods Literature reviews and interviews were conducted in two divisions of Kampala district with high neonatal mortality rates with mothers at antenatal clinics and at home, village health workers, community leaders, healthcare decision and policy makers, and frontline health workers from both public and private health facilities. Data analysis and brainstorming sessions were used to develop causal loop diagrams (CLDs) depicting the causes of neonatal mortality, which were validated by local and international stakeholders. Results We developed two CLDs for demand and supply side issues, depicting the range of factors associated with neonatal mortality such as maternal health, level of awareness of maternal and newborn health, and availability and quality of health services, among others. Further, the reinforcing and balancing feedback loops that resulted from this complexity were also examined. The potential high leverage points include special gender considerations to ensure that girls receive essential education, thereby increasing maternal literacy rates, improved socioeconomic status enabling mothers to keep healthy and utilise health services, improved supervision, and

  19. Exploring the district nurse role in facilitating individualised advance care planning.

    PubMed

    Boot, Michelle

    2016-03-01

    Health-care policy recognises the importance of engaging people in making decisions related to the management of their health. Advance care planning (ACP) offers a framework for decision making on end-of-life care. There are positive indicators that ACP enables health professionals to meet people's preferences. However, there are reports of insensitive attempts to engage people in end-of-life care decision making. District nurses are in the ideal position to facilitate ACP, as they have the opportunity to build relationships with the people they are caring for--an antecedent to sensitive ACP--and in recognising and fulfilling this role, they could ameliorate the risk of insensitive ACP. Distric nurse leaders also have a role to play in ensuring that organisational and environmental factors support appropriate ACP facilitation including: training, fostering a team culture that empowers district nurses to recognise and meet their ACP role, and advocating for appropriate ACP evaluation outcome measures. PMID:26940617

  20. Health Care Reform and the Federal Transformation Initiatives: Capitalizing on the Potential of Advanced Practice Psychiatric Nurses

    PubMed Central

    Hanrahan, Nancy P.; Delaney, Kathleen; Merwin, Elizabeth

    2012-01-01

    In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed. PMID:21233135

  1. Advancing Genomic Research and Reducing Health Disparities: What Can Nurse Scholars Do?

    PubMed Central

    Jaja, Cheedy; Gibson, Robert; Quarles, Shirley

    2012-01-01

    Purpose Advances in genomic research are improving our understanding of human diseases and evoking promise of an era of genomic medicine. It is unclear whether genomic medicine may exacerbate or attenuate extant racial group health disparities. We delineate how nurse scholars could engage in the configuration of an equitable genomic medicine paradigm. Organizing Construct We identify as legitimate subjects for nursing scholarship the scientific relevance, ethical, and public policy implications for employing racial categories in genomic research in the context of reducing extant health disparities. Findings Since genomic research is largely population specific, current classification of genomic data will center on racial and ethnic groups. Nurse scholars should be involved in clarifying how putative racial group differences should be elucidated in light of the current orthodoxy that genomic solutions may alleviate racial health disparities. Conclusions Nurse scholars are capable of employing their expertise in concept analysis to elucidate how race is used as a variable in scientific research, and to use knowledge brokering to delineate how race variables that imply human ancestry could be utilized in genomic research pragmatically in the context of health disparities. Clinical Relevance In an era of genomic medicine, nurse scholars should recognize and understand the challenges and complexities of genomics and race and their relevance to health care and health disparities. PMID:23452096

  2. Current status of neonatal intensive care in India.

    PubMed

    Karthik Nagesh, N; Razak, Abdul

    2016-05-01

    Globally, newborn health is now considered as high-level national priority. The current neonatal and infant mortality rate in India is 29 per 1000 live births and 42 per 1000 live births, respectively. The last decade has seen a tremendous growth of neonatal intensive care in India. The proliferation of neonatal intensive care units, as also the infusion of newer technologies with availability of well-trained medical and nursing manpower, has led to good survival and intact outcomes. There is good care available for neonates whose parents can afford the high-end healthcare, but unfortunately, there is a deep divide and the poor rural population is still underserved with lack of even basic newborn care in few areas! There is increasing disparity where the 'well to do' and the 'increasingly affordable middle class' is able to get the most advanced care for their sick neonates. The underserved urban poor and those in rural areas still contribute to the overall high neonatal morbidity and mortality in India. The recent government initiative, the India Newborn Action Plan, is the step in the right direction to bridge this gap. A strong public-private partnership and prioritisation is needed to achieve this goal. This review highlights the current situation of neonatal intensive care in India with a suggested plan for the way forward to achieve better neonatal care. PMID:26944066

  3. Improving Transitions of Care With an Advanced Practice Nurse: A Pilot Study.

    PubMed

    Hsueh, Martha; Dorcy, Kathleen

    2016-06-01

    Gaps in complex oncology care coordination between inpatient and outpatient settings can result in treatment and monitoring delays and omissions, which can negatively affect patient outcomes. Gaps also exist for patients facing complex treatment modalities and collaborations between multiple care teams working at geographically distant sites. A pilot advanced practice nurse care coordinator 
(APNCC) role to coordinate these complex care transitions and implement processes for safer and more efficient care has shown promise.
. PMID:27206289

  4. Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

    PubMed

    Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene

    2014-01-01

    The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate. PMID:24720938

  5. Advanced practice nursing for enduring health needs management: a global perspective.

    PubMed

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. PMID:21839552

  6. Advanced nursing roles in critical care--a natural or forced evolution?

    PubMed

    Coombs, Maureen; Chaboyer, Wendy; Sole, Mary Lou

    2007-01-01

    Meeting the expectation of delivering safe, effective, and timely health care services within current financial and workforce envelopes requires all health care clinicians to refine and adapt to their clinical roles. The arena of critical care is currently receiving increasing scrutiny regarding developing dedicated advanced practice roles. This is challenging to critical care nurses who historically neither have been exposed to nor have chosen to engage in such specific role developments. The critical care nursing community has, on the whole, embraced previous role expansions within the limits of existing group practices rather than an evolution of new subspecialties. International comparisons demonstrate that critical care nurses in the United States, the United Kingdom, and Australia are all facing common health policy drivers. Although there are some similarities in addressing these challenges, the solutions remain at various stages of development. The natural history framework of Bucher [Work and Occupations 1988;15:131-147] provides a useful and supportive tool to understand how it is necessary and natural for specialties within occupational groups to emerge to meet changing health care needs. A shared concern providing challenges at national and international levels involves the coordination of educational standards as well as competencies and clear articulation of the leadership component of advanced practice roles. These areas must be addressed to enable the international critical care community to naturally transform and evolve into fully established and legitimate advanced practitioners. PMID:17383600

  7. Description of the clinical practice of advanced practice nurses in family-centered early intervention in two rural settings.

    PubMed

    Kang, R; Barnard, K; Oshio, S

    1994-12-01

    The purpose of this study was to describe the scope of clinical practice of advanced practice nurses who were involved in a project designed to increase access of families with at-risk and disabled young children, newborn to 3 years of age, to early intervention services in rural Washington State. The findings from this study are based on the retrospective review of records of clients seen by the advanced practice nurses. Nursing diagnoses and nursing interventions were assigned to chart recordings. The most frequently occurring nursing diagnoses assigned to parents were Altered Parenting, Altered Family Processes, Fear, Noncompliance, and Knowledge Deficit. The most frequently occurring nursing diagnoses assigned to children were Impaired Physical Mobility, Impaired Verban Communication, Altered Nutrition: Less than Body Requirements, Sensory-Perceptual Alteration, and Altered Thought Processes. Categories of nursing intervention recorded most frequently were Monitoring, Planning and Information. Discussion of findings addresses the roles and reimbursement of advanced practice nurses who provide family-centered early intervention services in rural communities. PMID:7870654

  8. Surgeon-nurse anesthetist collaboration advanced surgery between 1889 and 1950.

    PubMed

    Koch, Bruce Evan

    2015-03-01

    To meet the need for qualified anesthetists, American surgeons recruited nurses to practice anesthesia during the Civil War and in the latter half of the 19th century. The success of this decision led them to collaborate with nurses more formally at the Mayo Clinic in Minnesota. During the 1890s, Alice Magaw refined the safe administration of ether. Florence Henderson continued her work improving the safety of ether administration during the first decade of the 20th century. Safe anesthesia enabled the Mayo surgeons to turn the St. Mary's Hospital into a surgical powerhouse. The prominent surgeon George Crile collaborated with Agatha Hodgins at the Lakeside Hospital in Cleveland to introduce nitrous oxide/oxygen anesthesia. Nitrous oxide/oxygen caused less cardiovascular depression than ether and thus saved the lives of countless trauma victims during World War I. Crile devised "anoci-association," an outgrowth of nitrous oxide/oxygen anesthesia. Hodgins' use of anoci-association made Crile's thyroid operations safer. Pioneering East Coast surgeons followed the lead of the surgeons at Mayo. William Halsted worked closely with Margaret Boise, and Harvey Cushing worked closely with Gertrude Gerard. As medicine became more complex, collaboration between surgeons and nurse anesthetists became routine and necessary. Teams of surgeons and nurse anesthetists advanced thoracic, cardiovascular, and pediatric surgery. The team of Evarts Graham and Helen Lamb performed the world's first pneumonectomy. Surgeon-nurse anesthetist collaboration seems to have been a uniquely American phenomenon. This collaboration facilitated both the "Golden Age of Surgery" and the profession we know today as nurse anesthesia. PMID:25695581

  9. Exploring the use of standardized patients for simulation-based learning in preparing advanced practice nurses.

    PubMed

    Kowitlawakul, Yanika; Chow, Yeow Leng; Salam, Zakir Hussian Abdul; Ignacio, Jeanette

    2015-07-01

    The use of standardized patients for simulation-based learning was integrated into the Master of Nursing curriculum in the 2012-2013 academic year. The study aimed to explore the Master of Nursing students' experiences with and perceptions of using standardized patients in simulations, and to identify the students' learning needs in preparing to become advanced practice nurses. The study adopted an exploratory descriptive qualitative design, using a focus group interview. The study was conducted at a university in Singapore. Seven Master of Nursing students who were enrolled in the Acute Care Track of Master of Nursing program in the 2012-2013 academic year participated in the study. The data were gathered at the end of the first semester. Content analysis was used to analyze the data. Three main categories - usefulness, clinical limitations, and realism - were identified in the study. The results revealed that the students felt using standardized patients was useful and realistic for developing skills in history taking, communication, and responding to an emergency situation. On the other hand, they found that the standardized patients were limited in providing critical signs and symptoms of case scenarios. To meet the learning objectives, future development and integration of standardized patients in the Master of Nursing curriculum might need to be considered along with the use of a high-fidelity simulator. This can be an alternative strategy to fill the gaps in each method. Obviously, using standardized patients for simulation-based learning has added value to the students' learning experiences. It is highly recommended that future studies explore the impact of using standardized patients on students' performance in clinical settings. PMID:25819268

  10. What is Family-Centered Care for Nursing Home Residents With Advanced Dementia?

    PubMed Central

    Lopez, Ruth Palan; Mazor, Kathleen M.; Mitchell, Susan L.; Givens, Jane L.

    2014-01-01

    To understand family members’ perspectives on person- and family-centered end-of-life care provided to nursing home (NH) residents with advanced dementia, we conducted a qualitative follow-up interview with 16 respondents who had participated in an earlier prospective study, Choices, Attitudes, and Strategies for Care of Advance Dementia at End of Life (CASCADE). Family members of NH residents (N = 16) with advanced dementia participated in semistructured qualitative interviews that inquired about overall NH experience, communication, surrogate decision making, emotional reaction, and recommendations for improvement. Analysis identified 5 areas considered important by family members: (1) providing basic care; (2) ensuring safety and security; (3) creating a sense of belonging and attachment; (4) fostering self-esteem and self-efficacy; and (5) coming to terms with the experience. These themes can provide a framework for creating and testing strategies to meet the goal of person- and family-centered care. PMID:24085250

  11. Providing a navigable route for acute medicine nurses to advance their practice: a framework of ascending levels of practice.

    PubMed

    Lees-Deutsch, Liz; Christian, Jan; Setchfield, Ian

    2016-01-01

    This article conveys concerns raised by delegates at the International SAM Conference (Manchester, 2015) regarding how to advance nursing practice in acute medicine. It endeavors to capture the essence of 'how to advance practice' and 'how to integrate advanced practice' within the workforce structures of an acute medicine unit (AMU). It addresses the production of tacit knowledge and the recognition and integration of this to developing the nursing workforce. The current context of NHS efficiencies and recruitment issues emphasize the value of retaining tacit knowledge. Uniquely, this article offers an early conceptual framework through which levels of advancement and potential transition points to advance nursing practice in acute medicine are articulated. Determining how to advance requires identification of prior accomplishments such as, tacit knowledge, experiential learning, CPD, specialist courses and management experience. This requires nurses to make judicious decisions to advance their practice and the distinction between 'amassing experience' and 'career progression'. It aims to stimulate thinking around the practicalities of advancement, the value of tacit knowledge and potential realization through the framework trajectory. PMID:27441313

  12. Immune Responses in Neonates

    PubMed Central

    Basha, Saleem; Surendran, Naveen; Pichichero, Michael

    2015-01-01

    Neonates have little immunological memory and a developing immune system, which increases their vulnerability to infectious agents. Recent advances in understanding of neonatal immunity indicate that both innate and adaptive responses are dependent on precursor frequency of lymphocytes, antigenic dose and mode of exposure. Studies in neonatal mouse models and human umbilical cord blood cells demonstrate the capability of neonatal immune cells to produce immune responses similar to adults in some aspects but not others. This review focuses mainly on the developmental and functional mechanisms of the human neonatal immune system. In particular, the mechanism of innate and adaptive immunity and the role of neutrophils, antigen presenting cells, differences in subclasses of T lymphocytes (Th1, Th2, Tregs) and B cells are discussed. In addition, we have included the recent developments in neonatal mouse immune system. Understanding neonatal immunity is essential to development of therapeutic vaccines to combat newly emerging infectious agents. PMID:25088080

  13. [Challenges and opportunities: contributions of the Advanced Practice Nurse in the chronicity. Learning from experiences].

    PubMed

    Appleby, Christine; Camacho-Bejarano, Rafaela

    2014-01-01

    Undoubtedly, our society is facing new economic, political, demographic, social and cultural challenges that require healthcare services able to meet the growing health needs of the population, especially in dealing with chronic conditions. In this new context, some countries such as the United Kingdom have made a firm commitment to develop new models for chronic patients care based on the introduction of new figures of Advanced Practice Nurses, which includes 4 cornerstones of professional practice: advanced clinical skills, clinical management, teaching and research. The implementation of this new figures implies a redefinition of professional competencies and has its own accreditation system and a specific catalogue of services adapted to the population requirements, in order to provide chronic care support from Primary Care settings. This trajectory allows us analysing the process of design and implementation of these new models and the organizational structure where it is integrated. In Spain, there are already experiences in some regions such as Andalucia and the Basque Country, focused on the creation of new advanced nursing roles. At present, it is necessary to consider suitable strategic proposals for the complete development of these models and to achieve the best results in terms of overall health and quality of life of patients with chronic conditions, improving the quality of services and cost-effectiveness through a greater cohesion and performance of healthcare teams towards the sustainability of healthcare services and patient satisfaction. PMID:24468497

  14. An Incentive Pay Plan for Advanced Practice Registered Nurses: Impact On Provider and Organizational Outcomes.

    PubMed

    Rhodes, Catherine A; Bechtle, Mavis; McNett, Molly

    2015-01-01

    Advanced practice registered nurses (APRNs) are integral to the provision of quality, cost-effective health care throughout the continuum of care. To promote job satisfaction and ultimately decrease turnover, an APRN incentive plan based on productivity and quality was formulated. Clinical productivity in the incentive plan was measured by national benchmarks for work relative value units for nonphysician providers. After the first year of implementation, APRNs were paid more for additional productivity and quality and the institution had an increase in patient visits and charges. The incentive plan is a win-win for hospitals that employ APRNs. PMID:26259336

  15. Positioning advanced practice registered nurses for health care reform: consensus on APRN regulation.

    PubMed

    Stanley, Joan M; Werner, Kathryn E; Apple, Kathy

    2009-01-01

    Advanced practice registered nurses (APRNs) have positioned themselves to serve an integral role in national health care reform. This article addresses both the policy and the process to develop this policy that has placed them in a strategic position. A successful transformation of the nation's health system will require utilization of all clinicians, particularly primary care providers, to the full extent of their education and scope of practice. APRNs are highly qualified clinicians who provide cost-effective, accessible, patient-centered care and have the education to provide the range of services at the heart of the reform movement, including care coordination, chronic care management, and wellness and preventive care. The APRN community faces many challenges amidst the opportunities of health reform. However, the APRN community's triumph in reaching consensus on APRN regulation signifies a cohesive approach to overcoming the obstacles. The consensus model for APRN regulation, endorsed by 44 national nursing organizations, will serve as a beacon for nursing, as well as a guidepost for consumers and policymakers, on titling, education, certification, accreditation, and licensing for all four APRN roles. PMID:19942200

  16. Following the learning curve: the evolution of kinder, gentler neonatal respiratory technology.

    PubMed

    Lockridge, T

    1999-01-01

    Immense progress has been made in all aspects of neonatal critical care during the past 4 decades, particularly in the realm of respiratory support. A historical overview of the evolution of neonatal respiratory support illustrates how technological advances are improving survival and outcome for many sick newborns. Major milestones in this history include continuous positive airway pressure, conventional ventilation, exogenous surfactant, extracorporeal membrane oxygenation, and high frequency ventilation. Changes in clinical and nursing care highlight the significant impact of technological and practice advances on neonatal respiratory morbidity. Although bronchopulmonary dysplasia still occurs, the incidence and severity have decreased. The nature and outcome of the neonatal intensive-care experience has been redefined for many infants; however, great challenges remain in the care of infants on the edge of viability. PMID:10438090

  17. [Neonatal hemochromatosis: Another entity that is no longer orphan. Advances in the diagnosis and management of the main cause of neonatal acute liver failure].

    PubMed

    Molera Busoms, C; Quintero Bernabeu, J; Martín de Carpi, J

    2015-09-01

    Neonatal hemochromatosis is the most common cause of acute liver failure in the neonatal period. It is associated with high morbidity and mortality due to iron overload in hepatic and extra-hepatic tissues. New evidence has emerged during the last few years as regards its alloimmune etiology, which have had an important repercussion on the diagnosis, treatment and prognosis of these patients. Treatment with immunoglobulins and exchange transfusions has radically changed the prognosis without liver transplant. Another great success has been the preventive use of immunoglobulin in pregnant women with a past history of neonatal hemochromatosis, thus decreasing the rate of disease recurrence up to 70%. This new paradigm has led to an entity with a poor prognosis becoming a curable disease if diagnosed and treated early. Nevertheless, a large widespread ignorance of the disease persists, with medical implications that result in significant health problems, due to the delayed referral of these patients to specialized centers. PMID:25801288

  18. To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership

    PubMed Central

    Gilligan, P; Bhatarcharjee, C; Knight, G; Smith, M; Hegarty, D; Shenton, A; Todd, F; Bradley, P

    2005-01-01

    Background and objectives: In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation. Methods: A prospective study was conducted at five emergency departments and one nurses' association meeting. All participants went through the same scenario. Details recorded included baseline blood pressure and pulse rate, time in post, time of ALS training, and subjective stress score (1 = hardly stressed; 10 = extremely stressed). Scoring took into account scenario understanding, rhythm recognition, time to defibrillation, appropriateness of interventions, and theoretical knowledge. Results: Of 57 participants, 20 were ALS trained nurses, 19 were ALS trained emergency senior house officers (SHOs), and 18 were emergency SHOs without formal ALS training. The overall mean score for doctors without ALS training was 69.5%, compared with 72.3% for ALS trained doctors and 73.7% for ALS trained nurses. Nurses found the experience less stressful (subjective stress score 5.78/10) compared with doctors without ALS training (6.5/10). The mean time taken to defibrillate from the appearance of a shockable rhythm on the monitor by the nurses and those SHOs without ALS training was 42 and 40.8 seconds, respectively. Conclusion: ALS trained nurses performed as well as ALS trained and non ALS trained emergency SHOs in a simulated cardiac arrest situation and had greater awareness of the potentially reversible causes of cardiac arrest. Thus if a senior or middle grade doctor is not available to lead the resuscitation team, it may be appropriate for experienced nursing staff with ALS training to act as ALS team leaders rather than SHOs. PMID:16113181

  19. Advanced Practice Nursing: Meeting the Caregiving Challenges for Families of Persons with Frontotemporal Dementia

    PubMed Central

    Merrilees, Jennifer; Ketelle, Robin

    2010-01-01

    Frontotemporal dementia (FTD), once thought to be a rare cause for dementia, is now acknowledged to be the most common presenile (before age 65) cause of dementia (1). FTD is associated with profound changes in behavior, personality, emotions, and cognition. The purpose of this paper is to describe two cases of patients with FTD in order to illustrate salient aspects of the caregiving experience. Issues faced by caregivers are organized into 6 categories: diagnosis, behavioral symptoms, function, communication, long term management and care, and maintenance of the caregiver’s emotional and physical health. Examples of interventions directed by advanced practice nurses are described. We suggest that management of FTD requires expertise as scientific advances and discoveries about FTD continually change the landscape of care. PMID:20716977

  20. Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

    PubMed

    Farrell, Kathleen; Payne, Camille; Heye, Mary

    2015-01-01

    The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN

  1. Developing a professional poster: four "ps" for advanced practice nurses to consider.

    PubMed

    Bindon, Susan L; Davenport, Joan M

    2013-01-01

    Professional posters play an important role in the dissemination of knowledge and the professional development of advanced practice nurses, graduate students, and clinical faculty. Posters should be considered an integral component in communication of professional work in practice, research, and education. The invitation to submit a poster abstract is an important opportunity for clinicians and faculty alike to consider. Though sometimes misperceived as less prestigious than a podium presentation, posters add a unique element to professional and academic events. The argument is made for posters as an equal among scholarly presentation formats. The poster serves as a tremendous opportunity for collaboration between partners and a way to communicate important findings and advertise the presenters' work. For the advanced practice nurse who is a novice in presenting best practice or evidence from research trials, the poster format may be less intimidating while allowing the invaluable sharing of results. Four critical elements of professional poster development are deciding on a clear Purpose, targeting the right People, outlining key steps in the Process, and delivering a memorable Presentation. Using the "4 Ps" as cornerstones for the work of developing, preparing, and delivering the poster to an audience, the authors aim to help organize the entire process into these essential considerations. The poster, as a means of scholarly work, is a viable and essential activity, as interdisciplinary collaboration and sharing of best practice becomes the expectation for all professional development. PMID:23615014

  2. Quality improvement for neonatal nurses, part II: using a PDSA quality improvement cycle approach to implement an oral feeding progression guideline for premature infants.

    PubMed

    Marcellus, Lenora; Harrison, Adele; Mackinnon, Kathleen

    2012-01-01

    The development of clinical practice guidelines involving multiple health care providers presents a challenge in the neonatal intensive care unit (NICU). Implementation and evaluation of the guideline is as important as the development of the guideline itself. We explored the use of a quality improvement approach in the implementation of a feeding framework. A Plan-Do-Study-Act (PDSA) quality improvement cycle model was used to implement and evaluate a stepwise oral infant feeding guideline with emphasis on parent and care provider satisfaction. Three PDSA cycles were conducted, with each cycle resulting in modifications to use of the framework and development of knowledge translation and parent education techniques and tools. A PDSA cycle approach can be used effectively in guideline implementation and evaluation involving multidisciplinary health care professionals. This is Part II of a two-part series. Part I introduced the concept of quality improvement and tools for advancing practice changes. PMID:22763248

  3. A survey of oncology advanced practice nurses in Ontario: profile and predictors of job satisfaction.

    PubMed

    Bryant-Lukosius, Denise; Green, Esther; Fitch, Margaret; Macartney, Gail; Robb-Blenderman, Linda; McFarlane, Sandra; Bosompra, Kwadwo; DiCenso, Alba; Matthews, Susan; Milne, Harry

    2007-01-01

    The purpose of this study was to examine role structures and processes and their impact on job satisfaction for oncology advanced practice nurses (APNs) in Ontario. APNs caring for adult, paediatric or palliative patients in integrated regional cancer programs, tertiary care hospitals or community hospitals and agencies were invited to complete a mailed self-report questionnaire. A total of 73 of 77 APNs participated in the study. Most APNs (55%) were acute care nurse practitioners employed by regional cancer programs or tertiary care hospitals. Adult patients with breast or haematological cancers and those receiving initial treatment or palliative care were the primary focus of APN roles. APN education needs related to specialization in oncology, leadership and research were identified. Overall, APNs were minimally satisfied with their roles. Role confidence (beta = .404, p = .001) and the number of overtime hours (beta = -.313, p = .008) were respective positive and negative predictors of APN job satisfaction. Progress in role development is described, and recommendations for improving role development and expanding the delivery of oncology APN services are provided. PMID:17619596

  4. A conceptual framework for advanced practice nursing in a pediatric tertiary care setting: the SickKids' experience.

    PubMed

    LeGrow, Karen; Hubley, Pam; McAllister, Mary

    2010-05-01

    Advanced practice nurses (APNs) at The Hospital for Sick Children (SickKids) are pediatric healthcare providers who integrate principles and theories of advanced nursing with specialty knowledge to provide autonomous, independent, accountable, ethical and developmentally appropriate care in complex, often ambiguous and rapidly changing healthcare environments. Caring for children and adolescents requires culturally sensitive and family-centred approaches to care that incorporate a unique body of knowledge. Family-centred care is an approach to planning, delivery and evaluation of healthcare that is governed by the establishment of mutually beneficial partnerships among APNs, health professionals and children/families. The cornerstone of APN practice at SickKids is the recognition of "family" as the recipients of care. By valuing and developing relationships with families, APNs promote excellence in healthcare across the care continuum to optimize the child's and family's physical, emotional, social, psychological and spiritual well-being. This paper outlines the evolution of advanced practice nursing at SickKids, beginning with the introduction of APN roles in the 1970s and culminating in the current critical mass of APNs who have been integrated throughout the hospital's infrastructure. We describe the process used to create a common vision and a framework to guide pediatric advanced nursing practice. PMID:20530994

  5. Opioid therapy for chronic low back pain: prescribing considerations for advanced practice registered nurses.

    PubMed

    Lall, Maureen Patricia

    2014-12-01

    Chronic low back pain is a common, disabling, and costly condition, and advanced practice registered nurses (APRNs) must carefully evaluate patients before considering long-term opioid therapy as a management strategy. APRNs should refer patients suspected of having a serious condition, or identifiable etiology, for specialist evaluation, as many patients improve with physical therapy, interventional pain management procedures, or surgical intervention. For patients unresponsive to nonopioid treatment, APRNs with an understanding of opioids, and the experience to assess and manage the risks of opioid misuse, abuse, and diversion, may consider long-term opioid therapy as part of a multimodal management plan. Such prescribing necessitates careful patient selection; informed consent; prudent opioid dosing and titration; and monitoring for response to treatment, adverse effects, and aberrant drug-taking behavior. Treatment and regulatory guidelines can assist APRNs in providing safe and effective care to patients with chronic low back pain. PMID:25365050

  6. Portfolio use as a tool to demonstrate professional development in advanced nursing practice.

    PubMed

    Hespenheide, Molly; Cottingham, Talisha; Mueller, Gail

    2011-01-01

    A concrete way of recognizing and rewarding clinical leadership, excellence in practice, and personal and professional development of the advanced practice registered nurse (APRN) is lacking in the literature and healthcare institutions in the United States. This article presents the process of developing and evaluating a professional development program designed to address this gap. The program uses APRN Professional Performance Standards, Relationship-Based Care, and the Magnet Forces as a guide and theoretical base. A key tenet of the program is the creation of a professional portfolio. Narrative reflections are included that illustrate the convergence of theories. A crosswalk supports this structure, guides portfolio development, and operationalizes the convergence of theories as they specifically relate to professional development in advanced practice. Implementation of the program has proven to be challenging and rewarding. Feedback from APRNs involved in the program supports program participation as a meaningful method to recognize excellence in advanced practice and a clear means to foster ongoing professional growth and development. PMID:22016019

  7. Child Psychiatric Nursing Option.

    ERIC Educational Resources Information Center

    Koehler, Mary Frances

    1981-01-01

    Describes a course at the Indiana University School of Nursing which allows senior students in a baccalaureate nursing program to concentrate on emotionally disturbed children in an advanced nursing course. Discusses course philosophy, clinical experiences, and program results. (CT)

  8. Advocacy and leadership when parental rights and child welfare collide: the role of the advanced practice nurse.

    PubMed

    Walton, Mary K

    2002-02-01

    This article describes the experience of an advanced practice nurse in a challenging clinical situation. A mother with mental illness and mental retardation seeks to retain parental rights and care for her newborn with cystic fibrosis. The nurse provides leadership to the hospital team and serves as an advocate throughout legal proceedings. A systematic, nonjudgmental, and empathic approach to gathering information, working with the family, welfare, and legal representatives is described. Enacting a complex and court-mandated homecare education regimen to the disabled mother is discussed. Preparation to testify in a termination of parental rights proceeding is outlined and a summary description of the testimony provided. PMID:11891494

  9. Partnership for the Advancement of Information Literacy in a Nursing Program

    ERIC Educational Resources Information Center

    Beck, Sheila; Blake-Campbell, Barbara; McKay, Devin

    2012-01-01

    Nursing educators know that healthcare stakeholders expect nursing graduates to be able to manage information. Consequently, many nursing education programs are exploring ways of integrating information literacy across the curriculum not only to bolster evidence-based practice, but also to enhance professional development and encourage lifelong…

  10. Advanced Practice Nursing: Is the Physician's Assistant an Accident of History or a Failure to Act?

    ERIC Educational Resources Information Center

    Christman, Luther

    1998-01-01

    The responses of some nursing organizations regarding the establishment of collaborative relationships in the nursing profession may be responsible for the development of the physician assistant profession. The nursing profession should examine these responses while planning strategies to cope with the current chaos in health care. (JOW)

  11. Mini Review of Integrated Care and Implications for Advanced Practice Nurse Role

    PubMed Central

    McIntosh, Diana; Startsman, Laura F.; Perraud, Suzanne

    2016-01-01

    Literature related to primary care and behavioral health integration initiatives is becoming abundant. The United States’ 2010 Patient Protection and Affordable Care Act included provisions encouraging increased collaboration of care for individuals with behavioral and physical health service needs in the public sector. There is relatively little known of Advanced Practice Registered Nurses’ (APRNs) roles with integrating primary and behavioral healthcare. The goal of this review article is to: (a) define integration of physical and behavioral healthcare and potential models; (b) answer the question as to what are effective evidence based models/strategies for integrating behavioral health and primary care; (c) explore the future role and innovations of APRNs in the integration of physical and behavioral healthcare. Results: The evidence- based literature is limited to three systematic reviews and six randomized controlled trials. It was difficult to generalize the data and the effective integration strategies varied from such interventions as care management to use of sertraline to depression management and to access. There were, though, implications for the integrated care advanced practice nurse to have roles inclusive of competencies, leadership, engagement, collaboration and advocacy. PMID:27347258

  12. Enhancing presentation skills for the advanced practice nurse: strategies for success.

    PubMed

    Vollman, Kathleen M

    2005-01-01

    Professional speaking is a component of the professional practice role of the advanced practice nurse (APN). The skills to communicate effectively to one person or an audience of 100 provide the APN with the essential tools for implementing change, collaborating effectively, presenting information at professional meetings, or communicating the impact of clinical outcomes in the boardroom. Public speaking skills, a professional image, and improved communication can facilitate advancement along any career ladder. The greater your fear, the more self-confidence you will gain by stepping up to a challenge and conquering it. This article describes strategies for organizing and presenting your message in a clear and concise format. Techniques to manage the anxiety produced when attempting to articulate your thoughts is essential for effective communication. Skills for enhancing the delivery of your message through effective body language, professional image, voice modulation, and use of audiovisual aids are addressed. Creative techniques for fielding questions are key in promoting a dynamic closure and provide consistent reinforcement of the key message content. PMID:15714019

  13. The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students.

    PubMed

    Defenbaugh, Nicole; Chikotas, Noreen E

    2016-01-01

    The purpose of this qualitative study was to examine the impact of standardized patient experiences (SPE) in the education of the Advanced Practice Nurse (APN). The education of the APN requires educators to make every attempt to promote competency in the areas of communication and clinical-decision making. SPE programs have been found to improve the interpersonal, problem solving, and critical thinking skills of nursing students. For this research twenty-nine APN students participated in SPEs over the course of two semesters. Fifteen student volunteers of those 29 participants were then interviewed three months after the experience. Results revealed that having an expert in the field of communication studies increased awareness of communication skills and how to improve nurse-patient encounters in the clinical setting. The interprofessional collaboration during the SPEs assisted in facilitating the application of learned communication skills into patient-centered care of the APN student. PMID:26122938

  14. Advancing HIV Nursing Practice: The Doctor of Nursing Practice HIV Specialty at Rutgers, the State University of New Jersey.

    PubMed

    Willard, Suzanne; Nelson, John; Reyes, Darcel; Linn, Annē

    2016-01-01

    The move to integrate HIV treatment and care into primary care is a major obstacle for the current U.S. health care workforce. Many HIV specialty providers will soon retire, while few primary care clinicians have been adequately trained in the diagnosis, care, and treatment of people living with HIV. The Health Resources and Services Administration (HRSA) has supported the development of a Doctor of Nursing Practice (DNP) program with an HIV specialty at Rutgers, the State University of New Jersey, to assure successful transition to an HIV primary care workforce. The Rutgers School of Nursing has been at the forefront of the DNP education movement and is among the first to develop an HIV-focused DNP program. Thirty-seven students have enrolled in the 3-year program, and two have graduated from the first cohort. Here we discuss the planning, implementation, successes, and recommendations of the new program. PMID:27086187

  15. From Nurse to Nurse Anesthetist: The Influence of Age and Gender on Professional Socialization and Career Commitment of Advanced Practice Nurses.

    ERIC Educational Resources Information Center

    Waugaman, Wynne R.; Lohrer, Donna J.

    2000-01-01

    A survey of 1,106 student nurse anesthetists (40% male) showed that increasing age was negatively correlated with socioeconomic rewards. Male gender was positively correlated with administrative/supervisory roles, female gender with holistic patient care. Men achieved socialization more readily in occupational orientation. (SK)

  16. Still spending dollars, still searching for sense: advanced practice nursing in an era of regulatory and economic turmoil.

    PubMed

    Safriet, B J

    1998-01-01

    Regulatory and market forces are dramatically affecting the practice prospects for advanced practice nurses (APNs). Examples include the designation of APNs as primary care providers by for-profit capitated systems, the elimination of "geographic" practice boundaries by the advent of telepractice, and the revision of governmental reimbursement provisions for entire categories of APNs. Educational, political, and economic challenges necessitate an increased APN leadership role in national and state policy reform efforts. PMID:9874960

  17. Computer Literacy Needs of Nurse Educators and Nurse Managers

    PubMed Central

    Arnold, Jean M.; Bauer, Carol A.

    1985-01-01

    A questionnaire was used to survey the computer literacy needs of 445 nurse educators and nurse managers within a northeastern metropolitan area. There are commonalities and differences between nurse educators and nurse managers regarding advanced computer applications; but both groups expressed an urgent need for continuing nursing education courses at the advanced level.

  18. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:25397338

  19. Advanced nurse practitioner-led referral for specialist care and rehabilitation.

    PubMed

    Mashlan, Wendy; Hayes, Julie; Thomas, Ceri

    2016-02-01

    In response to the need for appropriate and timely care of frail older patients admitted to hospital, a dedicated advanced nurse practitioner (ANP)-led referral service was developed. The service has continued to evolve over the 13 years since its implementation in accordance with changing service demands. This article describes the role of the ANP in care of the elderly/rehabilitation medicine and focuses on one area of clinical practice developed by the team: an ANP-led referral service. The aim of developing the service was to ensure that patients who required specialist care and rehabilitation could be identified and assessed as soon as possible after admission, with the premise that they could be transferred to a bed in care of the elderly medical wards. This was perceived by the ANPs to be advantageous for patients, who would receive care from a specialist team, and for care of the elderly staff who could use their knowledge and skills appropriately and safely. PMID:26938608

  20. Advanced Nurse Practitioner Educational Needs for Safe and Efficient Radiological Imaging.

    PubMed

    Logsdon, Roberta; Gleason, Robyn

    2015-01-01

    This study evaluated perceived knowledge and educational preparedness of advanced practice nurses (APNs) in the area of radiological imaging, including awareness and utilization of the American College of Radiology Appropriateness Criteria (ACR-AC). Previous studies have found a need for further education in radiological imaging for medical students, residents, and hospitalists; however, little to no research has been done to assess such knowledge and educational preparedness among APNs. An e-mail link to a researcher-developed questionnaire was sent to Florida licensed APNs. Statistical analysis used descriptive, parametric, and nonparametric methods including frequencies, percentages, and Mann-Whitney U statistics. Florida licensed APNs (n = 905) from 175 educational programs and 10 specialty areas responded to the questionnaire; 75.9% (n = 681) had never heard of the ACR-AC. Years of experience and training in acute care specialties increased perceived competency in ordering radiological tests. Results among APNs were similar to those reported from physician studies, and 92.3% of respondents (n = 829) stated that additional APN imaging education would be beneficial. These findings highlight the importance of incorporating more radiological imaging information into APN education, which could lead to a reduction in overall costs and improvement in perceived competence and knowledge of appropriate imaging utilization. PMID:26218489

  1. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2011-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families. PMID:21808173

  2. Maternal and Neonatal Care. Teacher Edition.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This curriculum guide contains the materials required to teach a course in maternal and neonatal care that will prepare students for employment as practical nurses. The course's five instructional units cover procedures for caring for the following: prenatal patients, patients in labor and delivery, postpartum patients, healthy neonates, and…

  3. Status of Neonatal Pain Assessment and Management in Jordan.

    PubMed

    Abdel Razeq, Nadin M; Akuma, Akuma O; Jordan, Sue

    2016-08-01

    Current pain assessment and management in neonates need to be fully described before neonatal pain care can be optimized. This study's purpose was to report neonatal nurses' knowledge, existing pain assessment practice, and pharmacological pain management of neonates in Jordan. A cross-sectional descriptive study was conducted. Eighteen neonatal intensive care units in Jordan were included in the study. One hundred eighty-four neonatal nurses participated. Questionnaires were distributed by and returned to the neonatal intensive care units' managers between June and August 2014. Descriptive and inferential statistics were used to present study results. Of 240 questionnaires distributed, 184 useable responses were returned. Nurses' knowledge regarding neonates' neurological development, nociception, and need for neonatal pain management was suboptimal. The analgesics most commonly used to treat neonatal pain were acetaminophen (52%) and lidocaine (45%). Benzodiazepines, phenobarbitone, and muscles relaxants were also used. Most nurses (54%-97%) reported that pain emanating from most painful procedures was never or rarely treated. Circumcision, lumbar punctures, and chest tube insertion were assigned the highest pain scores (≥9), but were rarely accompanied by analgesia. Pain assessment scales were more likely to be used, and procedural pain was more likely to be treated, in private hospitals than public hospitals. Neonates who require special care still suffer unnecessary pain that could be avoided and managed by following best practice recommendations. Disparities between developed and developing countries in quality of neonatal pain care appear to exist. Resources for education and routine care are needed to address these discrepancies. PMID:27108085

  4. Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

    PubMed

    Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

    2014-07-01

    Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs. PMID:24814999

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

    PubMed

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

    2015-01-01

    National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. PMID:25284433

  6. Conceptualizing Telehealth in Nursing Practice: Advancing a Conceptual Model to Fill a Virtual Gap.

    PubMed

    Nagel, Daniel A; Penner, Jamie L

    2016-03-01

    Increasingly nurses use various telehealth technologies to deliver health care services; however, there has been a lag in research and generation of empirical knowledge to support nursing practice in this expanding field. One challenge to generating knowledge is a gap in development of a comprehensive conceptual model or theoretical framework to illustrate relationships of concepts and phenomena inherent to adoption of a broad range of telehealth technologies to holistic nursing practice. A review of the literature revealed eight published conceptual models, theoretical frameworks, or similar entities applicable to nursing practice. Many of these models focus exclusively on use of telephones and four were generated from qualitative studies, but none comprehensively reflect complexities of bridging nursing process and elements of nursing practice into use of telehealth. The purpose of this article is to present a review of existing conceptual models and frameworks, discuss predominant themes and features of these models, and present a comprehensive conceptual model for telehealth nursing practice synthesized from this literature for consideration and further development. This conceptual model illustrates characteristics of, and relationships between, dimensions of telehealth practice to guide research and knowledge development in provision of holistic person-centered care delivery to individuals by nurses through telehealth technologies. PMID:25858897

  7. Healthcare Proxy Awareness of Suspected Infections Among Nursing Home Residents with Advanced Dementia

    PubMed Central

    Givens, Jane L.; Spinella, Sara; Ankuda, Claire K.; D’Agata, Erika; Shaffer, Michele L.; Habtemariam, Daniel; Mitchell, Susan L.

    2015-01-01

    Background Infections are common in advanced dementia. Little is known about healthcare proxy involvement in decision making regarding infections. Design Prospective cohort study Setting/Participants 362 nursing home (NH) residents with advanced dementia and their proxies in 35 Boston-area facilities. Measurements Charts were abstracted monthly (up to 12 months) for documentation of suspected infections and provider/proxy discussions for each episode. Proxies were interviewed within 8 weeks of the infection to determine their awareness and decision-making involvement. Factors associated with proxy awareness and discussion documentation were identified. Results There were 496 suspected infections; proxies were reached for interview for 395 (80%). Proxy/provider discussions were documented for 207/395 episodes (52%), yet proxies were aware of only 156/395 (39%). Proxies participated in decision-making for 89/156 (57%) episodes of which they were aware. Proxy awareness was associated with antimicrobial use (adjusted odds ratio (AOR) 3.43, 95% confidence interval (CI) 1.94–6.05), hospital transfer (AOR 3.00, 95% CI 1.19–7.53), infection occurrence within 30 days of death (AOR 3.32, 95% CI 1.54–7.18) and fewer days between infection and study interview (AOR 2.71, 95% CI 1.63–4.51). Discussion documentation was associated with the resident residing in a dementia special care unit (AOR 1.71, 95% CI 1.04–2.80), not on hospice (AOR 3.25, 95% CI 1.31–8.02), more provider visits (AOR 1.71, 95% CI 1.07–2.75), proxy visits > 7 hours/week (AOR 1.93, 95% CI 1.02–3.67), and episode within 30 days of death (AOR 3.99, 95% CI 1.98–8.02). Conclusion Proxies are unaware of and do not participate in decision-making for most suspected infections experienced by NH residents with advanced dementia. Proxy awareness of episodes and documentation of provider/proxy discussions are not congruent. PMID:26031905

  8. Neonatal sepsis

    MedlinePlus

    ... BE. Perinatal viral infections. In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal ... K. Postnatal bacterial infections. In Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal ...

  9. Nursing informatics: the future now.

    PubMed

    Mamta

    2014-01-01

    Technological advancements in the health care field have always impacted the health care practices. Nursing practice has also been greatly influenced by the technology. In the recent years, use of information technology including computers, handheld digital devices, internet has advanced the nursing by bridging the gap from nursing as an art to nursing as science. In every sphere of nursing practice, nursing research, nursing education and nursing informatics play a very important role. If used properly it is a way to save time, helping to provide quality nursing care and increases the proficiency of nursing personnel. PMID:25924417

  10. Advance directives and nursing home stays associated with less aggressive end-of-life care for patients with severe dementia.

    PubMed

    Nicholas, Lauren H; Bynum, Julie P W; Iwashyna, Theodore J; Weir, David R; Langa, Kenneth M

    2014-04-01

    The number of older adults with cognitive impairment is increasing, and such adults often require a surrogate to make decisions about health care. However, little is known about the aggressiveness of end-of-life care for these people, especially those who reside in the community. We found that cognitive impairment is common among older adults approaching the end of life, whether they live in the community or in a nursing home, and that nearly 30 percent of patients with severe dementia remained in the community until death. Among those patients, having an advance directive in the form of a living will was associated with significantly less aggressive care at the end of life, compared to similar patients without an advance directive-as measured by Medicare spending ($11,461 less per patient), likelihood of in-hospital death (17.9 percentage points lower), and use of the intensive care unit (9.4 percentage points lower). In contrast, advance directives were not associated with differences in care for people with normal cognition or mild dementia, whether they resided in the community or in a nursing home. Timely advance care planning after a diagnosis of cognitive impairment may be particularly important for older adults who reside in the community. PMID:24711329

  11. Type 2 diabetes, genomics, and nursing: necessary next steps to advance the science into improved, personalized care.

    PubMed

    Underwood, Patricia C

    2011-01-01

    Type 2 diabetes mellitus (T2DM) is an inherited, chronic disorder with long-term complications; including cardiovascular disease the leading cause of mortality in the United States. The prevalence of T2DM and its complications are on the rise in the United States, highlighting the need for improved individualized prevention and treatment strategies. Exciting advancements in the field of genomics has led to the recent discovery of numerous genetic markers for T2DM; completing a promising first step toward improved, individualized prevention and treatment strategies for T2DM. These genomic markers, identified using genome-wide association studies (GWAS), candidate gene, and rare variant methodology, identify new physiologic pathways underlying the development of T2DM. Much more work is needed to successfully translate the identification of genetic markers for T2DM into improved, individualized prevention and treatment strategies. As front line providers and leaders of prevention and treatment strategies for chronic disease, nurses, nurse practitioners, and nurse scientists must contribute to this translational effort. Thus, it is important for nurses at all levels to (a) be aware of the current science of genetics and T2DM and (b) participate in the translation of this genetic information into improved, personalized patient care. The aim of this review is to (a) provide an overview of the current state of the science of genetic markers and T2DM and (b) highlight essential next steps to successfully translate the identification of genetic markers for T2DM into improved prevention and treatment strategies; focusing particularly on the role of nursing in this process. PMID:22891509

  12. Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries.

    PubMed

    Coffey, Alice; McCarthy, Geraldine; Weathers, Elizabeth; Friedman, M Isabel; Gallo, Katherine; Ehrenfeld, Mally; Chan, Sophia; Li, William H C; Poletti, Piera; Zanotti, Renzo; Molloy, D William; McGlade, Ciara; Fitzpatrick, Joyce J; Itzhaki, Michal

    2016-06-01

    Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care. PMID:26823112

  13. The Integration of Research by Nurse Educators: Advancing Practice through Professional Development Programs.

    ERIC Educational Resources Information Center

    Waddell, Janice; Durrant, Michele; Avery, Shirley

    1999-01-01

    A nurse preceptorship program used narrative to help participants explore the complexity of pediatric clinical practice. Through narratives they shared clinical decision making, knowledge, and skills, transforming knowing into story telling into learning. (SK)

  14. Nursing and philanthropy: a partnership to advance professional excellence and exceptional care.

    PubMed

    Janney, Michelle A

    2014-01-01

    Michelle A. Janney, PhD, RN, NEA-BC, 2013 AONE President, Senior Vice President, and Wood-Prince Family Chief Nurse Executive at Northwestern Memorial Hospital, discusses the impact of engaging institutional leadership in nursing philanthropic and strategic priorities and the importance of developing a culture of philanthropy that permeates the organization and encourages participation from all levels. The article highlights key outcomes of Northwestern Memorial Hospital's collective efforts to build a culture of philanthropy that prioritizes nursing as consequential to the mission of the organization. The outcomes demonstrate how such a culture provides a critical platform for creating opportunities that enable nurses to be indispensable partners in a shared commitment to the highest-quality, scientifically driven, personalized care. PMID:25208145

  15. Advancing medical-surgical nursing practice: improving management of the changing patient condition.

    PubMed

    Monroe, Heidi; Plylar, Peggy; Krugman, Mary

    2014-01-01

    Higher patient acuities and more novice nurses on medical-surgical units have Educators focused on achieving positive outcomes with changes in patient condition. An educational program was developed to enhance nurses' knowledge, skill, and confidence in assessing hemodynamics, recognizing early signs of instability, and administering vasoactive medications. The program was successful with significant knowledge improvement as well as an increased use of the Medical Emergency Team while maintaining a low number of code calls. PMID:25407973

  16. Advance care planning for nursing home residents with dementia: policy vs. practice.

    PubMed

    2016-05-27

    Despite the potential benefits of ACP for nursing home residents with dementia, the authors of this study highlight that hardly any research has focused on the involvement of residents/families in ACP and that ACP is rarely realised for these people. Their research aimed to evaluate the ACP policy for people with dementia in nursing homes and to gain insight into the involvement of residents with dementia and their families in ACP. PMID:27231078

  17. Implementing computer-based testing in distance education for advanced practice nurses: lessons learned.

    PubMed

    Caudle, Patricia; Bigness, Joanne; Daniels, Judi; Gillmor-Kahn, Mickey; Knestrick, Joyce

    2011-01-01

    A distance education program utilized by graduate nursing students worldwide faces unique problems with testing. This article presents the results of a pilot study on the implementation of computer-based testing at the Frontier Nursing University. A detailed analysis of the evaluative survey completed by students in the pilot study revealed issues of hi-directional respect and trust between faculty and students and technological anxiety among students using computer-based testing. PMID:22029246

  18. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital

    PubMed Central

    Aberese-Ako, Matilda; Agyepong, Irene Akua; Gerrits, Trudie; Van Dijk, Han

    2015-01-01

    Background and Objectives This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethics Statement Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned. Results Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients. Conclusion To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers

  19. Evidence for best practices in the neonatal period.

    PubMed

    Beal, Judy A

    2005-01-01

    The purpose of this article is to provide a review of current nursing research that supports best practices during the newborn period. The literature review of peer-reviewed research articles published between January 2000 and October 2004 was conducted via keyword searches using the databases of the Cochrane Library, CINAHL, and MEDLINE. Key words included neonatal nursing, newborn, neonate, premature infant, preterm infant, and low birthweight. Content analysis revealed the following primary categories of studies that provide solid evidence for nursing practice: developmentally focused nursing care, neonatal skin care, feeding, skin-to-skin care, and pain management. Neonatal nurse researchers have made many important contributions to the research literature. Future research should expand the findings to date on the effective use of pain scales, the outcomes of skin-to-skin care and infant massage as standard practice for all neonates, and the effectiveness of nursing interventions to support the developmental sequelae of prematurity. Neonatal nurses should become familiar with and implement those findings from nursing research that strongly support evidence-based nursing practice. PMID:16260945

  20. Meaningful Use of Data in Care Coordination by the Advanced Practice Registered Nurse: The TeleFamilies Project

    PubMed Central

    Looman, Wendy S.; Erickson, Mary M.; Garwick, Ann W.; Cady, Rhonda G.; Kelly, Anne; Pettey, Carrie; Finkelstein, Stanley M.

    2012-01-01

    Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special health care needs. The purpose of this paper is to present a conceptual framework and example of meaningful use within an innovative telenursing intervention to coordinate care for children with complex special health care needs. The TeleFamilies intervention engages an advanced practice nurse in a full-time care coordinator role within an existing hospital-based medical home for children with complex special health care needs. Care coordination is facilitated by the synthesis and integration of internal and external data using an enhanced electronic health record and telehealth encounters via telephone and videoconferencing between the advanced practice nurse and the family at home. The advanced practice nurse’s ability to maintain an updated plan of care that is shared across providers and systems and build a relationship over time with the patient and family supports meaningful use of these data. PMID:22948406

  1. A new neurological focus in neonatal intensive care.

    PubMed

    Bonifacio, Sonia L; Glass, Hannah C; Peloquin, Susan; Ferriero, Donna M

    2011-09-01

    Advances in the care of high-risk newborn babies have contributed to reduced mortality rates for premature and term births, but the surviving neonates often have increased neurological morbidity. Therapies aimed at reducing the neurological sequelae of birth asphyxia at term have brought hypothermia treatment into the realm of standard care. However, this therapy does not provide complete protection from neurological complications and a need to develop adjunctive therapies for improved neurological outcomes remains. In addition, the care of neurologically impaired neonates, regardless of their gestational age, clearly requires a focused approach to avoid further injury to the brain and to optimize the neurodevelopmental status of the newborn baby at discharge from hospital. This focused approach includes, but is not limited to, monitoring of the patient's brain with amplitude-integrated and continuous video EEG, prevention of infection, developmentally appropriate care, and family support. Provision of dedicated neurocritical care to newborn babies requires a collaborative effort between neonatologists and neurologists, training in neonatal neurology for nurses and future generations of care providers, and the recognition that common neonatal medical problems and intensive care have an effect on the developing brain. PMID:21808297

  2. The Development of Evidence Briefs to Transfer Knowledge About Advanced Practice Nursing Roles to Providers, Policymakers and Administrators.

    PubMed

    Kilpatrick, Kelley; Carter, Nancy; Bryant-Lukosius, Denise; Charbonneau-Smith, Renee; DiCenso, Alba

    2015-03-01

    The transfer of health-related research knowledge between producers and users is a complex, dynamic and iterative process. There has been little research describing the preferred knowledge transfer strategies used by different stakeholder groups, including healthcare providers, policymakers and administrators. The purpose of the survey was to gain an understanding of the content and preferred dissemination strategies of knowledge users of briefing notes about the effectiveness of advanced practice nursing (APN) roles in Canada. An on-line cross-sectional survey was conducted from December 2011 to January 2012. Purposeful sampling was used to identify the target audience. The questionnaire included six items. The response rate was 44% (n=75/170). Participants identified that the briefing note should concisely summarize definitions for APN roles and information about the safety, effectiveness, cost savings and effective role implementation strategies. Multiple approaches were favoured to disseminate the information. Preferred dissemination strategies included personalized emails, meeting with briefing note recipients, engaging nurse practitioners and clinical nurse specialists in organizations where APN roles have been successfully implemented, engaging the media and using social media. The use of briefing notes has shown promise. More research is needed to evaluate the effectiveness of tailored briefing notes. PMID:26154117

  3. Promoting Excellence in End-of-Life Care: lessons learned from a cohort of nursing home residents with advanced Huntington disease.

    PubMed

    Dellefield, Mary E; Ferrini, Rebecca

    2011-08-01

    Huntington disease (HD) is a genetic neurodegenerative disorder that progresses over decades and is ultimately terminal. As HD advances, patients are frequently placed in institutional care settings, including nursing homes and hospices where family, nursing staff, and interdisciplinary team members are challenged to help patients live to their highest potential and die with dignity. Edgemoor, a distinct part of the San Diego County Psychiatric Hospital, is a regional referral facility for patients with HD. Over the past 8 years, we have cared for 53 patients with advanced HD and describe our experiences by presenting their demographic characteristics and the lessons we have learned in caring for them. Ultimately, we found that the Robert Wood Johnson Foundation's Promoting Excellence in End-of-Life Care Initiative provided a meaningful framework for setting clinical priorities. This framework is used to summarize the clinical lessons that nursing staff and interdisciplinary team members learned about caring well for institutionalized individuals with advanced HD. PMID:21796039

  4. Advanced Practice Registered Nurses and Physician Assistants in Sleep Centers and Clinics: A Survey of Current Roles and Educational Background

    PubMed Central

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

    2014-01-01

    Study Objectives: To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Methods: Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Results: Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through “on the job” training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. Conclusions: APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap. Citation: Colvin L, Cartwright Ann, Collop N, Freedman N, McLeod D, Weaver TE, Rogers AE. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background. J Clin Sleep Med 2014;10(5):581-587. PMID:24812545

  5. Multi-center development and testing of a simulation-based cardiovascular assessment curriculum for advanced practice nurses.

    PubMed

    Jeffries, Pamela R; Beach, Michael; Decker, Sharon I; Dlugasch, Lucie; Groom, Jeffrey; Settles, Julie; O'Donnell, John M

    2011-01-01

    Cardiovascular assessment skills are deficient among advanced practice nursing students, and effective instructional methods to improve assessment skills are needed. The purpose of this study was to develop, implement, and evaluate outcomes of a cardiovascular assessment curriculum for advanced practice nurses at four institutions. Each institution used a one-group pre-to-post-intervention design. Educational interventions included faculty-led, simulation-based case presentations using the Harvey cardiopulmonary patient simulator (CPS), and independent learning sessions using the CPS and a multimedia, computer-based CD-ROM program. Outcome measures included a 31-item cognitive written exam, a 13-item skills checklist used in each of a three-station objective structured clinical exam, learner self-efficacy and satisfaction survey, instructor satisfaction and self-efficacy survey, and a participant logbook to record practice time using the self-learning materials. Thirty-six students who received the simulation-based training showed statistically significant pre-to-post-test improvement in cognitive knowledge and cardiovascular assessment skills. PMID:22029244

  6. Evaluation of the Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Evans, Lois K.; Swan, Beth Ann; Lang, Norma E.

    2003-01-01

    In the Penn Macy Initiative, 21 nursing schools participated in summer institutes and follow-up consultations to refine practice. Evaluation data from participants' daily and postinstitute feedback, institutional self-evaluations, and comparison of school accomplishments identified critical indicators of progress in academic practice. A key…

  7. Pediatric Endocrinology Nurses Society

    MedlinePlus

    ... International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement ... PENS@kellencompany.com • Copyright © 2016 Pediatric Endocrinology Nursing Society • ALL RIGHTS RESERVED • Privacy Policy • Admin

  8. Certified nurse-midwife

    MedlinePlus

    ... laws. As with other advanced practice nurses, license requirements for CNMs can vary from state to state. ... national organization and all states have the same requirements for professional practice standards. Only graduates of nurse- ...

  9. Professional Behavior in Nursing.

    PubMed

    Kowalski, Karren

    2016-04-01

    Being clear about what constitutes professional behavior is a pathway to effective leadership. Not all nurses come out of educational programs with an understanding about what aspects of behavior signal true professionalism. This article uses the American Organization of Nurse Executives' Nurse Executive Competency for Processional Behavior to help professional development nurse faculty identify role modeling behavior and other aspects that new nurses can use to help them advance in their careers, while improving care to patients and families. PMID:27031029

  10. Neonatal euthanasia.

    PubMed

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate. PMID:19914522

  11. Lactational passage of fusaric acid from the feed of nursing dams to the neonate rat and effects on pineal neurochemistry in the F1 and F2 generations at weaning.

    PubMed

    Porter, J K; Wray, E M; Rimando, A M; Stancel, P C; Bacon, C W; Voss, K A

    1996-10-11

    200 ppm F2 pups. At weaning, no differences were observed in neurochemicals in the pineal gland for the F1 generation. However, in the F2 200 ppm male and female weanlings, fusaric acid decreased pineal serotonin (males, p < or = .001; females, p < or = .15) and tyrosine (males, p < or = .04; females, p < or = .07). The results indicate fusaric acid in diets at < or = 0.3 ppm (i.e., background control diet) lactationally passes from nursing dams to the neonate; in weanlings, at 200 ppm, fusaric acid decreases pineal serotonin and tyrosine. The data also suggest limited neonate weight gains may be related to either decreased milk production in dams or mycotoxin effects on the neonate. This is the first report of fusaric acid's lactational passage from the feed of nursing dams to neonates and the oral suppression of pineal serotonin and tyrosine in offspring. PMID:8874534

  12. Neonatal records and the computer.

    PubMed Central

    Walker, C H

    1977-01-01

    To use a combined single document clinical case sheet/computer record which can form the basic document for a life medical record is a practical proposition. With adequate briefing doctors and nurses soon become familiar with the record and appreciate its value. Secretarial and clerical requirements are reduced to a minimum as transcription of medical data is eliminated, so greatly speeding up processing and feed back to the medical services. A few illustrations of trends in neonatal statistics and of computer linked maternal/neonatal data are presented. PMID:879830

  13. [Treatment of neonatal hyperbilirubinemia

    PubMed

    Carvalho, M D

    2001-07-01

    OBJECTIVE: To review the recent medical literature on the treatment of neonatal jaundice, focusing on practical aspects that are relevant to pediatricians and neonatologists. SOURCES: An extensive review of the related literature was performed, also including the authors clinical experience in this field of investigation. SUMMARY OF THE FINDINGS: Jaundice is very common among infants during the first days of life. Several factors such as maternal and neonatal history have to be considered before implementing treatment. Significant advances have been made in the past few years concerning the treatment of jaundiced newborn infants. This review focuses on three forms of treatment of neonatal hyperbilirubinemia: phototherapy, exchange transfusion and the use of drugs to reduce serum bilirubin concentration. CONCLUSIONS: Nowadays, the in-depth knowledge about the mechanism of action of phototherapy, the development of intensified phototherapy units and the use of drugs to reduce bilirubin formation, have contributed to significantly decrease the need for exchange transfusion. PMID:14676895

  14. The role of the nurse in advanced practice in bereavement care.

    PubMed

    Glass, B C

    1993-03-01

    The CNS may be instrumental in assisting patients, families, and staff in dealing effectively with loss and grief. This paper presents a review of theoretical and research literature examining theories and current research on grief. Physical and emotional responses to loss are discussed, and factors that influence the bereavement process are presented. The role of the CNS in facilitating grief resolution and in assisting the staff nurse to intervene appropriately with the bereaved is examined. PMID:8364832

  15. Using an academic-community partnership model and blended learning to advance community health nursing pedagogy.

    PubMed

    Ezeonwu, Mabel; Berkowitz, Bobbie; Vlasses, Frances R

    2014-01-01

    This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery. PMID:24720659

  16. Maternal periodontal disease, pregnancy, and neonatal outcomes.

    PubMed

    Dasanayake, Ananda P; Gennaro, Susan; Hendricks-Muñoz, Karen D; Chhun, Nok

    2008-01-01

    The purpose of this article is to review the current literature on the association between maternal periodontal disease and poor pregnancy and neonatal outcomes and outline the role nurses can play in improving the oral health of pregnant women. Maternal periodontal disease is linked to preterm birth, low birthweight, and preterm low birthweight, but treatment of periodontal disease during pregnancy has been shown to be safe and effective. Nurses, nurse practitioners, and nurse-midwives are in a position to educate pregnant women on the benefits of good oral health and identify and refer women who are in need of dental care for treatment. PMID:18158527

  17. Cardiovascular nursing in Israel.

    PubMed

    Blaer, Yosef; Rosenberg, Orit; Reisin, Leonardo

    2003-01-01

    Cardiovascular (CV) nursing as an entity in Israel dates back to 1952, when the nurses in Tel-Hashomer hospital took care of postoperative heart surgery patients. The first intensive cardiac care units (ICCUs) were established in 1971. In 1982, the first ICCU course was established in Tel-Hashomer hospital nursing school. Today, most of the nursing staff in Israels ICCUs are graduates of ICCU courses. The nurses professional society, the Society for Nursing of Israel, was established in 1947. In 1989 the Society for Advancement of Cardiac Nursing in Israel (SACN) was established. The main goals of the society were: the exchange of CV nursing knowledge, CV nursing research, CV nursing education in nursing schools, education of nurses in other departments in the care of the cardiac patient, and CV nursing education in the community. The CV nurse takes a large role in the total care of the cardiac patient, which includes rehabilitation within the hospital and in the ambulatory setting and coordination of nursing in national and international multicenter clinical trials. In collaboration with the Ministry of Health Nursing Division, Israeli CV nurses participate in national and international projects to: develop and upgrade nursing education; train new CV nurses; develop, review, and revise nursing protocols and guidelines; and establish new, more advanced ICCUs in underdeveloped areas within Israel and around the world. Our vision for the future development of CV nursing in Israel includes coordination and management roles in the hospital setting, and the establishment and management of home-care programs. PMID:12624572

  18. Neonatal hypotonia.

    PubMed

    Sparks, Susan E

    2015-06-01

    Neonatal hypotonia is a common problem in the neonatal intensive care unit. The genetic differential diagnosis is broad, encompassing primary muscular dystrophies, chromosome abnormalities, neuropathies, and inborn errors of metabolism. Recognition of hypotonia is relatively straightforward, but determining the cause can be challenging. It is important for the neonatologist to have an organized approach to the assessment of neonatal hypotonia. Physical examination and history alongside basic laboratory testing and imaging aid in the differential diagnosis. Identification of the cause is essential for determining prognosis, associated morbidities, and recurrence risk. The prevailing therapeutic modality is physical, occupational, speech/feeding, and respiratory therapy. PMID:26042909

  19. The intention of advanced practice registered nurses to remain in positions at family planning clinics serving low-income women.

    PubMed

    Cheng, An-Lin; Kelly, Patricia J; Carlson, Kimberly; Witt, Jacki

    2014-01-01

    Federally funded Title X Family Planning Clinics are critical safety nets for reproductive health services in which advanced practice nurses (APRNs) provide the majority of care. The goal of this study was to identify factors affecting APRN's intention to remain in positions at these clinics. An Internet-administered survey was completed by 406 APRNs working in Title X clinics. The survey, based on a causal model of retention adapted for APRN practice, included 10 factors. Factor significance and model selection criteria were used to determine model fit. Intention to remain in current positions was associated with greater family responsibilities and lower levels of involvement in professional associations. Less routinization, more integration, and a greater sense of distributive justice were significant causal paths to job satisfaction (a significant mediator for intention to remain). Results provide Title X administrators information that can guide them in policy development to maximize APRN retention. PMID:24503318

  20. Considerations for design of an e-learning program augmenting advanced geriatric nurse practitioner's clinical skills training.

    PubMed

    Rostad, Hanne M; Grov, Ellen Karine; Moen, Anne

    2014-01-01

    E-learning programs offer learners flexibility, more control over their learning experience, possibilities for repetition and allows for learning to be more individualized compared to traditional teaching methods. This paper presents considerations for an interdisciplinary project to design an e-learning program for graduate students enrolled in a master's program in Advanced Geriatric Nursing. The e-learning program offers new opportunities for learners to apply theoretical knowledge and develop their skills in the process of collaborative knowledge creation. A model based on the systematic development of instruction and learning and a pedagogical framework for e-learning has guided the design process. This paper explains how the e-learning program was created and how content was developed and implemented in an e-learning environment. PMID:24943556

  1. Neonatal conjunctivitis

    MedlinePlus

    Newborn conjunctivitis; Conjunctivitis of the newborn; Ophthalmia neonatorum; Eye infection - neonatal conjunctivitis ... diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into ...

  2. Neonatal Death

    MedlinePlus

    ... story First Candle Centering Corporation The Compassionate Friends Star Legacy Foundation Last reviewed: November, 2015 Neonatal death ... story First Candle Centering Corporation The Compassionate Friends Star Legacy Foundation Last reviewed: November, 2015 Complications & Loss ...

  3. Neonatal sepsis

    MedlinePlus

    ... and some strains of streptococcus. Group B streptococcus (GBS) has been a major cause of neonatal sepsis. ... an infant's risk of early-onset bacterial sepsis: GBS colonization during pregnancy Preterm delivery Water breaking (rupture ...

  4. Treatment strategies for acute metabolic disorders in neonates

    PubMed Central

    Mohamed, Sarar

    2011-01-01

    Acute metabolic emergencies in neonates represent a challenge to the medical and nursing staff. If not treated optimally, these disorders are associated with poor outcome. Early diagnosis, supportive therapy and specific measures addressing the derranged metabolic process are the gold standards for favorable results. This review highlights treatment strategies for Inborn Errors of Metabolism (IEM) presenting in the neonatal period.

  5. Difficult-to-manage HIV/AIDS clients with psychiatric illness and substance abuse problems: a collaborative practice with psychiatric advanced practice nurses.

    PubMed

    Morgan, Betty D; Rossi, Anne P

    2007-01-01

    Complex clients with comorbid HIV disease, other medical illness, psychiatric illness, and substance abuse problems present tremendous challenges to providers. Medication adherence and case management become vital issues in providing comprehensive care to this population. This report describes the practice of two advanced practice psychiatric registered nurses who worked collaboratively with each other and with nurse practitioners to provide care to such complex clients. Description of collaborative practices and the model of collaboration used by the two practitioners are highlighted through three case studies. Conclusions about the practice and its use with complex clients are provided. PMID:17991601

  6. Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments: United States, 2008-2009

    MedlinePlus

    ... Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard Technical Notes Other Publications Advance Data From Vital and ... Vital Statistics of the United States: 1890-1938 Technical Appendices Miscellaneous Publications National Conference on Health Statistics ...

  7. Neonatal pain

    PubMed Central

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  8. Nursing and Professionalization: On the Road to Recovery.

    ERIC Educational Resources Information Center

    Rosenfeld, Peri

    1986-01-01

    The author discusses features that define a profession, barriers to high status for nurses, nursing as a traditionally female occupation, and nurses' responsibility to advance nursing as a profession. (CT)

  9. “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area

    PubMed Central

    Devik, Siri Andreassen; Hellzen, Ove; Enmarker, Ingela

    2015-01-01

    Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context. PMID:26362533

  10. "Picking up the pieces" - Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area.

    PubMed

    Devik, Siri Andreassen; Hellzen, Ove; Enmarker, Ingela

    2015-01-01

    Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients' strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context. PMID:26362533

  11. Neonatal transfusion.

    PubMed

    Kelly, Anne M; Williamson, Lorna M

    2013-11-01

    Neonates and particularly preterm neonates are frequent recipients of large volumes of blood products relative to their size. Good quality evidence for transfusion practice in this patient group has been lacking but is now increasing. Triggers for red cell transfusion are now better defined, with on-going trials of platelet transfusions likely to yield similar evidence. Transfusion is now extremely safe, but complications such as transfusion associated acute lung injury (TRALI) and transfusion associated circulatory overload (TACO) are likely to be under recognised, particularly in the sick extremely preterm neonate with respiratory symptoms. This review summarises the rationale and current practice with regard to blood component therapy. Background data on component specifications and hazards of transfusion are provided. Indications for transfusion of specific products including red cells, platelets, and plasma are discussed, and their use is illustrated by case examples. PMID:24095206

  12. Neonatal Stridor

    PubMed Central

    Daniel, Matija; Cheng, Alan

    2012-01-01

    Neonatal stridor is an important condition, in many cases implying an impending disaster with a very compromised airway. It is a sign that has to be considered with the rest of the history and examination findings, and appropriate investigations should then be undertaken to confirm the source of the noise. Neonates with stridor should be managed in a multidisciplinary setting, by clinicians familiar with the intricate physiology of these children, and with access to the multitude of medical and surgical investigative and therapeutic options required to provide first-rate care. PMID:22235209

  13. Considerations for emergencies & disasters in the neonatal intensive care unit.

    PubMed

    Schultz, Ronni; Pouletsos, Cheryl; Combs, Adriann

    2008-01-01

    This article outlines outside principles of emergency and disaster planning for neonatal intensive care units and includes resources available to organizations to support planning and education, and considerations for nurses developing hospital-specific neonatal intensive care unit disaster plans. Hospital disaster preparedness programs and unit-specific policies and procedures are essential in facilitating an effective response to major incidents or disasters, whether they are man-made or natural. All disasters place extraordinary stress on existing resources, systems, and personnel. If nurses in neonatal intensive care units work collaboratively to identify essential services in disasters, the result could be safer care for vulnerable patients. PMID:18664900

  14. Teamwork in the Neonatal Intensive Care Unit

    ERIC Educational Resources Information Center

    Barbosa, Vanessa Maziero

    2013-01-01

    Medical and technological advances in neonatology have prompted the initiation and expansion of developmentally supportive services for newborns and have incorporated rehabilitation professionals into the neonatal intensive care unit (NICU) multidisciplinary team. Availability of therapists specialized in the care of neonates, the roles of…

  15. [Recommendations for neonatal transport].

    PubMed

    Moreno Hernando, J; Thió Lluch, M; Salguero García, E; Rite Gracia, S; Fernández Lorenzo, J R; Echaniz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Sánchez Luna, M

    2013-08-01

    During pregnancy, it is not always possible to identify maternal or foetal risk factors. Infants requiring specialised medical care are not always born in centres providing intensive care and will need to be transferred to a referral centre where intensive care can be provided. Therefore Neonatal Transport needs to be considered as part of the organisation of perinatal health care. The aim of Neonatal Transport is to transfer a newborn infant requiring intensive care to a centre where specialised resources and experience can be provided for the appropriate assessment and continuing treatment of a sick newborn infant. Intrauterine transfer is the ideal mode of transport when the birth of an infant with risk factors is diagnosed. Unfortunately, not all problems can be detected in advance with enough time to safely transfer a pregnant woman. Around 30- 50% of risk factors will be diagnosed during labour or soon after birth. Therefore, it is important to have the knowledge and resources to resuscitate and stabilise a newborn infant, as well as a specialised neonatal transport system. With this specialised transport it is possible to transfer newly born infants with the same level of care that they would receive if they had been born in a referral hospital, without increasing their risks or affecting the wellbeing of the newborn. The Standards Committee of the Spanish Society of Neonatology reviewed and updated recommendations for intrauterine transport and indications for neonatal transfer. They also reviewed organisational and logistic factors involved with performing neonatal transport. The Committee review included the type of personnel who should be involved; communication between referral and receiving hospitals; documentation; mode of transport; equipment to stabilise newly born infants; management during transfer, and admission at the referral hospital. PMID:23434016

  16. Regulatory Advances in 11 Sub-Saharan Countries in Year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC).

    PubMed

    Dynes, Michelle; Tison, Laura; Johnson, Carla; Verani, Andre; Zuber, Alexandra; Riley, Patricia L

    2016-01-01

    Sub-Saharan Africa carries the greatest burden of the HIV pandemic. Enhancing the supply and use of human resources through policy and regulatory reform is a key action needed to improve the quality of HIV services in this region. In year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC), a President's Emergency Plan for AIDS Relief initiative, 11 country teams of nursing and midwifery leaders ("Quads") received small grants to carry out regulatory improvement projects. Four countries advanced a full stage on the Regulatory Function Framework (RFF), a staged capability maturity model used to evaluate progress in key regulatory functions. While the remaining countries did not advance a full stage on the RFF, important gains were noted. The year-3 evaluation highlighted limitations of the ARC evaluation strategy to capture nuanced progress and provided insight into how the RFF might be adapted for future use. PMID:27086189

  17. Regulatory Advances in 11 Sub-Saharan Countries in Year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC)

    PubMed Central

    Dynes, Michelle; Tison, Laura; Johnson, Carla; Verani, Andre; Zuber, Alexandra; Riley, Patricia L.

    2016-01-01

    Sub-Saharan Africa carries the greatest burden of the HIV pandemic. Enhancing the supply and use of human resources through policy and regulatory reform is a key action needed to improve the quality of HIV services in this region. In year 3 of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC), a President’s Emergency Plan for AIDS Relief initiative, 11 country teams of nursing and midwifery leaders (“Quads”) received small grants to carry out regulatory improvement projects. Four countries advanced a full stage on the Regulatory Function Framework (RFF), a staged capability maturity model used to evaluate progress in key regulatory functions. While the remaining countries did not advance a full stage on the RFF, important gains were noted. The year-3 evaluation highlighted limitations of the ARC evaluation strategy to capture nuanced progress and provided insight into how the RFF might be adapted for future use. PMID:27086189

  18. Neonatal meningitis.

    PubMed

    Heath, P T; Nik Yusoff, N K; Baker, C J

    2003-05-01

    Twelve years ago an annotation was published in Archives of Disease in Childhood regarding the antibiotic treatment of suspected neonatal meningitis. The authors recommended the use of cephalosporins rather than chloramphenicol and advocated intraventricular aminoglycoside treatment in selected cases. They noted the absence of clinical trials with third generation cephalosporins that showed an improvement in mortality or neurological outcome. PMID:12719388

  19. NURSE-LED INTERVENTION TO IMPROVE SURROGATE DECISION MAKING FOR PATIENTS WITH ADVANCED CRITICAL ILLNESS

    PubMed Central

    White, Douglas B.; Cua, Sarah Martin; Walk, Roberta; Pollice, Laura; Weissfeld, Lisa; Hong, Seoyeon; Landefeld, C. Seth; Arnold, Robert M.

    2013-01-01

    Background Problems persist with surrogate decision making in intensive care units, leading to distress for surrogates and treatment that may not reflect patients’ values. Objectives To assess the feasibility, acceptability, and perceived effectiveness of a multifaceted, nurse-led intervention to improve surrogate decision making in intensive care units. Study Design A single-center, single-arm, interventional study in which 35 surrogates and 15 physicians received the Four Supports Intervention, which involved incorporating a family support specialist into the intensive care team. That specialist maintained a longitudinal relationship with surrogates and provided emotional support, communication support, decision support, and anticipatory grief support. A mixed-methods approach was used to evaluate the intervention. Results The intervention was implemented successfully in all 15 patients, with a high level of completion of each component of the intervention. The family support specialist devoted a mean of 48 (SD 36) minutes per day to each clinician-patient-family triad. All participants reported that they would recommend the intervention to others. At least 90% of physicians and surrogates reported that the intervention (1) improved the quality and timeliness of communication, (2) facilitated discussion of the patient’s values and treatment preferences, and (3) improved the patient-centeredness of care. Conclusions The Four Supports Intervention is feasible, acceptable, and was perceived by physicians and surrogates to improve the quality of decision making and the patient-centeredness of care. A randomized trial is warranted to determine whether the intervention improves patient, family, and health system outcomes. PMID:23117903

  20. School Nurse Intention to Pursue Higher Education

    ERIC Educational Resources Information Center

    Broussard, Lisa; White, Debra

    2014-01-01

    In 2011, the Institute of Medicine recommended that 80% of the nurses possess a minimum of a bachelor of science in nursing by 2020 and double the number of doctorally prepared nurses. This has prompted a significant number of registered nurses to advance their educational level. School nurses in Louisiana are not required to have a…

  1. Nursing Training Act of 1975. Fact Sheets.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHEW/PHS), Bethesda, MD. Div. of Nursing.

    The Nursing training Act of 1975 revises and extends the nursing training authorities provided under Title VIII of the Public Health Service Act for a three-year period, thus providing aid to nursing training through September 30, 1978. It provides two new, separate authorities for the support of Advanced Nursing Training and Nursing Practitioner…

  2. Neonatal Infectious Diseases: Evaluation of Neonatal Sepsis

    PubMed Central

    Spearman, Paul W.; Stoll, Barbara J.

    2015-01-01

    Synopsis Neonatal sepsis remains a feared cause of morbidity and mortality in the neonatal period. Maternal, neonatal and environmental factors are associated with risk of infection, and a combination of prevention strategies, judicious neonatal evaluation and early initiation of therapy are required to prevent adverse outcomes. The following chapter reviews recent trends in epidemiology, and provides an update on risk factors, diagnostic methods and management of neonatal sepsis. PMID:23481106

  3. Perinatal and Neonatal Health Information Technology: Past, Present, and Future.

    PubMed

    McCartney, Patricia Robin; Drake, Emily Eiwen

    2016-01-01

    The 3 decades of The Journal of Perinatal & Neonatal Nursing history share the same 3 decades as the birth of the information age and health information technology (HIT). This article summarizes the history of HIT and the corresponding publication history of The Journal of Perinatal & Neonatal Nursing. Health information technology content has evolved from being the "how-to operate" topic of a publication to being integrated within a nursing practice publication. The article concludes with current HIT challenges and implications for the future. PMID:27465451

  4. The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia.

    PubMed

    Maier, Claudia B

    2015-12-01

    Task-shifting from physicians to nurses is increasing worldwide; however, research on how it is governed is scarce. This international study assessed task-shifting governance models and implications on practice, based on a literature scoping review; and a survey with 93 country experts in 39 countries (response rate: 85.3%). Governance was assessed by several indicators, regulation of titles, scope of practice, prescriptive authority, and registration policies. This policy analysis focused on eleven countries with task-shifting at the Advanced Practice Nursing/Nurse Practitioner (APN/NP) level. Governance models ranged from national, decentralized to no regulation, but at the discretion of employers and settings. In countries with national or decentralized regulation, restrictive scope of practice laws were shown as barrier, up-to-date laws as enablers to advanced practice. Countries with decentralized regulation resulted in uneven levels of practice. In countries leaving governance to individual settings, practice variations existed, moreover data availability and role clarity was limited. Policy options include periodic reviews to ensure laws are up to date, minimum harmonization in decentralized contexts, harmonized educational and practice-level requirements to reduce practice variation and ensure quality. From a European Union (EU) perspective, regulation is preferred over non-regulation as a first step toward the recognition of qualifications in countries with similar levels of advanced practice. Countries early on in the process need to be aware that different governance models can influence practice. PMID:26474745

  5. Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care Transport Paramedics and Nurses Using the CMAC Pocket Monitor

    PubMed Central

    Boehringer, Bradley; Choate, Michael; Hurwitz, Shelley; Tilney, Peter V. R.; Judge, Thomas

    2015-01-01

    Accurate endotracheal intubation for patients in extremis or at risk of physiologic decompensation is the gold standard for emergency medicine. Field intubation is a complex process and time to intubation, number of attempts, and hypoxia have all been shown to correlate with increases in morbidity and mortality. Expanding laryngoscope technology which incorporates active video, in addition to direct laryngoscopy, offers providers improved and varied tools to employ in management of the advanced airway. Over a nine-year period a helicopter emergency medical services team, comprised of a flight paramedic and flight nurse, intended to intubate 790 patients. Comparative data analysis was performed and demonstrated that the introduction of the CMAC video laryngoscope improved nearly every measure of success in airway management. Overall intubation success increased from 94.9% to 99.0%, first pass success rates increased from 75.4% to 94.9%, combined first and second pass success rates increased from 89.2% to 97.4%, and mean number of intubation attempts decreased from 1.33 to 1.08. PMID:26167501

  6. Addressing Spirituality Within the Care of Patients at the End of Life: Perspectives of Patients With Advanced Cancer, Oncologists, and Oncology Nurses

    PubMed Central

    Phelps, Andrea C.; Lauderdale, Katharine E.; Alcorn, Sara; Dillinger, Jennifer; Balboni, Michael T.; Van Wert, Michael; VanderWeele, Tyler J.; Balboni, Tracy A.

    2012-01-01

    Purpose Attention to patients' religious and spiritual needs is included in national guidelines for quality end-of-life care, but little data exist to guide spiritual care. Patients and Methods The Religion and Spirituality in Cancer Care Study is a multi-institution, quantitative-qualitative study of 75 patients with advanced cancer and 339 cancer physicians and nurses. Patients underwent semistructured interviews, and care providers completed a Web-based survey exploring their perspectives on the routine provision of spiritual care by physicians and nurses. Theme extraction was performed following triangulated procedures of interdisciplinary analysis. Multivariable ordinal logistic regression models assessed relationships between participants' characteristics and attitudes toward spiritual care. Results The majority of patients (77.9%), physicians (71.6%), and nurses (85.1%) believed that routine spiritual care would have a positive impact on patients. Only 25% of patients had previously received spiritual care. Among patients, prior spiritual care (adjusted odds ratio [AOR], 14.65; 95% CI, 1.51 to 142.23), increasing education (AOR, 1.26; 95% CI, 1.06 to 1.49), and religious coping (AOR, 4.79; 95% CI, 1.40 to 16.42) were associated with favorable perceptions of spiritual care. Physicians held more negative perceptions of spiritual care than patients (P < .001) and nurses (P = .008). Qualitative analysis identified benefits of spiritual care, including supporting patients' emotional well-being and strengthening patient-provider relationships. Objections to spiritual care frequently related to professional role conflicts. Participants described ideal spiritual care to be individualized, voluntary, inclusive of chaplains/clergy, and based on assessing and supporting patient spirituality. Conclusion Most patients with advanced cancer, oncologists, and oncology nurses value spiritual care. Themes described provide an empirical basis for engaging spiritual issues

  7. Stem Cells for Neonatal Brain Disorders.

    PubMed

    Ahn, So Yoon; Chang, Yun Sil; Park, Won Soon

    2016-01-01

    Despite recent advances in neonatal intensive care medicine, neonatal brain injury resulting from intraventricular hemorrhage or hypoxic-ischemic encephalopathy remains a major cause of neonatal mortality and neurologic morbidities in survivors. Several studies have indicated that stem cell therapy is a promising novel therapy for neonatal brain injury resulting from these disorders. This review summarizes recent advances in stem cell research for treating neonatal brain injury due to intraventricular hemorrhage or hypoxic-ischemic encephalopathy with a particular focus on preclinical data, covering important issues for clinical translation such as optimal cell type, route, dose and timing of stem cell therapy, and translation of these preclinical results into a clinical trial. PMID:27251746

  8. Value of intensified nursing

    PubMed Central

    Frank, Wilhelm; Konta, Brigitte; Prusa, Nina; Raymann, Cornelia

    2006-01-01

    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. From the thin literature to this topic a selection of predetermined topics was analysed where at least two articles with a sufficient high methodical quality were available. The selected topic groups were: „Infant and paediatric nursing", "gerontology" and "oncology". Generally the five publications concerning infant and paediatric nursing could conclusive show a benefit of intensified nursing. Further research is still needed to prove intensified nursing care. Two publications could be found to the gerontological intensified nursing; both used an extended nursing model and an enlarged use of resources. Both studies demonstrated a measurable success in the applied parameters. Two studies also could be analysed in the oncological field in which successes were also provable by the applied parameters. The success was given especially in a higher patient satisfaction, one study showed an improved scheduling (time planning) of nurses. There was not one article concerning economic questions of intensified nursing care. It has to be taken into account that the financial resources have to be used effectively also in nursing nowadays. It has to be assumed that the costs are driven by increased use of resources. Savings can be achieved, however, in the form of avoided therapies and days in hospital by intensified nursing. The intensified nursing can be considered as similar cost-effective as conventional models of nursing. Ethically it is necessary to consider that the possibilities of

  9. AWHONN Position Statement. The Role of Unlicensed Assistive Personnel (Nursing Assistive Personnel) in the Care of Women and Newborns.

    PubMed

    2016-01-01

    The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) recognizes that unlicensed assistive personnel (UAP) also known as nursing assistive personnel (NAP) can function as supportive members of the health care team under the direction of the professional registered nurse (AWHONN, 2010). The professional registered nurse is ultimately responsible for the coordination and delivery of nursing care to women and newborns. PMID:26815808

  10. Compilation of the neonatal palliative care clinical guideline in neonatal intensive care unit

    PubMed Central

    Zargham-Boroujeni, Ali; Zoafa, Aniyehsadat; Marofi, Maryam; Badiee, Zohreh

    2015-01-01

    Background: Clinical guidelines are important instruments for increasing the quality of clinical practice in the treatment team. Compilation of clinical guidelines is important due to special condition of the neonates and the nurses facing critical conditions in the neonatal intensive care unit (NICU). With 98% of neonatal deaths occurring in NICUs in the hospitals, it is important to pay attention to this issue. This study aimed at compilation of the neonatal palliative care clinical guidelines in NICU. Materials and Methods: This study was conducted with multistage comparative strategies with localization in Isfahan in 2013. In the first step, the components of the neonatal palliative care clinical guidelines were determined by searching in different databases. In the second stage, the level of expert group's consensus with each component of neonatal palliative care in the nominal group and focus group was investigated, and the clinical guideline was written based on that. In the third stage, the quality and applicability were determined with the positive viewpoints of medical experts, nurses, and members of the science board of five cities in Iran. Data were analyzed by descriptive statistics through SPSS. Results: In the first stage, the draft of neonatal palliative care was designed based on neonates’, their parents’, and the related staff's requirements. In the second stage, its rank and applicability were determined and after analyzing the responses, with agreement of the focus group, the clinical guideline was written. In the third stage, the means of indication scores obtained were 75%, 69%, 72%, 72%, and 68% by Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Conclusions: The compilation of the guideline can play an effective role in provision of neonatal care in nursing. PMID:26120329

  11. 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. PMID:22451639

  12. Advanced Practice Registered Nurses: Gateway to Screening for Bipolar Disorder in Primary Care

    PubMed Central

    Kriebel-Gasparro, Ann Marie

    2016-01-01

    Objective: The goal of this mixed methods descriptive study was to explore Advanced Practice Registered Nurses’ (APRNs’) knowledge of bipolar disorder (BPD) and their perceptions of facilitators and barriers to screening patients with known depression for BPD. Methods: A mixed method study design using surveys on BPD knowledge and screening practices as well as focus group data collection method for facilitators and barriers to screening. Results: 89 APRNs completed the survey and 12 APRNs participated in the focus groups. APRNs in any practice setting had low knowledge scores of BPD. No significant differences in screening for BPD for primary and non primary care APRNs. Qualitative findings revealed screening relates to tool availability; time, unsure of when to screen, fear of sigma, symptoms knowledge of BPD, accessible referral system, personal experiences with BPD, and therapeutic relationships with patients. Conclusion: Misdiagnosis of BPD as unipolar depression is common in primary care settings, leading to a long lag time to optimal diagnosis and treatment. The wait time to diagnosis and treatment could be reduced if APRNs in primary care settings screen patients with a diagnosis of depression by using validated screening tools. These results can inform APRN practice and further research on the effectiveness of screening for reducing the morbidity and mortality of BPDs in primary care settings; underscores the need for integration of mental health care into primary care as well as the need for more APRN education on the diagnosis and management of bipolar disorders. PMID:27347256

  13. Neonatal circumcision.

    PubMed

    Lerman, S E; Liao, J C

    2001-12-01

    The merits of neonatal circumcision continue to be debated hotly. Some argue that circumcision is a "uniquely American medical enigma." Most of the world's male population remains uncircumcised; however, most boys born in the United States continue to undergo neonatal circumcision. Review of existing literature supports that most children who are uncircumcised do well from a medical standpoint and, thus, the question of whether US health care practitioners are subjecting neonates to an unnecessary surgical procedure remains. The medical benefits of circumcision are multiple, but most are small. The clearest medical benefit of circumcision is the relative reduction in the risk for a UTI, especially in early infancy. Although this risk [figure: see text] is real, the absolute numbers are small (risk ranges from 1 in 100 to 1 in 1000), and one investigator has estimated that it may take approximately 80 neonatal circumcisions to prevent one UTI. In the case of a patient with known urologic abnormalities that predispose to UTI, neonatal circumcision has a clearer role in terms of medical benefit to the patient. Most of the other medical benefits of circumcision probably can be realized without circumcision as long as access to clean water and proper penile hygiene are achieved. Proper penile hygiene should all but eliminate the risk for foreskin-related medical problems that will require circumcision. Moreover, proper hygiene and access to clean water has been shown to reduce the rate of development of squamous cell carcinoma of the penis in the uncircumcised population. Proper techniques on the care of the foreskin are illustrated in the American Academy of Pediatrics pamphlet titled "How to care for the uncircumcised penis." Regarding the relationship between STDs and circumcision, patient education and the practice of low-risk sexual behavior make a far greater impact than does routine circumcision in hopes of reducing the spread of HIV and other STDs. Nevertheless

  14. AACN White Paper: Distance Technology in Nursing Education.

    ERIC Educational Resources Information Center

    American Association of Colleges of Nursing, Washington, DC.

    Technological advances have increased opportunities for nursing education, affording increased collaboration among nursing faculties in teaching, practice, and research. In an era when nurses are in demand, technology may help the profession educate nurses, prepare future educators, and advance the science of nursing. Several factors should be…

  15. Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians

    PubMed Central

    2014-01-01

    Background Physician recommendations for cancer screening and prevention are associated with patient compliance. However, time constraints may limit physicians’ ability to provide all recommended preventive services, especially with increasing demand from the Affordable Care Act in the United States. Team-based practice that includes advanced practice registered nurses and physician assistants (APRN/PA) may help meet this demand. This study investigates the relationship between an APRN/PA visit and receipt of guideline-consistent cancer screening and prevention recommendations. Methods Data from the 2010 National Health Interview Survey were analyzed with multivariate logistic regression to assess provider type seen and receipt of guideline-consistent cancer screening and prevention recommendations (n = 26,716). Results In adjusted analyses, women who saw a primary care physician (PCP) and an APRN/PA or a PCP without an APRN/PA in the past 12 months were more likely to be compliant with cervical and breast cancer screening guidelines than women who did not see a PCP or APRN/PA (all p < 0.0001 for provider type). Women and men who saw a PCP and an APRN/PA or a PCP without an APRN/PA were also more likely to receive guideline consistent colorectal cancer screening and advice to quit smoking and participate in physical activity than women and men who did not see a PCP or APRN/PA (all p < 0.01 for provider type). Conclusions Seeing a PCP alone, or in conjunction with an APRN/PA is associated with patient receipt of guideline-consistent cancer prevention and screening recommendations. Integrating APRN/PA into primary care may assist with the delivery of cancer prevention and screening services. More intervention research efforts are needed to explore how APRN/PA will be best able to increase cancer screening, HPV vaccination, and receipt of behavioral counseling, especially during this era of healthcare reform. PMID:24685149

  16. Nursing informatics competences still challenging nurse educators.

    PubMed

    Rajalahti, Elina; Saranto, Kaija

    2012-01-01

    In recent years nursing documentation has been one of the most important development areas of nursing informatics (NI) in Finland. The purpose of this study is to describe the development of the nurse educators' competences in nursing documentation during a project called eNNI. The eNNI project (2008-2010) was a cooperative project by nurse educators and working life experts. The goal of the project was to implement the national documentation model and thereby improve operational processes at workplaces. The study includes pre- and post-test questioning of NI applications with a web-based questionnaire (n=136). The data were analyzed with distribution, cross-tabulations and average tests and descriptive statistic multivariate method. According to the results, the ICT skills of the nurse educators were good at the end of the project, and they had good information literacy competence. On the other hand, their advanced NI skills left room for improvement. PMID:22874332

  17. Can training non-physician clinicians/associate clinicians (NPCs/ACs) in emergency obstetric, neonatal care and clinical leadership make a difference to practice and help towards reductions in maternal and neonatal mortality in rural Tanzania? The ETATMBA project

    PubMed Central

    Ellard, David R; Shemdoe, Aloisia; Mazuguni, Festo; Mbaruku, Godfrey; Davies, David; Kihaile, Paul; Pemba, Senga; Bergström, Staffan; Nyamtema, Angelo; Mohamed, Hamed-Mahfoudh; O'Hare, Joseph Paul

    2016-01-01

    Objectives During late 2010, 36 trainees including 19 assistant medical officers (AMOs) 1 senior clinical officer (CO) and 16 nurse midwives/nurses were recruited from districts across rural Tanzania and invited to join the Enhancing Human Resources and Use of Appropriate Technologies for Maternal and Perinatal Survival in the sub-Saharan Africa (ETATMBA) training programme. The ETATMBA project was training associate clinicians (ACs) as advanced clinical leaders in emergency obstetric care. The trainees returned to health facilities across the country with the hope of being able to apply their new skills and knowledge. The main aim of this study was to explore the impact of the ETATMBA training on health outcomes including maternal and neonatal morbidity and mortality in their facilities. Secondly, to explore the challenges faced in working in these health facilities. Design The study is a pre-examination/postexamination of maternal and neonatal health indicators and a survey of health facilities in rural Tanzania. The facilities surveyed were those in which ETATMBA trainees were placed post-training. The maternal and neonatal indicators were collected for 2011 and 2013 and the survey of the facilities was in early 2014. Results 16 of 17 facilities were surveyed. Maternal deaths show a non-significant downward trend over the 2 years (282–232 cases/100 000 live births). There were no significant differences in maternal, neonatal and birth complication variables across the time-points. The survey of facilities revealed shortages in key areas and some are a serious concern. Conclusions This study represents a snapshot of rural health facilities providing maternal and neonatal care in Tanzania. Enhancing knowledge, practical skills, and clinical leadership of ACs may have a positive impact on health outcomes. However, any impact may be confounded by the significant challenges in delivering a service in terms of resources. Thus, training may be beneficial, but it

  18. [Mental health support for nurses].

    PubMed

    Fukushima, Yoshie

    2012-01-01

    Burnout specific to human service workers has been reported in the U.S. in the 1970s. Since then, such burnout has become widely known and the mental health of nurses has attracted attention. Stressors in the work environment and complexity have increased with advancement in increasingly complicated medical care. One of the major roles of a psychiatric liaison nurse is to provide support to improve the mental health of nurses. In our hospital, a psychiatric liaison nurse has a staff position under the direct supervision of the director of the nursing department but operates outside the chain of command. A psychiatric liaison nurse is not involved in the performance review of nurses. Thus, the nursing staff and the nursing manager can discuss their problems with the psychiatric liaison nurse without risks. Psychiatric liaison nurses provide support as counselors through individual and group interviews so that nurses can become re-energized about their work. In addition, psychiatric liaison nurses provide consultations and education. They perform coordination function to organize an environment to promote consultations regarding nurse support to the staff nurses and the nursing manager and to promote support by supervisors. For support after reinstatement of a nurse following a medical leave, it is particularly important to work with not only the individual nurse but also the entire nursing team. In our hospital, newly graduated nurses are given the GHQ-28 after one month of employment to assess the support they might need. In our study, nurses with high risks were divided into a group with a score of at least 6 points but less than 10 points and a group with a score of at least 10 points. The group with at least 10 points had significantly higher rates of leave of absence and resignation. Thus, early intervention was thought to be necessary in newly graduated nurses with a score of at least 10 points in the GHQ. PMID:22712205

  19. [A neonate with pustules].

    PubMed

    Groot, Dominique T; van den Broek, Annique J M

    2016-01-01

    We describe a female neonate with non-grouped pustules directly postpartum without clinical signs of illness. There were no red maculae. At follow-up some pustules had turned to pigmented maculae, which confirmed the diagnosis of neonatal pustular melanosis. This benign transient condition occurs in 4-8% of dark-coloured neonates and in <1% of white neonates. PMID:26840934

  20. Establishing level II neonatal services in southwestern Oklahoma.

    PubMed

    McCoy, Michael; Makkar, Abhishek; Foulks, Arlen; Legako, Edward

    2014-01-01

    Historically, Neonatal Services in Oklahoma have relied upon Level III and IV NICUs within the largest metropolitan areas to provide services for premature and other sick newborns. Smaller, regional Level II nurseries have delivered care according to previous American Academy of Pediatrics (AAP) Guidelines for Levels of Care. With changing guidelines in perinatal and neonatal care, there has been the need to add to available neonatal resources to continue to allow infants to remain in their home. This article is a description of a partnership between Comanche County Memorial Hospital (CCMH) and the Department of Pediatrics, Neonatal-Perinatal Medicine Section at OU Health Sciences Center (OUHSC) to establish a regional Level II NICU and the planning and implementation required to meet local, state, and national standards. The process, which involved neonatologists, nurse practitioners, nurses, laboratory services, pharmacy services, radiology, and respiratory therapy, resulted in a fully-functioning 8-bed Level II NICU. PMID:25790596

  1. Neonatal resuscitation: Current issues

    PubMed Central

    Chadha, Indu A

    2010-01-01

    The following guidelines are intended for practitioners responsible for resuscitating neonates. They apply primarily to neonates undergoing transition from intrauterine to extrauterine life. The updated guidelines on Neonatal Resuscitation have assimilated the latest evidence in neonatal resuscitation. Important changes with regard to the old guidelines and recommendations for daily practice are provided. Current controversial issues concerning neonatal resuscitation are reviewed and argued in the context of the ILCOR 2005 consensus. PMID:21189881

  2. Caring in Nursing Professional Development.

    PubMed

    Martin, Mary Brigid

    2015-01-01

    Caring science has been identified and examined in the discipline of nursing for over 40 years. Within this period, the topic has been analyzed and studied resulting in theories, models, books, and articles published nationally and internationally. Although advancements have been made in caring knowledge development, opportunities to integrate caring science into all aspects of nursing abound, including the specialty of nursing professional development. The focus of this article is to present ways in which nursing professional development specialists may incorporate caring science into practice, using Ray's (2010) Transcultural Caring Dynamics in Nursing and Health Care model as an exceptional exemplar for understanding, awareness, and choice for nurses and patients. PMID:26381337

  3. Handbook of clinical nursing practice

    SciTech Connect

    Asheervath, J.; Blevins, D.R.

    1986-01-01

    Written in outline format, this reference will help nurses further their understanding of advanced nursing procedures. Information is provided on the physiological, psychological, environmental, and safety considerations of nursing activities associated with diagnostic and therapeutic procedures. Special consideration is given to the areas of pediatric nursing, nursing assessment, and selected radiologic and nuclear medicine procedures for each system. Contents: Clinical Introduction. Clinical Nursing Practice: Focus on Basics. Focus on Cardiovascular Function. Focus on Respiratory Function. Focus on Gastrointestinal Function. Focus on Renal and Genito-Urological Function. Focus on Neuro-Skeletal and Muscular Function. Appendices.

  4. They know!—Do they? A qualitative study of residents and relatives views on advance care planning, end-of-life care, and decision-making in nursing homes

    PubMed Central

    Bollig, Georg; Gjengedal, Eva; Rosland, Jan Henrik

    2015-01-01

    Background: Residents living in long-term care facilities are a vulnerable population. For many residents, a nursing home is their place of death. Palliative care and end-of-life decisions are important components of their care provision. Aim: To study the views of cognitively able residents and relatives on advance care planning, end-of-life care, and decision-making in nursing homes. Design: A qualitative study with in-depth interviews with nursing home residents and focus group interviews with relatives of nursing home residents. Analysis is based on interpretive description. Setting/participants: In total, 43 informants from nine nursing homes participated in the study (25 nursing home residents and 18 relatives). All included residents had capacity to provide informed consent and lived in long-term care. Results: The main findings of this study were the differing views about decision-making and advance care planning of residents and relatives. Residents do trust relatives and staff to make important decisions for them. The relatives are in contrast insecure about the residents’ wishes and experience decision-making as a burden. The majority of the residents had not participated in advance care planning. None of the residents stated challenges connected to end-of-life care or mentioned the wish for euthanasia. Conclusion: Although most residents seem to be satisfied with decision-making and end-of life care, there is a need for systematic advance care planning. Advance care planning could help to explore future wishes for care and ease decision-making for the relatives, physicians, and staff and should be offered to all cognitively able nursing homes residents. PMID:26396227

  5. [Neonatal cholestasis].

    PubMed

    Lacaille, F

    2016-03-01

    "Cholestasis" means abnormal synthesis or secretion of bile. The main symptom in a neonate or infant is jaundice. Urine is dark, staining diapers, and stools are variably pale or white. Vitamin K should be injected (to prevent coagulation disorders due to malabsorption). The two diagnoses requiring urgent treatment are urinary tract infection and biliary atresia. If stools are permanently white, biliary atresia is highly probable. A few genetic causes of intrahepatic cholestasis should be screened and corrective surgery organized. The diseases responsible for cholestasis in this age group are described as well as the investigations and treatments, including the management of non-specific complications of cholestasis. A delay in the diagnosis of biliary atresia can have such severe consequences that consultation with a hepatology unit or transfer should be easy and rapid. PMID:26850153

  6. North Carolina School Nurse Leadership Institute

    ERIC Educational Resources Information Center

    Guttu, Martha

    2007-01-01

    Recognizing that school nurse leaders are essential to the development of school nurses, the North Carolina School Nurse Leadership Institute was developed to enable school nurse leaders to update and advance their leadership skills. The Institute was a collaborative endeavor between the North Carolina Department of Health and Human Services,…

  7. Nursing Supplies

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Nursing Supplies Page Content Article Body Throughout most of ... budget. (Nursing equipment also makes wonderful baby gifts.) Nursing Bras A well-made nursing bra that comfortably ...

  8. A matter of size: Part 2. Evaluating the large-for-gestational-age neonate.

    PubMed

    Lawrence, Elizabeth J

    2007-08-01

    Large for gestational age (LGA) is another designation used to assess and monitor growth throughout the pregnancy and after delivery. Large for gestational age is an abnormal growth descriptor that assists in anticipating neonatal needs pre-and postnatally. Careful monitoring for abnormal growth trends in the fetus is imperative prenatally. The relative size of a neonate affects many aspects of prenatal and postnatal surveillance. Nursing care is guided by the maternal history and the delivery room complications that may occur. Anticipating complications in the delivery room is vital to the survival of LGA neonates. Nursing care for LGA neonates requires knowledge based on these potential complications. A thorough physical assessment with appropriate glucose monitoring and parental education is required. Size matters when it comes to the health and welfare of all sizes of neonates. Anticipatory guidance with prenatal monitoring and education can improve outcomes in the neonate at risk for LGA complications at birth. PMID:17700192

  9. Change in neonatal care pattern and neonatal mortality in a rural medical college.

    PubMed

    Chaturvedi, P; Potdar, S

    1988-02-01

    Due to the nonavailability of separate nursing staff for a special care neonatal unit in a rural medical college, the strategy for neonatal care of high risk babies was changed from January 1, 1985 onwards. These babies were managed mainly in postnatal wards with emphasis on maternal involvement reinforced by day-to-day orientation of mothers, nurses, and doctors to neonatal care. The incidence of fullterm (FT), preterm (PT), and low birthweight (LBW) babies were comparable in 1984 and 1985. The overall neonatal mortality (NM) was 8.3% in 1984 and 4.3% in 1985, NM in PT was 50.8% in 1984 and 30.0% in 1985, and NM in LBW was 17.0% in 1984 and 9.3% in 1985. These rates were reduced by approximately 40-50% of that recorded in 1984. The difference in all groups was statistically significant. However, the NM in the VLBW (1500 g) did not change substantially. Deaths due to severe asphyxia and intraventricular hemorrhage were reduced from 4.03% of all livebirths in 1984 to 2.2%, the difference being statistically significant. The most significant reeducation was seen in deaths due to infection which dropped from 2.45% of total livebirths in 1984 to 0.88% of the total in 1985. With this experience, the authors recommend the measures adopted by them to reduce the NM, especially in small centers and rural areas where nursing and other facilities are not optimal. PMID:3246397

  10. 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. In addition, many doctors share office space ...

  11. Supporting families in neonatal loss: relationship and faith key to comfort.

    PubMed

    Holston, Jane Treadwell

    2015-01-01

    Around 20,000 neonatal deaths occur each year, many from congenital heart defects such as hypoplastic left heart syndrome. Nurses are on the frontline of caring for families experiencing neonatal loss. Careful spiritual and cultural assessment, attention to beliefs, focusing on relationship, and helping families create legacy can assist with grieving and making meaning out of loss. PMID:25585464

  12. Nurse Mentors to Advance Quality Improvement in Primary Health Centers: Lessons From a Pilot Program in Northern Karnataka, India.

    PubMed

    Fischer, Elizabeth A; Jayana, Krishnamurthy; Cunningham, Troy; Washington, Maryann; Mony, Prem; Bradley, Janet; Moses, Stephen

    2015-12-01

    High-quality care during labor, delivery, and the postpartum period is critically important since maternal and child morbidity and mortality are linked to complications that arise during these stages. A nurse mentoring program was implemented in northern Karnataka, India, to improve quality of services at primary health centers (PHCs), the lowest level in the public health system that offers basic obstetric care. The intervention, conducted between August 2012 and July 2014, employed 53 full-time nurse mentors and was scaled-up in 385 PHCs in 8 poor rural districts. Each mentor was responsible for 6 to 8 PHCs and conducted roughly 6 mentoring visits per PHC in the first year. This paper reports the results of a qualitative inquiry, conducted between September 2012 and April 2014, assessing the program's successes and challenges from the perspective of mentors and PHC teams. Data were gathered through 13 observations, 9 focus group discussions with mentors, and 25 individual and group interviews with PHC nurses, medical officers, and district health officers. Mentors and PHC staff and leaders reported a number of successes, including development of rapport and trust between mentors and PHC staff, introduction of team-based quality improvement processes, correct and consistent use of a new case sheet to ensure adherence to clinical guidelines, and increases in staff nurses' knowledge and skills. Overall, nurses in many PHCs reported an increased ability to provide care according to guidelines and to handle maternal and newborn complications, along with improvements in equipment and supplies and referral management. Challenges included high service delivery volumes and/or understaffing at some PHCs, unsupportive or absent PHC leadership, and cultural practices that impacted quality. Comprehensive mentoring can build competence and improve performance by combining on-the-job clinical and technical support, applying quality improvement principles, and promoting team

  13. Update on Neonatal Hypoglycemia

    PubMed Central

    Rozance, Paul J.

    2014-01-01

    Purpose of Review Neonatal hypoglycemia is one of the most common biochemical abnormalities encountered in the newborn. However, controversy remains surrounding its definition and management especially in asymptomatic patients. Recent Findings New information has been published that describes the incidence and timing of low glucose concentrations in the groups most at risk for asymptomatic neonatal hypoglycemia. Furthermore, one large prospective study failed to find an association between repetitive low glucose concentrations and poor neurodevelopmental outcomes in preterm infants. But hypoglycemia due to hyperinsulinism, especially genetic causes, continued to be associated with brain injury. New advances were made in the diagnosis and management of hyperinsulinism, including acquired hyperinsulinism in small for gestational age infants and others. Continuous glucose monitoring remains an attractive strategy for future research in this area. Summary The fundamental question of how best to manage asymptomatic newborns with low glucose concentrations remains unanswered. Balancing the risks of over treating newborns with low glucose concentrations who are undergoing a normal transition following birth against the risks of under treating those in whom low glucose concentrations are pathological, dangerous, and/or a harbinger of serious metabolic disease remains a challenge. PMID:24275620

  14. Nurse Mentors to Advance Quality Improvement in Primary Health Centers: Lessons From a Pilot Program in Northern Karnataka, India

    PubMed Central

    Fischer, Elizabeth A; Jayana, Krishnamurthy; Cunningham, Troy; Washington, Maryann; Mony, Prem; Bradley, Janet; Moses, Stephen

    2015-01-01

    High-quality care during labor, delivery, and the postpartum period is critically important since maternal and child morbidity and mortality are linked to complications that arise during these stages. A nurse mentoring program was implemented in northern Karnataka, India, to improve quality of services at primary health centers (PHCs), the lowest level in the public health system that offers basic obstetric care. The intervention, conducted between August 2012 and July 2014, employed 53 full-time nurse mentors and was scaled-up in 385 PHCs in 8 poor rural districts. Each mentor was responsible for 6 to 8 PHCs and conducted roughly 6 mentoring visits per PHC in the first year. This paper reports the results of a qualitative inquiry, conducted between September 2012 and April 2014, assessing the program's successes and challenges from the perspective of mentors and PHC teams. Data were gathered through 13 observations, 9 focus group discussions with mentors, and 25 individual and group interviews with PHC nurses, medical officers, and district health officers. Mentors and PHC staff and leaders reported a number of successes, including development of rapport and trust between mentors and PHC staff, introduction of team-based quality improvement processes, correct and consistent use of a new case sheet to ensure adherence to clinical guidelines, and increases in staff nurses’ knowledge and skills. Overall, nurses in many PHCs reported an increased ability to provide care according to guidelines and to handle maternal and newborn complications, along with improvements in equipment and supplies and referral management. Challenges included high service delivery volumes and/or understaffing at some PHCs, unsupportive or absent PHC leadership, and cultural practices that impacted quality. Comprehensive mentoring can build competence and improve performance by combining on-the-job clinical and technical support, applying quality improvement principles, and promoting team

  15. Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case-Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees.

    PubMed

    Shaw-Battista, Jenna; Young-Lin, Nichole; Bearman, Sage; Dau, Kim; Vargas, Juan

    2015-01-01

    Ultrasound is an important aid in the clinical diagnosis and management of normal and complicated pregnancy and childbirth. The technology is widely applied to maternity care in the United States, where comprehensive standard ultrasound examinations are routine. Targeted scans are common and used for an increasing number of clinical indications due to emerging research and a greater availability of equipment with better image resolution at lower cost. These factors contribute to an increased demand for obstetric ultrasound education among students and providers of maternity care, despite a paucity of data to inform education program design and evaluation. To meet this demand, from 2012 to 2015 the University of California, San Francisco nurse-midwifery education program developed and implemented an interprofessional obstetric ultrasound course focused on clinical applications commonly managed by maternity care providers from different professions and disciplines. The course included matriculating students in nursing and medicine, as well as licensed practitioners such as registered and advanced practice nurses, midwives, and physicians and residents in obstetrics and gynecology and family medicine. After completing 10 online modules with a pre- and posttest of knowledge and interprofessional competencies related to teamwork and communication, trainees attended a case-based seminar and hands-on skills practicum with pregnant volunteers. The course aimed to establish a foundation for further supervised clinical training prior to independent practice of obstetric ultrasound. Course development was informed by professional guidelines and clinical and education research literature. This article describes the foundations, with a review of the challenges and solutions encountered in obstetric ultrasound education development and implementation. Our experience will inform educators who wish to facilitate obstetric ultrasound competency development among new and experienced

  16. Routine neonatal circumcision?

    PubMed Central

    Tran, P. T.; Giacomantonio, M.

    1996-01-01

    Routine neonatal circumcision is still a controversial procedure. This article attempts to clarify some of the advantages and disadvantages of neonatal circumcision. The increased rate of penile cancer among uncircumcised men appears to justify the procedure, but that alone is not sufficient justification. The final decision on neonatal circumcision should be made by parents with balanced counsel from attending physicians. PMID:8939321

  17. Health Care Reform: How Will It Affect Nursing?--Nursing Education.

    ERIC Educational Resources Information Center

    Zalon, Margarete Lieb

    Nursing educators have the opportunity to advance nursing's agenda for health care reform to ensure effective health care for all members of society. They have a key role in fostering the political involvement of student nurses and nurses who have returned to school for baccalaureate or graduate education. Role modeling is critical to increasing…

  18. Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design

    PubMed Central

    Brødsgaard, Anne; Zachariassen, Gitte; Clemensen, Jane

    2016-01-01

    Background For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. Objective To identify parental needs when wanting to provide neonatal home care supported by telemedicine. Methods The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. Results Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a “bell cord” to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. Conclusions Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using

  19. Neonatal euthanasia: moral considerations and criminal liability.

    PubMed

    Sklansky, M

    2001-02-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice. PMID:11233379

  20. Mindfulness-Based Stress Reduction in Advanced Nursing Practice: A Nonpharmacologic Approach to Health Promotion, Chronic Disease Management, and Symptom Control.

    PubMed

    Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula

    2015-09-01

    The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. PMID:25673578

  1. Nurses' beliefs and values about doing cue-based care in an NICU in Taiwan.

    PubMed

    Liaw, Jen-Jiuan; Chen, Shu-Yueh; Yin, Ying-Ti

    2004-12-01

    Although advances in medical technology have increased the survival rate of preterm infants, science is no cure-all for these high-risk patients. A growing number of studies report that caregiving interventions cause physiological and behavioral distress in such infants. The results have prompted changes in caregiving practices, attempting to reduce stress and strengthen protection for the infants, in order to promote their stability and development in the neonatal intensive care unit (NICU) . This study uses qualitative research methods to grasp the richness and diversity of nurses' beliefs and experience in the taking care of preterm infants. Ten groups of questions explore how NICU nurses take care of premature infants, nurses' perspectives on cue-based care, and the extent to which NICU nurses practice cue-based care. The results generated three themes: (1) timely and skillful management of the preterm infants; (2) compassionate and holistic care for the infants and their highly stressed families; and (3) the relationship between good nursing care and meeting the needs of preterm infants, families, physicians, units, and the environment. It is apparent that the approach to care delivery in NICU practice is still clinical-based, and that there are some obstacles to the delivery of cue-based care. The reasons for this include lack of knowledge, incomplete collaboration with team members, and insufficient support from the administrative systems. To improve the quality of nursing care and preterm infant outcomes, it will be necessary to educate NICU nurses on cue-based care, to enhance collaboration among all team members, to reduce their non-nursing workload, and to re-design NICUs for optimal cue-based care. PMID:15619178

  2. [The difficulties of staff retention in neonatal intensive care units].

    PubMed

    Deparis, Corinne

    2015-01-01

    Neonatal intensive care units attract nurses due to the technical and highly specific nature of the work. However, there is a high turnover in these departments. Work-related distress and the lack of team cohesion are the two main causes of this problem. Support from the health care manager is essential in this context. PMID:26183101

  3. Mothers of Pre-Term Infants in Neonate Intensive Care

    ERIC Educational Resources Information Center

    MacDonald, Margaret

    2007-01-01

    In this study, eight mothers of pre-term infants under the care of nursing staff and neonatologists in the Neonatal Intensive Care Unit (NICU) of Children's Hospital in Vancouver, British Columbia, were observed and interviewed about their birth experience and their images of themselves as mothers during their stay. Patterns and themes in the…

  4. 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…

  5. Nursing Homes

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed ... physical health and/or mental disabilities. Is a Nursing Home Right for You? Almost half of all ...

  6. Nursing Positions

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Nursing Positions KidsHealth > For Parents > Nursing Positions Print A ... and actually needs to feed. Getting Comfortable With Breastfeeding Nursing can be one of the most challenging ...

  7. Neonatal medicine in ancient art.

    PubMed

    Yurdakök, Murat

    2010-01-01

    There are a limited number of artistic objects from ancient times with particular importance in neonatal medicine. The best examples are figurines from ancient Egypt of Isis nursing Horus, showing the importance of breastfeeding. The earliest images of the human fetus were made by the Olmecs in Mexico around 1200- 400 BCE. One of the earliest representations of congenital anomalies is a figurine of diencephalic twins thought to be the goddess of Anatolia, dated to around 6500 BCE. In addition to these figurines, three sets of twins in the ancient world have medical importance, and Renaissance artists often used them as a subject for their paintings: "direct suckling animals" (Romulus and Remus), "heteropaternal superfecundation" (mother: Leda, fathers: Zeus, the king of the Olympian gods, and Leda's husband, Tyndareus), and "twin-to-twin transfusion" in monozygotic twins (Jacob and Esau). PMID:20560265

  8. Futile care and the neonate.

    PubMed

    Romesberg, Tricia L

    2003-10-01

    The concept of futile care is controversial and difficult to define. Efforts to prolong life, once considered an outcome of healing, may now be viewed by some as harmful acts of prolonging suffering. This article reviews a number of cases representing this challenging ethical dilemma, such as Baby K and MacDonald v. Milleville. The Baby Doe regulations, the Emergency Medical Treatment and Labor Act (EMTALA), and the Born-Alive Protection Act of 2001, also are discussed to provide an improved understanding of the legal framework that impacts ethical decision making. Nurses at the bedside must be equipped with the ethical knowledge and communication skills necessary to care for patients and families facing the ethical dilemma of futile care. An increased focus on neonatal palliative care is suggested to provide infants, families, and staff with the necessary tools to work through this painful process. PMID:14648518

  9. Reducing CBC Clotting Rates in the Neonatal Patient Care Areas.

    PubMed

    McCoy, Jennifer; Tichon, Tanya; Narvey, Michael

    2016-01-01

    Performing a complete blood count (CBC) is a common test performed in neonatal intensive care. Samples reported as "clotted" are not able to be analyzed and require redraw. A perceived "high" clotting rate elicits frustration among team members and has negative effects on patient flow and patient satisfaction. Process mapping and a root cause analysis determined that an educational intervention was required to optimize blood collection skills of front-line nurses. Through four rapid PDSA cycles over a three year period, the neonatal patient care areas were able to decrease their CBC clotting rates from 30% (monthly rate when the problem was identified) to 16% (yearly average at the end of the project). The CBC clotting rates continue to decease over time due to the integration of a multi-faceted educational plan into biannual education days designed for current staff nurses, as well as into the orientation plan for newly hired and student nurses. PMID:27493749

  10. Reducing CBC Clotting Rates in the Neonatal Patient Care Areas

    PubMed Central

    McCoy, Jennifer; Tichon, Tanya; Narvey, Michael

    2016-01-01

    Performing a complete blood count (CBC) is a common test performed in neonatal intensive care. Samples reported as “clotted” are not able to be analyzed and require redraw. A perceived “high” clotting rate elicits frustration among team members and has negative effects on patient flow and patient satisfaction. Process mapping and a root cause analysis determined that an educational intervention was required to optimize blood collection skills of front-line nurses. Through four rapid PDSA cycles over a three year period, the neonatal patient care areas were able to decrease their CBC clotting rates from 30% (monthly rate when the problem was identified) to 16% (yearly average at the end of the project). The CBC clotting rates continue to decease over time due to the integration of a multi-faceted educational plan into biannual education days designed for current staff nurses, as well as into the orientation plan for newly hired and student nurses. PMID:27493749

  11. Preparation of academic nurse educators.

    PubMed

    Booth, Tracy L; Emerson, Christi J; Hackney, Michele G; Souter, Sharon

    2016-07-01

    Nursing practice is diverse, with nurses serving in both direct and indirect patient care roles. For nurse educators, the realm of nursing practice extends beyond direct patient care to include preparing students for nursing practice. Academic nurse educators must be prepared to serve as educators, researchers, and to have experience in a clinical specialty area. For many nurse educators, advanced academic preparation often relates to a clinical area of practice rather than pedagogical practice. Graduate-level knowledge of evidence-based research and practice, teaching methods, and curriculum design and development form the foundation for academic practice. Because education and nursing are two distinctive disciplines, clinical expertise does not naturally result in teaching expertise. Lack of consensus regarding the educational preparation of nurse educators adds to the complexity of the nursing profession. The purpose of this article is to advocate for pedagogical preparation for academic nurse educators. Additionally, this article contains recommendations for pedagogical competencies indicative of academic nurse educator preparation. PMID:27428693

  12. Neonatal peripherally inserted central catheters: recommendations for prevention of insertion and postinsertion complications.

    PubMed

    Paulson, Pamela R; Miller, Kellee M

    2008-01-01

    Peripherally inserted central catheters (PICCs) continue to be necessary in neonatal care. They benefit many premature infants and those needing long-term intravenous access. An experienced inserter, early recognition of PICC candidates, early PICC placement, knowledge of anatomy, and correct choice of vein all increase placement success. As with any invasive procedure, there are risks. These include pain, difficulty advancing the catheter, damage to vessels, catheter malposition, and bleeding. Utilizing assessment skills, following the product manufacturer's instructions, and carefully placing the catheter should minimize most of these risks. Additional risks include postinsertion complications such as occlusions, thrombosis, catheter failure, infection, and catheter malposition. Proper nursing care--which includes controlling infection, properly securing the catheter, and changing the dressing as needed--is key to preventing complications and maintaining the PICC until treatment has been completed. PMID:18697655

  13. Nursing: Registered Nurses

    MedlinePlus

    ... nurses for jobs in health planning and development, marketing, consulting, policy development, and quality assurance. Some RNs ... workers was $36,200. Recommend this page using: Facebook Twitter LinkedIn tools Areas at a Glance Industries ...

  14. Development of a Composite Pain Measure for Persons with Advanced Dementia: Exploratory Analyses in Self-Reporting Nursing Home Residents

    PubMed Central

    Ersek, Mary; Polissar, Nayak; Neradilek, Moni Blazej

    2010-01-01

    Context Experts agree that pain assessment in non-communicative persons requires data from sources that do not rely on self-report, including proxy reports, health history, and observation of pain behaviors. However, there is little empirical evidence to guide clinicians in weighting or combining these sources to best approximate the person’s experience. Objectives The aim of this exploratory study was to identify a combination of observer-dependent pain indicators that would be significantly more predictive of self-reported pain intensity than any single indicator. Because self-reported pain is usually viewed as the criterion measure for pain, self-reported usual and worst pain were the dependent variables. Methods The sample consisted of 326 residents (mean age: 83.2 years; 69% female) living in one of 24 nursing homes. Independent variables did not rely on self-report: surrogate reports from certified nursing assistants (CNA IPT), Checklist of Nonverbal Pain Indicators (CNPI), Cornell Scale for Depression in Dementia (CSDD), Pittsburgh Agitation Scale (PAS), number of painful diagnoses, and Minimum Data Set (MDS) pain variables. Results In univariate analyses, the CNA IPT scores were correlated most highly with self-reported pain. The final multivariate model for self-reported usual pain included CNA IPT, CSDD, PAS and education; this model accounted for only 14% of the variance. The more extensive of the two final models for worst pain included MDS pain frequency, CSDD, CNA IPT, CNPI and age (R2 = 0.14). Conclusion Additional research is needed to develop a predictive pain model for nonverbal persons. PMID:21094018

  15. Innovation in transformative nursing leadership: nursing informatics competencies and roles.

    PubMed

    Remus, Sally; Kennedy, Margaret Ann

    2012-12-01

    In a recent brief to the Canadian Nurses Association's National Expert Commission on the Health of Our Nation, the Academy of Canadian Executive Nurses (ACEN) discussed leadership needs in the Canadian healthcare system, and promoted the pivotal role of nursing executives in transforming Canada's healthcare system into an integrated patient-centric system. Included among several recommendations was the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. This paper focuses on an emerging "avant-garde executive leadership competency" recommended for today's health leaders to guide health system transformation. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive. The authors of this paper propose that distinct nursing informatics competencies are required to augment traditional executive skills to support transformational outcomes of safe, integrated, high-quality care delivery through knowledge-driven care. International trends involving nursing informatics competencies and the evolution of new corporate informatics roles, such as chief nursing informatics officers (CNIOs), are demonstrating value and advanced transformational leadership as nursing executive roles that are informed by clinical data. PMID:23803423

  16. Genomics Nursing Faculty Champion Initiative

    PubMed Central

    Jenkins, Jean; Calzone, Kathleen A.

    2016-01-01

    Nurse faculty are challenged to keep up with the emerging and fast-paced field of genomics and the mandate to prepare the nursing workforce to be able to translate genomic research advances into routine clinical care. Using Faculty Champions and other options, the initiative stimulated curriculum development and promoted genomics curriculum integration. The authors summarize this yearlong initiative for undergraduate and graduate nursing faculty. PMID:24300251

  17. Awareness of self and expanding consciousness: using nursing theories to prepare nurse-therapists.

    PubMed

    Vandemark, Lisa M

    2006-07-01

    Psychotherapy is an accepted role of the advanced practice psychiatric nurse. Nursing theorists, notably Hildegard Peplau and Margaret Newman, offer guidance on the psychological and professional development of the nurse. This paper examines Newman's theory of health as expanding consciousness and the concept of awareness of self in Peplau's theory, and suggests that psychiatric advanced practice nursing programs consider the need for nurses to develop self-knowledge to facilitate the nurse-patient relationship and to improve outcomes of patient care in psychotherapy. PMID:16923732

  18. Oxygen therapy in neonatal intensive care units in Khartoum State

    PubMed Central

    Omer, Ilham M; Ibrahim, Nada G; Nasr, Abdalhalim M A

    2015-01-01

    Oxygen is a drug that is essential in the treatment and prevention of neonatal hypoxia. The goal of oxygen therapy is to deliver sufficient oxygen to tissues while minimizing oxygen toxicity and oxidative stress. Improvement in monitoring technology of oxygen therapy has helped to improve clinicians’ ability to appropriately apply and deliver oxygen. The objectives of this prospective observational descriptive hospital based study were: to evaluate the practice of oxygen therapy in the neonatal intensive care units (NICUs) in Khartoum State, to identify guidelines of oxygen therapy in NICUs, to determine the mode of oxygen delivery to the neonates, and to assess the practice of long term follow up of patients who used oxygen. During the period January – June 2014, 139 neonates were included. Oxygen was delivered to the neonates in the study depending on the clinical assessment. Saturation was not measured at the time of oxygen administration in 119 (85.6%) neonates. Oxygen was delivered by central device in 135 neonates (97.1%). The majority of the staff did not know the practice of long-term follow up. Hundred and sixteen (83.5%) of the nursing staff knew that oxygen has complications but the majority didn’t know the nature of the complications and what causes them. The study showed that there is lack of guidelines of oxygen therapy in the NICUs and lack of monitoring procedures, which is important to be highlighted to overcome the complications and to improve the practice of oxygen therapy.

  19. Career Preferences of Nursing Students

    ERIC Educational Resources Information Center

    Gould, Odette N.; MacLennan, Anna; Dupuis-Blanchard, Suzanne

    2012-01-01

    This study investigates novice and experienced student nurses' attitudes about caring for patients across the lifespan. Students were also asked why they would enjoy or not enjoy caring for children and older adults. Both novice (n = 114) and advanced (n = 56) nursing students were relatively positive about caring for patients across the lifespan.…

  20. A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study

    PubMed Central

    2011-01-01

    Background Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD) have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described. Methods/Design In a longitudinal controlled study, we compare 1 intervention region (4 nursing homes [n/hs], altogether 421 residents) with 2 control regions (10 n/hs, altogether 985 residents). Inclusion went from 01.02.09 to 30.06.09, observation lasted until 30.06.10. Primary endpoint is the prevalence of ADs at follow-up, 17 (12) months after the first (last) possible inclusion. Secondary endpoints compare relevance and validity of ADs, process quality, the rate of life-sustaining interventions and, in deceased residents, location of death and intensity of treatment before death. The regional multifaceted intervention on the basis of the US program Respecting Choices® comprises training of n/h staff as facilitators, training of General Practitioners, education of hospital and ambulance staff, and development of eligible tools, including Physician Orders for Life-Sustaining Treatment in case of Emergency (POLST-E). Participation data: Of 1406 residents reported to live in the 14 n/hs plus an estimated turnover of 176 residents until the last possible inclusion date, 645 (41%) were willing to participate. Response rates were 38% in the intervention region and 42% in the control region. Non-responder analysis shows an equal distribution of sex and age but a bias towards dependency on nursing care in the responder group. Outcome analysis of this study will become available in the course of 2011. Discussion Implementing an ACP program for the n/hs and related health care providers of a region requires a

  1. Primary Neonatal Diaphragmatic Abscess

    PubMed Central

    Zouari, Mohamed; Jallouli, Mohamed; Ben Thabet, Afef; Ben Dhaou, Mahdi; Gargouri, Abdellatif; Mhiri, Riadh

    2015-01-01

    Neonatal diaphragmatic abscesses are extremely rare and they usually develop by direct extension from a liver abscess. The first case of primary diaphragmatic abscess in a neonate is reported and the difficulties of diagnosing this rare entity are discussed. PMID:26023529

  2. Overview of neonatal lupus.

    PubMed

    Johnson, Benay

    2014-01-01

    Neonatal lupus (NL) is defined by the presentation of the fetus and the newborn who possess autoantibodies received from the mother. It is the dysfunction of the maternal immune system that leads to the production of autoantibodies to anti-Sjögren syndrome-A, anti-Sjögren syndrome-B, and anti-ribonuclear protein antigens. These antibodies are shared through the placenta and produce bodily changes in the fetal skin and heart, as well as potential changes in other body systems. Congenital complete heart block is the most dangerous manifestation of NL that can occur in utero or after birth. This article will provide an overview the presentation of NL and current therapies. Prenatal steroids have been the mainstay of therapy to try to reverse first- and second-degree congenital heart block and to prevent progression to a more advanced stage. New therapies are combining steroids with intravenous immunoglobulin and plasmapheresis. This article will provide guidelines for practitioners so they can consider NL as a differential diagnosis when presented with cutaneous lesions, congenital heart block, or abnormal findings in the hematologic, hepatobiliary, neurologic, and musculoskeletal systems. PMID:24100008

  3. Technology and nursing: an anatomy of definition.

    PubMed

    Barnard, A

    1996-08-01

    This paper discusses technology in relation to nursing practice development in order to demonstrate the need to apprehend nursing within the context of technological advancement. Issues pertinent to formulating an understanding of technology are reviewed and four common approaches to the definition of technology within the domain of nursing are critiqued. The purpose of the paper is to analyse issues relevant to defining technology, and to make obvious the limitations of current nursing literature. PMID:8836767

  4. Legal Considerations of Psychiatric Nursing Practice.

    PubMed

    Barloon, Linda Funk; Hilliard, Wanda

    2016-06-01

    There are major legal issues that affect psychiatric nursing and guidelines for practicing in a legal and responsible manner. Advances in understanding of psychiatric conditions and developments in how nurses care for psychiatric patients result in changes in regulations, case law, and policies that govern nursing practice. Professional development, keeping abreast of current research and literature regarding clinical practice and trends, and involvement in professional organizations are some of the ways that psychiatric nurses can meet the challenges of their profession. PMID:27229273

  5. Distance Technology in Nursing Education. AACN White Paper.

    ERIC Educational Resources Information Center

    American Association of Colleges of Nursing, Washington, DC.

    Careful use of technology in education may enhance the ability of the nursing education profession to educate nurses for practice, prepare future nurse educators, and advance nursing science. To take full advantage of technology, several factors must be addressed. Superior distance education programs require substantial institutional financial…

  6. The value of nursing: a literature review.

    PubMed

    Horton, Khim; Tschudin, Verena; Forget, Armorel

    2007-11-01

    This article is part of a wider study entitled Value of Nursing, and contains the literature search from electronic databases. Key words for the search included 'values of nursing', 'values in nursing', 'organisational values' and 'professional identity'. Thirty-two primary reports published in English between 2000 and 2006 were identified. The findings highlight the importance of understanding values and their relevance in nursing and how values are constructed. The value of nursing is seen to be influenced by cultural change, globalization, and advancement in technology and medicine. These factors are crucial in providing a more structured and measured view of what nursing is, which will result in greater job satisfaction among nurses, better nurse retention and enhanced patient care within a supportive and harmonious organization. The findings of this review have implications for policy makers in recruitment and retention in determining the global value of nursing. PMID:17901183

  7. The Neurointensive Care Nursery and Evolving Roles for Nursing.

    PubMed

    Peloquin, Susan; Carley, Annette; Bonifacio, Sonia L; Glass, Hannah C

    2016-01-01

    Neonatal neurocritical care is an emerging subspecialty that combines the expertise of critical care medicine and neurology with that of nursing and other providers in an interprofessional team approach to care. Neurocritical care of the neonate has roots in adult and pediatric practice. It has been demonstrated that adults with acute neurologic conditions who are treated in a specialized neurocritical care unit have reduced morbidity and mortality, as well as decreased length of stay, lower costs, and reduced need for neurosurgical procedures. In pediatrics, neurocritical care has focused on various primary and secondary neurologic conditions complicating critical care that also contribute to mortality, morbidity, and duration of hospitalization. However, the concept of neurocritical care as a subspecialty in pediatric practice is still evolving, and evidence demonstrating improved outcomes is lacking. In the neonatal intensive care nursery, neurocritical care is also evolving as a subspecialty concept to address both supportive and preventive care and optimize neurologic outcomes for an at-risk neonatal patient population. To enhance effectiveness of this care approach, nurses must be prepared to appropriately recognize acute changes in neurologic status, implement protocols that specifically address neurologic conditions, and carefully monitor neurologic status to help prevent secondary injury. The complexity of this team approach to brain-focused care has led to the development of a specialized role: the neurocritical care nurse (neonatal intensive care nursery [NICN] nurse). This article will review key concepts related to neonatal neurocritical care and the essential role of nursing. It will also explore the emerging role of the NICN nurse in supporting early recognition and management of at-risk infants in this neonatal subspecialty practice. PMID:27052983

  8. Medical staffing in Ontario neonatal intensive care units.

    PubMed

    Paes, B; Mitchell, A; Hunsberger, M; Blatz, S; Watts, J; Dent, P; Sinclair, J; Southwell, D

    1989-06-01

    Advances in technology have improved the survival rates of infants of low birth weight. Increasing service commitments together with cutbacks in Canadian training positions have caused concerns about medical staffing in neonatal intensive care units (NICUs) in Ontario. To determine whether an imbalance exists between the supply of medical personnel and the demand for health care services, in July 1985 we surveyed the medical directors, head nurses and staff physicians of nine tertiary level NICUs and the directors of five postgraduate pediatric residency programs. On the basis of current guidelines recommending an ideal neonatologist:patient ratio of 1:6 (assuming an adequate number of support personnel) most of the NICUs were understaffed. Concern about the heavy work pattern and resulting lifestyle implications has made Canadian graduates reluctant to enter this subspecialty. We propose strategies to correct staffing shortages in the context of rapidly increasing workloads resulting from a continuing cutback of pediatric residency positions and restrictions on immigration of foreign trainees. PMID:2720515

  9. Challenges Associated with Route of Administration in Neonatal Drug Delivery.

    PubMed

    Linakis, Matthew W; Roberts, Jessica K; Lala, Anita C; Spigarelli, Michael G; Medlicott, Natalie J; Reith, David M; Ward, Robert M; Sherwin, Catherine M T

    2016-02-01

    The administration of drugs to neonates poses significant challenges. The aim of this review was to provide insight into some of these challenges and resolutions that may be encountered with several of the most commonly used routes of administration and dosage forms in neonatal care, including oral, parenteral, transdermal, intrapulmonary, and rectal. Important considerations include fluctuations in stomach pH hours to years after birth, the logistics of setting up an intravenous infusion, the need for reduced particle size for aerosol delivery to the developing neonatal lung, and variation in perirectal venous drainage. Additionally, some of the recently developed technologies for use in neonatal care are described. While the understanding of neonatal drug delivery has advanced over the past several decades, there is still a deficiency of technologies and formulations developed specifically for this population. PMID:26245673

  10. Collaborative Partnerships: Raising the Professional Practice of Nursing.

    PubMed

    Talley, Linda B

    2016-06-01

    The journey to Magnet® provides the ideal platform to demonstrate the impact of nursing and how strong interprofessional partnerships advance care and problem solving in an increasingly complex healthcare arena. Nurses in Magnet organizations use collaborative partnerships to forge innovative solutions, improve nursing care across the continuum, advance health in populations, effect desired change, and improve outcomes. PMID:27214329

  11. Oral Lesions in Neonates

    PubMed Central

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  12. Oral Lesions in Neonates.

    PubMed

    Patil, Shankargouda; Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  13. Pain Management: Knowledge and Attitudes of Senior Nursing Students and Practicing Registered Nurses

    ERIC Educational Resources Information Center

    Messmer, Sherry

    2009-01-01

    Despite scientific advances in pain management, inadequate pain relief in hospitalized patients continues to be an on-going phenomenon. Although nurses do not prescribe medication for pain, the decision to administer pharmacological or other interventions for pain relief is part of nursing practice. Nurses play a critical role in the relief of…

  14. A Model for Collaboration: The Frances Payne Bolton School of Nursing and the Frontier Nursing Service.

    ERIC Educational Resources Information Center

    Novotny, Jeanne M.; And Others

    1996-01-01

    The collaboration between the Frontier Nursing Service and the Frances Payne Bolton School of Nursing provides a way for those with associate degrees in midwifery to obtain a baccalaureate degree in nursing and become eligible for advanced training in midwifery. Distance learning facilitates instruction for the geographically dispersed midwives.…

  15. Challenges in the diagnosis and management of neonatal sepsis

    PubMed Central

    Zea-Vera, Alonso

    2015-01-01

    Neonatal sepsis is the third leading cause of neonatal mortality and a major public health problem, especially in developing countries. Although recent medical advances have improved neonatal care, many challenges remain in the diagnosis and management of neonatal infections. The diagnosis of neonatal sepsis is complicated by the frequent presence of noninfectious conditions that resemble sepsis, especially in preterm infants, and by the absence of optimal diagnostic tests. Since neonatal sepsis is a high-risk disease, especially in preterm infants, clinicians are compelled to empirically administer antibiotics to infants with risk factors and/or signs of suspected sepsis. Unfortunately, both broad-spectrum antibiotics and prolonged treatment with empirical antibiotics are associated with adverse outcomes and increase antimicrobial resistance rates. Given the high incidence and mortality of sepsis in preterm infants and its long-term consequences on growth and development, efforts to reduce the rates of infection in this vulnerable population are one of the most important interventions in neonatal care. In this review, we discuss the most common questions and challenges in the diagnosis and management of neonatal sepsis, with a focus on developing countries. PMID:25604489

  16. Nursing Home Checklist

    MedlinePlus

    Nursing home checklist Name of nursing home: ____________________________________________________ Address: ________________________________________________________________ Phone number: __________________________________________________________ Date of visit: _____________________________________________________________ Basic information Yes No Notes Is the nursing home Medicare certified? Is the nursing ...

  17. Nursing Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A handbook with laws, rules, and regulations of the State Education Department of New York governing nursing practice is presented. It describes licensure requirements and includes complete application forms and instructions for obtaining license and first registration as a licensed practical nurse and professional registered nurse. Applicants are…

  18. Neuroimaging and Other Neurodiagnostic Tests in Neonatal Encephalopathy.

    PubMed

    Merhar, Stephanie L; Chau, Vann

    2016-09-01

    Hypoxic-ischemic encephalopathy is associated with a high risk of morbidity and mortality in the neonatal period. Long-term neurodevelopmental disability is also frequent in survivors. Conventional MRI defines typical patterns of injury that reflect specific pathophysiologic mechanisms. Advanced magnetic resonance techniques now provide unique perspectives on neonatal brain metabolism, microstructure, and connectivity. The application of these imaging techniques has revealed that brain injury commonly occurs at or near the time of birth and evolves over the first weeks of life. Amplitude-integrated electroencephalogram and near-infrared spectroscopy are increasingly used as bedside tools in neonatal intensive care units to monitor brain function. PMID:27524451

  19. [Neonatal herpes simplex infection].

    PubMed

    van Ham-Borawitz, V E J; Stam, E D; Welborn, K M; Sas, T C J

    2016-01-01

    Neonatal encephalitis caused by herpes simplex virus (HSV) is a familiar disease with a high mortality and morbidity rate. Isolated skin-eye-mouth infection is less familiar among professionals. In this article we present two neonates with an isolated skin lesion caused by an HSV infection. Of the neonates infected with HSV, 40-45% show isolated skin-eye-mouth disease. With correct treatment, the risk of spread to the central nervous system will decrease from 50-60% to 5-10%. Typical HSV skin lesions may present at a late stage of the disease or may be masked by a secondary bacterial infection. When a neonate presents with atypical skin lesions starting 7-12 days after the birth, immediate testing for HSV and immediate treatment are required, to decrease the risk of further progression of the disease. PMID:27122069

  20. Neonatal pain management

    PubMed Central

    Bhalla, Tarun; Shepherd, Ed; Tobias, Joseph D.

    2014-01-01

    The past 2-3 decades have seen dramatic changes in the approach to pain management in the neonate. These practices started with refuting previously held misconceptions regarding nociception in preterm infants. Although neonates were initially thought to have limited response to painful stimuli, it was demonstrated that the developmental immaturity of the central nervous system makes the neonate more likely to feel pain. It was further demonstrated that untreated pain can have long-lasting physiologic and neurodevelopmental consequences. These concerns have resulted in a significant emphasis on improving and optimizing the techniques of analgesia for neonates and infants. The following article will review techniques for pain assessment, prevention, and treatment in this population with a specific focus on acute pain related to medical and surgical conditions. PMID:25538531

  1. Neonatal respiratory distress syndrome

    MedlinePlus

    Hyaline membrane disease (HMD); Infant respiratory distress syndrome; Respiratory distress syndrome in infants; RDS - infants ... Neonatal RDS occurs in infants whose lungs have not yet fully ... disease is mainly caused by a lack of a slippery substance in ...

  2. Neonatal abstinence syndrome

    MedlinePlus

    NAS; Neonatal abstinence symptoms ... may contribute to the severity of a baby's NAS symptoms. ... symptoms of withdrawal. Even after medical treatment for NAS is over and babies leave the hospital, they ...

  3. Maternal and neonatal tetanus.

    PubMed

    Thwaites, C Louise; Beeching, Nicholas J; Newton, Charles R

    2015-01-24

    Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58,000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure. PMID:25149223

  4. Expanding the role of the oncology nurse

    PubMed Central

    Quinn, A

    2008-01-01

    Oncology nursing continues to evolve in response to advances in cancer treatment, information and biotechnology. As new scientific and technological discoveries are integrated into cancer care, oncology nurses need to play a key role in the management of this patient population. The role of the oncology nurse has expanded significantly and can differ greatly across cultures. Sophisticated treatments and the growth of targeted therapies will create the challenge of ensuring that all nurses working in this arena are well-educated, independent thinkers. Thus the future success of oncology nurses will focus on enhancement of nursing practice through advanced education. The increased globalisation of healthcare offers exciting opportunities to accomplish this goal by allowing for collaborative relationships among oncology nurses across the globe. PMID:21611002

  5. Neonatal polycystic kidney disease.

    PubMed

    Verghese, Priya; Miyashita, Yosuke

    2014-09-01

    This article provides an up-to-date comprehensive review and summary on neonatal polycystic kidney disease (PKD) with emphasis on the differential diagnosis, clinical manifestations, diagnostic techniques, and potential therapeutic approaches for the major causes of neonatal PKD, namely hereditary disease, including autosomal recessive and autosomal dominant PKD and nonhereditary PKD, with particular emphasis on multicystic dysplastic kidney. A brief overview of obstructive cystic dysplasia and simple and complex cysts is also included. PMID:25155726

  6. Neonatal Jaundice Detection System.

    PubMed

    Aydın, Mustafa; Hardalaç, Fırat; Ural, Berkan; Karap, Serhat

    2016-07-01

    Neonatal jaundice is a common condition that occurs in newborn infants in the first week of life. Today, techniques used for detection are required blood samples and other clinical testing with special equipment. The aim of this study is creating a non-invasive system to control and to detect the jaundice periodically and helping doctors for early diagnosis. In this work, first, a patient group which is consisted from jaundiced babies and a control group which is consisted from healthy babies are prepared, then between 24 and 48 h after birth, 40 jaundiced and 40 healthy newborns are chosen. Second, advanced image processing techniques are used on the images which are taken with a standard smartphone and the color calibration card. Segmentation, pixel similarity and white balancing methods are used as image processing techniques and RGB values and pixels' important information are obtained exactly. Third, during feature extraction stage, with using colormap transformations and feature calculation, comparisons are done in RGB plane between color change values and the 8-color calibration card which is specially designed. Finally, in the bilirubin level estimation stage, kNN and SVR machine learning regressions are used on the dataset which are obtained from feature extraction. At the end of the process, when the control group is based on for comparisons, jaundice is succesfully detected for 40 jaundiced infants and the success rate is 85 %. Obtained bilirubin estimation results are consisted with bilirubin results which are obtained from the standard blood test and the compliance rate is 85 %. PMID:27229489

  7. Neonatal clinical pharmacology

    PubMed Central

    Allegaert, Karel; van de Velde, Marc; van den Anker, John

    2013-01-01

    Effective and safe drug administration in neonates should be based on integrated knowledge on the evolving physiological characteristics of the infant who will receive the drug, and the pharmacokinetics (PK) and pharmacodynamics (PD) of a given drug. Consequently, clinical pharmacology in neonates is as dynamic and diverse as the neonates we admit to our units while covariates explaining the variability are at least as relevant as median estimates. The unique setting of neonatal clinical pharmacology will be highlighted based on the hazards of simple extrapolation of maturational drug clearance when only based on ‘adult’ metabolism (propofol, paracetamol). Secondly, maturational trends are not at the same pace for all maturational processes. This will be illustrated based on the differences between hepatic and renal maturation (tramadol, morphine, midazolam). Finally, pharmacogenetics should be tailored to neonates, not just mirror adult concepts. Because of this diversity, clinical research in the field of neonatal clinical pharmacology is urgently needed, and facilitated through PK/PD modeling. In addition, irrespective of already available data to guide pharmacotherapy, pharmacovigilance is needed to recognize specific side effects. Consequently, paediatric anesthesiologists should consider to contribute to improved pharmacotherapy through clinical trial design and collaboration, as well as reporting on adverse effects of specific drugs. PMID:23617305

  8. Neonatal surgery in Africa.

    PubMed

    Chirdan, Lohfa B; Ngiloi, Petronilla J; Elhalaby, Essam A

    2012-05-01

    The management of neonatal surgical problems continues to pose considerable challenges, particularly in low-resource settings. The burden of neonatal surgical diseases in Africa is not well documented. The characteristics of some neonatal surgical problems are highlighted. Late presentation coupled with poor understanding of the milieu interior of the neonates by incompetent health care providers and poorly equipped hospitals combine to give rise to the unacceptable high morbidity and mortality in most parts of Africa. Proper training of all staff involved in neonatal health care coupled with community awareness must be vigorously pursued by all stakeholders. Various governments throughout the continent of Africa, in conjunction with international donor agencies, must not only provide an adequate budget for health care services and improve infrastructures, but must also deliberately encourage and provide funding for neonatal surgical care and research across the continent. The well-established pediatric surgical training programs, particularly in North and South Africa, should hold the moral responsibility of training all possible numbers of young surgeons from other African countries that do not have any existing pediatric surgical training programs or those countries suffering from remarkable shortage of trained pediatric surgeons. PMID:22475121

  9. American Nurses Association Nursing World

    MedlinePlus

    ... Annual Conference Join » Care Coordination: Capitalizing on the Nursing Role in Population Health --Register Now ! For more ... ANA » My ANA » Shop » ANA Nursing Knowledge Center Nursing Insider News 9/15/16 Update Your MyANA ...

  10. 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…

  11. Neonatal intensive care unit lighting: update and recommendations.

    PubMed

    Rodríguez, Roberto G; Pattini, Andrea E

    2016-08-01

    Achieving adequate lighting in neonatal intensive care units is a major challenge: in addition to the usual considerations of visual performance, cost, energy and aesthetics, there appear different biological needs of patients, health care providers and family members. Communicational aspects of light, its role as a facilitator of the visual function of doctors and nurses, and its effects on the newborn infant physiology and development were addressed in order to review the effects of light (natural and artificial) within neonatal care with a focus on development. The role of light in regulating the newborn infant circadian cycle in particular and the therapeutic use of light in general were also reviewed. For each aspect, practical recommendations were specified for a proper well-lit environment in neonatal intensive care units. PMID:27399015

  12. Fatal Neonatal Herpes Simplex Infection Likely from Unrecognized Breast Lesions.

    PubMed

    Field, Scott S

    2016-02-01

    Type 1 herpes simplex virus (HSV-1) is very prevalent yet in rare circumstances can lead to fatal neonatal disease. Genital acquisition of type 2 HSV is the usual mode for neonatal herpes, but HSV-1 transmission by genital or extragenital means may result in greater mortality rates. A very rare scenario is presented in which the mode of transmission was likely through breast lesions. The lesions were seen by nurses as well as the lactation consultant and obstetrician in the hospital after delivery of the affected baby but not recognized as possibly being caused by herpes. The baby died 9 days after birth with hepatic failure and disseminated intravascular coagulation. Peripartum health care workers need to be aware of potential nongenital (including from the breast[s]) neonatal herpes acquisition, which can be lethal. PMID:26185119

  13. Can training in advanced clinical skills in obstetrics, neonatal care and leadership, of non-physician clinicians in Malawi impact on clinical services improvements (the ETATMBA project): a process evaluation

    PubMed Central

    Ellard, David R; Chimwaza, Wanangwa; Davies, David; O'Hare, Joseph Paul; Kamwendo, Francis; Quenby, Siobhan; Griffiths, Frances

    2014-01-01

    Objectives The ‘enhancing human resources and the use of appropriate technologies for maternal and perinatal survival in sub-Saharan Africa’ (ETATMBA) project is training emergency obstetric and new-born care (EmONC) non-physician clinicians (NPCs) as advanced clinical leaders. Our objectives were to evaluate the implementation and changes to practice. Design A mixed methods process evaluation with the predominate methodology being qualitative. Setting Rural and urban hospitals in 8 of the 14 districts of northern and central Malawi. Participants 54 EmONC NPCs with 3 years’ plus experience. Intervention Training designed and delivered by clinicians from the UK and Malawi; it is a 2-year plus package of training (classroom, mentorship and assignments). Results We conducted 79 trainee interviews over three time points during the training, as well as a convenience sample of 10 colleagues, 7 district officers and 2 UK obstetricians. Trainees worked in a context of substantial variation in the rates of maternal and neonatal deaths between districts. Training reached trainees working across the target regions. For 46 trainees (8 dropped out of the course), dose delivered in terms of attendance was high and all 46 spent time working alongside an obstetrician. In early interviews trainees recalled course content unprompted indicating training had been received. Colleagues and district officers reported cascading of knowledge and initial changes in practice indicating early implementation. By asking trainees to describe actual cases we found they had implemented new knowledge and skills. These included life-saving interventions for postpartum haemorrhage and eclampsia. Trainees identified the leadership training as enabling them to confidently change their own practice and initiate change in their health facility. Conclusions This process evaluation suggests that trainees have made positive changes in their practice. Clear impacts on maternal and perinatal mortality

  14. Nurse educators establishing new venues in global nursing education.

    PubMed

    Shishani, Kawkab; Allen, Carol; Shubnikov, Eugene; Salman, Khlood; Laporte, Ronald E; Linkov, Faina

    2012-01-01

    Nurses represent the largest number of health care workers worldwide, but they are currently underutilized for global health practices. This may be due to the fact that global health programs are not incorporated in nursing education in many countries. The World Health organization (WHO) recognized the importance of building capacity and having well-prepared nurses who are able to exchange knowledge and expertise worldwide, but did not offer practical solutions. A nursing Super course recognizes the gap between what WHO advocates for and what needs to be done in nursing education to achieve well prepared nurses. A solution suggested is to develop well-structured contents that are applicable and can be shared among nursing programs worldwide. A nursing Supercourse is proposed to provide lectures prepared by expert nursing educators and researchers in global health. The nursing Supercourse has emerged from the parent Supercourse that is a virtual library of lectures developed by world experts in public health and medicine. It represents a global library of over 4,300 public health and medical lectures and a network of over 56,000 public health professionals in 174 countries of the world. These lectures are written in different languages, prepared in easy format, and can be accessed through the internet. In other words does not require the usage of any advanced technology. The Supercourse educational technology has been used successfully in Epidemiology education focusing on multiple topics in public health such as non- communicable disease prevention (NCD), chronic diseases, disaster preparedness, environmental health, and others. Training of nursing students in global health while there are attending nursing programs needs to be a part of the national and international health efforts for disease prevention and health promotion. PMID:22459145

  15. Methylphenidate and/or a Nursing Telephone Intervention for Fatigue in Patients With Advanced Cancer: A Randomized, Placebo-Controlled, Phase II Trial

    PubMed Central

    Bruera, Eduardo; Yennurajalingam, Sriram; Palmer, J. Lynn; Perez-Cruz, Pedro E.; Frisbee-Hume, Susan; Allo, Julio A.; Williams, Janet L.; Cohen, Marlene Z.

    2013-01-01

    Purpose Cancer-related-fatigue (CRF) is common in advanced cancer. The primary objective of the study was to compare the effects of methylphenidate (MP) with those of placebo (PL) on CRF as measured using the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) fatigue subscale. The effect of a combined intervention including MP plus a nursing telephone intervention (NTI) was also assessed. Patients and Methods Patients with advanced cancer with a fatigue score of ≥ 4 out of 10 on the Edmonton Symptom Assessment Scale (ESAS) were randomly assigned to one of the following four groups: MP+NTI, PL+NTI, MP + control telephone intervention (CTI), and PL+CTI. Methylphenidate dose was 5 mg every 2 hours as needed up to 20 mg per day. The primary end point was the median difference in FACIT-F fatigue at day 15. Secondary outcomes included anxiety, depression, and sleep. Results One hundred forty-one patients were evaluable. Median FACIT-F fatigue scores improved from baseline to day 15 in all groups: MP+NTI (median score, 4.5; P = .005), PL+NTI (median score, 8.0; P < .001), MP+CTI (median score, 7.0; P = .004), and PL+CTI (median score, 5.0; P = .03). However, there were no significant differences in the median improvement in FACIT-F fatigue between the MP and PL groups (5.5 v 6.0, respectively; P = .69) and among all four groups (P = .16). Fatigue (P < .001), nausea (P = .01), depression (P = .02), anxiety (P = .01), drowsiness (P < .001), appetite (P = .009), sleep (P < .001), and feeling of well-being (P < .001), as measured by the ESAS, significantly improved in patients who received NTI. Grade ≥ 3 adverse events did not differ between MP and PL (40 of 93 patients v 29 of 97 patients, respectively; P = .06). Conclusion MP and NTI alone or combined were not superior to placebo in improving CRF. PMID:23690414

  16. The Research Doctorate in Nursing: The PhD.

    PubMed

    Rice, David

    2016-03-01

    When nurses are considering an advanced degree beyond the master's level of educational preparation, a number of considerations may direct the decision-making process. The doctorate of philosophy (PhD) in nursing is a research degree that will well serve nurses who have the desire to apply theory and develop formal programs of research, become faculty of nursing, combine clinical practice with formal research, and advance through professional leadership in the ranks of hospitals and health systems organizations. 
. PMID:26906125

  17. Resuscitation and Obstetrical Care to Reduce Intrapartum-Related Neonatal Deaths: A MANDATE Study.

    PubMed

    Kamath-Rayne, Beena D; Griffin, Jennifer B; Moran, Katelin; Jones, Bonnie; Downs, Allan; McClure, Elizabeth M; Goldenberg, Robert L; Rouse, Doris; Jobe, Alan H

    2015-08-01

    To evaluate the impact of neonatal resuscitation and basic obstetric care on intrapartum-related neonatal mortality in low and middle-income countries, using the mathematical model, Maternal and Neonatal Directed Assessment of Technology (MANDATE). Using MANDATE, we evaluated the impact of interventions for intrapartum-related events causing birth asphyxia (basic neonatal resuscitation, advanced neonatal care, increasing facility birth, and emergency obstetric care) when implemented in home, clinic, and hospital settings of sub-Saharan African and India for 2008. Total intrapartum-related neonatal mortality (IRNM) was acute neonatal deaths from intrapartum-related events plus late neonatal deaths from ongoing intrapartum-related injury. Introducing basic neonatal resuscitation in all settings had a large impact on decreasing IRNM. Increasing facility births and scaling up emergency obstetric care in clinics and hospitals also had a large impact on decreasing IRNM. Increasing prevalence and utilization of advanced neonatal care in hospital settings had limited impact on IRNM. The greatest improvement in IRNM was seen with widespread advanced neonatal care and basic neonatal resuscitation, scaled-up emergency obstetric care in clinics and hospitals, and increased facility deliveries, resulting in an estimated decrease in IRNM to 2.0 per 1,000 live births in India and 2.5 per 1,000 live births in sub-Saharan Africa. With more deliveries occurring in clinics and hospitals, the scale-up of obstetric care can have a greater effect than if modeled individually. Use of MANDATE enables health leaders to direct resources towards interventions that could prevent intrapartum-related deaths. A lack of widespread implementation of basic neonatal resuscitation, increased facility births, and emergency obstetric care are missed opportunities to save newborn lives. PMID:25656720

  18. NEONATAL DESTRUCTION OF DOPAMINERGIC NEURONS

    EPA Science Inventory

    Rats treated as neonates with 6-hydroxydopamine are proposed to model the dopamine deficiency associated with Lesch-Nyhan syndrome (LNS). o understand the neurobiological basis of specific behaviors in LNS, investigations were undertaken in these neonatally lesioned rats. everal ...

  19. Neonatal follow-up program: Where do we stand?

    PubMed Central

    H. Sobaih, Badr

    2012-01-01

    Neonatal follow-up program (NFP) is becoming the corner stone of standard, high quality care provided to newborns at risk of future neuorodevelopmental delay. Most of the recognized neonatal intensive care units in the developed countries are adopting NFP as part of their mandatory care for the best long term outcome of high risk infants, especially very low birth weight (VLBW) infants. Unfortunately, in the developing and in underdeveloped countries, such early detection and intervention programs are rarely existing, mainly because of the lack of awareness of and exposure to such programs in spite of the increasing numbers of surviving sick newborns due to advancement in neonatal care in these countries. This is a review article to explore the Neonatal follow-up programs looking at historical development, benefts and aims, and standard requirements for successful program development that can be adopted in our countries. In conclusion, proper Neonatal follow-up programs are needed to improve neonatal outcome. Therefore all professionals working in the feld of neonatal care in developing countries should cooperate to create such programs for early detection and hence early intervention for any adverse long term outcome in high-risk newborn infants

  20. Prevention of nosocomial infections in neonatal intensive care units.

    PubMed

    Manzoni, Paolo; De Luca, Daniele; Stronati, Mauro; Jacqz-Aigrain, Evelyne; Ruffinazzi, Giulia; Luparia, Martina; Tavella, Elena; Boano, Elena; Castagnola, Elio; Mostert, Michael; Farina, Daniele

    2013-02-01

    Neonatal sepsis causes a huge burden of morbidity and mortality and includes bloodstream, urine, cerebrospinal, peritoneal, and lung infections as well as infections starting from burns and wounds, or from any other usually sterile sites. It is associated with cytokine - and biomediator-induced disorders of respiratory, hemodynamic, and metabolic processes. Neonates in the neonatal intensive care unit feature many specific risk factors for bacterial and fungal sepsis. Loss of gut commensals such as Bifidobacteria and Lactobacilli spp., as occurs with prolonged antibiotic treatments, delayed enteral feeding, or nursing in incubators, translates into proliferation of pathogenic microflora and abnormal gut colonization. Prompt diagnosis and effective treatment do not protect septic neonates form the risk of late neurodevelopmental impairment in the survivors. Thus prevention of bacterial and fungal infection is crucial in these settings of unique patients. In this view, improving neonatal management is a key step, and this includes promotion of breast-feeding and hygiene measures, adoption of a cautious central venous catheter policy, enhancement of the enteric microbiota composition with the supplementation of probiotics, and medical stewardship concerning H2 blockers with restriction of their use. Additional measures may include the use of lactoferrin, fluconazole, and nystatin and specific measures to prevent ventilator associated pneumonia. PMID:23292914

  1. Neonatal herpes simplex virus.

    PubMed

    Berardi, Alberto; Lugli, Licia; Rossi, Cecilia; Maria, Chiara Laguardia; Guidotti, Isotta; Gallo, Claudio; Ferrari, Fabrizio

    2011-10-01

    Herpes simplex virus is an important cause of neonatal infection, which can lead to death or long-term disabilities. Rarely in utero, the transmission frequently occurs during delivery. The disease may be disseminated, localized to the central nervous system, or involving skin, eye and/or mouth. Mortality rates markedly decreased with high-dose antiviral treatment. Diagnosis of neonatal infection is based on viral isolation from ulcerated vesicles or by scarifying mucocutaneous lesions. Recently polymerase chain reaction plays a central role for both viral detection (skin, mucosal, cerebrospinal fluid samples) and response to therapy. Vertical transmission may be decreased by prophylactic antiviral treatment. PMID:21942600

  2. Perceived roles of oncology nursing.

    PubMed

    Lemonde, Manon; Payman, Naghmeh

    2015-01-01

    The Canadian Association of Nurses in Oncology (CANO) Standards of Care (2001) provides a framework that delineates oncology nursing roles and responsibilities. The purpose of this study was to explore how oncology nurses perceive their roles and responsibilities compared to the CANO Standards of Care. Six focus groups were conducted and 21 registered nurses (RNs) from a community-based hospital participated in this study. Transcripts were analyzed using qualitative inductive content analysis. Three themes were identified: (1) Oncology nurses perceive a gap between their defined roles and the reality of daily practice, as cancer care becomes more complex and as they provide advanced oncology care to more patients while there is no parallel adaptation to the health care system to support them, such as safe staffing; (2) Oncology nursing, as a specialty, requires sustained professional development and leadership roles; and (3) Oncology nurses are committed to providing continuous care as a reference point in the health care team by fostering interdisciplinary collaboration andfacilitating patient's navigation through the system. Organizational support through commitment to appropriate staffing and matching scope ofpractice to patient needs may lead to maximize the health and well-being of nurses, quality of patient care and organizational performance. PMID:26897865

  3. Forecasting the nursing workforce in a dynamic health care market.

    PubMed

    Dumpe, M L; Herman, J; Young, S W

    1998-01-01

    The ability to discern the interacting factors that affect supply and demand for nurses could help nurse educators and nurse leaders allocate resources to meet these needs. Forecasting models must take into account the interactions of three crucial groups of health care providers--physicians, nurse practitioners, and physician's assistants. Buerhaus has noted that market size, wages, preferences for nursing services, and availability of substitutes influence the demand for nursing services. Changes in nurse supply resulting from Medicare reimbursement for nursing services have not been studied, though it could safely be projected that such reimbursement will increase nurse supply. Nurses with baccalaureate degrees and advanced practice preparation will be in the greatest demand in ambulatory care, managed care, public health, and home care settings, raising concerns again that the educational mix is in need of adjustment upwards. PMID:9748982

  4. Conscientious objection: a call to nursing leadership.

    PubMed

    Ford, Natalie J; Fraser, Kimberly D; Marck, Patricia B

    2010-09-01

    In this paper we argue that nurse leaders need to work actively to create morally supportive environments for nurses in Canada that provide adequate room to exercise conscientious objection. Morally supportive environments engender a safe atmosphere to engage in open dialogue and action regarding conflict of conscience. The CNA's 2008 Code of Ethics for Registered Nurses has recognized the importance of conscientious objection in nursing and has created key guidelines for the registered nurse to follow when a conflict in conscience is being considered or declared. Nurse leaders need to further develop the understanding of conflicts of conscience through education, well-written guidelines for conscientious objection in workplaces and engagement in research to uncover underlying barriers to the enactment of conscientious objections. With advancements in technology, changing healthcare policies and increasing scope of practice, both reflection and dialogue on conscientious objection are critical for the continuing moral development of nurses in Canada. PMID:24947301

  5. Developing a social media platform for nurses.

    PubMed

    Jackson, Jennifer; Kennedy, Maggie

    2015-11-18

    Social media tools provide opportunities for nurses to connect with colleagues and patients and to advance personally and professionally. This article describes the process of developing an innovative social media platform at a large, multi-centre teaching hospital, The Ottawa Hospital, Canada, and its benefits for nurses. The platform, TOH Nurses, was developed using a nursing process approach, involving assessment, planning, implementation and evaluation. The aim of this initiative was to address the barriers to communication inherent in the large number of nurses employed by the organisation, the physical size of the multi-centre hospital and the shift-work nature of nursing. The platform was used to provide educational materials for clinical nurses, and to share information about professional practice. The implications of using a social media platform in a healthcare setting were considered carefully during its development and implementation, including concerns regarding privacy and confidentiality. PMID:26576914

  6. Functional characteristics of neonatal rat β cells with distinct markers.

    PubMed

    Martens, G A; Motté, E; Kramer, G; Stangé, G; Gaarn, L W; Hellemans, K; Nielsen, J H; Aerts, J M; Ling, Z; Pipeleers, D

    2014-02-01

    Neonatal β cells are considered developmentally immature and hence less glucose responsive. To study the acquisition of mature glucose responsiveness, we compared glucose-regulated redox state, insulin synthesis, and secretion of β cells purified from neonatal or 10-week-old rats with their transcriptomes and proteomes measured by oligonucleotide and LC-MS/MS profiling. Lower glucose responsiveness of neonatal β cells was explained by two distinct properties: higher activity at low glucose and lower activity at high glucose. Basal hyperactivity was associated with higher NAD(P)H, a higher fraction of neonatal β cells actively incorporating (3)H-tyrosine, and persistently increased insulin secretion below 5 mM glucose. Neonatal β cells lacked the steep glucose-responsive NAD(P)H rise between 5 and 10 mM glucose characteristic for adult β cells and accumulated less NAD(P)H at high glucose. They had twofold lower expression of malate/aspartate-NADH shuttle and most glycolytic enzymes. Genome-wide profiling situated neonatal β cells at a developmental crossroad: they showed advanced endocrine differentiation when specifically analyzed for their mRNA/protein level of classical neuroendocrine markers. On the other hand, discrete neonatal β cell subpopulations still expressed mRNAs/proteins typical for developing/proliferating tissues. One example, delta-like 1 homolog (DLK1) was used to investigate whether neonatal β cells with basal hyperactivity corresponded to a more immature subset with high DLK1, but no association was found. In conclusion, the current study supports the importance of glycolytic NADH-shuttling in stimulus function coupling, presents basal hyperactivity as novel property of neonatal β cells, and provides potential markers to recognize intercellular developmental differences in the endocrine pancreas. PMID:24049066

  7. Scrotal Swelling in the Neonate

    PubMed Central

    Basta, Amaya M.; Courtier, Jesse; Phelps, Andrew; Copp, Hillary L.; MacKenzie, John D.

    2016-01-01

    Discovery of scrotal swelling in a neonate can be a source of anxiety for parents, clinicians, and sonologists alike. This pictorial essay provides a focused review of commonly encountered scrotal masses and mimics specific to the neonatal setting. Although malignancy is a concern, it is very uncommon, as most neonatal scrotal masses are benign. Key discriminating features and management options are highlighted to improve the radiologist’s ability to diagnose neonatal scrotal conditions and guide treatment decisions. Neonatal scrotal processes ranging from common to uncommon will be discussed. PMID:25715370

  8. Facility Death Review of Maternal and Neonatal Deaths in Bangladesh

    PubMed Central

    Biswas, Animesh; Rahman, Fazlur; Eriksson, Charli; Halim, Abdul; Dalal, Koustuv

    2015-01-01

    Objectives To explore the experiences, acceptance, and effects of conducting facility death review (FDR) of maternal and neonatal deaths and stillbirths at or below the district level in Bangladesh. Methods This was a qualitative study with healthcare providers involved in FDRs. Two districts were studied: Thakurgaon district (a pilot district) and Jamalpur district (randomly selected from three follow-on study districts). Data were collected between January and November 2011. Data were collected from focus group discussions, in-depth interviews, and document review. Hospital administrators, obstetrics and gynecology consultants, and pediatric consultants and nurses employed in the same departments of the respective facilities participated in the study. Content and thematic analyses were performed. Results FDR for maternal and neonatal deaths and stillbirths can be performed in upazila health complexes at sub-district and district hospital levels. Senior staff nurses took responsibility for notifying each death and conducting death reviews with the support of doctors. Doctors reviewed the FDRs to assign causes of death. Review meetings with doctors, nurses, and health managers at the upazila and district levels supported the preparation of remedial action plans based on FDR findings, and interventions were planned accordingly. There were excellent examples of improved quality of care at facilities as a result of FDR. FDR also identified gaps and challenges to overcome in the near future to improve maternal and newborn health. Discussion FDR of maternal and neonatal deaths is feasible in district and upazila health facilities. FDR not only identifies the medical causes of a maternal or neonatal death but also explores remediable gaps and challenges in the facility. FDR creates an enabled environment in the facility to explore medical causes of deaths, including the gaps and challenges that influence mortality. FDRs mobilize health managers at upazila and district

  9. Faculty practice plan entrance strategy for nursing.

    PubMed

    Parsons, M A; Felton, G M; Chassie, M B

    1996-01-01

    Nursing is a practice discipline that places great value on members of the profession who excel as providers of direct care. With health care reform, nursing faculty have unprecedented opportunities for advanced practice and are implementing entrepreneurial ventures to meet their commitments to practice. The purpose of this article is to describe a nursing faculty practice plan in conjunction with a decentralized medical school plan. The major benefits and barriers to its adoption are addressed. PMID:9087037

  10. Priorities in neonatal care in developing countries.

    PubMed

    Ho, N K

    1996-08-01

    Lower perinatal and neonatal mortality have been achieved in the developed countries following advancement of neonatal care, introduction of high technologies, and better knowledge of pathophysiology of the newborn infants. Other contributing factors are organised delivery room care with skillful resuscitative techniques as well as risk identification and efficient transport of the sick infants including in utero transfer of the fetus, etc. It cannot be assumed that similar results can be attained in developing countries where financial and human resources are the problems. With limited resources, it is necessary to prioritize neonatal care in the developing countries. It is essential to collect minimum meaningful perinatal data to define the problems of each individual country. This is crucial for monitoring, auditing, evaluation, and planning of perinatal health care of the country. The definition and terminology in perinatology should also be uniform and standardised for comparative studies. Paediatricians should be well trained in resuscitation and stabilisation of the newborn infants. Resuscitation should begin in the delivery room and a resuscitation team should be formed. This is the best way to curtail complication and morbidity of asphyxiated births. Nosocomial infections have been the leading cause of neonatal deaths. It is of paramount importance to prevent infections in the nursery. Staff working in the nursery should pay attention to usage of sterilised equipment, isolation of infected babies and aseptic procedures. Paediatricians should avoid indiscriminate use of antibiotics. Most important of all, hand-washing before examination of the baby is mandatory and should be strictly adhered to. Other simpler measures include warming devices for maintenance of body temperature of the newborn babies, blood glucose monitoring, and antenatal steroid for mothers in premature labour. In countries where neonatal jaundice is prevalent, effective management to

  11. Advancing Evidence in Preterm Neonatal Medicine

    ERIC Educational Resources Information Center

    Donahue, Pamela K.; Robinson, Karen A.

    2010-01-01

    Few interventions and treatments for premature infants have undergone the rigors of a randomized controlled trial (RCT), the cornerstone of evidence-based healthcare. Multiple barriers in establishing a quality evidence base for the care of preterm infants are examined including the systematic exclusion of children from drug trials, vulnerability…

  12. Phase Contrast Imaging in Neonates

    PubMed Central

    Zhong, Kai; Ernst, Thomas; Buchthal, Steve; Speck, Oliver; Anderson, Lynn; Chang, Linda

    2011-01-01

    Magnetic resonance phase images can yield superior gray and white matter contrast compared to conventional magnitude images. However, the underlying contrast mechanisms are not yet fully understood. Previous studies have been limited to high field acquisitions in adult volunteers and patients. In this study, phase imaging in the neonatal brain is demonstrated for the first time. Compared to adults, phase differences between gray and white matter are significantly reduced but not inverted in neonates with little myelination and iron deposits in their brains. The remaining phase difference between the neonatal and adult brains may be due to different macromolecule concentration in the unmyelinated brain of the neonates and thus different frequency due to water macromolecule exchange. Additionally, the susceptibility contrast from brain myelination can be separately studied in neonates during brain development. Therefore, magnetic resonance phase imaging is suggested as a novel tool to study neonatal brain development and pathologies in neonates. PMID:21232619

  13. [Essential professional core competencies for nurses].

    PubMed

    Chen, Yu-Chih

    2010-10-01

    Core competency is vital to the nursing profession. Such helps guarantee the high quality and effectiveness of delivered care and maintains the social value and status of the nursing profession. This article introduces the definition of nursing core competency and its connotations. The core competency profile for the nursing profession embraces basic behavioral attributes as well as mastery of advanced practice skills. The former include such attributes as gentleness, willingness to serve, keen observation and judgment, efficiency, skillfulness, responsibility and accountability. The latter embraces skills in general care, communication and collaboration, management, self-development, innovation and research, and stress-adjustment. To cultivate competent nurses, academic education should emphasize critical thinking skills, integrate problem-based and evidence-based learning approaches into curricula, and use objective structured clinical examination to evaluate learning outcomes. In the healthcare sector, systematic professional training models such as the clinical ladder with multidiscipline rotation hold the potential to train novice nurses as expert professionals. Meanwhile, to advance the professional capabilities of nurses, nursing administrators should provide a positive work environment to fuel and maintain learning motivation. Education and healthcare systems should work closely together to promote the professional competence of nurses and to strengthen the value of the nursing profession. PMID:20878605

  14. Hawai‘i's Nursing Workforce: Keeping Pace with Healthcare

    PubMed Central

    Qureshi, Kristine

    2015-01-01

    Nursing is the largest segment of the healthcare workforce, but over the next decade even more nurses will be required. Changing population demographics, new technologies, and evolving models of healthcare will stimulate expansion of nursing roles and the need for a highly educated nursing workforce. The current nursing workforce is aging, and large numbers of retirements are anticipated. By 2025, the United States is expected to experience a nursing shortage; in Hawai‘i this shortfall is forecast to be 3,311 professional nurses. Currently there are nine nursing programs across the state in public and private universities and colleges. These programs are partnering to implement the Institute of Medicine's recommendations for the future of nursing. In Hawai‘i, nursing practice is being expanded; different pathways to advanced nursing education are being implemented; and nurses are partnering with other groups to reshape healthcare. The Hawai‘i State Center for Nursing collects ongoing data on the nursing workforce to inform strategic planning. Current gaps in nursing specialty education include school health and mental health. The purpose of this paper is to provide an overview of Hawai‘i's nursing workforce in relationship to statewide population demographics, healthcare needs and gaps, and then outline steps being taken by the profession to address these needs and gaps while implementing the Institute of Medicine recommendations. PMID:25755912

  15. Depression Management by NICU Nurses: Mothers' Views.

    PubMed

    Segre, Lisa S; Orengo-Aguayo, Rosaura E; Siewert, Rebecca Chuffo

    2016-06-01

    The purpose of this article was to evaluate attitudes of mothers of newborns hospitalized on the neonatal intensive care unit (NICU) toward nurse-delivered depression screening and counseling. NICU mothers (N = 200) completed questionnaires assessing their views toward being screened for depression by nurses, treatment provider preference, and interest in learning about Listening Visits (LV), a nurse-delivered intervention. The views of 23 LV recipients were also assessed. Most mothers were receptive to depression screening by nurses, two thirds would see a nurse for counseling, and half were interested in learning more about LV. Among LV recipients, half readily embraced the idea and the remaining recipients were skeptical but opted to try. After receiving LV, recipients unanimously rated LV and the skill of the LV provider highly. Screening and counseling by NICU nurses could increase detection of depression and treatment use among at-risk women. Assessing nurses' perspectives about implementing this model of care is an important future research direction. PMID:26137943

  16. Ethical issues in neonatal intensive care units.

    PubMed

    Liu, Jing; Chen, Xin-Xin; Wang, Xin-Ling

    2016-07-01

    On one hand, advances in neonatal care and rescue technology allow for the healthy survival or prolonged survival time of critically ill newborns who, in the past, would have been non-viable. On the other hand, many of the surviving critically ill infants have serious long-term disabilities. If an infant eventually cannot survive or is likely to suffer severe disability after surviving, ethical issues in the treatment process are inevitable, and this problem arises not only in developed countries but is also becoming increasingly prominent in developing countries. In addition, ethical concerns cannot be avoided in medical research. This review article introduces basic ethical guidelines that should be followed in clinical practice, including respecting the autonomy of the parents, giving priority to the best interests of the infant, the principle of doing no harm, and consent and the right to be informed. Furthermore, the major ethical concerns in neonatal intensive care units (NICUs) in China are briefly introduced. PMID:26382713

  17. Maternal, neonatal and community factors influencing neonatal mortality in Brazil.

    PubMed

    Machado, Carla Jorge; Hill, Kenneth

    2005-03-01

    Child mortality (the mortality of children less than five years old) declined considerably in the developing world in the 1990s, but infant mortality declined less. The reductions in neonatal mortality were not impressive and, as a consequence, there is an increasing percentage of infant deaths in the neonatal period. Any further reduction in child mortality, therefore, requires an understanding of the determinants of neonatal mortality. 209,628 birth and 2581 neonatal death records for the 1998 birth cohort from the city of São Paulo, Brazil, were probabilistically matched. Data were from SINASC and SIM, Information Systems on Live Births and Deaths of Brazil. Logistic regression was used to find the association between neonatal mortality and the following risk factors: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. Infants of older mothers were less likely to die in the neonatal period. Caesarean delivery was not found to be associated with neonatal mortality. Low birth weight, pre-term birth and low Apgar scores were associated with neonatal death. Having a mother who lives in the highest developed community decreased the odds of neonatal death, suggesting that factors not measured in this study are behind such association. This result may also indicate that other factors over and above biological and more proximate factors could affect neonatal death. PMID:15768774

  18. Quality improvement initiatives in neonatal intensive care unit networks: achievements and challenges.

    PubMed

    Shah, Vibhuti; Warre, Ruth; Lee, Shoo K

    2013-01-01

    Neonatal intensive care unit networks that encompass regions, states, and even entire countries offer the perfect platform for implementing continuous quality improvement initiatives to advance the health care provided to vulnerable neonates. Through cycles of identification and implementation of best available evidence, benchmarking, and feedback of outcomes, combined with mutual collaborative learning through a network of providers, the performance of health care systems and neonatal outcomes can be improved. We use examples of successful neonatal networks from across North America to explore continuous quality improvement in the neonatal intensive care unit, including the rationale for the formation of neonatal networks, the role of networks in continuous quality improvement, quality improvement methods and outcomes, and barriers to and facilitators of quality improvement. PMID:24268090

  19. Neonatal resuscitation in low-resource settings: What, who, and how to overcome challenges to scale up?

    PubMed Central

    Wall, Stephen N.; Lee, Anne CC; Niermeyer, Susan; English, Mike; Keenan, William J.; Carlo, Wally; Bhutta, Zulfiqar A.; Bang, Abhay; Narayanan, Indira; Ariawan, Iwan; Lawn, Joy E.

    2009-01-01

    Background Each year approximately 10 million babies do not breathe immediately at birth, of which about 6 million require basic neonatal resuscitation. The major burden is in low-income settings, where health system capacity to provide neonatal resuscitation is inadequate. Objective To systematically review the evidence for neonatal resuscitation content, training and competency, equipment and supplies, cost, and key program considerations, specifically for resource-constrained settings. Results Evidence from several observational studies shows that facility-based basic neonatal resuscitation may avert 30% of intrapartum-related neonatal deaths. Very few babies require advanced resuscitation (endotracheal intubation and drugs) and these newborns may not survive without ongoing ventilation; hence, advanced neonatal resuscitation is not a priority in settings without neonatal intensive care. Of the 60 million nonfacility births, most do not have access to resuscitation. Several trials have shown that a range of community health workers can perform neonatal resuscitation with an estimated effect of a 20% reduction in intrapartum-related neonatal deaths, based on expert opinion. Case studies illustrate key considerations for scale up. Conclusion Basic resuscitation would substantially reduce intrapartum-related neonatal deaths. Where births occur in facilities, it is a priority to ensure that all birth attendants are competent in resuscitation. Strategies to address the gap for home births are urgently required. More data are required to determine the impact of neonatal resuscitation, particularly on long-term outcomes in low-income settings. PMID:19815203

  20. The Future of Nursing Education: 10 Trends To Watch.

    ERIC Educational Resources Information Center

    Heller, Barbara R.; Oros, Marla T.; Durney-Crowley, Jane

    2000-01-01

    Ten trends affecting nursing are as follows: changing demographics, technology, globalization, educated consumers, population-based care, health care costs/managed care, health policy and regulation, need for interdisciplinary education and collaboration, nursing shortage, and advances in nursing science and research. (SK)

  1. 42 CFR 440.166 - Nurse practitioner services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... are furnished by a registered professional nurse who meets a State's advanced educational and clinical... registered professional nurse who meets the requirements specified in either paragraphs (b)(1) or (b)(2) of... practitioner must— (i) Be currently licensed to practice in the State as a registered professional nurse;...

  2. Epistemic Authority in Nursing Practice vs. Doctors' Orders.

    PubMed

    Reed, Pamela G

    2016-07-01

    The practice policy of doctors' orders is still deeply embedded in 21st century professional nurse practice, despite its profound incongruence with nursing's perspective, standards of practice, and advanced knowledge. The author in this article elaborates on the doctors' orders policy in relation to nursing's disciplinary perspective and epistemic authority in professional practice. PMID:27271139

  3. Neonatal Intensive Care and Child Psychiatry Inpatient Care: Do Different Working Conditions Influence Stress Levels?

    PubMed Central

    Mörelius, Evalotte; Gustafsson, Per A.; Ekberg, Kerstin

    2013-01-01

    Introduction. Nurses often experience work-related stress. High stress can negatively affect job satisfaction and lead to emotional exhaustion with risk of burnout. Aim. To analyse possible differences in biological stress markers, psychosocial working conditions, health, and well-being between nurses working in two different departments. Methods. Stress was evaluated in nurses working in a neonatal intensive care unit (NICU) (n = 33) and nurses working in a child and adolescent psychiatry inpatient ward (CAP) (n = 14) using salivary cortisol and HbA1c. Salivary cortisol was measured three times a day on two consecutive days during two one-week periods, seven weeks apart (= 12 samples/person). Psychosocial working conditions, health, and well-being were measured once. Results. NICU nurses had better social support and more self-determination. CAP nurses had a lower salivary cortisol quotient, poorer general health, and higher client-related burnout scores. Conclusion. When comparing these nurses with existing norm data for Sweden, as a group their scores reflect less work-related stress than Swedes overall. However, the comparison between NICU and CAP nurses indicates a less healthy work situation for CAP nurses. Relevance to Clinical Practice. Healthcare managers need to acknowledge the less healthy work situation CAP nurses experience in order to provide optimal support and promote good health. PMID:23878734

  4. Men Who Enter Nursing: A Sociological Analysis.

    ERIC Educational Resources Information Center

    Auster, Donald; Auster, Nancy R.

    Little is known about the relationship between the choice of a sex discrepant occupation and the selection of a nursing career, attitudes toward training, and professional socialization. The research design included a cross-sectional attitude survey of both beginning and advanced nursing school students. Data were obtained from a…

  5. Generational differences in registered nurse turnover.

    PubMed

    LeVasseur, Sandra A; Wang, Chen-Yen; Mathews, Barbara; Boland, Mary

    2009-08-01

    The chronic nature of the nursing workforce shortage in the United States is a continuing concern. As the nationwide gap between supply and demand grows, it remains unknown what impact turnover will have on nursing, access to care, and efforts to improve quality and safety of health care. It also remains unclear whether the recent turnover trends among new graduate registered nurses differ from past generational cohorts of new nurses. The aims of this study were to identify the reasons why registered nurses turnover by generational cohort (Veterans, Baby Boomers, and GenXMs) and to compare the length of time nurses were employed in their first five nursing positions by generational cohort. The findings suggest the three generational cohorts displayed similar reasons for leaving nursing positions with relocation, career advancement, and personal/family reasons reported most frequently. Except for the first nursing position, significant generational effects were found in the length of time Veterans, Baby Boomer, and GenXMs stayed employed in their nursing positions. It remains unknown why the GenXMs displayed a significantly shorter length of employment time in their second, third, fourth, and fifth nursing positions. The decline in length of employment time displayed in both the Baby Boomers and GenXMs may be an issue of concern requiring future research. PMID:20026454

  6. Prevalence of porcine neonatal isosporosis in Brazil.

    PubMed

    Sayd, S M; Kawazoe, U

    1996-12-31

    The prevalence of Isospora suis and clinical signs of isosporosis were observed in 33 swine farms from 20 sites in the southeastern state of São Paulo, Brazil. The study was performed by collecting 177 faecal samples from nursing and weaned piglets. A history of clinical neonatal isosporosis, as well as the type of farrowing and nursery houses and the pig management in the farms were correlated to the prevalence of I. suis oocysts. Six faecal samples were collected in each of the farms (two from groups of 10- to 19-day-old piglets, two from groups of 20- to 29-day-old and another two from groups of 30- to 50-day-old pigs). Faecal consistency was also registered at the time of their collection. Chi-square tests were used for statistical analysis. Oocysts were more prevalent in farms with a history of neonatal isosporosis than in those without previous cases. Faecal consistency was not related to oocyst elimination. In farms with a history of clinical isosporosis, faecal samples from groups of 10- to 19-day-old piglets showed a higher prevalence of oocysts than the groups of other ages studied. There was no difference in the prevalence of oocysts between nursing and weaned piglets. Oocysts were more prevalent in faecal samples collected from dirty-cemented floors than from self-cleaning floors in the farrowing houses. Types of floor and pig management in nursery houses were not associated with the presence of oocysts in weaned pigs. PMID:9017865

  7. End-of-Life Decision Making for Nursing Home Residents with Dementia: A Survey of Nursing Home Social Services Staff

    ERIC Educational Resources Information Center

    Lacey, Debra

    2006-01-01

    The purpose of this survey was to describe nursing home social services staff roles and perceptions related to end-of-life medical decision making for nursing home residents in endstage dementia. Using a self-designed questionnaire, 138 nursing home social services staff from across New York State answered questions about advance directives,…

  8. [Construction of terminology subsets: contributions to clinical nursing practice].

    PubMed

    Clares, Jorge Wilker Bezerra; de Freitas, Maria Célia; Guedes, Maria Vilaní Cavalcante; da Nóbrega, Maria Miriam Lima

    2013-08-01

    The International Classification for Nursing Practice (ICNP®) is a classification system that unifies the elements of nursing practice (diagnoses, interventions and outcomes), enabling elucidation of elements of a specific nursing language through the construction of terminology subsets. In this reflective essay, aspects relevant to the construction of ICNP® terminology subsets are highlighted, as well as their contributions to clinical nursing practice. The development of subsets as a tool that contributes to making nursing language universal, facilitates the communication process, as well as the scientific and technological advancement of the profession, is discussed. Therefore, its use by nurses worldwide is encouraged. PMID:24310697

  9. Validation of holistic nursing competencies: role-delineation study, 2012.

    PubMed

    Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Campbell, Joan A; Brekke, Mary E; Sandor, M Kay

    2013-12-01

    The American Holistic Nurses Credentialing Corporation (AHNCC), certifying body for nurses practicing within the precepts of holistic nursing, uses a systematic process to guide program development. A previous publication described their early work that distinguished basic and advanced holistic nursing and development of related examinations. A more recent publication described the work of AHNCC from 2004 to 2012, including a role-delineation study (RDS) that was undertaken to identify and validate competencies currently used by holistic nurses. A final report describes the RDS design, methods, and raw data information. This article discusses AHNCC's goals for undertaking the 2012 Holistic Nursing RDS and the implications for the certification programs. PMID:23783664

  10. PhD or DNP: planning for doctoral nursing education.

    PubMed

    Bednash, Geraldine; Breslin, Eileen T; Kirschling, Jane M; Rosseter, Robert J

    2014-10-01

    Leading authorities from inside and outside of nursing are calling for a rapid increase in the number of nurses holding doctoral degrees. More nurses with the terminal degree are needed to serve as Advanced Practice Registered Nurses, assume faculty roles, embark on research careers, and pursue top leadership positions. Today's prospective nursing student can choose from doctoral programs focused on research or practice. The authors explore the differences in these degree options, expectations for students enrolled in these programs, key questions to ask when selecting a degree type, and the career choices available to doctorally-prepared nurses, including faculty positions. PMID:25248773

  11. Universal bilirubin screening for severe neonatal hyperbilirubinemia.

    PubMed

    Bhutani, V K; Vilms, R J; Hamerman-Johnson, L

    2010-10-01

    To reduce the incidence of severe neonatal hyperbilirubinemia affecting newborns with jaundice in the United States and to prevent kernicterus, there is a need to implement proven prevention strategies for severe neonatal hyperbilirubinemia as recommended in the 2004 American Academy of Pediatrics Guidelines for newborns >35 weeks gestational age. The purpose of universal predischarge bilirubin screening is to identify infants with bilirubin levels >75th percentile for age in hours and track those with rapid rates of bilirubin rise (>0.2 mg per 100 ml per h). Early identification has been reported to predict severe hyperbilirubinemia and allow for evidence-based targeted interventions. A systems approach is likely to reduce the preventable causes of acute bilirubin encephalopathy. To do so, highest priority should be given to (i) designating extreme hyperbilirubinemia (total serum bilirubin >427 μmol l(-1) or >25 mg per 100 ml) as a reportable condition by laboratories and health-care providers through public health mandates; (ii) implementation of Joint Commission's Sentinel Report for kernicterus; (iii) nursing outreach to communities for education of prospective parents; (iv) development of clinical pathways to monitor, evaluate and track infants with extreme hyperbilirubinemia; and (v) societal awareness. These efforts should be monitored by a state and national surveillance system in order to critically improve the timeliness and completeness of notifications and to allow evaluation and interventions at the policy and individual family level. PMID:20877410

  12. Developing leadership talent: a statewide nurse leader mentorship program.

    PubMed

    Rich, Mary; Kempin, Bettyann; Loughlin, Mary Jo; Vitale, Tracy R; Wurmser, Theresa; Thrall, Terese Hudson

    2015-02-01

    Nurse leaders continue to seek support programs essential for advancement to senior roles. Providing such support presents a challenge for the future of nursing in the state of New Jersey and on a national level. This article discusses the creation of a mentorship program by the Organization of Nurse Executives of New Jersey (ONE NJ). In recognition of the program, which has contributed to the advancement of New Jersey nursing leadership, the ONE NJ received the 2014 American Organization of Nurse Executives Chapter Achievement Award. PMID:25621746

  13. Ethics in independent nurse consulting: strategies for avoiding ethical quicksand.

    PubMed

    Creel, Eileen L; Robinson, Jennifer C

    2010-11-01

    Changes in health care have created a variety of new roles and opportunities for nurses in advanced practice. One of these changes is the increasing number of advanced practice nurses carrying out independent consultation. Differences in goals between business and health care may create ethical dilemmas for nurse consultants. The purpose of this article is to describe possible ethical pitfalls that nurse consultants may encounter and strategies to prevent or solve these dilemmas. Three themes related to nursing codes of ethics will be discussed: the duty to uphold human rights, the duty to fulfill commitments, and the duty to practice the profession competently. PMID:21097975

  14. Development and validation of a simple algorithm for initiation of CPAP in neonates with respiratory distress in Malawi

    PubMed Central

    Hundalani, Shilpa G; Richards-Kortum, Rebecca; Oden, Maria; Kawaza, Kondwani; Gest, Alfred; Molyneux, Elizabeth

    2015-01-01

    Background Low-cost bubble continuous positive airway pressure (bCPAP) systems have been shown to improve survival in neonates with respiratory distress, in developing countries including Malawi. District hospitals in Malawi implementing CPAP requested simple and reliable guidelines to enable healthcare workers with basic skills and minimal training to determine when treatment with CPAP is necessary. We developed and validated TRY (T: Tone is good, R: Respiratory Distress and Y=Yes) CPAP, a simple algorithm to identify neonates with respiratory distress who would benefit from CPAP. Objective To validate the TRY CPAP algorithm for neonates with respiratory distress in a low-resource setting. Methods We constructed an algorithm using a combination of vital signs, tone and birth weight to determine the need for CPAP in neonates with respiratory distress. Neonates admitted to the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi, were assessed in a prospective, cross-sectional study. Nurses and paediatricians-in-training assessed neonates to determine whether they required CPAP using the TRY CPAP algorithm. To establish the accuracy of the TRY CPAP algorithm in evaluating the need for CPAP, their assessment was compared with the decision of a neonatologist blinded to the TRY CPAP algorithm findings. Results 325 neonates were evaluated over a 2-month period; 13% were deemed to require CPAP by the neonatologist. The inter-rater reliability with the algorithm was 0.90 for nurses and 0.97 for paediatricians-in-training using the neonatologist's assessment as the reference standard. Conclusions The TRY CPAP algorithm has the potential to be a simple and reliable tool to assist nurses and clinicians in identifying neonates who require treatment with CPAP in low-resource settings. PMID:25877290

  15. Neonatal pain management: still in search of the Holy Grail

    PubMed Central

    Allegaert, Karel; van den Anker, John N.

    2016-01-01

    Inadequate pain management but also inappropriate use of analgesics in early infancy has negative effects on neurodevelopmental outcome. As a consequence, neonatal pain management is still in search for the Holy Grail. At best, effective pain management is based on prevention, assessment, and treatment followed by a re-assessment of the pain to determine if additional treatment is still necessary. Unfortunately, epidemiological observations suggest that neonates are undergoing painful procedures very frequently, unveiling the need for effective preventive, non-pharmacological strategies. In addition, assessment is still based on validated, multimodal, but subjective pain assessment tools. Finally, in neonatal intensive care units, there is a shift in clinical practices (e.g., shorter intubation and ventilation), and this necessitates the development and validation of new pharmacological treatment modalities. To illustrate this, a shift in the use of opioids to paracetamol has occurred and short-acting agents (remifentanil, propofol) are more commonly administered to neonates. In addition to these new modalities and as part of a more advanced approach of the developmental pharmacology of analgesics, pharmacogenetics also emerged as a tool for precision medicine in neonates. To assure further improvement of neonatal pain management the integration of pharmacogenetics with the usual covariates like weight, age and/or disease characteristics is needed. PMID:27087155

  16. Neonatal pain management: still in search for the Holy Grail.

    PubMed

    Allegaert, Karel; van den Anker, John N

    2016-07-01

    Inadequate pain management but also inappropriate use of analgesics in early infancy has negative effects on neurodevelopmental outcome. As a consequence, neonatal pain management is still in search for the Holy Grail. At best, effective pain management is based on prevention, assessment, and treatment followed by a re-assessment of the pain to determine if additional treatment is still necessary. Unfortunately, epidemiological observations suggest that neonates are undergoing painful procedures very frequently, unveiling the need for effective preventive, non-pharmacological strategies. In addition, assessment is still based on validated, multimodal, but subjective pain assessment tools. Finally, in neonatal intensive care units, there is a shift in clinical practices (e.g., shorter intubation and ventilation), and this necessitates the development and validation of new pharmacological treatment modalities. To illustrate this, a shift in the use of opioids to paracetamol has occurred and short-acting agents (remifentanil, propofol) are more commonly administered to neonates. In addition to these new modalities and as part of a more advanced approach of the developmental pharmacology of analgesics, pharmacogenetics also emerged as a tool for precision medicine in neonates. To assure further improvement of neonatal pain management the integration of pharmacogenetics with the usual covariates like weight, age and/or disease characteristics is needed. PMID:27087155

  17. Prevention of healthcare-associated infections in neonates: room for improvement.

    PubMed

    Legeay, C; Bourigault, C; Lepelletier, D; Zahar, J R

    2015-04-01

    Infants in neonatal intensive care units (NICUs) are highly susceptible to infection due to the immaturity of their immune systems. Healthcare-associated infections (HCAIs) are associated with prolonged hospital stay, and represent a significant risk factor for neurological development problems and death. Improving HCAI control is a priority for NICUs. Many factors contribute to the occurrence of HCAIs in neonates such as poor hand hygiene, low nurse-infant ratios, environmental contamination and unnecessary use of antibiotics. Prevention is based on improving neonatal management, avoiding unnecessary use of central venous catheters, restricting use of antibiotics and H2 blockers, and introducing antifungal prophylaxis if necessary. Quality improvement interventions to reduce HCAIs in neonates seem to be the cornerstone of infection control. PMID:25748794

  18. Distribution of mercury in neonatal guinea pigs after exposure to mercury vapor

    SciTech Connect

    Yoshida, Minoru; Aoyama, Haruhiko; Kojima, Sakae; Yamamura, Yukio ); Satoh, Hiroshi )

    1989-11-01

    The mammalian fetus and neonate is well known to be particularly susceptible to the toxic effects of heavy metals and other chemical substances and subsequently the potentially adverse effects appear in the developing individuals. Exposure of the neonate to toxic metals occurs in the living environment through nursing and intake of metal-containing foods and water, and respiration in contaminated atmospheres. Significant exposure of the neonate to mercury compounds, such as mercuric mercury and methylmercury, is often a potential hazard; higher gastrointestinal absorption of these compounds in suckling animals results in more accumulation and retention of mercury than in the adult. It is still unknown how the toxic effects and metabolism of mercury vapor in immature animals differ from that in adults. The purpose of this study is to clarify the accumulation and distribution of mercury in neonatal animals after exposure to mercury vapor.

  19. The Integrality of Situated Caring in Nursing and the Environment

    PubMed Central

    Jarrin, Olga F.

    2012-01-01

    Much emphasis has been placed on the importance of the environment as a determinant of health; however, little theoretical work in nursing has specifically articulated the importance of the nursing practice environment as a factor in patient outcomes. This work advances the unitary-transformative-caring paradigm by focusing on the concept of integrality and exploring the nursing meta-paradigm concepts (nursing, environment, human being, and health) through integral philosophical inquiry. PMID:22222236

  20. E-Mentoring: Confidence Intervention for Senior Nursing Students Preparing for Readiness to Practice

    ERIC Educational Resources Information Center

    LaRose, Patrick S., Sr.

    2013-01-01

    The role of the registered nurse has evolved over the years as technology has changed and the practice of nursing has advanced. There are many factors that influence how a new nurse enters practice; however, confidence appears to play a large role in the way nursing students see themselves and how this self perception regulates transition to…

  1. The Evolution of School Nursing Data Indicators in Massachusetts: Recommendations for a National Data Set

    ERIC Educational Resources Information Center

    Gapinski, Mary Ann; Sheetz, Anne H.

    2014-01-01

    The National Association of School Nurses' research priorities include the recommendation that data reliability, quality, and availability be addressed to advance research in child and school health. However, identifying a national school nursing data set has remained a challenge for school nurses, school nursing leaders, school nurse…

  2. Distance Learning Is Changing and Challenging Nursing Education. AACN Issue Bulletin.

    ERIC Educational Resources Information Center

    American Association of Colleges of Nursing, Washington, DC.

    Technology is enhancing the ability of distance education to reach both aspiring nursing students and professional nurses who want to advance their skills. Distance education also improves access to education and, in doing so, counters the nation's increasing shortage of nurses. It allows nurses to continue to work while enrolling in online…

  3. Nursing Homes

    MedlinePlus

    ... up like a hospital. The staff provides medical care, as well as physical, speech and occupational therapy. ... relationships with residents. Some nursing homes have special care units for people with serious memory problems such ...

  4. Neonatal iliopsoas abscess.

    PubMed

    Horiuchi, Atsushi; Kameoka, Kazuhiro; Kuwabara, Jun; Watanabe, Yuji; Kawakami, Sanae; Tauchi, Hisamichi; Ishii, Eiichi

    2012-10-01

    Iliopsoas abscess (IPA) is rare in children, particularly in neonates. A male neonate was born at 38 weeks of gestation with a weight of 2915 g. On day 22 after birth, his family noticed that his right thigh was swollen. Abdominal computed tomography showed a mass extending to the right iliopsoas from the right thigh with thick septa. Puncture to the right groin yielded purulent fluid, and so a diagnosis of abscess was made. The puncture was followed by surgical drainage through a small inguinal incision, and the abscess cavity was irrigated thoroughly using normal saline. Culture of abscess fluid was positive for Streptococcus pneumoniae, so intravenous ABPC infusion was continued. The postoperative magnetic resonance imaging indicate that the IPA was derived from arthritis of the hip, and the patients received Riemenbügel for the incomplete hip dislocation. He is doing well at 2 years of age. PMID:23005905

  5. Remifentanil: applications in neonates.

    PubMed

    Kamata, Mineto; Tobias, Joseph D

    2016-06-01

    Remifentanil is a synthetic opioid derivative that was introduced into clinical practice in the United States in 1996. The unique modification of its chemical structure to include a methyl-ester ring allows its hydrolysis by non-specific plasma and tissue esterases. This molecular configuration results in its rapid metabolism thereby providing a rapid onset, easy titration by continuous infusion, and a short context-sensitive half-life with rapid elimination. These principles are stable and consistent across all age groups regardless of the infusion characteristics. Owing to these pharmacokinetic characteristics, it is an effective agent in the neonatal population allowing the provision of intense analgesia and anesthesia with a rapid recovery profile in various clinical scenarios. Here, we review the pharmacokinetics of remifentanil in neonates, discuss its clinical applications including intraoperative administration for anesthetic care, unique applications for procedural sedation including endotracheal intubation, and its potential use for sedation in the Intensive Care Unit setting during mechanical ventilation. PMID:26758072

  6. Development and psychometric testing of the nursing culture assessment tool.

    PubMed

    Kennerly, Susan M; Yap, Tracey L; Hemmings, Annette; Beckett, Gulbahar; Schafer, John C; Borchers, Andrea

    2012-11-01

    A valid and reliable nursing culture assessment tool aimed at capturing general aspects of nursing culture is needed for use in health care settings to assess and then reshape indicated troubled areas of the nursing culture. This article summarizes the Nursing Culture Assessment Tool's (NCAT) development and reports on a cross-sectional, exploratory investigation of its psychometric properties. The research aims were to test the tool's psychometric properties; discover its dimensionality; and refine the item structure to best represent the construct of nursing culture, an occupational subset of organizational culture. Empirical construct validity was tested using a sample of licensed nurses and nursing assistants (n = 340). Exploratory and confirmatory factor analysis (CFA) and logistical regression yielded a 6-factor, 19-item solution. Evidence supports the tool's validity for assessing nursing culture as a basis for shaping the culture into one that supports change, thereby accelerating, improving, and advancing nursing best practices and care outcomes. PMID:22523245

  7. Understanding Clinical Expertise: Nurse Education, Experience, and the Hospital Context

    PubMed Central

    McHugh, Matthew D.; Lake, Eileen T.

    2010-01-01

    Clinical nursing expertise is central to quality patient care. Research on factors that contribute to expertise has focused largely on individual nurse characteristics to the exclusion of contextual factors. To address this, we examined effects of hospital contextual factors and individual nurse education and experience on clinical nursing expertise in a cross-sectional analysis of data from 8,611 registered nurses. In a generalized ordered logistic regression analysis, the composition of the hospital staff, particularly the proportion of nurses with at least a bachelor of science in nursing degree, was associated with significantly greater odds of a nurse reporting a more advanced expertise level. Our findings suggest that, controlling for individual characteristics, the hospital context significantly influences clinical nursing expertise. PMID:20645420

  8. Neonatal mortality in Meerut district.

    PubMed

    Garg, S K; Mishra, V N; Singh, J V; Bhatnagar, M; Chopra, H; Singh, R B

    1993-09-01

    A study of neonatal mortality in Meerut district revealed an infant mortality rate of 50.1 per 1000 live births. Neonatal mortality accounted for 37.8% of infant mortality with a neonatal mortality rate of 19.0 per 1000 live births. 90.5% of these neonates were delivered at home largely by untrained personnel (57.2%). Only 28.6% of these neonates were treated by qualified doctors and only 30.9% of their mothers were fully immunized against tetanus. At least 2/3rd of neonatal mortality was due to exogenous factors with tetanus neonatorum and septicaemia being the principal causes of mortality each accounting for a mortality rate of 4.7 per 1000 live births. PMID:8112786

  9. [Physiopathology of neonatal hyperbilirubinemia].

    PubMed

    Vert, P

    1998-09-01

    The most important steps of bilirubin metabolism involved in the pathophysiology of neonatal hyperbilirubinemia are: 1) hemoglobin degradation by heme oxygenase; 2) bilirubin binding to serum albumin; 3) bilirubin conjugation to acid glucoronic by glucoronyl transferase. Progress in the knowledge of these metabolic steps allows to understanding of why massive hemolysis, infections, hypoxia and prematurity increase the risk of kernicterus and therefore justify adapted preventive and therapeutic measures. PMID:9789638

  10. [A new vision of nursing: the evolution and development of nursing informatics].

    PubMed

    Feng, Rung-Chuang; Yeh, Yu-Ting

    2014-08-01

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

  11. Nursing-sensitive indicators: a concept analysis

    PubMed Central

    Heslop, Liza; Lu, Sai

    2014-01-01

    Aim To report a concept analysis of nursing-sensitive indicators within the applied context of the acute care setting. Background The concept of ‘nursing sensitive indicators’ is valuable to elaborate nursing care performance. The conceptual foundation, theoretical role, meaning, use and interpretation of the concept tend to differ. The elusiveness of the concept and the ambiguity of its attributes may have hindered research efforts to advance its application in practice. Design Concept analysis. Data sources Using ‘clinical indicators’ or ‘quality of nursing care’ as subject headings and incorporating keyword combinations of ‘acute care’ and ‘nurs*’, CINAHL and MEDLINE with full text in EBSCOhost databases were searched for English language journal articles published between 2000–2012. Only primary research articles were selected. Methods A hybrid approach was undertaken, incorporating traditional strategies as per Walker and Avant and a conceptual matrix based on Holzemer's Outcomes Model for Health Care Research. Results The analysis revealed two main attributes of nursing-sensitive indicators. Structural attributes related to health service operation included: hours of nursing care per patient day, nurse staffing. Outcome attributes related to patient care included: the prevalence of pressure ulcer, falls and falls with injury, nosocomial selective infection and patient/family satisfaction with nursing care. Conclusion This concept analysis may be used as a basis to advance understandings of the theoretical structures that underpin both research and practical application of quality dimensions of nursing care performance. PMID:25113388

  12. Public health nursing, ethics and human rights.

    PubMed

    Ivanov, Luba L; Oden, Tami L

    2013-05-01

    Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations. PMID:23586767

  13. [Towards a pluralistic approach in nursing].

    PubMed

    Nazon, Evy; Perron, Amélie

    2014-03-01

    For many years, nurses have contributed in the advancement of knowledge in nursing. From theories to conceptual models, several researchers offered their vision on how to achieve this goal. Beyond the diversity and differences of opinion, monistic and pluralistic conceptions emerge from their position. Using Karl Popper's (1979) theories of open and closed societies and McLennan's (1995) definition of pluralism, this study argues for pluralism in nursing. Pluralism provides the opportunity for nurse researchers to combine their research to other theories, other concepts, other approaches and other disciplines to enable further analysis and a broader perspective of the nursing discipline. This study is a theoretical reflection on interdisciplinarity in nursing research. PMID:24830219

  14. Validation of oppressed group behaviors in nursing.

    PubMed

    Matheson, Linda Kay; Bobay, Kathleen

    2007-01-01

    The possibility that nurses exhibit oppressed group behaviors was first broached by Roberts [Roberts, S. J. (1983). Oppressed group behavior: Implications for nursing. Advances in Nursing Science, 21-30] when Freire's model [Freire, P. (1970). Pedagogy of the oppressed. New York: Herder and Herder] was applied to nursing. Since then, scholarly discussion has focused on aspects of oppression in nursing, but little research toward validation of Freire's model has occurred. An extensive literature search in CINAHL was completed seeking exploration and validation of the oppressed group behavior model and its dimensions. The Educational Testing Services, PsychInfo, Health and Psychosocial Instruments, and Sociological Abstracts databases were searched for measurement tools created within the last 10 years. This literature review identified that a model of oppressed group behavior has not been developed and validated, and that oppressed group behaviors have been studied independent of each other; however, oppressed group behaviors may have implications for the current nursing shortage. PMID:17675118

  15. Project Management: Essential Skill of Nurse Informaticists.

    PubMed

    Sipes, Carolyn

    2016-01-01

    With the evolution of nursing informatics (NI), the list of skills has advanced from the original definition that included 21 competencies to 168 basic competencies identified in the TIGER-based Assessment of Nursing Informatics Competencies (TANIC) and 178 advanced skills in the Nursing Informatics Competency Assessment (NICA) L3/L4 developed by Chamberlain College of Nursing, Nursing Informatics Research Team (NIRT). Of these competencies, project management is one of the most important essentials identified since it impacts all areas of NI skills and provides an organizing framework for processes and projects including skills such as design, planning, implementation, follow-up and evaluation. Examples of job roles that specifically require project management skills as an essential part of the NI functions include management, administration, leadership, faculty, graduate level master's and doctorate practicum courses. But first, better understanding of the NI essential skills is vital before adequate education and training programs can be developed. PMID:27332201

  16. Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care

    PubMed Central

    Lake, Eileen T; Staiger, Douglas; Horbar, Jeffrey; Kenny, Michael J; Patrick, Thelma; Rogowski, Jeannette A

    2015-01-01

    Objective To determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics. Data Sources Nurse survey and VLBW infant registry data. Study Design Retrospective study of 8,252 VLBW infants in 98 Vermont Oxford Network hospital neonatal intensive care units (NICUs) nationally. NICUs were classified into three groups based on their percent of infants of black race. Two nurse-sensitive perinatal quality standards were studied: nosocomial infection and breast milk. Data Collection Primary nurse survey (N = 5,773, 77 percent response rate). Principal Findings VLBW infants born in high-black concentration hospitals had higher rates of infection and discharge without breast milk than VLBW infants born in low-black concentration hospitals. Nurse understaffing was higher and practice environments were worse in high-black as compared to low-black hospitals. NICU nursing features accounted for one-third to one-half of the hospital-level health disparities. Conclusions Poorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country. PMID:25250882

  17. Primary congenital pulmonary hypoplasia of a neonate.

    PubMed

    Hsu, Jui-Sheng; Lee, Yu-Sheng; Lin, Chin-Hsuan; Li, Fen-Yau; Jeng, Mei-Jy; Soong, Wen-Jue; Chen, Sue-Jen; Tang, Ren-Bin

    2012-02-01

    Pulmonary hypoplasia is a rare but usually lethal disease. We report a full-term male neonate who presented with respiratory failure immediately after birth. Chest X-ray revealed a small lung volume despite advanced ventilator support. Respiratory failure persisted and this baby died at 40.5 hours of age. The autopsy showed a lung-to-birth weight ratio of 0.69% and a radial alveoli count of 2.97. All this information confirmed the diagnosis of primary congenital pulmonary hypoplasia. PMID:22340744

  18. Tales of sociology and the nursing curriculum: revisiting the debates.

    PubMed

    Aranda, Kay; Law, Kate

    2007-08-01

    The relationship between nursing and sociology has been extensively debated for more than two decades [Cox, C.A., 1979. Who cares? Nursing and sociology: the development of a symbiotic relationship. Journal of Advanced Nursing 4, 237-252; Cooke, H., 1993. Why teach sociology? Nurse Education Today 13, (3) 210-216; Sharpe, K., 1994. Sociology and the nursing curriculum: a note of caution. Journal of Advanced Nursing 20, (2) 391-395; Sharpe, K., 1995. Why indeed should we teach sociology? A response to Hannah Cooke. Nurse Education Today 15, (1) 52-55; Sharpe, K., 1996. Feedback - sociology and the nursing curriculum: a reply to Sam Porter. Journal of Advanced Nursing 23, (7) 1275-1278; Balsamo, D., Martin, S.I., 1995a. Developing the sociology of health in nurse education: towards a more critical curriculum. Part 1. Andragogy and sociology in Project 2000. Nurse Education Today 15, 427-432; Balsamo, D., Martin, S.I., 1995b. Developing the sociology of health in nurse education: towards a more critical curriculum. Part 2. Linking methodology and epistemology. Nurse Education Today 15, 427-432; Porter, S., 1995. Sociology and the nursing curriculum: a defence. Journal of Advanced Nursing 21, (6) 1130-1135; Porter, S., 1996. Why teach sociology? A contribution to the debate. Nurse Education Today, 16, 170-174; Porter, S., 1997. Sociology and the nursing curriculum: a further comment. Journal of Advanced Nursing 26, (1) 214-218; Porter, S., 1998. Social Theory and Nursing Practice. Macmillan, Basingstoke; Corlett, J., 2000. The perceptions of nurse teacher, student nurses and preceptors of the theory-practice gap in nurse education. Nurse Education Today 20, 499-505; Allen, D., 2001. Review article: nursing and sociology: an uneasy marriage?. Sociology of Health and Illness 23, (3) 386-396; Pinikahana, J., 2003. Role of sociology within the nursing enterprise: some reflections on the unfinished debate. Nursing and health Sciences 5, (2) 175-180; Holland, K., 2004

  19. Nurses' adherence to the Kangaroo Care Method: support for nursing care management1

    PubMed Central

    da Silva, Laura Johanson; Leite, Josete Luzia; Scochi, Carmen Gracinda Silvan; da Silva, Leila Rangel; da Silva, Thiago Privado

    2015-01-01

    OBJECTIVE: construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management. METHOD: qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed. RESULTS: four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (de)motivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method. CONCLUSIONS: the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (dis)continuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model. PMID:26155013

  20. The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada.

    PubMed

    Carter, Nancy; Martin-Misener, Ruth; Kilpatrick, Kelley; Kaasalainen, Sharon; Donald, Faith; Bryant-Lukosius, Denise; Harbman, Patricia; Bourgeault, Ivy; DiCenso, Alba

    2010-12-01

    Supportive nursing leadership is important for the successful introduction and implementation of advanced practice nursing roles in Canadian healthcare settings. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe and explore organizational leadership in planning and implementing advanced practice nursing roles. Leadership strategies that optimize successful role integration include initiating systematic planning to develop the roles based on patient and community needs, engaging stakeholders, using established Canadian role implementation toolkits, ensuring utilization of all dimensions of the role, communicating clear messages to increase awareness about the roles in the organization, creating networks and facilitating mentorship for those in the role, and negotiating role expectations with physicians and other members of the healthcare team. Leaders face challenges in creating and securing sustainable funding for the roles and providing adequate infrastructure support. PMID:21478692

  1. Update on the management of neonatal sepsis in horses.

    PubMed

    Palmer, Jon

    2014-08-01

    Despite advances in neonatal intensive care sepsis, severe sepsis and septic shock remain the biggest killers of neonatal foals. Management of this severe syndrome remains difficult, requiring intensive intervention. Key aspects of management include infection control, hemodynamic support, immunomodulatory interventions, and metabolic/endocrine support. Infection control largely consists of early antimicrobial therapy, plasma transfusions, and local therapy for the infected focus. In cases with severe sepsis or septic shock, hemodynamic support with fluids, vasoactive agents, and respiratory support insuring oxygen delivery to vital organs is important. Nutritional support is important, but close monitoring is needed to avoid hyperglycemia and hypoglycemia. PMID:25016494

  2. Nursing Leadership.

    PubMed

    Crisp, Carol

    2016-01-01

    Nurse transformational leaders can serve in academic settings and at local, national, international professional nursing organizations and community-based groups. As a transformational leader, nurses can lead in any workplace. According to a study by Stanley (2012), clinical leaders are not sought for their capacity to outline a vision, but for their values and beliefs on display that are easily recognized in their actions. This encompasses the moral component of transformational leadership. It is the APRNs duty to continue to strive towards a better vision for the well-being of all nurses, patients, and colleagues. Autonomous APRNs are happier, healthier, and better prepared to provide the best patient care to their patients. We should not be happy to sit back and let others fight this fight. APRNs need to be on the frontline, leading the way. This is only an insight that I have gained after many frustrating years of cheering our profession and then being made to feel inferior at the same time. Only nurses, who have that nurturing spirit, would hold back if they felt it might hurt others. Don't back off or hold back! It might hurt those that follow! PMID:27089563

  3. Nosocomial outbreak of staphylococcal scalded skin syndrome in neonates: epidemiological investigation and control.

    PubMed

    El Helali, N; Carbonne, A; Naas, T; Kerneis, S; Fresco, O; Giovangrandi, Y; Fortineau, N; Nordmann, P; Astagneau, P

    2005-10-01

    Over a three-month period, 13 neonates developed staphylococcal scalded skin syndrome (SSSS) in a maternity unit, between four and 18 days after their birth. An epidemiological and descriptive study followed by a case-control study was performed. A case was defined as a neonate with blistering or peeling skin, and exfoliative toxin A Staphylococcus aureus positive cultures. Controls were selected at random from the asymptomatic, non-colonized neonates born on the same day as the cases. All staff members and all neonates born during the outbreak period were screened for carriage by nasal swabs and umbilical swabs, respectively. S. aureus isolates were polymerase chain reaction (PCR) screened for etA gene and genotyped by pulsed-field gel electrophoresis (PFGE). Two clusters of eight and five cases were identified. Receiving more than one early umbilical care procedure by the same ancillary nurse was the only risk factor identified in the case-control study (odds ratio=15, 95% confidence intervals 2-328). The ancillary nurse suffered from chronic dermatitis on her hands that favoured S. aureus carriage. Exfoliative-toxin-A-producing strains, as evidenced by PCR and indistinguishable by PFGE, were isolated from all but one of the SSSS cases, from four asymptomatic neonates, from two staff members and from the ancillary nurse's hands. Removal of the ancillary nurse from duty, infection control measures (isolation precautions, chlorhexidine handwashing and barrier protections), and treatment of the carriers (nasal mupirocin and chlorhexidine showers) led to control of the epidemic. In conclusion, this study emphasizes the need for tight surveillance of chronic dermatitis in healthcare workers. PMID:16009455

  4. Neonatal neurosonography: A pictorial essay

    PubMed Central

    Bhat, Venkatraman; Bhat, Varun

    2014-01-01

    Neurosonography is a simple, established non-invasive technique for the intracranial assessment of preterm neonate. Apart from established indication in the evaluation of periventricular haemorrhage, it provides clue to wide range of pathology. This presentation provides a quick roadmap to the technique, imaging anatomy and spectrum of pathological imaging appearances encountered in neonates. PMID:25489132

  5. Nursing informatics knowledge and competencies: a national survey of nursing education programs in the United States.

    PubMed

    McNeil, Barbara J; Elfrink, Victoria L; Pierce, Susan T; Beyea, Suzanne C; Bickford, Carol J; Averill, Carolyn

    2005-12-01

    An online survey of deans/directors of 266 baccalaureate and higher nursing programs in the U.S. was developed by informatics expert nurses. Participants (1) identified nursing informatics (NI) competencies and knowledge of undergraduate and/or graduate students in their nursing programs; (2) determined faculty preparedness to teach NI and to use informatics tools; and (3) provided perceptions of NI requirements of local practicing nurses. Frequency data and qualitative responses were analyzed. Approximately half of undergraduate nursing programs were teaching information literacy skills and required students to enter with word-processing and email skills. Least visible informatics content at all levels included the use of information system data standards, the Nursing Information and Data Set Evaluation Center criteria, the unified medical language system (UMLS), and the nurse's role in the life cycle of an information system. Almost 50% of respondents perceived faculty as "novice" and "advanced beginners" in teaching and using NI applications. Participants reported no future plans to offer NI training in their region. Findings have major implications for nurse faculty, staff developers, and program administrators who are planning continuing education opportunities and designing nursing curricula that prepare nurses for use of the electronic health record and 21st century professional practice. PMID:16046276

  6. Process of seeking connectivity: social relations of power between staff nurses and nurse managers.

    PubMed

    Udod, Sonia A

    2012-12-01

    This study explored the process of how power is exercised in nurse-manager relationships in the hospital setting, to better understand what fosters and constrains staff nurse empowerment. Semi-structured interviews and participant observations were conducted with 26 participants in a hospital in Western Canada. Seeking connectivity was the basic social process in which nurses strive to connect with their manager to create a workable partnership in the provision of high-quality patient care while responding to the demands of the organizational context. The overarching finding was that the manager plays a critical role in modifying the work environment for nurses and, as such, nurses seek connection with their manager. Findings revealed two patterns within the process of seeking connectivity: (a) in the absence of a meaningful engagement with the manager, power was held over nurses through institutional patterns of behaviour and practices, and nurses employed a variety of resistance strategies; (b) when managers provided guidance and engaged nurses as co-collaborators, power was shared and nurses were able to influence patient outcomes positively. The results of this study support Laschinger's program of research on nurse empowerment from an organizational perspective, and advance nurse empowerment from a critical perspective. PMID:23803425

  7. Establishing Policy Foundations and Regulatory Systems to Enhance Nursing Practice in the United Arab Emirates

    PubMed Central

    Hunter, Lyndal H.; Aqtash, Salah; Day, Gary E.

    2015-01-01

    In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care—particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. PMID:25944674

  8. Establishing Policy Foundations and Regulatory Systems to Enhance Nursing Practice in the United Arab Emirates.

    PubMed

    Brownie, Sharon M; Hunter, Lyndal H; Aqtash, Salah; Day, Gary E

    2015-01-01

    In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care-particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. PMID:25944674

  9. Fetal and Neonatal Arrhythmias.

    PubMed

    Jaeggi, Edgar; Öhman, Annika

    2016-03-01

    Cardiac arrhythmias are an important aspect of fetal and neonatal medicine. Premature complexes of atrial or ventricular origin are the main cause of an irregular heart rhythm. The finding is typically unrelated to an identifiable cause and no treatment is required. Tachyarrhythmia most commonly relates to supraventricular reentrant tachycardia, atrial flutter, and sinus tachycardia. Several antiarrhythmic agents are available for the perinatal treatment of tachyarrhythmias. Enduring bradycardia may result from sinus node dysfunction, complete heart block and nonconducted atrial bigeminy as the main arrhythmia mechanisms. The management and outcome of bradycardia depend on the underlying mechanism. PMID:26876124

  10. Hyperbilirubinemia in Preterm Neonates.

    PubMed

    Bhutani, Vinod K; Wong, Ronald J; Stevenson, David K

    2016-06-01

    Preterm neonates with increased bilirubin production loads are more likely to sustain adverse outcomes due to either neurotoxicity or overtreatment with phototherapy and/or exchange transfusion. Clinicians should rely on expert consensus opinions to guide timely and effective interventions until there is better evidence to refine bilirubin-induced neurologic dysfunction or benefits of bilirubin. In this article, we review the evolving evidence for bilirubin-induced brain injury in preterm infants and highlight the clinical approaches that minimize the risk of bilirubin neurotoxicity. PMID:27235203

  11. Hemolysis in Preterm Neonates.

    PubMed

    Christensen, Robert D; Yaish, Hassan M

    2016-06-01

    Hemolysis can be an important cause of hyperbilirubinemia in premature and term neonates. It can result from genetic abnormalities intrinsic to or factors exogenous to normal to red blood cells (RBCs). Hemolysis can lead to a relatively rapid increase in total serum/plasma bilirubin, hyperbilirubinemia that is somewhat slow to fall with phototherapy, or hyperbilirubinemia that is likely to rebound after phototherapy. Laboratory methods for diagnosing hemolysis are more difficult to apply, or less conclusive, in preterm infants. Transfusion of donor RBCs can present a bilirubin load that must be metabolized. Genetic causes can be identified by next-generation sequencing panels. PMID:27235204

  12. Managing the multigenerational nursing team.

    PubMed

    Hu, Jie; Herrick, Charlotte; Hodgin, Kim Allard

    2004-01-01

    Today's workforce is more diverse in age than ever before. This study examined the generational profiles of two groups (the Silent Generation, and Baby Boomers vs. Generation X and Generation Y) in terms of the following variables: characteristics, communication styles, and significance of tasks. The purpose was to assist nurse managers to maximize departmental effectiveness by capitalizing on the unique characteristics of the multigenerational nursing team. A descriptive design was used to examine nursing staff perceptions of their generational profiles, communication styles, and significance of tasks. The convenience sample included registered nurses, nurse technicians and nursing secretaries from two departments, a medical-surgical and a critical care department (N = 62). The study provided participants with the opportunity to give their interpretations of their generational types. Similarities and differences of generational profiles were found between the two groups. There were no significant differences in communication style and significance of tasks between the two groups (P > .05). However, there were differences in expectations regarding commitment to the manager versus the organization and the type and timing of rewards for performance. All four generational groups had vastly different employment demands and different needs for orientation, training, advancement, benefits, perks, and retirement options. PMID:15638341

  13. Inclusion of temporal priors for automated neonatal EEG classification

    PubMed Central

    Temko, Andriy; Stevenson, Nathan; Marnane, William; Boylan, Geraldine; Lightbody, Gordon

    2014-01-01

    The aim of this paper is to use recent advances in the clinical understanding of the temporal evolution of seizure burden in neonates with hypoxic ischemic encephalopathy to improve the performance of automated detection algorithms. Probabilistic weights are designed from temporal locations of neonatal seizure events relative to time of birth. These weights are obtained by fitting a skew-normal distribution to the temporal seizure density and introduced into the probabilistic framework of the previously developed neonatal seizure detector. The results are validated on the largest available clinical dataset, comprising 816.7 hours. By exploiting these priors, the ROC area is increased by 23% (relative) reaching 96.74%. The number of false detections per hour is decreased from 0.45 to 0.25, while maintaining the correct detection of seizure burden at 70%. PMID:22713600

  14. Socializing nurses for nursing entrepreneurship roles.

    PubMed

    Batra, C

    1990-01-01

    Whatever directions nursing takes in the future, it is likely that creative and motivated nurses, more and more, will seek to run their own businesses. Batra prepares the student nurse for this eventuality by devising a course that teaches the student how to organize an entrepreneurial nursing business. PMID:2300274

  15. Clinical research nurse or nurse researcher?

    PubMed

    Jones, Helen Claire

    This article gives an overview of two research-related roles that can form part of a nurse's career path: clinical research nurse and nurse researcher. It highlights the influences on both roles, and the skills and differences within them, as well as offering advice on how nurses can access either role. PMID:26182597

  16. The History of Care of Premature Infants: From Neonate Intensive Care to Special Care Baby Unit (SCBU).

    ERIC Educational Resources Information Center

    Douret, L.; And Others

    1994-01-01

    Outlines the history of and reviews the literature on the care of premature infants. Focuses on the medicalization of birth; early neonatology; the effect of advances in medicine on the survival and safety of neonates; and the importance of early mother-neonate interactions. (BC)

  17. Hartford Gerontological Nursing Leaders: From Funding Initiative to National Organization.

    PubMed

    Van Cleave, Janet H; Szanton, Sarah L; Shillam, Casey; Rose, Karen; Rao, Aditi D; Perez, Adriana; O'Connor, Melissa; Walker, Rachel; Buron, Bill; Boltz, Marie; Bellot, Jennifer; Batchelor-Murphy, Melissa

    2016-01-01

    In 2000, the John A. Hartford Foundation established the Building Academic Geriatric Nursing Capacity Program initiative, acknowledging nursing's key role in the care of the growing population of older adults. This program has supported 249 nurse scientists with pre- and postdoctoral awards. As a result of the program's success, several Building Academic Geriatric Nursing Capacity Program awardees formed an alumni organization to continue to advance the quality care of older adults. This group of Building Academic Geriatric Nursing Capacity Program awardees joined others receiving support from the John A. Hartford Foundation nursing initiatives to grow a formal organization, the Hartford Gerontological Nursing Leaders (HGNL). The purpose of this article is to present the development, accomplishments, and challenges of the HGNL, informing other professional nursing organizations that are experiencing similar accomplishments and challenges. This article also demonstrates the power of a funding initiative to grow an organization dedicated to impact gerontological health and health care through research, practice, education, and policy. PMID:26802588

  18. Neonatal Subventricular Zone Electroporation

    PubMed Central

    Feliciano, David M.; Lafourcade, Carlos A.; Bordey, Angélique

    2013-01-01

    Neural stem cells (NSCs) line the postnatal lateral ventricles and give rise to multiple cell types which include neurons, astrocytes, and ependymal cells1. Understanding the molecular pathways responsible for NSC self-renewal, commitment, and differentiation is critical for harnessing their unique potential to repair the brain and better understand central nervous system disorders. Previous methods for the manipulation of mammalian systems required the time consuming and expensive endeavor of genetic engineering at the whole animal level2. Thus, the vast majority of studies have explored the functions of NSC molecules in vitro or in invertebrates. Here, we demonstrate the simple and rapid technique to manipulate neonatal NPCs that is referred to as neonatal subventricular zone (SVZ) electroporation. Similar techniques were developed a decade ago to study embryonic NSCs and have aided studies on cortical development3,4 . More recently this was applied to study the postnatal rodent forebrain5-7. This technique results in robust labeling of SVZ NSCs and their progeny. Thus, postnatal SVZ electroporation provides a cost and time effective alternative for mammalian NSC genetic engineering. PMID:23426329

  19. Insights Into Fetal and Neonatal Development Through Analysis of Cell-Free RNA in Body Fluids

    PubMed Central

    Bianchi, Diana W.; Maron, Jill L.; Johnson, Kirby L.

    2010-01-01

    The use of cell-free nucleic acids in the circulation of pregnant women for noninvasive prenatal diagnosis is arguably one of the hottest current topics in prenatal medicine. Between 1997 and the present era this field has gone from basic research to clinical application for diagnosis of fetal gender and Rhesus D status. Over the next few years it is likely that noninvasive prenatal diagnosis for Down syndrome will also be possible. Here we summarize current and future clinical applications of analyzing cell-free fetal DNA and RNA in both maternal and neonatal body fluids, including maternal plasma, serum, whole blood, amniotic fluid, and neonatal saliva. We describe methods to evaluate normal and abnormal fetal and neonatal development using gene expression microarrays. We also discuss the ways in which differentially-regulated gene lists can advance knowledge of both fetal and neonatal biology, as well as suggest novel possibilities for fetal and neonatal treatment. PMID:20851538

  20. Nursing leaders can deliver a new model of care.

    PubMed

    Shalala, Donna E

    2014-01-01

    Millions more insured Americans. Increasing numbers of older patients. Higher rates of chronic illness. Fewer providers. How can our healthcare system not only manage these challenges but also improve performance and access to care while containing costs? The answer lies with our nurses. In some parts of the United States, nurses provide the full spectrum of primary and preventive care. They have successfully improved access and quality in rural areas. In other parts, nurses' hands are tied by antiquated laws and regulations that limit their ability to expand access to care. Our system cannot increase access when we have providers who are not allowed to perform to the top of their education, training, and capability. It is time to rethink how we deliver primary and preventive care and redefine the roles of doctors and nurses. This article examines the history of the Institute of Medicine's (IOM) Future of Nursing report (chaired by the author) and the resulting Future of Nursing Campaign for Action, which is working to institute the report's recommendations in all 50 states. The IOM report's recommendations are simple: 1. Remove outdated restrictions on nursing practice. 2. Promote nurse leadership on hospital boards and in all healthcare sectors. 3. Strengthen nurse education and training, and increase the number of nurses with advanced degrees. 4. Increase diversity in the nursing workforce to better reflect the patient population. 5. Improve data reporting and compilation to predict workforce needs. New York, Kentucky, and Minnesota are three recent states to remove barriers pre venting advanced practice registered nurses from practicing at the top of their license. Similar efforts in California, Florida, and Indiana failed initially but are expected to make progress in the near future. The article makes clear how and why the Center to Champion Nursing in America (an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation) is working to

  1. Everyday Excellence: A Framework for Professional Nursing Practice in Long-Term Care

    PubMed Central

    Lyons, Stacie Salsbury; Specht, Janet Pringle; Karlman, Susan E.

    2009-01-01

    Registered nurses make measurable contributions to the health and wellness of persons living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively impact resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based upon eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness of this framework for professional nursing practice. PMID:20077966

  2. Hypothalamic control of the male neonatal testosterone surge.

    PubMed

    Clarkson, Jenny; Herbison, Allan E

    2016-02-19

    Sex differences in brain neuroanatomy and neurophysiology underpin considerable physiological and behavioural differences between females and males. Sexual differentiation of the brain is regulated by testosterone secreted by the testes predominantly during embryogenesis in humans and the neonatal period in rodents. Despite huge advances in understanding how testosterone, and its metabolite oestradiol, sexually differentiate the brain, little is known about the mechanism that actually generates the male-specific neonatal testosterone surge. This review examines the evidence for the role of the hypothalamus, and particularly the gonadotropin-releasing hormone (GnRH) neurons, in generating the neonatal testosterone surge in rodents and primates. Kisspeptin-GPR54 signalling is well established as a potent and critical regulator of GnRH neuron activity during puberty and adulthood, and we argue here for an equally important role at birth in driving the male-specific neonatal testosterone surge in rodents. The presence of a male-specific population of preoptic area kisspeptin neurons that appear transiently in the perinatal period provide one possible source of kisspeptin drive to neonatal GnRH neurons in the mouse. PMID:26833836

  3. Nursing Matters.

    ERIC Educational Resources Information Center

    Adamson, Charles

    A two-semester English-for-Special-Purposes (ESP) course designed for nursing students at a Japanese university is described, including the origins and development of the course, text development, and teaching methods. The content-based course was designed to meet licensure requirements for English language training, emphasized listening and…

  4. Investing in human capital: an academic-service partnership to address the nursing shortage.

    PubMed

    Clark, Rebecca Culver; Allison-Jones, Lisa

    2011-01-01

    The well-documented shortage of nurses and the impact of educational preparation of nurses on patient care outcomes provide a compelling argument for the need to increase the number of registered nurses and to advance their educational preparation. This article describes the application of human capital theory in a creative venture between a health system and a school of nursing that has demonstrated success in addressing these issues. A tuition advancement program was developed to support interested personnel in attaining the associate degree in nursing and to support current RNs in attaining the baccalaureate degree. The venture included support for graduate preparation of nurses interested in becoming faculty. PMID:21473476

  5. Neonates need tailored drug formulations

    PubMed Central

    Allegaert, Karel

    2013-01-01

    Drugs are very strong tools used to improve outcome in neonates. Despite this fact and in contrast to tailored perfusion equipment, incubators or ventilators for neonates, we still commonly use drug formulations initially developed for adults. We would like to make the point that drug formulations given to neonates need to be tailored for this age group. Besides the obvious need to search for active compounds that take the pathophysiology of the newborn into account, this includes the dosage and formulation. The dosage or concentration should facilitate the administration of low amounts and be flexible since clearance is lower in neonates with additional extensive between-individual variability. Formulations need to be tailored for dosage variability in the low ranges and also to the clinical characteristics of neonates. A specific focus of interest during neonatal drug development therefore is a need to quantify and limit excipient exposure based on the available knowledge of their safety or toxicity. Until such tailored vials and formulations become available, compounding practices for drug formulations in neonates should be evaluated to guarantee the correct dosing, product stability and safety. PMID:25254168

  6. Assessing and addressing moral distress and ethical climate Part II: neonatal and pediatric perspectives.

    PubMed

    Sauerland, Jeanie; Marotta, Kathleen; Peinemann, Mary Anne; Berndt, Andrea; Robichaux, Catherine

    2015-01-01

    Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented. PMID:25470266

  7. What Is Nursing Informatics?

    ERIC Educational Resources Information Center

    McGonigle, D.; And Others

    Information technology has developed to the point of providing a means to manage nursing and related health-care data effectively for nursing administrators, educators, practitioners, and researchers. Therefore, the newly recognized area of nursing informatics is important to the nursing profession as a whole. Nursing informatics is defined as the…

  8. Camp Nursing: Student Internships.

    ERIC Educational Resources Information Center

    Harwood, Catherine Hoe; Van Hofwegen, Lynn

    2002-01-01

    Camps can meet or supplement their health care delivery needs by using student nurses. Three models for student nurse internships, basic information about nursing education, and tips for negotiating student nurse internships are described. Sidebars present resources for camp health centers, nursing student competence characteristics, types of…

  9. Leaders from Nursing's History.

    ERIC Educational Resources Information Center

    Fondiller, Shirley H.; And Others

    1995-01-01

    Looks at the lives and accomplishments of four leaders in professional nursing: (1) Loretta Ford, who championed the cause of nurse practitioners; (2) Mable Staupers, a pioneer in community health and nursing; (3) Janet Geister, a leader in private nursing; and (4) Isabel Stewart, who led the movement to standardize nursing education. (JOW)

  10. Top 10 reasons to become a trauma nurse practitioner.

    PubMed

    Galicyznski, Susan F

    2006-01-01

    Nurse practitioners have played a pivotal role in both advances in patient care and healthcare policy over the last 40 years. As the healthcare environment continues to change, so too does the role of the nurse practitioner. Nurse practitioners are becoming the norm instead of the exception in the critical care setting and, more recently, have been welcomed as valuable members to trauma teams around the country. As the role continues to evolve and grow, the growing pains will multiply. This article will discuss one nurse's experience of being the new nurse practitioner in a new role and the challenges, both positive and negative, that have grown out of that experience. PMID:17052090

  11. Linking critical care nursing and genetics with research funding opportunities.

    PubMed

    Sigmon, H D

    1998-11-01

    The purpose of this article is threefold: to reveal how a disease that afflicts many critical care patients can be the impetus for forging into a research career; to illustrate a program of research undertaken by a nurse investigator to answer a critical care nursing question using genetic technology; and to identify exciting opportunities for research training, career development, and investigator-initiated research activities for the advanced practice critical care nurse at the National Institute of Nursing Research. The article concludes by identifying future linkages between nursing research and genetics. PMID:9855867

  12. Nurses' attitudes toward organ donation: an Australian perspective.

    PubMed

    Duke, J; Murphy, B; Bell, A

    1998-01-01

    Australia's rate of organ donation, which has shown a continuing downward trend, is among the lowest in the developed world. Research has demonstrated that nurses' attitudes and behaviors are important functions in organ donation, particularly retrieval. This study investigated the attitudes and knowledge levels about organ donation of paediatric nurses in a large metropolitan children's hospital and nurses in two rural hospitals. The results highlight the role that critical care nurses and advanced practice nurses need to play in improving levels of organ donation. PMID:10639986

  13. Patient advocacy from the clinical nurses' viewpoint: a qualitative study

    PubMed Central

    Davoodvand, Shirmohammad; Abbaszadeh, Abbas; Ahmadi, Fazlollah

    2016-01-01

    One of the advanced nursing care procedures emphasized by nursing organizations around the world is patient or nursing advocacy. In addition to illustrating the professional power of nursing, it helps to provide effective nursing care. The aim of the present study was to explain the concept of patient advocacy from the perspective of Iranian clinical nurses. This was a qualitative study that examined the viewpoint and experiences of 15 clinical nurses regarding patient advocacy in nursing. The nurses worked in intensive care units (ICUs), coronary care units (CCUs), and emergency units. The study participants were selected via purposeful sampling. The data was collected through semi-structured interviews and analyzed using content analysis. Data analysis showed that patient advocacy consisted of the two themes of empathy with the patient (including understanding, being sympathetic with, and feeling close to the patient) and protecting the patients (including patient care, prioritization of patients’ health, commitment to the completion of the care process, and protection of patients' rights). The results of this study suggest that nurses must be empathetic toward and protective of their patients. The results of the present study can be used in health care delivery, nursing education, and nursing management and planning systems to help nurses accomplish their important role as patient advocates. It is necessary to further study the connections between patient advocacy and empathy. PMID:27471588

  14. A retention strategy for newly graduated nurses: an integrative review of orientation programs.

    PubMed

    Park, Mihyun; Jones, Cheryl B

    2010-01-01

    To address nurse recruitment and retention issues, hospitals have increased the number of newly graduated nurses in their hiring pools and have simultaneously established orientation programs for those nurses. Structured orientation programs facilitate newly graduated nurse transition from novice to advanced beginner. The outcome of these programs is twofold: First, they promote the confidence and competency level of new nurses in providing patient care, and second, they increase nurse retention. This literature review presents the most useful interventions used in the programs that reported positive affects on new nurses. PMID:20683297

  15. Fibroblast growth factor 21 in breast milk controls neonatal intestine function

    PubMed Central

    Gavaldà-Navarro, Aleix; Hondares, Elayne; Giralt, Marta; Mampel, Teresa; Iglesias, Roser; Villarroya, Francesc

    2015-01-01

    FGF21 is a hormonal factor with important functions in the control of metabolism. FGF21 is found in rodent and human milk. Radiolabeled FGF21 administered to lactating dams accumulates in milk and is transferred to neonatal gut. The small intestine of neonatal (but not adult) mice highly expresses β-Klotho in the luminal area. FGF21-KO pups fed by FGF21-KO dams showed decreased expression and circulating levels of incretins (GIP and GLP-1), reduced gene expression of intestinal lactase and maltase-glucoamylase, and low levels of galactose in plasma, all associated with a mild decrease in body weight. When FGF21-KO pups were nursed by wild-type dams (expressing FGF21 in milk), intestinal peptides and digestive enzymes were up-regulated, lactase enzymatic activity was induced, and galactose levels and body weight were normalized. Neonatal intestine explants were sensitive to FGF21, as evidenced by enhanced ERK1/2 phosphorylation. Oral infusion of FGF21 into neonatal pups induced expression of intestinal hormone factors and digestive enzymes, lactase activity and lactose absorption. These findings reveal a novel role of FGF21 as a hormonal factor contributing to neonatal intestinal function via its presence in maternal milk. Appropriate signaling of FGF21 to neonate is necessary to ensure optimal digestive and endocrine function in developing intestine. PMID:26329882

  16. Fibroblast growth factor 21 in breast milk controls neonatal intestine function.

    PubMed

    Gavaldà-Navarro, Aleix; Hondares, Elayne; Giralt, Marta; Mampel, Teresa; Iglesias, Roser; Villarroya, Francesc

    2015-01-01

    FGF21 is a hormonal factor with important functions in the control of metabolism. FGF21 is found in rodent and human milk. Radiolabeled FGF21 administered to lactating dams accumulates in milk and is transferred to neonatal gut. The small intestine of neonatal (but not adult) mice highly expresses β-Klotho in the luminal area. FGF21-KO pups fed by FGF21-KO dams showed decreased expression and circulating levels of incretins (GIP and GLP-1), reduced gene expression of intestinal lactase and maltase-glucoamylase, and low levels of galactose in plasma, all associated with a mild decrease in body weight. When FGF21-KO pups were nursed by wild-type dams (expressing FGF21 in milk), intestinal peptides and digestive enzymes were up-regulated, lactase enzymatic activity was induced, and galactose levels and body weight were normalized. Neonatal intestine explants were sensitive to FGF21, as evidenced by enhanced ERK1/2 phosphorylation. Oral infusion of FGF21 into neonatal pups induced expression of intestinal hormone factors and digestive enzymes, lactase activity and lactose absorption. These findings reveal a novel role of FGF21 as a hormonal factor contributing to neonatal intestinal function via its presence in maternal milk. Appropriate signaling of FGF21 to neonate is necessary to ensure optimal digestive and endocrine function in developing intestine. PMID:26329882

  17. Bacillus species infections in neonates.

    PubMed

    Patrick, C C; Langston, C; Baker, C J

    1989-01-01

    A case of neonatal meningitis due to Bacillus cereus is presented. Postmortem histopathologic examination revealed an invasive disease involving the brain parenchyma, with a cellular composition consistent with an indolent process indicative of possible perinatally acquired infection. One other neonate from our institution with systemic disease due to a nonanthrax bacillus is described, and a review of the English-language literature since 1900 reveals four additional neonates infected with these unusual pathogens. Such Bacillus species infections are rare but should be suspected when gram-positive bacilli are noted on gram stain, especially in an immunocompromised host. PMID:2505353

  18. [Nursing development at the Solothurn hospitals. Towards clinically oriented nursing expertise and practice development].

    PubMed

    Schäfer, Ursi Barandun; Hirsbrunner, Therese; Jäger, Susanne; Näf, Ernst; Römmich, Sabine; Horlacher, Kathrin

    2011-02-01

    At the Solothurn Hospitals (soH), 13 academically educated nurses are responsible for the development of nursing care with the goal to improve patient-oriented, effective, appropriate, and economic care. The strategy contains three priorities: a) expert care of single patients in demanding situations, b) sustained application of organisational methods such as primary nursing, nursing process, and skill/grade mix, and c) design and management of practice development projects related to specific patient groups. A first evaluation with qualitative and quantitative methods showed that the exemplary care of single patients by expert nurses was evaluated as positive for the patients as well as for the teams on two wards by nurses who were interviewed. After the introduction of primary nursing, the application rate was 81 to 90 % and the introduction of fall prevention methods in geriatric rehabilitation decreased the fall rate from 8.2 to 5.5 per 1000 patient days. A comparision with the literature shows that the expert nurses of soH perform both, working at the bedside and being responsible for practice development projects, as specialised Advanced Practice Nurses (APNs). APNs at the Solothurn Hospitals work also as generalists when organisational methods need to be consolidated. Their successes depend from their integration into the hierarchy and both, into the nursing as well as into the interprofessional teams. Competencies in Transformational Leadership also are essential at all management levels. PMID:21274841

  19. Resource requirements for a quality Doctor of Nursing Practice program.

    PubMed

    Frantz, Rita A

    2013-08-01

    Fundamental to planning, implementing, and sustaining a quality Doctor of Nursing Practice (DNP) program is access to the resources needed to foster a learning environment that prepares nurses for advanced practice and leadership in the future redesigned health care system. This creates formidable challenges for schools and colleges of nursing as they endeavor to address the nation's need for an increased supply of advanced practice nurses to provide access to high-quality, cost-effective care for an aging population. This article describes the essential resources needed to support the delivery of a DNP program and the proposed strategies needed to address the resource challenges. PMID:23855341

  20. Juvenile Myelomonocytic Leukemia in a Premature Neonate Mimicking Neonatal Sepsis.

    PubMed

    Lee, Ming-Luen; Yen, Hsiu-Ju; Chen, Shu-Jen; Hung, Giun-Yi; Tsao, Pei-Chen; Soong, Wen-Jue

    2016-04-01

    Juvenile myelomonocytic leukemia (JMML) is a rare hematologic malignancy in children. Its presentations include anemia, thrombocytopenia, monocytosis, skin rash, marked hepatomegaly, and/or splenomegaly. Fever and respiratory involvement are common. Here, we report a case of a premature neonate with initial symptoms of respiratory distress. She gradually developed clinical manifestations of JMML that mimicked neonatal sepsis. Three weeks after birth, JMML was diagnosed. This is the first reported case of JMML presenting in a premature infant in Taiwan. PMID:24269860

  1. Nursing students learning to utilize nursing research in clinical practice.

    PubMed

    Mattila, Lea-Riitta; Eriksson, Elina

    2007-08-01

    The purpose of the study was to examine the significance of a learning assignment in relation to research skills and learning of nursing students in clinical practice. The learning assignment included an oral presentation of a nursing research article, which the students gave to their fellow students and ward nurses. The students also chaired the discussion after the presentation. The target group for the study was nursing students of a Finnish polytechnic who had been studying for 2-2 1/2 years and had accomplished a minimum of 120 ECTS credits of the total of 210 ECTS credits. When participating in the study, the students were completing a six-week clinical practice of optional studies. The data were collected with a questionnaire designed for the study. It consisted of six open-ended questions. Three of the questions were related to learning of research skills. Two questions were concerned with learning during the ongoing clinical practice. The final question inquired the students' views on the development of the learning assignment. The students received the questionnaire before the commencement of their clinical practice, and they returned it to the other researcher after their clinical practice. The questionnaire was given to 80 students, of which 50 returned it; the response rate was 63%. The data were analysed by content analysis question by question. According to the results, the learning assignment advanced the understanding of research concepts for the majority of the students. In particular, the students reported that the oral presentation clarified the research concepts, and the structure of a scientific article was also elucidated. The students stated that the assignment generated ideas concerning the development of nursing care. In relation to the ongoing clinical practice, the assignment advanced patient encounters and interaction, and bearing responsibility the most. Proposals for the further development of the learning assignment were expressed by

  2. Transient neonatal zinc deficiency.

    PubMed

    Krieger, I; Alpern, B E; Cunnane, S C

    1986-06-01

    We report an infant who developed clinical manifestations of zinc deficiency during the first month of life although the diet was adequate for zinc and no other causes could be ascertained. The diagnosis was confirmed by low plasma-zinc concentrations and a positive response to zinc treatment. The fatty acid profile of plasma phospholipids was typical of zinc deficiency (ie, arachidonic acid was markedly decreased). The transient nature of this disorder was evident when no relapse occurred after cessation of zinc therapy and plasma-zinc and arachidonic acid concentrations remained normal. Several explanations for the development of transient neonatal zinc deficiency are offered. The observation demonstrates that occasional infants may have requirements for zinc that are beyond the intakes of the conventional RDA. PMID:3717070

  3. Neonatal sensitization to latex.

    PubMed

    Worth, J

    2000-05-01

    Babies born in delivery rooms of hospitals are exposed to latex through skin and mucous membrane contact with prepowdered latex gloves worn by midwives and doctors, and through the inhalation of latex-bound starch powder in the air of the delivery room. This paper examines the hypothesis that they are at risk for latex sensitization, and that part of the sharp increase of childhood asthma, eczema and anaphylaxis in the past 30-40 years may be linked. These possibilities seem hitherto unsuspected. In over 700 papers on latex allergy no mention of neonatal exposure to latex has been found. Even obstetric papers discussing the risks for an atopic mother (atopy - a tendency to develop allergies) do not seem to anticipate any risk for the baby, who might also be atopic. Latex allergy is primarily regarded as an occupational hazard. This paper suggests that it is a hazard for every baby handled by latex gloves at birth. PMID:10859678

  4. Neonatal pulmonary hemosiderosis.

    PubMed

    Limme, Boris; Nicolescu, Ramona; Misson, Jean-Paul

    2014-01-01

    Idiopathic pulmonary hemosiderosis (IPH) is a rare complex entity characterized clinically by acute or recurrent episodes of hemoptysis secondary to diffuse alveolar hemorrhage. The radiographic features are variable, including diffuse alveolar-type infiltrates, and interstitial reticular and micronodular patterns. We describe a 3-week-old infant presenting with hemoptysis and moderate respiratory distress. Idiopathic pulmonary hemosiderosis was the first working diagnosis at the Emergency Department and was confirmed, 2 weeks later, by histological studies (bronchoalveolar lavage). The immunosuppressive therapy by 1 mg/kg/d prednisone was immediately started, the baby returned home on steroid therapy at a dose of 0,5 mg/kg/d. The diagnosis of idiopathic pulmonary hemosiderosis should be evocated at any age, even in the neonate, when the clinical presentation (hemoptysis and abnormal radiological chest images) is strongly suggestive. PMID:25389504

  5. The development of the next generation of nurse leaders.

    PubMed

    Aduddell, Kathie A; Dorman, Genie E

    2010-03-01

    This article explains the development of a value-added leadership focus to a graduate nursing program. With the changes to and complexity within the health care system, advanced practice nurses need academic preparation in advanced care management of populations and leadership competencies. Strategic environmental scanning suggested that some revisions could better prepare future nurse leaders. Through literature review and focus groups, faculty's analysis provided evidence for development of a different kind of advanced practice nurse. This process led to a graduate program that prepares nurse leaders who are competent in the clinical settings and leadership roles of today's health care organizations. The 40-semester hour program allows flexibility for minimum career disruption and a choice of tracks to accommodate individuals' educational needs. Grounded in practicum experiences and guided by health care theory, policy, and research, graduates possess the knowledge and competencies to assume the advanced leadership roles required in future health care systems. PMID:19954136

  6. Social media use in nursing education.

    PubMed

    Schmitt, Terri L; Sims-Giddens, Susan S; Booth, Richard G

    2012-09-01

    As technological advances continue to expand connectivity and communication, the number of patients and nurses engaging in social media increases. Nurses play a significant role in identification, interpretation, and transmission of knowledge and information within healthcare. Social media is a platform that can assist nursing faculty in helping students to gain greater understanding of and/or skills in professional communication; health policy; patient privacy and ethics; and writing competencies. Although there are barriers to integration of social media within nursing education, there are quality resources available to assist faculty to integrate social media as a viable pedagogical method. This article discusses the background and significance of social media tools as pedagogy, and provides a brief review of literature. To assist nurse educators who may be using or considering social media tools, the article offers selected examples of sound and pedagogically functional use in course and program applications; consideration of privacy concerns and advantages and disadvantages; and tips for success. PMID:23036058

  7. Different Vancomycin Immunoassays Contribute to the Variability in Vancomycin Trough Measurements in Neonates

    PubMed Central

    Smits, Anne; Spriet, Isabel; Soldatovic, Ivan; Atkinson, Andrew; Bajcetic, Milica; Van Den Anker, John N.; Allegaert, Karel

    2016-01-01

    Substantial interassay variability (up to 20%) has been described for vancomycin immunoassays in adults, but the impact of neonatal matrix is difficult to quantify because of blood volume constraints in neonates. However, we provide circumstantial evidence for a similar extent of variability. Using the same vancomycin dosing regimens and confirming similarity in clinical characteristics, vancomycin trough concentrations measured by PETINIA (2011-2012, n = 400) were 20% lower and the mean difference was 1.93 mg/L compared to COBAS (2012–2014, n = 352) measurements. The impact of vancomycin immunoassays in neonatal matrix was hereby suggested, supporting a switch to more advanced techniques (LC-MS/MS).

  8. International Transplant Nurses Society

    MedlinePlus

    ... Register for the 25th Annual ITNS Symposium The International Transplant Nurses Society (ITNS) cordially invites transplant nurses ... Barriers (PDF) This pocket guide, developed by the International Transplant Nurses Society (ITNS), provides an overview of ...

  9. Maternal adiponectin controls milk composition to prevent neonatal inflammation.

    PubMed

    Jin, Zixue; Du, Yang; Schwaid, Adam G; Asterholm, Ingrid W; Scherer, Philipp E; Saghatelian, Alan; Wan, Yihong

    2015-04-01

    Adiponectin is an important adipokine. Increasing evidence suggests that altered adiponectin levels are linked with metabolic and inflammatory disorders. Here we report an important yet previously unrecognized function of adiponectin in lactation by which maternal adiponectin determines the inflammatory status in the nursing neonates. Surprisingly, both maternal adiponectin overexpression in the transgenic mice and maternal adiponectin deletion in the knockout mice lead to systemic inflammation in the pups, manifested as transient hair loss. However, distinct mechanisms are involved. Adiponectin deficiency triggers leukocyte infiltration and production of inflammatory cytokines in the lactating mammary gland. In contrast, adiponectin overabundance increases lipid accumulation in the lactating mammary gland, resulting in excessive long-chain saturated fatty acids in milk. Interestingly, in both cases, the inflammation and alopecia in the pups can be rescued by Toll-like receptor (TLR)-2/4 deletion because TLR2/4 double-knockout pups are resistant. Mechanistically, long-chain saturated fatty acid activation of inflammatory genes is TLR2/4 dependent and can be potentiated by proinflammatory cytokines, indicating that the inflammatory stimuli in both scenarios functionally converge by activating the TLR2/4 signaling. Therefore, our findings reveal adiponectin as a dosage-dependent regulator of lactation homeostasis and milk quality that critically controls inflammation in the nursing neonates. Furthermore, these results suggest that inflammatory infantile disorders may result from maternal adiponectin dysregulation that can be treated by TLR2/4 inhibition. PMID:25590242

  10. The “Immunocrit,” a Simple Measure of Passive Transfer, is a Useful Predictor of Nursing Ability and Preweaning Mortality of Piglets

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Initiation of lactation and newborn piglet nursing ability are two factors that can influence preweaning mortality. We have developed the “immunocrit” that can assess both lactation initiation and neonatal piglet nursing ability based on the transfer of immunoglobulin G (IgG) from the sow to the pig...

  11. Nurse Staffing and NICU Infection Rates

    PubMed Central

    Rogowski, Jeannette A.; Staiger, Douglas; Patrick, Thelma; Horbar, Jeffrey; Kenny, Michael; Lake, Eileen T.

    2016-01-01

    Importance There are substantial shortfalls in nurse staffing in US neonatal intensive care units (NICUs) relative to national guidelines. These are associated with higher rates of nosocomial infections among infants with very low birth weights. Objective To study the adequacy of NICU nurse staffing in the United States using national guidelines and analyze its association with infant outcomes. Design Retrospective cohort study. Data for 2008 were collected by web survey of staff nurses. Data for 2009 were collected for 4 shifts in 4 calendar quarters (3 in 2009 and 1 in 2010). Setting Sixty-seven US NICUs from the Vermont Oxford Network, a national voluntary network of hospital NICUs. Participants All inborn very low-birth-weight (VLBW) infants, with a NICU stay of at least 3 days, discharged from the NICUs in 2008 (n = 5771) and 2009 (n = 5630). All staff-registered nurses with infant assignments. Exposures We measured nurse understaffing relative to acuity-based guidelines using 2008 survey data (4046 nurses and 10 394 infant assignments) and data for 4 complete shifts (3645 nurses and 8804 infant assignments) in 2009–2010. Main Outcomes and Measures An infection in blood or cerebrospinal fluid culture occurring more than 3 days after birth among VLBW inborn infants. The hypothesis was formulated prior to data collection. Results Hospitals understaffed 31% of their NICU infants and 68% of high-acuity infants relative to guidelines. To meet minimum staffing guidelines on average would require an additional 0.11 of a nurse per infant overall and 0.34 of a nurse per high-acuity infant. Very low-birth-weight infant infection rates were 16.4% in 2008 and 13.9% in 2009. A 1 standard deviation–higher understaffing level (SD, 0.11 in 2008 and 0.08 in 2009) was associated with adjusted odds ratios of 1.39 (95% CI, 1.19–1.62; P < .001) in 2008 and 1.40 (95% CI, 1.19–1.65; P < .001) in 2009. Conclusions and Relevance Substantial NICU nurse understaffing relative to

  12. The effectiveness of a standardised positioning tool and bedside education on the developmental positioning proficiency of NICU nurses.

    PubMed

    Spilker, Arlene; Hill, Constance; Rosenblum, Ruth

    2016-08-01

    In order to improve the developmental proficiency of neonatal intensive care unit nurses, a standardised infant positioning assessment tool and a bedside education programme were introduced to the registered nurses in a 46 bed level III neonatal intensive care unit in the western United States. A developmental positioning team collected pre-intervention positioning scores on 54 preterm infants. This was followed by a survey of the registered nurses beliefs and attitudes, the introduction of the standardised assessment tool and an informal education programme. Post-intervention positioning scores were collected on 55 preterm infants, and analysis of the data indicated there was a statistically significant change in mean positioning scores. Additionally, the registered nurses identified several barriers to the implementation of developmental positioning. This research indicates the use of a standardised infant positioning assessment tool and bedside education may be useful strategies for improving the developmental positioning proficiency of NICU nurses. PMID:26947083

  13. Therapeutic drug monitoring in neonates.

    PubMed

    Pauwels, Steven; Allegaert, Karel

    2016-04-01

    Therapeutic drug monitoring (TDM) aims to integrate drug measurement results into clinical decision making. The basic rules apply when using TDM in neonates (aminoglycosides, vancomycin, phenobarbital, digoxin), but additional factors should also be taken into account. First, due to both pharmacokinetic variability and non-pharmacokinetic factors, the correlation between dosage and concentration is poor in neonates, but can be overcome with the use of more complex, validated dosing regimens. Second, the time to reach steady state is prolonged, especially when no loading dose is used. Consequently, the timing of TDM sampling is important in this population. Third, the target concentration may be uncertain (vancomycin) or depend on specific factors (phenobarbital during whole body cooling). Finally, because of differences in matrix composition (eg, protein, bilirubin), assay-related inaccuracies may be different in neonates. We anticipate that complex validated dosing regimens, with subsequent TDM sampling and Bayesian forecasting, are the next step in tailoring pharmacotherapy to individual neonates. PMID:26803050

  14. Mastitis in a neonatal filly

    PubMed Central

    Gilday, Rebecca; Lewis, Danyse; Lohmann, Katharina L.

    2015-01-01

    Neonatal mastitis is a rare occurrence in the horse. This report documents a case of mastitis caused by an organism within the Streptococcus dysgalactiae group in a 1-week-old Paint filly. PMID:25565717

  15. Neonatal and pediatric respiratory care

    SciTech Connect

    Koff, P.B. ); Eitzman, D.V.; Nev, J. )

    1988-01-01

    This book contains 23 chapters. Some of the titles are: Radiographic evaluations; Neonatal parenchymal diseases: physiologic development; Oxygen therapy; Pediatric parenchymal diseases; and Care of the neurologically injured child.

  16. Neonatal euthanasia: The Groningen Protocol*

    PubMed Central

    Vizcarrondo, Felipe E.

    2014-01-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  17. Therapeutic hypothermia in neonatal asphyxia

    PubMed Central

    Cornette, L.

    2012-01-01

    Hypoxic ischemic encephalopathy is a serious condition affecting newborn infants which can result in death and disability. There is now strong clinical evidence that moderate post-asphyxial total body cooling or hypothermia in full term neonates results in long-term neuroprotection, allowing us to proclaim this innovative therapy as “standard of care.” The treatment is a time-critical emergency and should be started within 6 hours after the insult. Such requires optimal collaboration among local hospitals, transport teams and the closest neonatal intensive care unit. The technique is only safe when applied according to published clinical trial protocols, and with admission of these patients to a neonatal intensive care unit. Future studies should be aimed at optimizing the onset, duration, and depth of hypothermia. Combination of hypothermia and drugs may further improve neuroprotection in asphyxiated full term neonates. PMID:24753900

  18. Neonatal euthanasia: The Groningen Protocol.

    PubMed

    Vizcarrondo, Felipe E

    2014-11-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  19. Wound Care Nursing: Professional Issues and Opportunities

    PubMed Central

    Corbett, Lisa Q.

    2012-01-01

    As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineate leadership and reimbursement issues to meet current health care challenges. A review of the role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty. PMID:24527304

  20. Wound Care Nursing: Professional Issues and Opportunities.

    PubMed

    Corbett, Lisa Q

    2012-10-01

    As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineate leadership and reimbursement issues to meet current health care challenges. A review of the role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty. PMID:24527304

  1. Developing nursing care plans.

    PubMed

    Ballantyne, Helen

    2016-02-24

    This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred. PMID:26907149

  2. Students requiring personal nursing care in school: nursing care models and a checklist for school nurses.

    PubMed

    Shannon, Robin Adair; Minchella, Lindsey

    2015-03-01

    Unprecedented numbers of children in the United States are now surviving extreme conditions and complications of prematurity, severe congenital anomalies, and significant birth trauma. Advances in medical science and technology have given rise to a marked increase in the population of children with special health care needs who require continuous nursing care, including at school. Students who are considered medically complex and/or are health technology-dependent present many rewards and challenges for families, educational staff, district administrators, and school nurses who may not feel prepared to integrate involved health care for students into the school setting. The purpose of this article is to describe care delivery models for success in providing for the health and safety needs of students who require continuous or personal nursing care at school. PMID:25816436

  3. Danger signs of neonatal illnesses: perceptions of caregivers and health workers in northern India.

    PubMed Central

    Awasthi, Shally; Verma, Tuhina; Agarwal, Monica

    2006-01-01

    OBJECTIVE: To assess household practices that can affect neonatal health, from the perspective of caregivers and health workers; to identify signs in neonates leading either to recognition of illness or health-care seeking; and to ascertain the proportion of caregivers who recognize the individual items of the integrated management of neonatal and childhood illnesses (IMNCI) programme. METHODS: The study was carried out in a rural community in Sarojininagar Block, Uttar Pradesh, India, using qualitative and quantitative research designs. Study participants were mothers, grandmothers, grandfathers, fathers or "nannies" (other female relatives) caring for infants younger than 6 months of age and recognized health-care providers serving the area. Focus group discussions (n = 7), key informant interviews (n = 35) and structured interviews (n = 210) were conducted with these participants. FINDINGS: Many household practices were observed which could adversely affect maternal and neonatal health. Among 200 caregivers, 70.5% reported home deliveries conducted by local untrained nurses or relatives, and most mothers initiated breastfeeding only on day 3. More than half of the caregivers recognized fever, irritability, weakness, abdominal distension/vomiting, slow breathing and diarrhoea as danger signs in neonates. Seventy-nine (39.5%) of the caregivers had seen a sick neonate in the family in the past 2 years, with 30.38% in whom illness manifested as continuous crying. Health care was sought for 46 (23%) neonates. Traditional medicines were used for treatment of bulging fontanelle, chest in-drawing and rapid breathing. CONCLUSION: Because there is no universal recognition of danger signs in neonates, and potentially harmful antenatal and birthing practices are followed, there is a need to give priority to implementing IMNCI, and possible incorporation of continuous crying as an additional danger sign. PMID:17128362

  4. Relational Communications Strategies to Support Family-Centered Neonatal Intensive Care.

    PubMed

    Benzies, Karen M

    2016-01-01

    The philosophy of family-centered care in neonatal intensive care units is intended to facilitate parental involvement, shared decision-making, and improved outcomes for infants and families. To support family-centered care, there are multiple interventions with different components and associated outcomes that have been described in the research literature. This evidence leaves many unanswered questions about how best to implement and evaluate strategies to enhance family-centered care. This article provides a brief overview of interventions designed to support family-centered care in neonatal intensive care units and offers an evidence-informed staff education strategy to enhance family-centered care. The evidence-informed relational communications strategies of circular pattern diagrams, questioning, and commendations are described, along with specific examples of how nurses can use them in in their day-to-day practice in neonatal intensive care units. PMID:27465456

  5. Opportunities for nursing research in tobacco control.

    PubMed

    Bialous, Stella Aguinaga; Sarna, Linda

    2009-01-01

    Nurse scientists have made important contributions to evidence-based practice in tobacco control. This chapter will discuss recent tobacco control developments in the United States and globally, such as legislation giving the U.S. Food and Drug Administration regulatory authority over tobacco products manufacturing, marketing and sales, the World Health Organization Framework Convention on Tobacco Control, and a brief review of research that has guided policy advances and nursing research in tobacco control. Suggestions for future research based on the update of the U.S. Public Health Services Treating Tobacco Use and Dependence clinical practice guideline will be explored. These developments offer nursing researchers a wealth of opportunities and challenges to advance nursing and tobacco control knowledge, address research gaps, and bring a unique nursing perspective to tobacco use prevention, reduction of exposure to secondhand smoke, tobacco dependence treatment, and tobacco control policies. Additionally, we will address how nursing scholarship can and should be supported by academic and organizational leadership to support nurses in realizing their full potential in mitigating the global epidemic of tobacco-caused death and disease. PMID:20192113

  6. [Communicative action for building nursing knowledge].

    PubMed

    do Nascimento, Suzana Rodrigues; do Prado, Marta Lenise

    2004-01-01

    It is a theoretical essay aiming at proposing the usage of the communicative action theory, by philosopher Jürger Habermas, as a mediator of educational technologies in building nursing knowledge. Based on the contributions by the philosopher and authors such as Demo, Morin, Assman, Perrenoud, Waldow, and Ramos, we reflect on technological advances and the necessary innovations in the field of nursing education. We believe that this proposal can contribute to implementing the national curriculum guidelines in undergraduate courses. PMID:15535528

  7. Introducing Information Literacy Competency Standards for Nursing.

    PubMed

    Phelps, Sue F; Hyde, Loree; Planchon Wolf, Julie

    2015-01-01

    The Association for College and Research Libraries published the Information Literacy Competency Standards for Nursing (ILCSN) in January 2014, written by a task force of the Health Sciences Interest Group of the American Library Association. The ILCSN describes skills ranging from basic to advanced information research competencies for students enrolled in nursing programs at all levels and for professional nurses. This article guides administrators and faculty in use of the standards to design programs and coursework in information skills to support evidence-based practice. PMID:25997150

  8. School for health sciences university students' opinions about male nurses.

    PubMed

    Saritaş, Serdar; Karadağ, Mevlüde; Yildirim, Duygu

    2009-01-01

    This study was conducted after the new nursing law was passed in Turkey in May 2007. According to the old nursing law in Turkey, only women could legally work as nurses. However, the new law made it possible for men to work as nurses as well. The researchers who conducted this study developed a survey for determining university nursing and midwifery students' opinions about the concept of a male nurse. No sampling method was used in this research, and the survey was administered to all students who came to school on the dates it was administered and agreed to participate voluntarily. A total of 331 students (88.7%) were administered the survey personally by the researchers. Of the participants in the study, 53.5% were in nursing and 46.5% were in midwifery schools. The majority (82.2%) of the students thought that nursing should be done by both genders, 74.0% thought that having male members of the profession would have a part in the advancement of the profession, 72.8% thought that male nurses should be admitted to schools, 61.3% thought that male nurses could give care to male and female patients, and 80.7% thought that they could work in harmony with male and female nurses. In general, the students at our university have a positive attitude toward male nurses. PMID:19751932

  9. Nursing faculty practice: benefits vs costs.

    PubMed

    Budden, L

    1994-06-01

    The transfer of nurse education from the hospital setting to the university sector has increased the dichotomy between theory and practice. Nurse academics have been exploring methods of maintaining clinical competence and credibility through organizational structures such as faculty practice. Faculty practice is a formal arrangement which exists between a clinical setting and a university which allows nurse academics to consult and deliver client care resulting in research and scholarly outcomes. The most important advantage of faculty practice is its potential to contribute to nursing knowledge and validate theories through the use of reflective practice and professional journaling by nurse academics which can help demystify and analyse the intricate elements of nursing. Other advantages of faculty practice are described as improving student's learning and client care through the application of an advanced knowledge base and facilitation by a faculty member. It also facilitates communication with clinical staff and assists in the professional development of nurse academics. The major barriers which need to be addressed to facilitate faculty practice are the allocation of time in the nurse academic's workload which incorporates consultation and faculty practice, organization and administrative support and the recognition of clinical competence in the promotion and tenure process of universities. PMID:7930106

  10. Continuing education in nursing: a concept analysis.

    PubMed

    Gallagher, Lorraine

    2007-07-01

    The importance of continuing education for nurses has been increasingly emphasized in the nursing literature since the beginning of the profession. The concept of continuing education is often used as a substitute for associated terms such as continuing professional development and lifelong learning, thus highlighting a need for its clarification. The purpose of this article is to explain and describe continuing education, in order to encourage a broader understanding of the concept among nurses. The concept analysis is directed by Rodgers' [Rodgers, B.L., 1989. Concept analysis and the development of nursing knowledge: the evolutionary cycle. Journal of Advanced Nursing 14, 330-335] 'evolutionary approach' which is viewed as an ongoing dynamic process, and one that identifies the shared meaning of concepts. Examining everyday discourse used in the nursing literature identified the critical attributes, antecedents and consequence of continuing education in nursing. As a result, the emerging attributes of the concept are synthesised into a conceptual model. The article concludes with an exploration of the application of the concept of continuing education within nursing and its implications for professional development. PMID:17109998

  11. Effect of peer education on the noise management in Iranian neonatal intensive care unit

    PubMed Central

    Biabanakigoortani, Azam; Namnabati, Mahboobeh; Abdeyazdan, Zahra; Badii, Zohreh

    2016-01-01

    Background: Advancements in neonatal intensive care unit (NICU) science and technology have increased the survival rate of preterm infants. Despite these advances, they are still facing with neurobehavioral problems. Noise level in NICU is a potential source of stress for preterm infants. It should be decreased to the standard level as much as possible. The purpose of this study was to evaluate the effect of peer education on the performance of staff in noise management in the NICU. Materials and Methods: A pre-post test quasi-experimental design was used. Fifty-eight staff members (nurses and physicians) participated in this study. Sound pressure levels were measured before and after the intervention. Peer education program formed the intervention. The staff performance in noise management was evaluated before and after the intervention by using a questionnaire. Data analysis was done by using t-test. Results: The results of the study showed that the mean sound level in different environments significantly decreased after the intervention. It reached from 86.7 to 74.9 dB in the center of unit and from 68.2 to 48.50 dB in the infants' bedside (P < 0.0001). The mean score of the staff performance in noise management significantly increased after the intervention, compared to the pre-intervention score. It increased from 74.6 to 83.4 (P < 0.0001). Conclusions: Peer education was found to be successful in noise management because behavioral changes were done to avoid generating unnecessary noise by the staff. PMID:27186211

  12. What nurses want: the nurse incentives project.

    PubMed

    Wieck, K Lynn; Dols, Jean; Northam, Sally

    2009-01-01

    Today's nurse executives are struggling with leadership challenges of managing the multigenerational workforce, financial imperatives to deliver better care for lower costs, and competition to provide the optimal work environment to retain nurses. The purpose of the Nurse Incentives Project was to determine satisfaction with current employment incentives and potential managerial actions which might decrease or delay turnover by registered nurses. This study spawned recommendations regarding the role of incentives in designing an environment where benefits and perks will be seen as incentives to stay and thrive in the current nursing workplace. The results show that nurses know what they want. Attention to generational priorities and flexible benefits programs may help to create the cohesive work environment that nurses seek. Investment into creating delivery arenas where satisfied nurses are caring for satisfied patients is a worthwhile goal. PMID:19558077

  13. Nursing Jobs in Nursing Homes

    ERIC Educational Resources Information Center

    Torpey, Elka Maria

    2011-01-01

    The need for practical nurses who focus on caring for older people is growing. According to the U.S. Census Bureau, the number of people ages 65 and older is expected to increase from 40 million to 72 million between 2010 and 2030. And the U.S. Bureau of Labor Statistics (BLS) projects that this increasing population will result in job growth for…

  14. Nursing, knowledge and practice.

    PubMed

    Allen, D

    1997-07-01

    Recent commentators have suggested that academic knowledge is irrelevant to nursing practice and may actually undermine nursing's traditional caring ethos. Furthermore, by making nursing more academic, it is claimed that 'natural' but non-academic carers are prevented from pursuing a career in nursing. Debates about the relationship between nursing, knowledge and practice have a long history and have to be understood in terms of wider political and economic issues relating to nursing, its status within society and the changing role of nurses within the health services division of labour. One crucial issue is nursing's status as women's work. Critics of developments in nurse education draw an ideological equation between nursing work and the traditional female role. From this perspective the qualities that make a good nurse cannot be taught, rather they are founded on 'natural' feminine skills. Irrespective of whether caring is 'natural' or not, it is questionable as to whether, for today's nurses, being caring is sufficient. The shape of nursing jurisdiction is a long way removed from its origins in the Victorian middle-class household. In addition to their traditional caring role, contemporary nurses may also have complex clinical, management and research responsibilities, as well as being crucial coordinators of service provision. It is suggested that these and future developments in health services make the need for an educated nursing workforce even more pressing. In order to adequately prepare nurses for practice, however, it is vital that nurse education reflects the reality of service provision. PMID:10180381

  15. Applying Benner's model to school nursing of multiple handicapped children.

    PubMed

    Pesata, V L

    1994-09-01

    The role of the school health nurse has become more complex in recent years due to public policy changes. The focus of this article is on changes in school health nursing since enactment of Public Law 94-142, the Education for All Handicapped Children Act, which places medically complex and multiply handicapped children in the public school system. The changing character of school health nursing increases the need for the advanced practice nurse (APN) to use nursing theories to guide nursing decisions. In this article, Benner's Model of Expert Practice is used by the APN in the challenging setting of school health nursing. A case study is included to describe how an APN can use this model to promote optimal functioning in a child with multiple handicaps while helping the child and family transition through developmental stages. PMID:7882256

  16. Minimizing nurses' risks for needlestick injuries in the hospital setting.

    PubMed

    Rohde, Karin A; Dupler, Alice E; Postma, Julie; Sanders, Allan

    2013-05-01

    Despite advances in safety mechanisms for sharps, nurses continue to be at high risk for needlestick injuries, with more than half of all nurses experiencing at least one needlestick injury during their careers. Needlestick injury risk appears to be the result of three incident factors: nurses' sense of urgency, variable shift work, and lower skill level related to years of experience, academic degree, and younger age. This article synthesizes the evidence related to these risk factors among nurses in the hospital setting. Evidence linking needlestick injury risk with both variable shift work and lower skill level is demonstrated. The evidence supporting a relationship between needlestick injury risk and nurses' sense of urgency is conflicting. It is the authors' goal to reduce needlestick injury risk for nurses; therefore, specific changes to hospital nursing practice are recommended based on the evidence identified. PMID:23650894

  17. A consensus statement on critical thinking in nursing.

    PubMed

    Scheffer, B K; Rubenfeld, M G

    2000-11-01

    The purpose of this study was to define critical thinking in nursing. A Delphi technique with 5 rounds of input was used to achieve this purpose. An international panel of expert nurses from nine countries: Brazil, Canada, England, Iceland, Japan, Korea, Netherlands, Thailand, and 23 states in the U.S. participated in this study between 1995 and 1998. A consensus definition (statement) of critical thinking in nursing was achieved. The panel also identified and defined 10 habits of the mind (affective components) and 7 skills (cognitive components) of critical thinking in nursing. The habits of the mind of critical thinking in nursing included: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open-mindedness, perseverance, and reflection. Skills of critical thinking in nursing included: analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting and transforming knowledge. These findings can be used by practitioners, educators and researchers to advance understanding of the essential role of critical thinking in nursing. PMID:11103973

  18. [Concurrent development trends in the international nursing profession].

    PubMed

    Lee, Sheuan; Huang, Cheng-Yi

    2006-06-01

    The modern nursing profession, established by Florence Nightingale, is influenced by myriad factors that include politics, legislation, societal priorities, advances in medical and computer technologies, and changes in the economic and the medical environments. Nursing profession development in Taiwan is further influenced by western culture through overseas study by scholars and the frequent holding of academic activities. Nursing education, administration and standards of practice in Taiwan are similar to that in western countries. In fact, we can anticipate that the gap that still remains between Taiwan and international nursing development will close during the course of the 21st century. The purpose of this article is to analyze the vision and development of ICN and ANA, the two nursing organizations responsible for keeping Taiwan in step with international nursing profession trends, to help the readers understand concurrent developments in the international nursing profession. PMID:16767619

  19. Mycoplasmas and Ureaplasmas as Neonatal Pathogens

    PubMed Central

    Waites, Ken B.; Katz, Brenda; Schelonka, Robert L.

    2005-01-01

    The genital mycoplasmas represent a complex and unique group of microorganisms that have been associated with a wide array of infectious diseases in adults and infants. The lack of conclusive knowledge regarding the pathogenic potential of Mycoplasma and Ureaplasma spp. in many conditions is due to a general unfamiliarity of physicians and microbiology laboratories with their fastidious growth requirements, leading to difficulty in their detection; their high prevalence in healthy persons; the poor design of research studies attempting to base association with disease on the mere presence of the organisms in the lower urogenital tract; the failure to consider multifactorial aspects of diseases; and considering these genital mycoplasmas only as a last resort. The situation is now changing because of a greater appreciation of the genital mycoplasmas as perinatal pathogens and improvements in laboratory detection, particularly with regard to the development of powerful molecular nucleic acid amplification tests. This review summarizes the epidemiology of genital mycoplasmas as causes of neonatal infections and premature birth; evidence linking ureaplasmas with bronchopulmonary dysplasia; recent changes in the taxonomy of the genus Ureaplasma; the neonatal host response to mycoplasma and ureaplasma infections; advances in laboratory detection, including molecular methods; and therapeutic considerations for treatment of systemic diseases. PMID:16223956

  20. Parish nursing: an innovative community nursing service.

    PubMed

    Laming, Eleanor; Stewart, Angela

    2016-07-13

    This article explains the concept of parish nursing and provides a historical perspective of this service. It describes the development of a parish nursing service in Heartsease, Norwich, which complements community nursing practice by focusing on the importance of providing spiritual care alongside physical, psychological and social care. Case studies are provided to illustrate the benefits of a parish nursing service to individuals and the community. PMID:27406519