Sample records for current nursing practice
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Scanlon, Andrew; Cashin, Andrew; Watson, Ngaire; Bryce, Julianne
2012-11-01
To define what can be considered to be nursing practice, time that can be calculated as the practice of nursing as well as what is considered to be advanced nursing practice and how all this can be related to the current endorsement process for nurse practitioner (NP) in Australia. Current codes and guidelines cited by the Nurse and Midwifery Board of Australia related to nursing practice and NPs, cited competency standards from the Australian Midwifery Accreditation Council, as well as published material of peak nursing bodies from within Australia as well as internationally were used. Information was also obtained through government health and professional organization websites. All information in the literature regarding current and past status and nomenclature of advanced practice nursing was considered relevant. The definitional entanglement of what is considered to be nursing practice, the calculation of specific hours and what is advanced nursing practice interferes with endorsement of NPs in Australia, and a clear understanding of what is meant by advanced practice is required to move forward. Dependent on how practice is interpreted by the Nurse and Midwifery Board of Australia directly affects the outcome of the endorsement proceedings for individual NP candidates. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.
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Striving for best practice: standardising New Zealand nursing procedures, 1930-1960.
Wood, Pamela J; Nelson, Katherine
2013-11-01
To identify how nurses in the past determined best practice, using the context of New Zealand, 1930-1960. In the current context of evidence-based practice, nurses strive to provide the best care, based on clinical research. We cannot assume that nurses in the past, prior to the evidence-based practice movement, did not also have a deliberate process for pursuing best practice. Discovering historical approaches to determining best practice will enrich our understanding of how nurses' current efforts are part of a continuing commitment to ensuring quality care. Historical research. The records of the Nursing Education Committee of the New Zealand Registered Nurses' Association, 1940-1959, and the 309 issues of New Zealand's nursing journal, Kai Tiaki, 1930-1960, were analysed to identify the profession's approach to ensuring best practice. This approach was then interpreted within the international context, particularly Canada and the USA. For nearly 30 years, nurse leaders collaborated in undertaking national surveys of training hospitals requesting information on different nursing practices. They subsequently distributed instructions for a range of procedures and other aspects of nursing care to standardise practice. Standardising nursing care was an effective way to ensure quality nursing at a time when hospital care was delivered mostly by nurses in training. The reasons for and timing of standardisation of nursing care in New Zealand differed from the international move towards standardisation, particularly in the USA. Historically, nurses also pursued best practice, based on standardising nursing procedures. Examining the antecedents of the present evidence-based approach to care reminds us that the process and reasons for determining best practice change through time. As knowledge and practice continually change, current confident assertions of best practice should and will continue to be challenged in future. © 2013 John Wiley & Sons Ltd.
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Leadership practices and staff nurses' intent to stay: a systematic review.
Cowden, Tracy; Cummings, Greta; Profetto-McGrath, Joanne
2011-05-01
The aim of the present study was to describe the findings of a systematic review of the literature that examined the relationship between managers' leadership practices and staff nurses' intent to stay in their current position. The nursing shortage demands that managers focus on the retention of staff nurses. Understanding the relationship between leadership practices and nurses' intent to stay is fundamental to retaining nurses in the workforce. Published English language articles on leadership practices and staff nurses' intent to stay were retrieved from computerized databases and a manual search. Data extraction and quality assessments were completed for the final 23 research articles. Relational leadership practices influence staff nurses' intentions to remain in their current position. This study supports a positive relationship between transformational leadership, supportive work environments and staff nurses' intentions to remain in their current positions. Incorporating relational leadership theory into management practices will influence nurse retention. Advancing current conceptual models will increase knowledge of intent to stay. Clarifying the distinction between the concepts intent to stay and intent to leave is needed to establish a clear theoretical foundation for further intent to stay research. Nurse managers and leaders who practice relational leadership and ensure quality workplace environments are more likely to retain their staff. The findings of the present study support the claim that leadership practices influence staff nurse retention and builds on intent to stay knowledge. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
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Handwerker, Sarah M
2012-09-12
Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning.
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Paediatric fever management: continuing education for clinical nurses.
Walsh, Anne M; Edwards, Helen E; Courtney, Mary D; Wilson, Jenny E; Monaghan, Sarah J
2006-01-01
This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. Fifty-one nurses from medical wards in an Australian metropolitan paediatric hospital completed a self-report descriptive survey. Knowledge of fever management was mediocre (Mean 12.4, SD 2.18 on 20 items). Nurses practicing at a higher level and those with between one and four years paediatric or current experience were more knowledgeable than novices or more experienced nurses. Negative beliefs that would impact nursing practice were identified. Interestingly, beliefs about fever, antipyretic use in fever management and febrile seizures were similar; they were not influenced by nurses' knowledge, experience, education or level of practice. Paediatric nurses are not expert fever managers. Knowledge deficits and negative attitudes influence their practice irrespective of additional paediatric education, paediatric or current experience or level of practice. Continuing education is therefore needed for all paediatric nurses to ensure the latest clear evidence available in the literature for best practice in fever management is applied.
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Evidence-based practice and research utilization activities among rural nurses.
Olade, Rosaline A
2004-01-01
To identify the extent to which rural nurses utilize evidence-based practice guidelines from scientific research in their practice; to describe both previous and current research utilization activities in which they have participated, and to identify the specific barriers they face in their practice settings. Data for this descriptive study were collected through questionnaires with open-ended questions focused on (a) current utilization of nursing research findings, (b) previous involvement in nursing research activities, and (c) participation in medical research activities. The participants were 106 nurses from various practice areas in six rural counties of a southwestern state in the United States. Results revealed that only 20.8% of the participants stated they were currently involved in research utilization, and they were mostly nurses with bachelor's degrees. The two most common areas of current research utilization were pain management and pressure ulcer prevention and management. Barriers to research utilization, such as rural isolation and lack of nursing research consultants, were identified. The types of research utilization activities identified by these nurses indicate how much the facilities in which these nurses work in the rural areas are striving with the utilization of available scientific evidence. Rural nurses face unique barriers related to situational and geographic factors, with implications for nursing administrators, researchers, and educators.
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Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.
Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne
2018-06-01
Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.
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The development of professional practice standards for Australian general practice nurses.
Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine
2017-08-01
The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.
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Predictors of NCLEX-PN Success for Practical Nursing Students
ERIC Educational Resources Information Center
Eickhoff, Mary Ann
2016-01-01
There is currently a nursing shortage in the United States. By 2022, the Bureau of Labor Statistics (BLS) expects, the number of job openings for Practical Nurses (PN) will be 168,500, an increase of 25% over 2012 (BLS, 2014). Nursing education does not currently meet present, much less future needs. Nursing programs have limited space; according…
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Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.
Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska
2012-10-01
This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.
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From royal wet nurses to Facebook: The evolution of breastmilk sharing.
Baumgartel, Kelley L; Sneeringer, Larissa; Cohen, Susan M
2016-11-01
Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation.
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From royal wet nurses to Facebook: The evolution of breastmilk sharing
Baumgartel, Kelley L; Sneeringer, Larissa; Cohen, Susan M
2017-01-01
Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation. PMID:28936030
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Scoping the role and education needs of practice nurses in London.
Procter, Susan; Griffiths, Lauren; Fanning, Agnes; Wallman, Lizzie; Loveday, Heather P
2017-07-01
Aims To identify education priorities for practice nursing across eight London Clinical Commissioning Groups (CCGs); to identify the education, training, development and support needs of practice nurses in undertaking current and future roles. The education needs of practice nurses have long been recognised but their employment status means that accessing education requires the support of their GP employer. This study scopes the educational requirements of the practice nurse workforce and working with educational providers and commissioners describes a coherent educational pathway for practice nurses. A survey of practice nurses to scope their educational attainment needs was undertaken. Focus groups were carried out which identified the education, training, development and support needs of practice nurses to fulfil current and future roles. Findings A total of 272 respondents completed the survey. Practice nurses took part in three focus groups (n=34) and one workshop (n=39). Findings from this research indicate a practice nurse workforce which lacked career progression, role autonomy or a coherent educational framework. Practice nurses recognised the strength of their role in building relationship-centred care with patients over an extended period of time. They valued this aspect of their role and would welcome opportunities to develop this to benefit patients. This paper demonstrates an appetite for more advanced education among practice nurses, a leadership role by the CCGs in working across the whole system to address the education needs of practice nurses, and a willingness on the part of National Health Service education commissioners to commission education which meets the education needs of the practice nurse workforce. Evidence is still required, however, to inform the scope of the practice nurse role within an integrated system of care and to identify the impact of practice nursing on improving health outcomes and care of local populations.
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McInnis-Perry, Gloria; Greene, Ann; Mina, Elaine Santa
2015-09-01
Standards of practice (SOPs) comprise competency statements, which are grounded in current knowledge and research, and provide foundations for performance that support professional accountability. The nursing profession, and specifically the psychiatric-mental health specialty of nursing practice in Canada, develops and revises practice standards regularly. The current article describes the collaborative, evidence-informed journey of the Canadian Federation of Mental Health Nurses during its fourth revision of the Canadian Psychiatric-Mental Health Nursing SOPs. An intraprofessional team of psychiatric-mental health nurses from the clinical, academic, research, and policy areas developed and nurtured collaborative processes that emphasize collegial and authentic relationships. Effective communication and a respectful learning environment supported the process for all members of the team. The current article provides recommendations for other professional organizations considering developing and/or revising SOPs. Copyright 2015, SLACK Incorporated.
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Guy, Jacqui; Taylor, Christine; Roden, Janet; Blundell, Jennifer; Tolhurst, Gerda
2011-04-01
The Australian nurse teacher competencies were introduced in 1996; however, the researchers perceived that changes to the health care system and a nursing workforce shortage may have affected nurse teacher roles over the past decade. This study aimed to explore perceptions of nurse teachers on the applicability of the current Australian nurse teacher competencies to practice, and modify the nurse teacher competencies to better reflect current practice. Methodology utilized mixed methods, and data collection was via focus groups, telephone interviews, and survey data. Results revealed that participants were mostly positive about the original competency statements, although there were some variations between items. Themes that emerged from the qualitative data were: changing trends in health care; preparation for teaching; understanding of the competencies, contextual influences on education role; nurse teachers as change agents, and resource management. Conclusions were that the Australian nurse teacher competencies (1996) were reflective of the current generic roles of nurse teachers however some of the competencies needed reframing to meet the current needs of nurse teachers. However, changes needed to be made in areas such as reducing complex language, inclusion of technology, and cultural competencies. Nurse teachers were supportive of the research because they valued the teacher competencies for reflection on their practice and the development of portfolios, job descriptions and performance appraisals. Copyright © 2010. Published by Elsevier Ltd.
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Nursing Practice Environment and Outcomes for Oncology Nursing
Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.
2012-01-01
Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101
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The lingering presence of the Nightingale legacy.
Hegge, Margaret J
2011-04-01
The history of the nursing profession is still evolving. One-hundred years ago, Nightingale died, leaving a legacy of philosophical cornerstones that still infuses the profession. Her idealism flows through her writings, as fresh today as 150 years ago. The initiatives of nursing today had their roots in Nightingale ideals. The alignment of current trends in nursing with Nightingale constructs is striking. Contemporary nurses are challenged to propel these ideals forward. The author here tracks Nightingale quotes, events, and writings with current initiatives, linking philosophical ideals to practical realities of current nursing practice. Nightingale constructs influencing nursing theories and models are examined.
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Nursing: caring or codependent?
Caffrey, R A; Caffrey, P A
1994-01-01
Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a value system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem.
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Microbiology Education in Nursing Practice.
Durrant, Robert J; Doig, Alexa K; Buxton, Rebecca L; Fenn, JoAnn P
2017-01-01
Nurses must have sufficient education and training in microbiology to perform many roles within clinical nursing practice (e.g., administering antibiotics, collecting specimens, preparing specimens for transport and delivery, educating patients and families, communicating results to the healthcare team, and developing care plans based on results of microbiology studies and patient immunological status). It is unclear whether the current microbiology courses required of nursing students in the United States focus on the topics that are most relevant to nursing practice. To gauge the relevance of current microbiology education to nursing practice, we created a confidential, web-based survey that asked nurses about their past microbiology education, the types of microbiology specimens they collect, their duties that require knowledge of microbiology, and how frequently they encounter infectious diseases in practice. We used the survey responses to develop data-driven recommendations for educators who teach microbiology to pre-nursing and nursing students. Two hundred ninety-six Registered Nurses (RNs) completed the survey. The topics they deemed most relevant to current practice were infection control, hospital-acquired infections, disease transmission, and collection and handling of patient specimens. Topics deemed least relevant were the Gram stain procedure and microscope use. In addition, RNs expressed little interest in molecular testing methods. This may reflect a gap in their understanding of the uses of these tests, which could be bridged in a microbiology course. We now have data in support of anecdotal evidence that nurses are most engaged when learning about microbiology topics that have the greatest impact on patient care. Information from this survey will be used to shift the focus of microbiology courses at our university to topics more relevant to nursing practice. Further, these findings may also support an effort to evolve national recommendations for microbiology education in pre-nursing and nursing curricula.
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Changes to nurses' practice environment over time.
Roche, Michael A; Duffield, Christine; Friedman, Sarah; Twigg, Di; Dimitrelis, Sofia; Rowbotham, Samantha
2016-07-01
To examine changes in the nursing practice environment, retention-related factors, unit stability and patient care tasks delayed or left undone, over two periods between 2004 and 2013. Positive nurse practice environments have been linked to nurse retention and care quality outcomes. The collection of the Practice Environment Scale of the Nursing Work Index, job satisfaction, intent to leave, unit instability and tasks delayed or not done at six acute-care hospitals across three Australian states, in two waves between 2004 and 2013; results from the two waves are compared. On average, practice environment scores declined slightly; nurses reported a greater difficulty in finding another nursing position, lower intent to leave their current job and greater instability in their current position. Rates of delayed tasks increased over the period, whereas rates of tasks left undone have decreased over the period. The decline in nurses' perceptions of the quality of the practice environment is disappointing, particularly given the protracted workforce shortages that have persisted. Significant organisational restructuring and turnover of nurse executives may have contributed to this decline. Managers need to apply existing evidence to improve nurse practice environments and manage instability. © 2016 John Wiley & Sons Ltd.
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A critical review of current nursing faculty practice.
Sawyer, M J; Alexander, I M; Gordon, L; Juszczak, L J; Gilliss, C
2000-12-01
To critically examine the current literature on nursing faculty practice, using the National Organization of Nurse Practitioner Faculties (NONPF) Guidelines for Evaluation of Faculty Practice, and to examine faculty practice models' strengths, weaknesses, and barriers. Thirty-five articles describing models of faculty practice were identified through an exhaustive search on CINAHL and Medline. Two NONPF monographs on nursing faculty practice were used as guidelines for the critical review. Faculty practice has become an integral component of faculty-role expectations at many schools of nursing. Workload, especially without adequate compensation, remains a hindrance to practice. The value of faculty practice time and expertise has not been sufficiently demonstrated. Integration of practitioner, educator and researcher roles remains extremely difficult and sometimes elusive. Faculty practice offers many advantages to schools of nursing, including educational and research opportunities for faculty and students, as well as practice sites and affordable community healthcare. Providing health care in the community presents an opportunity for independent and collaborative practice. To fully utilize the great research opportunities provided by faculty practice, more emphasis must be placed on gathering and analyzing descriptive data.
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Keating, Sarah B
2016-07-01
As a member of the Silent Generation, the author, through her lived experiences, reflects upon the successes and challenges facing nursing education in the mid-20th to 21st centuries. The author looks "back to the future" and reviews current issues that surround four key nursing education milestones. From the early entry-level baccalaureate programs in the 1950s to the current growth of the Doctor of Nursing Practice as entry into advanced practice, milestones in nursing education are linked to the cultural changes and healthcare system demands that took place at the time and their influence on nursing education and the profession. Looking to the future, the author speaks of the implications from the forecasted changes in the healthcare system that will demand interdisciplinary education and practice and the continued need for nursing research to increase the body of scientific knowledge in practice, education, and technology. Keating. © 2015 Wiley Periodicals, Inc.
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ERIC Educational Resources Information Center
Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.
2011-01-01
Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led…
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Best Practices for Onboarding New Nursing Faculty: The Role of the Nurse Administrator
ERIC Educational Resources Information Center
Lee, Antwinett O.
2017-01-01
This study explored best practices for onboarding new faculty in nursing programs in Washington State of the United States. The purpose of this study was to examine, (a) onboarding practices to orient new faculty currently used at nursing programs that provide an Associate Degree, (b) the perceived nurse administrator's role in providing…
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Rosa, William
Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.
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Current trends in nursing theories.
Im, Eun-Ok; Chang, Sun Ju
2012-06-01
To explore current trends in nursing theories through an integrated literature review. The literature related to nursing theories during the past 10 years was searched through multiple databases and reviewed to determine themes reflecting current trends in nursing theories. The trends can be categorized into six themes: (a) foci on specifics; (b) coexistence of various types of theories; (c) close links to research; (d) international collaborative works; (e) integration to practice; and (f) selective evolution. We need to make our continuous efforts to link research and practice to theories, to identify specifics of our theories, to develop diverse types of theories, and to conduct international collaborative works. Our paper gives implications for future theoretical development in diverse clinical areas of nursing research and practice. © 2012 Sigma Theta Tau International.
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ERIC Educational Resources Information Center
Carlisle, Joanna; Bhanugopan, Ramudu; Fish, Alan
2011-01-01
Purpose: This paper seeks to provide an overview of the concept of training needs analysis (TNA), current practice, models and the impact that training needs analysis currently has on nurses in public hospitals in Australia. Thus, the paper should aid future research in the area of TNA of nurses through helping researchers to clarify the…
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Microbiology Education in Nursing Practice†
Durrant, Robert J.; Doig, Alexa K.; Buxton, Rebecca L.; Fenn, JoAnn P.
2017-01-01
Nurses must have sufficient education and training in microbiology to perform many roles within clinical nursing practice (e.g., administering antibiotics, collecting specimens, preparing specimens for transport and delivery, educating patients and families, communicating results to the healthcare team, and developing care plans based on results of microbiology studies and patient immunological status). It is unclear whether the current microbiology courses required of nursing students in the United States focus on the topics that are most relevant to nursing practice. To gauge the relevance of current microbiology education to nursing practice, we created a confidential, web-based survey that asked nurses about their past microbiology education, the types of microbiology specimens they collect, their duties that require knowledge of microbiology, and how frequently they encounter infectious diseases in practice. We used the survey responses to develop data-driven recommendations for educators who teach microbiology to pre-nursing and nursing students. Two hundred ninety-six Registered Nurses (RNs) completed the survey. The topics they deemed most relevant to current practice were infection control, hospital-acquired infections, disease transmission, and collection and handling of patient specimens. Topics deemed least relevant were the Gram stain procedure and microscope use. In addition, RNs expressed little interest in molecular testing methods. This may reflect a gap in their understanding of the uses of these tests, which could be bridged in a microbiology course. We now have data in support of anecdotal evidence that nurses are most engaged when learning about microbiology topics that have the greatest impact on patient care. Information from this survey will be used to shift the focus of microbiology courses at our university to topics more relevant to nursing practice. Further, these findings may also support an effort to evolve national recommendations for microbiology education in pre-nursing and nursing curricula. PMID:28861140
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Implications of utility and deontology for the clinical nurse specialist.
Ayres, L
1989-01-01
Faced with prospective payment plans and personnel shortages nurses in advanced clinical practice are under pressure to find practical solutions. These solutions may reflect the institutional philosophy of utility rather than the traditional nursing ethic of deontology, illustrating the need to examine the differences between utilitarian and deontological principles as they affect nursing practice. This paper discusses deontology and utility as they apply to nursing practice, considers how these different philosophical positions may affect advanced practitioners, and describes the current status of ethics in nursing.
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Factors Associated With Full Implementation of Scope of Practice.
Ganz, Freda DeKeyser; Toren, Orly; Fadlon, Yafit
2016-05-01
To describe whether nurses fully implement their scope of practice; nurses' perceptions of future practice implementation; and the association between scope of practice implementation with professional autonomy and self-efficacy. A descriptive correlational study was conducted using a convenience sample of 145 registered nurses with post-basic certification from two Israeli university hospitals, from May 2012 to September 2013. Five questionnaires were distributed: (a) Demographic and Work Characteristics, (b) Implementation of Scope of Practice, (c) Attitudes Towards Future Practice, (d) Practice Behavior Scale, and (e) Practice Self-Efficacy. Descriptive statistics for all demographic and questionnaire data were analyzed. Two regression models were developed, where current and future implementations were the criterion variables and demographic and work characteristics, professional autonomy, and self-efficacy were the predictors. High levels of professional autonomy, self-efficacy, and attitudes towards future practice were found in contrast to low or moderate levels of current implementation of the full extent of scope of practice. Primary reasons associated with low implementation were lack of relevance to practice and permission to perform the practice. Significant associations were found between professional autonomy, self-efficacy, and attitudes towards future practice, but not with current implementation. Nurses wanted to practice to the full extent of their scope of practice and felt able to do so but were hindered by administrative and not personal barriers. Even though staff nurses with post-basic certification had high levels of professional autonomy and self-efficacy, many were not implementing the full extent of their scope of practice. Similar to findings from around the world, external factors, such as administrative and policy barriers, were found to thwart the full implementation of nurses' full scope of practice. Therefore, practicing nurses should be aware of these barriers and work towards reducing them. © 2016 Sigma Theta Tau International.
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ICU nurses' oral-care practices and the current best evidence.
DeKeyser Ganz, Freda; Fink, Naomi Farkash; Raanan, Ofra; Asher, Miriam; Bruttin, Madeline; Nun, Maureen Ben; Benbinishty, Julie
2009-01-01
The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics. A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients' teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67+/-27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care. While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all ICU nurses to introduce and use evidence-based, oral-care protocols. Practicing ICU nurses in this survey were often not adhering to the latest evidence-based practice and therefore need to be educated and encouraged to do so in order to improve patient care.
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Hallmarks of the Professional Nursing Practice Environment. AACN White Paper.
ERIC Educational Resources Information Center
Journal of Professional Nursing, 2002
2002-01-01
This white paper from the American Association of Colleges of Nursing depicts the current environment of nursing practice, including supply and demand. It describes work environments that support professional practice and outlines eight indicators for the practice environment. Contains 48 references and an appendix with suggested questions for…
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School nurse book clubs: an innovative strategy for lifelong learning.
Greenawald, Deborah A; Adams, Theresa M
2008-04-01
Recognizing the ongoing need for continuing education for school nurses, the authors discuss the use of school nurse book clubs as an innovative lifelong-learning strategy. Current research supports the use of literature in nursing education. This article discusses the benefits of book club participation for school nurses and includes suggested fiction and nonfiction books that can be used to enhance nursing knowledge and practice. Through reading and discussion, school nurses can increase their knowledge of nursing history and current health care issues, thus becoming better prepared to address challenging issues that arise in practice. In addition, the use of literature as a learning strategy allows school nurses to broaden their understanding of unique cultural factors that influence the health beliefs and practices of students and their families. Book club participation can also assist school nurses in honing leadership and communication skills and becoming energized to become better advocates for children and families.
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Nurses in Australian general practice: implications for chronic disease management.
Halcomb, Elizabeth J; Davidson, Patricia M; Salamonson, Yenna; Ollerton, Richard; Griffiths, Rhonda
2008-03-01
The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses' role. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role. National postal survey embedded in a sequential mixed method design. 284 practice nurses completed a postal survey during 2003-2004. Descriptive statistics and factor analysis were utilized to analyse the data. Most participants were female (99%), Registered Nurses (86%), employed part-time in a group practice, with a mean age of 45.8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = -0.779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0.8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion. Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions. Relevance to clinical practice. Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease, particularly within the context of contemporary policy initiatives.
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Nurse education regarding agitated patients and its effects on clinical practice.
Ozdemir, Leyla; Karabulut, Erdem
This study identified the impact of an education program on nurses' practices for agitated patients and documented the changes in practice after completion of the training. Eighteen cardiac intensive care nurses were included to the study. Prior to nurses' participation in an education program, a pre-test indicating nurses' current practices for 40 agitated patients was evaluated with the 'Nurse Practice Form'. After the pre-test data collection period was completed, the 2-day training program on caring for agitated patients was conducted. The last step of the study was evaluation of post-test nurses' practices for 40 agitated patients using the 'Nurse Practice Form'. The findings indicated that instead of pre-test nurses' use of physical restraints for controlling agitated patients without a physician order, none of post-test nurses applied them. The training program provided nurses the knowledge and skills needed to evaluate and to manage the causes of agitation.
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Clinical supervision: from rhetoric to accident and emergency practice.
Castille, K
1996-01-01
Clinical supervision is firmly on the nursing agenda and, when implemented, will affect every practising nurse. However, current literature offers little in the way of advice on the practical application in a setting like the Accident and Emergency department (A & E). The aim of this article is to encourage A & E nurses to consider how clinical supervision can best be implemented into their current practice. A framework is presented to show how one A & E department has embraced the concept of clinical supervision and incorporated in into their A & E nursing practice. The evaluation, to date, has been positive and A & E nurses have reported that they enjoy the sessions and consider clinical supervision to be a useful learning experience.
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Survey of Current Academic Practices for Full-Time Postlicensure Nursing Faculty Who Teach Online
ERIC Educational Resources Information Center
Hanford, Karen J.
2010-01-01
Purpose: The purpose of this study was to determine current academic practices of compensation, workload, rewards, and tenure and promotion for nursing faculty who teach graduate and postlicensure programs that are delivered 50% to 100% online. Deans and directors who are members of the American Association of Colleges of Nursing (AACN) were the…
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ERIC Educational Resources Information Center
Kerr, Elizabeth E.; And Others
This sub-study of a 39-month longitudinal study conducted by the University of Illinois in cooperation with the University of Iowa, undertook to discern the trends in practical nursing in Iowa and to record a history of its development. The 435 member 10 percent random sample of practical nurses licensed in Iowa through December 1965, which was…
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Practical ethical theory for nurses responding to complexity in care.
Fairchild, Roseanne Moody
2010-05-01
In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.
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ERIC Educational Resources Information Center
Killingsworth, Erin Elizabeth
2013-01-01
With the widespread use of classroom exams in nursing education there is a great need for research on current practices in nursing education regarding this form of assessment. The purpose of this study was to explore how nursing faculty members make decisions about using best practices in classroom test construction, item analysis, and revision in…
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Strudwick, Gillian; Hardiker, Nicholas R
2016-10-01
In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Newell, Mary E.
2013-01-01
The purpose of this quantitative research study was to identify the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and determine if they felt adequately prepared to effectively practice in the role of a school nurse. A descriptive, quantitative on-line survey was conducted of Washington State…
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Mental Health Nurses Attitudes and Practice Toward Physical Health Care in Jordan.
Ganiah, Amal N; Al-Hussami, Mahmoud; Alhadidi, Majdi M B
2017-08-01
Patients with mental illnesses are at high risk for physical disorders and death. The aim of this study is to describe mental health nurses' attitudes and practice toward physical health care for patients with mental illnesses. A descriptive cross-sectional design was used to collect data using self- reported questionnaire from 202 mental health nurses working in mental health settings in Jordan. The study adopted translated version of Robson and Haddad Physical Health Attitudes Scale to the Arabic language. There was significant positive correlation between the participants' positive attitudes and their current practice (r = .388, p = .000), mental health nurses who have more positive attitudes regarding physical health care involved physical health care more in their current practice. Mental health nurses' attitudes affect the quality of care provided to patients with mental illnesses. The results provide implications for practice, education, and research.
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Fundamental care guided by the Careful Nursing Philosophy and Professional Practice Model©.
Meehan, Therese Connell; Timmins, Fiona; Burke, Jacqueline
2018-02-05
To propose the Careful Nursing Philosophy and Professional Practice Model © as a conceptual and practice solution to current fundamental nursing care erosion and deficits. There is growing awareness of the crucial importance of fundamental care. Efforts are underway to heighten nurses' awareness of values that motivate fundamental care and thereby increase their attention to effective provision of fundamental care. However, there remains a need for nursing frameworks which motivate nurses to bring fundamental care values to life in their practice and strengthen their commitment to provide fundamental care. This descriptive position paper builds on the Careful Nursing Philosophy and Professional Practice Model © (Careful Nursing). Careful Nursing elaborates explicit nursing values and addresses both relational and pragmatic aspects of nursing practice, offering an ideal guide to provision of fundamental nursing care. A comparative alignment approach is used to review the capacity of Careful Nursing to address fundamentals of nursing care. Careful Nursing provides a value-based comprehensive and practical framework which can strengthen clinical nurses' ability to articulate and control their practice and, thereby, more effectively fulfil their responsibility to provide fundamental care and measure its effectiveness. This explicitly value-based nursing philosophy and professional practice model offers nurses a comprehensive, pragmatic and engaging framework designed to strengthen their control over their practice and ability to provide high-quality fundamental nursing care. © 2018 John Wiley & Sons Ltd.
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Medical Simulation Practices 2010 Survey Results
NASA Technical Reports Server (NTRS)
McCrindle, Jeffrey J.
2011-01-01
Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity
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Nursing philosophy: A review of current pre registration curricula in the UK.
Mackintosh-Franklin, Carolyn
2016-02-01
Nursing in the UK has been subject to criticism for failing to provide care and compassion in practice, with a series of reports highlighting inadequacies in care. This scrutiny provides nursing with an ideal opportunity to evaluate the underpinning philosophy of nursing practice, and for nurse educators to use this philosophy as the basis for programmes which can inculcate neophyte student nurses with a fundamental understanding of the profession, whilst providing other health care professionals and service users with a clear representation of professional nursing practice. The key word philosophy was used in a systematic stepwise descriptive content analysis of the programme specifications of 33 current undergraduate programme documents, leading to an undergraduate award and professional registration as a nurse. The word philosophy featured minimally in programme specification documents, with 12 (36%) documents including it. Its use was superficial in 3 documents and focused on educational philosophy in a further 3 documents. 2 programme specifications identified their philosophy as the NMC (2010) standards for pre-registration nurse education. 2 programme specifications articulated a philosophy specific to that programme and HEI, focusing on caring, and 2 made reference to underpinning philosophies present in nursing literature; the Relationship Centred Care Approach, and The Humanising Care Philosophy. The philosophy of nursing practice is not clearly articulated in pre-registration curricula. This failure to identify the fundamental nature of nursing is detrimental to the development of the profession, and given this lack of direction it is not surprising that some commentators feel nursing has lost its way. Nurse educators must review their current curricula to ensure that there is clear articulation of nursing's professional philosophical stance, and use this as the framework for pre-registration curricula to support the development of neophyte nursing students towards a clear and focused understanding of what nursing practice is. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Winter, Peggi
2016-01-01
Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.
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The History and State of Neonatal Nursing Quality Improvement Practice and Education.
Kukla, Aniko; Dowling, Donna A; Dolansky, Mary A
2018-03-01
Quality improvement has evolved rapidly in neonatal nursing. This review outlines the history and current state of quality improvement practice and education in neonatal nursing. The future of neonatal nursing includes a stronger emphasis on quality improvement in advanced practice education that promotes doctoral projects that result in clinical improvements. A collective focus will ensure that neonatal nurses not only deliver evidence-based care, but also continually improve the care they deliver.
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Designing nursing excellence through a National Quality Forum nurse scholar program.
Neumann, Julie A; Brady-Schluttner, Katherine A; Attlesey-Pries, Jacqueline M; Twedell, Diane M
2010-01-01
Closing the knowledge gap for current practicing nurses in the Institute of Medicine (IOM) core competencies is critical to providing safe patient care. The National Quality Forum (NQF) nurse scholar program is one organization's journey to close the gap in the IOM core competencies in a large teaching organization. The NQF nurse scholar program is positioned to provide a plan to assist current nurses to accelerate their learning about quality improvement, evidence-based practice, and informatics, 3 of the core competencies identified by the IOM, and focus on application of skills to NQF nurse-sensitive measures. Curriculum outline, educational methodologies, administrative processes, and aims of the project are discussed.
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The law and the expanding nursing role.
Bullough, B
1976-01-01
Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities. PMID:769567
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The law and the expanding nursing role.
Bullough, B
1976-03-01
Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities.
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Fealy, Gerard M; Rohde, Daniela; Casey, Mary; Brady, Anne-Marie; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine
2015-12-01
The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal consequences, time restrictions and lack of remuneration. Professional satisfaction, patients' needs, organisational support and having access to continuing professional education were perceived as facilitators of practice expansion. Older nurses and midwives as well as nurses and midwives holding more senior promotional grades, such as clinical nurse manager grades, perceived fewer barriers than their younger and more junior counterparts. Nurses and midwives continue to experience difficulties in relation to expanding their practice. Practitioners can operate to optimal scope of practice when practitioner-centred and workplace-based circumstances are optimal. The optimal circumstances for practice expansion exist when the facilitators of practice expansion outweigh the barriers. Given the critical role that nurses and midwives play in modern health services, it is important that they are empowered and enabled to expand their practice and to work to full scope of practice when patient needs and service requirements warrant it. © 2015 John Wiley & Sons Ltd.
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Why history matters to nursing.
Holme, Annie
2015-05-01
This paper proposes that poor knowledge and understanding of the history of nursing particularly in the UK influences the media and public analysis of nursing practice. Comparing reports of current poor practice with a 'golden age' of nursing in the past undermines public confidence in today's nursing and nurse education and has the potential to lead to simplistic and flawed policy decisions in response. The lack of detailed knowledge of past nursing practice, experience and values suggests the need for more historical research in this field. A greater critical understanding of nursing history could strengthen and enrich nursing identity and further develop critical thinking skills in nursing students. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Putting Safety in the Frame: Nurses' Sensemaking at Work.
O'Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley
2015-01-01
Current patient safety policy focuses nursing on patient care goals, often overriding nurses' safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used "frames" built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses' decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses' frames question current policy and practice by challenging how nurses' safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.
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The doctor of nursing practice and nursing education: highlights, potential, and promise.
Danzey, Ida Maria; Ea, Emerson; Fitzpatrick, Joyce J; Garbutt, Susan J; Rafferty, Margaret; Zychowicz, Michael E
2011-01-01
The success of the doctor of nursing practice (DNP) programs have exceeded everyone's expectations and resulted in increased interest in doctoral education in nursing. A shortage of doctorally prepared nurse educators continues to plague the profession and has a severe impact on the ability of schools of nursing to educate future generations of nurses. As a terminal degree in nursing practice, there is little focus on DNP graduates who are prepared as educators. To remedy this deficit, this article will therefore discuss and highlight (a) the significant potential of the DNP to mitigate the current nursing faculty shortage and to close the practice-education gap, (b) the specialized role of DNP graduates as educators and leaders in nursing education, and (c) the implications of the DNP for nursing scholarship. Copyright © 2011 Elsevier Inc. All rights reserved.
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Profile of advanced nursing practice in Spain: A cross-sectional study.
Sevilla Guerra, Sonia; Miranda Salmerón, Josep; Zabalegui, Adelaida
2018-03-01
In this study, we described the profile of advanced nursing practice in Spain. A cross-sectional study design was used to explore the extent and patterns of advanced nursing practice activity within the domains of expert care planning, integrated care, interprofessional collaboration, education, research, evidence-based practice, and professional leadership. Data were collected in 2015/2016. Purposive sampling yielded a sample of 165 specialist and expert nurses employed by a dual tertiary and community hospital in an urban setting. The study included specialist and expert nurses who had a higher practice profile than registered general nurses. The performance of activities according to age, current position, years of experience, nursing grade, and education was compared. Practice domains were more strongly influenced by the predictors of nursing position and professional career ladder. Age and experience predictors were found to be weak predictors of advanced practice domains. This study offers essential information of the nursing workforce, and clarifies both the advanced nursing practice profile and nomenclature in the context of study. © 2017 John Wiley & Sons Australia, Ltd.
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WOC practice in cyberspace: legal and ethical issues.
Hoyman, K
2001-07-01
WOC nurses have the opportunity to extend their practice geographically by using electronic media, also called telehealth or "practicing in cyberspace." Currently, laws and regulations affecting this aspect of practice are in rapid flux. In addition, practicing electronically makes the ethical issues of choice, privacy, and confidentiality more acute. This article describes the current status of relevant legislation, discusses relevant ethical issues, and provides guidelines for WOC nurses who are considering the use of e-mail and video conferencing within their practice.
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Transformational leadership training programme for charge nurses.
Duygulu, Sergul; Kublay, Gulumser
2011-03-01
This paper is a report of an evaluation of the effects of a transformational leadership training programme on Unit Charge Nurses' leadership practices. Current healthcare regulations in the European Union and accreditation efforts of hospitals for their services mandate transformation in healthcare services in Turkey. Therefore, the transformational leadership role of nurse managers is vital in determining and achieving long-term goals in this process. The sample consisted of 30 Unit Charge Nurses with a baccalaureate degree and 151 observers at two university hospitals in Turkey. Data were collected using the Leadership Practices Inventory-Self and Observer (applied four times during a 14-month study process from December 2005 to January 2007). The transformational leadership training programme had theoretical (14 hours) and individual study (14 hours) in five sections. Means, standard deviations and percentages, repeated measure tests and two-way factor analysis were used for analysis. According the Leadership Practices Inventory-Self and Observer ratings, leadership practices increased statistically significantly with the implementation of the programme. There were no significant differences between groups in age, length of time in current job and current position. The Unit Charge Nurses Leadership Practices Inventory self-ratings were significantly higher than those of the observers. There is a need to develop similar programmes to improve the leadership skills of Unit Charge Nurses, and to make it mandatory for nurses assigned to positions of Unit Charge Nurse to attend this kind of leadership programme. © 2010 Blackwell Publishing Ltd.
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Phillips, Carswella
2015-12-01
Globally, a greater emphasis has been placed on the delivery of safe, patient-centered, evidence-based nursing care. As point-of-care providers, critical care nurses play a key role in ensuring that patients receive the safest, most effective treatment available. In order to deliver scientific-based care, critical care nurses must stay abreast of the current trends, as well as engage in the evidence-based practice process. This study aimed to describe research activities, to identify barriers to implement evidence-based practice and to explore professional factors related to the use of evidence-based practice among critical care nurses at three teaching hospitals in south-eastern United States. A survey design and convenience sampling method was used. A sample of 30 critical care staff nurses participated in the study. A 61-item online questionnaire composed of a demographic survey - BARRIERS scale - and Evidence-Based Practice Questionnaire was used. Simple descriptive statistics, Pearson's product moment correlations, and independent-sample t test procedures were used to analyze the data. Critical care nurses' reported positive attitudes, but viewed knowledge and use of evidence-based practice less favorably. These results may indicate that having a positive attitude towards evidence-based practice does not necessarily translate to knowledge and use of the evidence-based practice process in clinical practice. An unwillingness to change and time constraints were identified as the top barriers to use evidence-based practice in this study. Perceptions of barriers to use evidence-based practice were higher in those critical care nurses who had less practical experience and educational preparation. The results suggest that critical care nurses possess the foundation to engage in the evidence-based practice process; however, their knowledge, practice, and attitudes just need to be cultivated and strengthened. Understanding the nurses' professional factors, current use and barriers to implement evidence-based practice is an essential step to ensuring competency and value for engaging in the evidence-based practice process. The results of this study support the need for future research to address barriers that impact critical care nurses' ability to deliver state-of-the-science care.
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2018-04-25
Wound, ostomy, and continence (WOC) nursing was recognized as a nursing specialty by the American Nurses Association in February 2010, and the Society published the original scope and standards of WOC nursing practice in May 2010. The Wound, Ostomy, and Continence Nursing: Scope and Standards of Practice, 2nd Edition is the definitive resource promoting excellence in professional practice, quality care, and improved patient outcomes in WOC specialty practice. It can be used to articulate the value of WOC nurses to administrators, legislators, payers, patients, and others. The second edition also provides an overview of the scope of WOC nursing practice including a description of the specialty, the history and evolution of WOC nursing, characteristics of WOC nursing practice, and description of the trispecialty. The document describes various WOC nurse roles, populations served, practice settings, care coordination, and collaboration. Educational preparation, levels of practice within WOC specialty nursing, certification, mandate for continuous professional development, ethics, current trends, future considerations and challenges, and standards of WOC nursing practice and professional performance with competencies for each standard are provided. The purpose of this Executive Summary is to describe the process for developing the scope and standards document, provide an overview of the scope of WOC nursing practice, and list the standards of practice and professional performance along with the competencies for each level of WOC nurse provider. The original document is available from the WOCN Society's online book store (www.wocn.org).
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Beyond the classroom: nurse leader preparation and practices.
O'Connor, Mary
2011-01-01
Formal academic education and experience as a nurse are established preparation for the chief nurse executive (CNE) or upcoming nurse leaders. This article proposes that the nurse leader must build on these fundamentals through self-discipline, lifelong learning, and practice. Three critical ingredients are discussed to guide the nurse leader on a life/career for the CNE and the nurse leader at every level. These include fostering relationships, feeding intellectual curiosity, and engaging in self-care practices. These indispensable ingredients of the successful nurse leader serve as an augmentation to formal education and experience for the nurse aspiring to reach the CNE level and beyond as well as for the current CNE mentoring future leaders.
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Education on fluid management and encouraging critical thinking skills.
Dale, Willette
2012-01-01
The unit is currently utilizing hematocrit-based blood volume monitoring on each patient, resulting in improved monitoring in patients achieving their target weight. The nurses expressed confidence in their understanding of the use of hematocrit-based blood volume monitoring. This learning experience provided a vivid look at the importance of fluid management in nephrology nursing. This area should always be included in nephrology nurse competencies and represented in a way that it ignites critical thinking within the nursing professional. It is the responsibility of a professional nurse to stay current in evidence-based practice and continuing education. Professional pride stimulates nephrology nurses to seek new learning experiences to enhance their practice.
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Promoting leadership and management in Australian general practice nursing: what will it take?
Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth
2008-10-01
This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.
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Clinical education in nursing: rethinking learning in practice settings.
Ironside, Pamela M; McNelis, Angela M; Ebright, Patricia
2014-01-01
Clinical education is a time- and resource-intensive aspect of contemporary nursing programs. Despite widespread agreement in the discipline about the centrality of clinical experiences to learning nursing, little is known about if and how current clinical experiences contribute to students' learning and readiness for practice. Before large-scale studies testing specific educational interventionals can be conducted, it is important to understand what currently occurs during clinical experiences. This study, funded by the National Council of State Boards of Nursing, examined the nature of contemporary clinical education by describing students' and faculty's experiences at three geographically diverse universities in the United States. Findings suggest that teachers' and students' focus on task completion persists and often overshadows the more complex aspects of learning nursing practice. Copyright © 2014 Elsevier Inc. All rights reserved.
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Charting the future of hospital nursing.
Aiken, L H
1990-01-01
Nursing roles are expanding in all health care settings; however, the majority of nurses will continue to practice in hospitals for the foreseeable future. Yet hospital nursing is experiencing great ferment and turmoil. Nurses are dissatisfied increasingly with hospital practice, and vacancy and turnover rates are high enough to raise major concerns about adverse consequences for patients. This paper focuses on the nature and causes of the current problems in hospital nursing and advances recommendations for charting a new course for hospital nursing.
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Improving the Quality of Electronic Documentation in Critical Care Nursing
ERIC Educational Resources Information Center
Stevens, Brent
2017-01-01
Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…
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ERIC Educational Resources Information Center
Long, Patricia R.
2017-01-01
This study is a descriptive survey incorporating two predictive questions of registered nurses (RN) who previously held a diploma (DI) or associate degree in nursing (ADN) and returned to school to earn a Bachelor of Science in Nursing (BSN); the attitude, or perception, of nursing practice was examined. This study investigated whether the…
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Linking nursing theory and practice: a critical-feminist approach.
Georges, Jane M
2005-01-01
Situated in a critical-feminist perspective, this article describes a pedagogical approach to linking nursing theory and practice. The inclusion of the critical humanities is emphasized in creating an environment in which this linkage can be reified for learners. Implications for the future of nursing theory and its links to practice in the context of current political realities in academia are considered.
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Introduction to Genetics and Childhood Obesity: Relevance to Nursing Practice
Seal, Nuananong
2013-01-01
Purpose The aims for this article are to provide an overview of the current state of research on genetic contributions to the development of childhood obesity and to suggest genetic-focused nursing practices to prevent childhood obesity. Organizing Constructs Genetic epidemiology of childhood obesity, modes to identifying obesity genes, types of human obesity genes, and nursing implications are discussed. Clinical Relevance The successful integration of genetics into nursing practice will provide opportunities for nurses to participate fully as major agents and collaborators in the health care revolution. Conclusions Practicing nurses across the profession will need to become knowledgeable about genetics and take part in obesity prevention through genetic assessment of susceptibility and appropriate environmental interventions. PMID:20798151
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Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H
2014-01-01
The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role). A longitudinal analysis of the Ontario nurses' registration database from 2005 to 2010 and a survey of specialist nurses in Canada was conducted. The setting was Canada. The database sample consisted of 3 specialist groups, consisting of RN(EC), CNS, and APN-other, as well as 1 nonspecialist RN staff nurse group. The survey sample involved 359 nurses who were classified into groups based on self-reported job title and RN specialty-certification status. Data sources included College of Nurses of Ontario registration database and survey data. The study measures were the Nursing Work Index, a 4-item measure of job satisfaction, and 1-item measure of intent to leave current job. Nurses registered with the College of Nurses of Ontario were tracked over the study period to identify changes in their employment status with comparisons made between nurses employed in specialist roles and those registered as general staff nurses. Analysis involved descriptive summaries, mean comparisons with independent-samples t test, and χ(2) tests for categorical data. Exit rates from direct practice were highest for APN-other (7.6%) and CNS (6.2%) and lowest for RN(EC) (1.0%) and staff nurses (1.2%). χ(2) Tests indicated yearly exit rates of both APN-other and CNS nurse groups were significantly higher than those of staff nurses in all years evaluated (α = .025). Every specialist employment group scored significantly higher than staff nurses on measures of work environment and satisfaction outcomes. We provided a description of specialist nurses in Ontario and examined the relationship between specialization and employment patterns of nurses to inform nurse retention strategies in the future. Employment in specialist nursing positions is significantly associated with differences in transitions or exits from nursing among the specialist and nonspecialist groups. Registered nurses (EC) displayed improved retention characteristics compared with staff nurses. Advanced practice nurse-other and APN-CNS exit rates from nursing practice in Ontario were comparable to staff nurses, but exit rates from direct clinical practice roles were higher than those of staff nurses. Targeted strategies are required to retain CNS and APN-other in direct clinical practice roles.
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Hayes Lane, Susan; Serafica, Reimund; Huffman, Carolyn; Cuddy, Alyssa
2016-01-01
In the current healthcare environment, nurses must have a basic understanding of research to lead change and implement evidence-based practice. The purpose of this study was to evaluate the effectiveness of an educational intervention formulated on the framework of the Great American Cookie Experiment measuring nurses' research knowledge, attitudes, and practice using mobile device gaming. This multisite quantitative study provides insight into promotion of research and information about best practices on innovative teaching strategies for nurses.
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A code of ethics for nurse educators: revised.
Rosenkoetter, Marlene M; Milstead, Jeri A
2010-01-01
Nurse educators have the responsibility of assisting students and their colleagues with understanding and practicing ethical conduct. There is an inherent responsibility to keep codes current and relevant for existing nursing practice. The code presented here is a revision of the Code of ethics for nurse educators originally published in 1983 and includes changes that are intended to provide for that relevancy.
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A Conceptual Model of the Information Requirements of Nursing Organizations
Miller, Emmy
1989-01-01
Three related issues play a role in the identification of the information requirements of nursing organizations. These issues are the current state of computer systems in health care organizations, the lack of a well-defined data set for nursing, and the absence of models representing data and information relevant to clinical and administrative nursing practice. This paper will examine current methods of data collection, processing, and storage in clinical and administrative nursing practice for the purpose of identifying the information requirements of nursing organizations. To satisfy these information requirements, database technology can be used; however, a model for database design is needed that reflects the conceptual framework of nursing and the professional concerns of nurses. A conceptual model of the types of data necessary to produce the desired information will be presented and the relationships among data will be delineated.
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Education of advanced practice nurses in Canada.
Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba
2010-12-01
In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. 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 the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.
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Nursing education trends: future implications and predictions.
Valiga, Theresa M Terry
2012-12-01
This article examines current trends in nursing education and proposes numerous transformations needed to ensure that programs are relevant, fully engage learners, reflect evidence-based teaching practices, and are innovative. Such program characteristics are essential if we are to graduate nurses who can practice effectively in today's complex, ambiguous, ever-changing health care environments and who are prepared to practice in and, indeed, shape tomorrow's unknown practice environments. Copyright © 2012 Elsevier Inc. All rights reserved.
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Shiu, Ann T Y; Lee, Diana T F; Chau, Janita P C
2012-08-01
This article is a report on a study to explore the development of expanding advanced nursing practice in nurse-led clinics in Hong Kong. Nurse-led clinics serviced by advanced practice nurses, a common international practice, have been adopted in Hong Kong since 1990s. Evaluations consistently show that this practice has good clinical outcomes and contributes to containing healthcare cost. However, similar to the international literature, it remains unclear as to what the elements of good advanced nursing practice are, and which directions Hong Kong should adopt for further development of such practice. A multiple-case study design was adopted with six nurse-led clinics representing three specialties as six case studies, and including two clinics each from continence, diabetes and wound care. Each case had four embedded units of analysis. They included non-participant observation of nursing activities (9 days), nurse interviews (N = 6), doctor interviews (N = 6) and client interviews (N = 12). The data were collected in 2009. Within- and cross-case analyses were conducted. The cross-case analysis demonstrated six elements of good advanced nursing practice in nurse-led clinics, and showed a great potential to expand the practice by reshaping four categories of current boundaries, including community-hospital, wellness-illness, public-private and professional-practice boundaries. From these findings, we suggest a model to advance the scope of advanced nursing practice in nurse-led clinics. The six elements may be applied as audit criteria for evaluation of advanced nursing practice in nurse-led clinics, and the proposed model provides directions for expanding such practice in Hong Kong and beyond. © 2011 Blackwell Publishing Ltd.
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Sroczynski, Maureen; Gravlin, Gayle; Route, Paulette Seymour; Hoffart, Nancy; Creelman, Patricia
2011-01-01
Education and practice partnerships are key to effective academic program design and implementation in a time of decreasing supply and increasing demands on the nursing profession. An integrated education/practice competency model can positively impact patient safety, improve patient care, increase retention, and ensure a sufficient and competent nursing workforce, which is paramount to survival of the health care system. Through the contributions of nursing leaders from the broad spectrum of nursing and industry organizations within the state, the Massachusetts Nurse of the Future project developed a competency-based framework for the future design of nursing educational programs to meet current and future practice needs. The Massachusetts Nurse of the Future Nursing Core Competencies(©) expand on the Institute of Medicine's core competencies for all health care professionals and the Quality and Safety Education for Nurses competencies for quality and safety to define the expectations for all professional nurses of the future. The Massachusetts Nurse of the Future Nursing Core Competencies define the knowledge, attitude, and skills required as the minimal expectations for initial nursing practice following completion of a prelicensure professional nursing education program. These competencies are now being integrated into new models for seamless, coordinated nursing curriculum and transition into practice within the state and beyond. Copyright © 2011 Elsevier Inc. All rights reserved.
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Code of Federal Regulations, 2010 CFR
2010-07-01
.... Clinical nurse specialist means a licensed professional nurse with a master's degree in nursing and a major..., correspondence, and telephone use. Nurse practitioner means a licensed professional nurse who is currently licensed to practice in the State; who meets the State's requirements governing the qualifications of nurse...
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Code of Federal Regulations, 2013 CFR
2013-07-01
.... Clinical nurse specialist means a licensed professional nurse with a master's degree in nursing and a major..., correspondence, and telephone use. Nurse practitioner means a licensed professional nurse who is currently licensed to practice in the State; who meets the State's requirements governing the qualifications of nurse...
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Code of Federal Regulations, 2011 CFR
2011-07-01
.... Clinical nurse specialist means a licensed professional nurse with a master's degree in nursing and a major..., correspondence, and telephone use. Nurse practitioner means a licensed professional nurse who is currently licensed to practice in the State; who meets the State's requirements governing the qualifications of nurse...
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Code of Federal Regulations, 2012 CFR
2012-07-01
.... Clinical nurse specialist means a licensed professional nurse with a master's degree in nursing and a major..., correspondence, and telephone use. Nurse practitioner means a licensed professional nurse who is currently licensed to practice in the State; who meets the State's requirements governing the qualifications of nurse...
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Code of Federal Regulations, 2014 CFR
2014-07-01
.... Clinical nurse specialist means a licensed professional nurse with a master's degree in nursing and a major..., correspondence, and telephone use. Nurse practitioner means a licensed professional nurse who is currently licensed to practice in the State; who meets the State's requirements governing the qualifications of nurse...
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Lunney, Margaret
2008-01-01
This paper reviews current knowledge regarding intelligence and thinking, and relates this knowledge to learning to diagnose human responses and to select health outcomes and nursing interventions. Knowledge from relevant literature sources was summarized. The provision of high-quality nursing care requires use of critical thinking with three elements of nursing care: nursing diagnosis, health outcomes, and nursing interventions. Metacognition (thinking about thinking) should be used with knowledge of the subject matter and repeated practice in using the knowledge. Because there are limited clinical opportunities to practice using metacognition and knowledge of these nursing care elements, case studies can be used to foster nurses' expertise. Simulations of clinical cases are needed that illustrate application of the nursing knowledge represented in NANDA International, Nursing Outcomes Classification, and Nursing Interventions Classification. The International Journal of Nursing Terminologies and Classifications will promote the dispersion of case studies as a means of facilitating the implementation and use of nursing languages and classifications.
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Introduction of assistive devices: home nurses' practices and beliefs.
Roelands, Marc; Van Oost, Paulette; Depoorter, Anne Marie; Buysse, Ann; Stevens, Veerle
2006-04-01
This paper reports a study describing home nurses' intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self-efficacy). Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age-related disabilities in mobility and self-care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses' beliefs about the introduction of assistive devices could affect their daily practices. A cross-sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self-administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices. Home nurses had positive attitudes and high levels of intention, subjective norm and self-efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self-efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses' current practices. The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.
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Nursing practice environment: a strategy for mental health nurse retention?
Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda
2015-06-01
Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required. © 2015 Australian College of Mental Health Nurses Inc.
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Academic-Practice Partnerships: The Interdependence Between Leadership and Followership.
Everett, Linda Q
2016-04-01
In this article, there is a discussion focused on three contemporary nursing topics: leadership, followership, and academic-practice partnerships. These comments are framed within the context of the current healthcare system transformation. There is a focus on why each of these topics is relevant to the nursing profession in leading change and advancing health. Finally, there is a description about the interdependence of leadership and followership and the significance these hold for the interdependence between nursing education and nursing practice. © The Author(s) 2016.
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Mboineki, Joanes Faustine; Zhang, Weihong
The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.
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After the Gap Analysis: Education and Practice Changes to Prepare Nurses of the Future.
Beauvais, Audrey Marie; Kazer, Meredith Wallace; Aronson, Barbara; Conlon, Suzanne E; Forte, Pamela; Fries, Kathleen S; Hahn, Judith M; Hullstrung, Russell; Levvis, Meg; McCauley, Paula; Morgan, Patricia Padula; Perfetto, Linda; Rebeschi, Lisa M; Solernou, Sheila B; Span, Patricia; Sundean, Lisa J
The purpose of the study was to describe the Connecticut Nursing Collaborative-Action Coalition's work in identifying and addressing gaps between nursing education and practice based on the Institute of Medicine's Future of Nursing report. Massachusetts Nurse of the Future (NOF) Competencies highlight the knowledge, skills, and attitudes/behaviors required for professional nurses. Integrating these concepts into the educational system will prepare the nursing workforce to respond to current/future health care needs and population health issues. Education and practice partners in four regions conducted a gap analysis of the education to practice transition for new graduate nurses using NOF as a framework for assessment. Gaps in competencies were similar across regions. However, each organization uniquely addressed curricular gaps to best prepare nurses of the future. Curriculum improvements will provide students the advantage of being prepared for the rapid changes happening in health care.
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Raterink, Ginger
2008-09-01
Critical thinking has been an outcome of nursing education since the 1980s. There remains a lack of agreement on definitions, methods of teaching, and methods of evaluation among practicing nurses. This study asked practicing nurses to define critical thinking. It also asked nurses to describe what work-related factors enhanced or posed barriers to the use of critical thinking in practice. Elements of the definitions presented were found to be consistent with current nursing definitions of critical thinking. Enhancers and barriers overlapped and were found to be consistent among the nurses at all facilities studied, with implications for continuing education and staff development.
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Mixed-methods research in nursing - a critical review.
Bressan, Valentina; Bagnasco, Annamaria; Aleo, Giuseppe; Timmins, Fiona; Barisone, Michela; Bianchi, Monica; Pellegrini, Ramona; Sasso, Loredana
2017-10-01
To review the use of mixed-methods research in nursing with a particular focus on the extent to which current practice informs nurse researchers. It also aimed to highlight gaps in current knowledge, understanding and reporting of this type of research. Mixed-methods research is becoming increasingly popular among nurses and healthcare professionals. Emergent findings from this type of research are very useful for nurses in practice. The combination of both quantitative and qualitative methods provides a scientific base for practice but also richness from the qualitative enquiry. However, at the same time mixed-methods research is underdeveloped. This study identified mixed-methods research papers and critically evaluated their usefulness for research practice. To support the analysis, we performed a two-stage search using CINAHL to find papers with titles that included the key term 'mixed method'. An analysis of studies that used mixed-methods research revealed some inconsistencies in application and reporting. Attempts to use two distinct research methods in these studies often meant that one or both aspects had limitations. Overall methods were applied in a less rigorous way. This has implications for providing somewhat limited direction for novice researchers. There is also potential for application of evidence in healthcare practice that limited validity. This study highlights current gaps in knowledge, understanding and reporting of mixed-methods research. While these methods are useful to gain insight into clinical problems nurses lack guidance with this type of research. This study revealed that the guidance provided by current mixed-methods research is inconsistent and incomplete and this compounds the lack of available direction. There is an urgent need to develop robust guidelines for using mixed-methods research so that findings may be critically implemented in practice. © 2016 John Wiley & Sons Ltd.
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The context & clinical evidence for common nursing practices during labor.
Simpson, Kathleen Rice
2005-01-01
The purpose of this article is to review the context and current evidence for common nursing care practices during labor and birth. Although many nursing interventions during labor and birth are based on physician orders, there are a number of care processes that are mainly within the realm of nursing practice. In many cases, particularly in community hospitals, routine physician orders for intrapartum care provide wide latitude for nurses in how they ultimately carry out those orders. An important consideration of common nursing practices during labor is the context or practice model in which those practices occur. Nursing practice is not the same in all clinical environments. Intrapartum nursing practice consists of an assortment of different roles depending on the circumstances, hospital setting, and context in which it takes place. A variety of intrapartum nursing practice models have evolved as a result and in response to the range of sizes, locations, and provider practice styles found in hospitals providing obstetric services. A summary of intrapartum nursing models is presented. The evidence is reviewed for the three most common clinical practices for which nurses have primary responsibility in most settings and that comprise the majority of their time in caring for women during labor: (1) maternal-fetal assessment, (2) management of oxytocin infusions, and (3) second-stage care. Evidence exists for these nursing interventions that can be used to promote maternal-fetal well-being, minimize risk, and enhance patient safety.
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Nurses’ Wisdom in Action in the Emergency Department
Matney, Susan A.; Staggers, Nancy; Clark, Lauren
2016-01-01
Nurses seek to understand better what practicing with wisdom means and how to apply wisdom to practice; however, the experience of wisdom in nursing has not been well defined or researched. This study was designed to understand how emergency department (ED) nurses construct the meaning of wisdom within the culture of clinical nursing practice. Using Charmaz’s constructivist grounded theory methodology, we developed a preliminary theory capturing the experience of wisdom in practice. The core theoretical model focuses on two juxtaposed processes, technical and affective, and is grounded in expertise. Significant findings were the recognition of affective categories, such as emotional intelligence, required to practice using wisdom. Results reinforce and extend the current wisdom literature and provide a new perspective on wisdom in practice in a nursing context. PMID:28462339
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Education evolution: a historical perspective of associate degree nursing.
Orsolini-Hain, Liana; Waters, Verle
2009-05-01
Exploring the inception and growth of associate degree nursing education informs our understanding of what led to such explosive growth so that most of the nursing workforce is currently educated at the associate degree level. The success of associate degree nursing programs led to many divisive years in nursing education of differentiation of practice debates that were hardly productive. Work world practices and patient needs are creating pressures on community colleges to join forces with universities to increase the percentage of baccalaureate-educated nurses. Associate degree nursing education continues to evolve to meet the demands of a higher educated nursing workforce.
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In their own words: The experience of professional nurses in a Northern Vietnamese women's hospital.
Ng'ang'a, Njoki; Byrne, Mary Woods; Ngo, Toan Anh
2014-01-01
Abstract Background: Nurses in Vietnam, as is typical of many low-income countries, are hampered from impacting health outcomes by low occupational status, overcrowded hospitals and few career development opportunities. In order to understand the current practice environment encountered by nurses in Vietnam in the most realistic way, we listened to the voices of nurses currently performing nursing roles in Vietnam. The purpose of this study was to explore the emic (insider) perspectives on cultural meaning applied by nurses at a northern Vietnamese women's hospital to influence professional practice and interpret experience. A micro-ethnography approach was used. Seven nurses and one Vice Dean of a school of nursing were interviewed. Data collection consisted of open-ended interviews, participant observation and journal recordings. Spradley's (1979, 1980) Development Research Sequence was used to guide data collection and analysis. Five themes emerged. These were the big number of patients is a burden for nurses; nurses do not, cannot make their own decisions (but they can and do); my feeling depends on doctor's feeling; nurses learn more from doctor; and just a few nurses can attend the [Vietnamese Nurses Association] meeting. The experiences described by the nurses and the Vice Dean of a nursing school reflect the challenges of practicing nursing in one Vietnamese hospital and the resourcefulness of nurses in overcoming those challenges. Recurrent themes highlight the need to better position nurses in Vietnam to advance toward full expression of the professional nursing role.
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Current practice in airway management: A descriptive evaluation.
Kjonegaard, Rebecca; Fields, Willa; King, Major L
2010-03-01
Ventilator-associated pneumonia, a common complication of mechanical ventilation, could be reduced if health care workers implemented evidence-based practices that decrease the risk for this complication. To determine current practice and differences in practices between registered nurses and respiratory therapists in managing patients receiving mechanical ventilation. A descriptive comparative design was used. A convenience sample of 41 registered nurses and 25 respiratory therapists who manage critical care patients treated with mechanical ventilation at Sharp Grossmont Hospital, La Mesa, California, completed a survey on suctioning techniques and airway management practices. Descriptive and inferential statistics were used to analyze the data. Significant differences existed between nurses and respiratory therapists for hyperoxygenation before suctioning (P =.03). In the 2 groups, nurses used the ventilator for hyper-oxygenation more often, and respiratory therapists used a bag-valve device more often (P =.03). Respiratory therapists instilled saline (P <.001) and rinsed the closed system with saline after suctioning (P =.003) more often than nurses did. Nurses suctioned oral secretions (P <.001) and the nose of orally intubated patients (P =.01), brushed patients' teeth with a toothbrush (P<.001), and used oral swabs to clean the mouth (P <.001) more frequently than respiratory therapists did. Nurses and respiratory therapists differed significantly in the management of patients receiving mechanical ventilation. To reduce the risk of ventilator-associated pneumonia, both nurses and respiratory therapists must be consistent in using best practices when managing patients treated with mechanical ventilation.
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Evidence-based practice for pain identification in cognitively impaired nursing home residents.
Sacoco, Christina; Ishikawa, Sally
2014-09-01
Pain identification of cognitively impaired elderly is very challenging. This project aimed to identify best practices for pain assessment in nursing home residents with cognitive impairment and to establish a standardized pain assessment guide to optimize nursing practice and resident outcomes. The Iowa Model of Evidence-Based Practice to Promote Quality of Care guided the project's process. Phase I of the project analyzed data gained from chart reviews on current practices of pain assessment, and Phase II used the results of Phase I to develop, implement, and evaluate an evidence-based practice standard for nursing assessment of pain for cognitively impaired residents. Copyright © 2014 Elsevier Inc. All rights reserved.
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Wound Care Nursing: Professional Issues and Opportunities
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
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A spatial analysis of the expanding roles of nurses in general practice.
Pearce, Christopher; Hall, Sally; Phillips, Christine; Dwan, Kathryn; Yates, Rachael; Sibbald, Bonnie
2012-08-07
Changes to the workforce and organisation of general practice are occurring rapidly in response to the Australian health care reform agenda, and the changing nature of the medical profession. In particular, the last five years has seen the rapid introduction and expansion of a nursing workforce in Australian general practices. This potentially creates pressures on current infrastructure in general practice. This study used a mixed methods, 'rapid appraisal' approach involving observation, photographs, and interviews. Nurses utilise space differently to GPs, and this is part of the diversity they bring to the general practice environment. At the same time their roles are partly shaped by the ways space is constructed in general practices. The fluidity of nursing roles in general practice suggests that nurses require a versatile space in which to maximize their role and contribution to the general practice team.
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Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A
2017-07-01
Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles and should be routinely followed. However, seven out of 15 current guideline sections (describing a decision problem, choosing type of economic evaluation, selecting comparators, determining the study perspective, estimating effectiveness, measuring and valuing health, and assessing resource use and costs) may require additional role-specific considerations to capture costs and effects of these roles. Current guidelines for economic evaluation should form the foundation for economic evaluations of nurse practitioner and clinical nurse specialist roles. The proposed role-specific considerations, which clarify application of standard guidelines sections to economic evaluation of nurse practitioner and clinical nurse specialist roles, may strengthen the quality and comprehensiveness of future economic evaluations of these roles. Copyright © 2017 Elsevier Ltd. All rights reserved.
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An exploration of jealousy in nursing: a Kleinian analysis.
Evans, Alicia M; Traynor, Michael; Glass, Nel
2014-06-01
It is well established that nursing practice produces considerable anxiety, and it can also give rise to envy and jealousy. While envy in nursing was identified in the literature more than 50 years ago, there remains a paucity of articles addressing either envy or jealousy for nurses. In a recent research study on current experiences of clinical practice, we analysed a fragment of nurses' speech via Klein's theory of jealousy. The results revealed that the nurses expressed jealousy at the privilege afforded to doctors. We argue that it is important to acknowledge jealousy in nursing practice because it has the potential for 'spoiling' effective care delivery and as such, can have detrimental ramifications in the health system. Also, jealousy may keep the nurse from fully focusing on their nursing practice in that it divides the nurse's attention and so limits the nurse's treatment of the patient. Nurses' jealousy of doctors is a taboo topic in nursing, and yet it warrants serious consideration due to the potential deleterious consequences that can arise when this dynamic is present. © 2013 John Wiley & Sons Ltd.
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Care, compassion, and communication in professional nursing: art, science, or both.
Palos, Guadalupe R
2014-04-01
Debate continues as to whether nursing is a science, art, or a combination of the two. Given the recent growing emphasis in the current healthcare environment to deliver patient-centered care, the art of nursing and its impact on patient outcomes is being re-examined. The current article discusses a case narrative to provide a venue for self-reflection in nursing practice.
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Chikotas, Noreen Elaine
2008-01-01
The need to evaluate current strategies in educating the advanced practice nurse, specifically the nurse practitioner, is becoming more and more imperative due to the ever-changing health care environment. This article addresses the role of problem-based learning (PBL) as an instructional strategy in educating and preparing the nurse practitioner for future practice.Two theoretical frameworks supporting PBL, andragogy and constructivism, are presented as important to the use of PBL in the education of the nurse practitioner.
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Nurses' perceptions of health beliefs and impact on teaching and practice: a Q-sort study.
Cao, R; Stone, T E; Petrini, M A; Turale, S
2018-03-01
To understand Chinese nurses' perceptions of health beliefs, their content, origin and the influence of sociocultural factors, as a basis of their evidence-based practice. This study contributes to a larger study to establish the health beliefs of Japanese, Australian, Chinese, South Korean and Thai nurses. Registered nurses teach patients and students about maintaining or attaining health are subject to the same range of influences and their health beliefs may be antithetical to current health evidence. Q-method design using q-sort and interview was used to explore the perspectives on a range of health beliefs of 60 nurses in four cities in China. Three factors arose from the perceptions of the participants about health and accounted for 50.2% of the total variance: (1) social impact, (2) 'the importance of evidence', and (3) beliefs rooted in culture. Influence on nurses' health beliefs was explored in terms of the internalized and frequently unconscious beliefs, values and norms tying them to their communities, reflecting the need for nurses to be aware of their health beliefs and behaviours. Education for nurses in practice needs to acknowledge that individual practitioners' beliefs strongly influence health teaching for patients and families. In order to implement evidenced-based practice and teach in line with current evidence nurses need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs. Education policy needs to consider that culture and societal pressures affect nurses' health beliefs and practice. Critical thinking, reflective and evidence-based practice need to be emphasized in clinical training and nurse education. China also needs to develop policies to allow nurses to be able to assess the reliability of health information on the Internet and to make quality health research more available. © 2017 International Council of Nurses.
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Articulating nursing in an interprofessional world.
Sommerfeldt, Susan C
2013-11-01
It is essential that nurses in practice clearly articulate their role in interprofessional clinical settings. Assumptions, stereotypes, power differentials and miscommunication can complicate the interaction of healthcare professionals when clarity does not exist about nurses' knowledge, skills and roles. Conflicting views among nurse scholars as to the nature of nursing knowledge and its relationship to practice complicate the task of nurses in explaining their performance and role to others in interprofessional environments. Interprofessionality is potentially misunderstood by nurse leaders, practitioners and educators, isolating nurses in an increasingly inter-disciplinary healthcare system. The theorization of contemporary nursing is explored through the views and perspectives of current nurse scholars. The ability to explain nursing knowledge, skills and roles to others in interprofessional interactions is a nursing competency, as well as an interprofessional one. Nurses, nurse leaders and nurse educators are challenged to engage in interprofessionalism so as to have an influence in the evolution of healthcare education and practice environments. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Skela-Savič, Brigita; Hvalič-Touzery, Simona; Pesjak, Katja
2017-08-01
To establish the connection between values, competencies, selected job characteristics and evidence-based practice use. Nurses rarely apply evidence-based practice in everyday work. A recent body of research has looked at various variables explaining the use of evidence-based practice, but not values and competencies. A cross-sectional, non-experimental quantitative explorative research design. Standardized instruments were used (Nurse Professional Values Scale-R, Nurse Competence Scale, Evidence-Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015. The study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence-based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence-based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence-based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence-based practice implementation in nursing practice is low. Study results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence-based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association. © 2017 John Wiley & Sons Ltd.
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Writing a bachelor thesis generates transferable knowledge and skills useable in nursing practice.
Lundgren, Solveig M; Robertsson, Barbro
2013-11-01
Generic skills or transferable skills have been discussed in terms of whether or not skills learned in one context can be transferred into another context. The current study was aimed to explore nurses' self-perceptions of the knowledge and skills they had obtained while writing a Bachelor's thesis in nursing education, their experience of the extent of transfer and utilization in their current work. Responding nurses (N=42) had all worked from 1 to 1.5 years after their final examination and had completed a questionnaire that was structured with open-ended questions. Only five nurses reported that they were unable to use any of the knowledge and skills they had obtained from writing a thesis. A majority of the nurses (37/42) could give many examples of the practical application of the skills and knowledge they had obtained. Our findings indicate that writing a thesis as part of an undergraduate degree program plays a major role in the acquisition and development of knowledge and skills which can subsequently be transferred into and utilized in nursing practice. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Comparison of Administrators' and School Nurses' Perception of the School Nurse Role
ERIC Educational Resources Information Center
Green, Rebecca; Reffel, Jim
2009-01-01
The current tenuous status of public education funding requires that school nurses be proactive in advocacy efforts on behalf of their school nursing programs. Advocating for nursing practice within an educational setting presents unique challenges. Lack of state or national consensus for support of school nurse services creates an opportunity for…
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Big Data and Nursing: Implications for the Future.
Topaz, Maxim; Pruinelli, Lisiane
2017-01-01
Big data is becoming increasingly more prevalent and it affects the way nurses learn, practice, conduct research and develop policy. The discipline of nursing needs to maximize the benefits of big data to advance the vision of promoting human health and wellbeing. However, current practicing nurses, educators and nurse scientists often lack the required skills and competencies necessary for meaningful use of big data. Some of the key skills for further development include the ability to mine narrative and structured data for new care or outcome patterns, effective data visualization techniques, and further integration of nursing sensitive data into artificial intelligence systems for better clinical decision support. We provide growth-path vision recommendations for big data competencies for practicing nurses, nurse educators, researchers, and policy makers to help prepare the next generation of nurses and improve patient outcomes trough better quality connected health.
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The theory-practice gap and skill acquisition: an issue for nursing education.
Scully, Natashia Josephine
2011-01-01
Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the "theory-practice gap". This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses--given their novice, rule governed status--who find themselves in the midst of the theory-practice void. This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in relation to student anxiety levels, nurse education (specifically the roles of the classroom teacher and clinical educators), teaching methods and the responsibility of the student to become accountable for their own education. I intend to communicate how my personal situation was dealt with and evaluate that experience in relation to current nursing literature. Ultimately, this discussion will demonstrate the value of reflection underpinning the development of competency in nursing and its role in bridging the theory-practice gap.
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O’Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley
2015-01-01
Current patient safety policy focuses nursing on patient care goals, often overriding nurses’ safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used “frames” built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses’ decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses’ frames question current policy and practice by challenging how nurses’ safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management. PMID:28462311
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Understanding critical care nurses' autonomy in Jordan.
Maharmeh, Mahmoud
2017-10-02
Purpose The aim of this study was to describe Jordanian critical care nurses' experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse's autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses' job satisfaction. Therefore, improving nurses' clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.
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Holistic Nursing in the Genetic/Genomic Era.
Sharoff, Leighsa
2016-06-01
Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base. © The Author(s) 2015.
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Nursing department orientation: are we missing the mark?
Kennedy, Julie Marie; Nichols, Amy A; Halamek, Louis P; Arafeh, Julie M R
2012-01-01
Hospitals routinely provide orientation for the new nurses they hire. The evolution of nursing practice is not reflected in the current teaching methods of nursing orientation. The authors examine the past 60 years of nursing department orientation and assert the need to move toward more effective and innovative teaching strategies.
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Rosenfeld, Peri
2007-05-01
Attempts to address the nursing shortage must consider the aging nursing supply and the decreased labor participation among nurses at age 55 and older. Efforts to retain older, experienced nurses have been meager, and little attention is paid to the role of eldercare in decisions to leave the profession. This pilot study examines current workplace practices that may contribute to early withdrawal of older nurses from the hospital workforce. Interviews with 28 elder caregiving registered nurses and assistive nursing personnel at a New York hospital were conducted. Respondents reported that successful management of their dual roles rests on identifying units and shifts that suit their needs, erecting clear boundaries between home and work, and their love of nursing. "Caregiver-friendly" practices such as creative, flexible scheduling; access to social workers; financial and legal services; and increased awareness among managers about caregiver strains were recommended.
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In Their Own Words: The Experience of Professional Nurses in a Northern Vietnamese Women's Hospital.
Ng'ang'a, Njoki; Byrne, Mary W; Anh Ngo, Toan
2014-04-11
Abstract Background Nurses in Vietnam, as is typical of many low-income countries, are hampered from impacting health outcomes by low occupational status, overcrowded hospitals and few career development opportunities. In order to understand the current practice environment encountered by nurses in Vietnam in the most realistic way, we listened to the voices of nurses currently performing nursing roles in Vietnam. Purpose The purpose of this study was to explore the emic (insider) perspectives on cultural meaning applied by nurses at a northern Vietnamese women�s hospital to influence professional practice and interpret experience. Design A micro-ethnography approach was used. Methods Seven nurses and one vice-Dean of a school of nursing were interviewed. Data collection consisted of open-ended interviews, participant observation and journal recordings. Spradley�s (1979, 1980) Development Research Sequence was used to guide data collection and analysis. Results/Findings Five themes emerged. These were the big number of patients is a burden for nurses; nurses do not, cannot make their own decisions (but they can and do); my feeling depends on doctor's feeling; nurses learn more from doctor; and just a few nurses can attend the [Vietnamese Nurses Association] meeting. Conclusion The experiences described by the nurses and the vice-Dean of a nursing school reflect the challenges of practicing nursing in one Vietnamese hospital and the resourcefulness of nurses in overcoming those challenges. Recurrent themes highlight the need to better position nurses in Vietnam to advance towards full expression of the professional nursing role.
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Leading nurses in dire straits: head nurses' navigation between nursing and leadership roles.
Sørensen, Erik E; Delmar, Charlotte; Pedersen, Birthe D
2011-05-01
The present study reports selected findings from a doctoral study exploring the negotiation between nursing and leadership in hospital head nurses' leadership practice. The importance of bringing a nursing background into leadership is currently under debate. In spite of several studies of nursing and clinical leadership, it is still unclear how nurses' navigate between nursing and leadership roles. An 11-month-long ethnographic study of 12 head nurses' work: five worked at a first line level and seven at a department level. At the first line level, leadership practices were characterized by an inherent conflict between closeness and distance to clinical practice; at the department level practises were characterized by 'recognition games'. On both levels, three interactive roles were identified, that of clinician, manager and a hybrid role. Where clinician or manager roles were assumed, negotiation between roles was absent, leading to reactive, adaptive and isolated practices. The hybrid role was associated with dialectical negotiation of roles leading to stable and proactive practices. Nursing leadership practises depend on leaders' negotiation of the conflicting identities of nurse and leader. Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
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A nurse-led model of chronic disease management in general practice: Patients' perspectives.
Young, Jacqueline; Eley, Diann; Patterson, Elizabeth; Turner, Catherine
2016-12-01
Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community. The objective of this article is to examine patients' perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia. This article reports on the second phase of a mixed-methods study in which semi-structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care. Three themes emerged from the data - time, ambiance and dimensions of the nurse role. The results suggest that general practice nurses had a positive impact on patients' ability to manage their chronic disease. This infers that there is scope for general practice nurses to expand their role in chronic disease management to assist patients to better self-manage their chronic diseases.
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Re-defining nursing expertise in the United kingdom.
Hardy, Sally; Titchen, Angie; Manley, Kim; McCormack, Brendan
2006-07-01
There is now international recognition of the importance of practice expertise in modern and effective health services. The Expertise in Practice Project in the United Kingdom began in May 1998 and continued to 2004. It included nurses working in all four countries of the United Kingdom, and it covered clinical specialists from pediatrics to palliative care. The project added to the current understanding of what nursing practice expertise is, through the identification and verification of attributes and factors which enable expert practice. The proposed framework offers a language for sharing what constitutes practice expertise and offers insight into what occurs between the expert practitioner and the people that experience their care. The Expertise in Practice Project demonstrates that nurses affect change and facilitate performance and organizational development.
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Guevara, Edilma B; Mendias, Elnora P
2002-11-01
To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nurses about their perceptions of nursing practice and changes in work environments. Descriptions of characteristics and trends in nursing practice in the study sites were also obtained. Reorganization of health services has occurred in all five of the countries, responding to health sector reform initiatives and affecting nursing practice in each country. Respondents from all five countries mentioned an emphasis on private enterprise, changes in payment systems for patients and providers, redistributions in the nursing workforce, changes in the personnel mix and nursing-practice functions, work shifting from the hospital to the community, and greater emphasis on cost control and prevention in practice settings. The study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries. Nurses maintain their core values despite increased work stress and greater patient care needs in all the countries as well as economic crises in the Latin American countries.
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Back to the future: personal digital assistants in nursing education.
McLeod, Renee P; Mays, Mary Z
2008-12-01
This article provides an overview of the current state of the art for incorporating personal digital assistants (PDAs) into nursing education. The development of PDA technology and the lessons learned by educators integrating PDA technology into nursing curricula are described. The current cycle of PDA evolution is discussed and contrasted with a proposed model for maximizing the impact of PDAs on technological innovation in nursing education and practice.
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Hay, Benjamin; Carr, Peter J; Dawe, Lydia; Clark-Burg, Karen
2017-01-01
The purpose of this study was to identify in what way social media and mobile technology assist with learning and education of the undergraduate nurse. The study involved undergraduate nursing students across three campuses from the University of Notre Dame Australia. Participants were invited to complete an online questionnaire that related to their current knowledge, preferences, and practice with mobile technology and social media within their undergraduate nursing degree. A quantitative descriptive survey design was adapted from an initial pilot survey by the authors. A total of 386 nursing students (23.47% of the total enrolment) completed the online survey. Overall, results suggested that students are more supportive of social media and mobile technology in principle than in practice. Students who frequently use mobile technologies prefer to print out, highlight, and annotate the lecture material. Findings suggest that nursing students currently use mobile technology and social media and are keen to engage in ongoing learning and collaboration using these resources. Therefore, nursing academia should encourage the appropriate use of mobile technology and social media within the undergraduate curriculum so that responsible use of such technologies positively affects the future nursing workforce.
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Nursing practice in stroke rehabilitation: systematic review and meta-ethnography.
Clarke, David J
2014-05-01
To identify and synthesise the available research evidence in order to generate an explanatory framework for nursing practice in stroke rehabilitation. Although nurses are the largest professional group working with stroke survivors, there is limited understanding of nursing practice in stroke units. In particular, there is currently very little evidence in respect of nurses' involvement in poststroke rehabilitation. Meta-ethnography. A systematic review was undertaken. The review question was: 'What is the nature of nursing practice in the care and rehabilitation of inpatient stroke survivors?' Searches of 12 electronic databases identified 14,655 publications, and after screening, 778 remained; 137 papers were obtained and 54 retained for mapping. Sixteen qualitative studies were included in the meta-ethnography. Nurses' involvement in poststroke rehabilitation was limited. Contextual factors impacted on nurses' perceptions and practice. Nurses' integration of rehabilitation skills was perceived to be contingent on adequate nurse staffing levels and management of demands on nurses' time. Team working practices and use of the built environment indicated separation of nursing and therapy work. Physical care and monitoring were prioritised. Stroke-specific education and training was evident, but not consistent in content or approach. Stroke survivors and families needed help to understand nurses' role in rehabilitation. The review provides compelling evidence that there is an need to re-examine the role of nurses in contributing to poststroke rehabilitation, including clarifying when this process can safely begin and specifying the techniques that can be integrated in nurses' practice. Integrating stroke-specific rehabilitation skills in nurses' practice could contribute substantially to improving outcomes for stroke survivors. The explanatory framework developed from the review findings identifies issues which will need to be addressed in order to maximise nurses' contribution to the rehabilitation of stroke survivors. © 2013 John Wiley & Sons Ltd.
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Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan
2015-08-01
The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.
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Current State of Test Development, Administration, and Analysis: A Study of Faculty Practices.
Bristol, Timothy J; Nelson, John W; Sherrill, Karin J; Wangerin, Virginia S
Developing valid and reliable test items is a critical skill for nursing faculty. This research analyzed the test item writing practice of 674 nursing faculty. Relationships between faculty characteristics and their test item writing practices were analyzed. Findings reveal variability in practice and a gap in implementation of evidence-based standards when developing and evaluating teacher-made examinations.
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The Historical Evolution of Theories and Conceptual Models for Nursing.
ERIC Educational Resources Information Center
Hawkins, Joellen W.
The development of nursing models can be traced to the inception of nursing as a profession. Florence Nightingale laid the foundation for current nursing practice and differentiated nursing from medicine. The late 19th and early 20th centuries contributed a number of important nurse theorists, better known for other contributions to the neophyte…
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Felstead, Ian S; Springett, Kate
2016-02-01
Patients' expectations of being cared for by a nurse who is caring, competent, and professional are particularly pertinent in current health and social care practice. The current drive for NHS values-based recruitment serves to strengthen this. How nursing students' development of professionalism is shaped is not fully known, though it is acknowledged that their practice experience strongly shapes behaviour. This study (in 2013-14) explored twelve adult nursing students' lived experiences of role modelling through an interpretive phenomenological analysis approach, aiming to understand the impact on their development as professional practitioners. Clinical nurses influenced student development consistently. Some students reported that their experiences allowed them to learn how not to behave in practice; a productive learning experience despite content. Students also felt senior staff influence on their development to be strong, citing 'leading by example.' The impact of patients on student professional development was also a key finding. Through analysing information gained, identifying and educating practice-based mentors who are ready, willing, and able to role model professional attributes appear crucial to developing professionalism in nursing students. Those involved in nurse education, whether service providers or universities, may wish to acknowledge the influence of clinical nurse behaviour observed by students both independent of and in direct relation to care delivery and the impact on student nurse professional development. A corollary relates to how students should be guided and briefed/debriefed to work with a staff to ensure their exposure to a variety of practice behaviours. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Revisioning a clinical nurse specialist curriculum in 3 specialty tracks.
Arslanian-Engoren, Cynthia; Sullivan, Barbara-Jean; Struble, Laura
2011-01-01
The objective of the present study was to revise 3 clinical nurse specialist (CNS) educational tracks with current National Association of Clinical Nurse Specialist core competencies and educational expectations. National curricula recommendations include core competencies by the 3 spheres of influence. Advanced practice registered nurses consensus model educational requirements include a minimum of 500 faculty-supervised clinical hours; separate graduate courses in pharmacology, pathophysiology, and advanced physical assessment; and content in differential diagnosis disease management, decision making, and role preparation. This educational initiative was designed to (1) align with core competencies and advanced practice registered nurse consensus model recommendations, (2) create an innovative learning environment, (3) meet the needs of diverse student populations, (4) align with emerging doctor of nursing practice programs, (5) create a high-efficiency and high-quality environment to manage human and fiscal resources, and (6) reduce duplication of efforts. Courses were revised that did not meet current CNS educational preparation expectations. A total of 11 didactic and clinical sequences courses were developed for the 3 tracks to (1) ensure minimum numbers of clinical hours; (2) expand content on health promotion and risk reduction, advanced practice nurse role, and the healthcare delivery system; (3) consolidate clinical courses; and (4) resequence foundational content before beginning clinical courses. Revisioning a CNS curriculum in 3 specialty tracks is challenging but doable using innovative and creative approaches. The innovative process used to revise our CNS curriculum will assist nurse educators faced with similar program delivery challenges to meet future directions for educating CNS students in advanced nursing practice. Copyright © 2011 Lippincott Williams & Wilkins.
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Information technology from novice to expert: implementation implications.
Courtney, Karen L; Alexander, Gregory L; Demiris, George
2008-09-01
This paper explores how the Novice-to-Expert Nursing Practice framework can illuminate the challenges of and opportunities in implementing information technology (IT), such as clinical decision support systems (CDSS), in nursing practice. IT implementation in health care is increasing; however, substantial costs and risks remain associated with these projects. The theoretical framework of Novice-to-Expert Nursing Practice was applied to current design and implementation literature for CDSS. Organizational policies and CDSS design affect implementation and user adoption. Nursing CDSS can improve the overall quality of care when designed for the appropriate end-user group and based on a knowledge base reflecting nursing expertise. Nurse administrators can positively influence CDSS function and end-user acceptance by participating in and facilitating staff nurse involvement in IT design, planning and implementation. Specific steps for nurse administrators and managers are included in this paper.
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Liaw, Sok Ying; Koh, Yiwen; Dawood, Rabiah; Kowitlawakul, Yanika; Zhou, Wentao; Lau, Siew Tiang
2014-03-01
Preparing nursing students for making the transition to graduate nurse is crucial for entry into practice. Final year student nurses at the National University of Singapore (NUS) are required to undergo a consolidated clinical practice to prepare them for their transition to graduate nurse. To describe the development, implementation and evaluation of a simulation program known as SIMulated Professional Learning Environment (SIMPLE) in preparing the final year student nurses for their clinical practicum in transition to graduate nurse practice. A set of simulation features and best practices were used as conceptual framework to develop and implement the simulation program. 94 final year student nurses participated in the 15-hour SIMPLE program that incorporated multiple simulation scenarios based on actual ward clinical practices. Pre and post-tests were conducted to assess the students' preparedness for their clinical practice in transition to graduate nurse practice. The students also completed a satisfaction questionnaire and open questions to evaluate their simulation experiences. The student nurses demonstrated a significant improvement (t=12.06, p<0.01) on post-test score (mean=117.21, SD=15.17) from pre-test score (mean=97.86, SD=15.08) for their perceived preparedness towards their clinical practicum in transition to graduate nurse practice. They were highly satisfied with their simulation learning. Themes emerged from the comments on the most valuable aspects of the SIMPLE program and ways to improve the program. The study provided evidences on the effectiveness of the SIMPLE program in enhancing the students' preparedness for their transition to graduate nurse practice. A key success of the SIMPLE program was the used of simulation strategy and the involvement of practicing nurses that closely linked the students with the realities of current nursing practice to prepare them for the role of staff nurses. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol
2016-06-01
Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Rowe, Jennifer; Jones, Liz
2008-03-01
Transfers between neonatal units are significant transitional experiences for parents of preterm infants. The study aimed to investigate practices that nurses identify as supportive to parents during preterm infants' transfers. It explored the influence of organisational context on practice and what strategies nurses perceive would help them to provide supportive care. Parents' experiences of neonatal nurseries, their stressors and needs have been well documented. The powerful position of nurses in influencing parenting experience is also recognised. However, nurses' understanding of the transfer process, their roles in supporting parents through this and the organisational context influencing practice have not been explored. A focus group design was used composed of registered nurses from two neonatal units who met for a series of group interviews. Eleven registered nurses participated. They explored and critiqued their current practices and then established aims and strategies for practice development. A qualitative content analysis was conducted. Participants identified validation, empowerment and communication as critical to effective practice. They identified a range of organisational dynamics, from logistical issues to nursing authority and scope of practice, as these influenced practice. They presented strategies for practice development, including staff education and the development of nurse practitioner roles. This study explores nurses' understanding and insights into transitions for parents of preterm infants. It shows a congruence between nurses' perceptions of parents' experiences and needs and those reported by parents in previous studies. It articulates the way nurses practice in response to these perceptions, and the manner in which organisational dynamics influence their ability to facilitate transitions. The need to invest in transitions and invest in nurses to facilitate transitions is proposed, ultimately by increasing their clinical authority and autonomy.
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Hallinan, Christine M; Hegarty, Kelsey L
2016-01-01
The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.
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Advancing leadership capacity in nursing.
Scott, Elaine S; Miles, Jane
2013-01-01
To address the potential shortage of nurse leaders, the profession must evaluate current strategies in both education and practice. While many new graduates dream of becoming a nurse practitioner or nurse anesthetist, few transition into practice with the goal of becoming a nurse leader. To increase the number of nurses capable of leadership, the profession must address 2 critical issues. First, effort must be made to augment faculty and students' conceptualization of nursing such that leadership is seen as a dimension of practice for all nurses, not just those in formal leadership roles. In so doing, leadership identity development would be seen as a part of becoming an expert nurse. Second, a comprehensive conceptual framework for lifelong leadership development of nurses needs to be designed. This framework should allow for baseline leadership capacity building in all nurses and advanced leadership development for those in formal administrative and advanced practice roles. The knowledge and skill requirements for quality improvement and patient safety have been explored and recommendations made for Quality and Safety Education for Nurses, but parallel work needs to be done to outline educational content, objectives, and effective pedagogy for advancing leadership development in nursing students at all levels.
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The impact of emerging technology on nursing care: warp speed ahead.
Huston, Carol
2013-05-31
While myriad forces are changing the face of contemporary healthcare, one could argue that nothing will change the way nursing is practiced more than current advances in technology. Indeed, technology is changing the world at warp speed and nowhere is this more evident than in healthcare settings. This article identifies seven emerging technologies that will change the practice of nursing; three skill sets nurses will need to develop to acquire, use, and integrate these emerging technologies; and four challenges nurse leaders will face in integrating this new technology.
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Northway, Ruth; Parker, Michelle; James, Neil; Davies, Lynsey; Johnson, Kaye; Wilson, Sally
2015-12-01
Whilst there is a need to develop the research base within learning disability nursing it is also significant that currently there is little published data as to how research is taught to this group of nurses. To increase understanding of how research is currently taught to learning disability nurses within the UK. A survey design was used. The research was undertaken at a conference held in the UK in March 2014. 310 learning disability nurses attending the conference of which 212 completed the free text question. This comprised student nurses (n=158), registered nurses working in practice settings (n=25) and registered nurses working in educational institutions (n=24). Five participants did not specify their background. Participants were invited to complete a questionnaire that included a free text question regarding the teaching of research to learning disability nurses: it is the responses to this question that are reported in this paper. Responses were transcribed and thematically analysed. Eight themes emerged: Teaching approach--the good and the bad; finding the right level; right from the start; we need more time; generic versus specialist; there's not enough; getting research into practice; and what should we focus on? Variations exist in terms of the timing of research education, the teaching approaches used, and hence the quality of student experience. Of particular concern is the apparent gap between research teaching and the use of research in practice, and the reported lack of support for research within practice settings. However, enthusiasm for research is evident and hence recommendations are made both to enhance teaching and to strengthen links with practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Analysing the role of the PICU nurse to guide education of new graduate nurses.
Long, Debbie A; Young, Jeanine; Rickard, Claire M; Mitchell, Marion L
2013-04-01
One strategy to address the current nursing shortage in specialty areas has been to introduce graduate nurse programs. However introducing novice nurses to specialty areas raises concerns around education and competency which, in turn, highlights the need to identify and prioritise the elements of competent paediatric intensive care unit (PICU) nursing care considered essential to safe practice. To determine the key knowledge, skills and attributes of competent level PICU nurses. A practice analysis survey of 15 nurse educators was conducted in all eight Australian and New Zealand PICUs during 2008. Three areas of practice essential to PICU nursing competence were explored: patients most commonly cared for; frequency and criticality of activities performed; and level of independence against critical care nursing competency standards. Data were analysed using descriptive statistics. Cardiac and respiratory problems accounted for over 50% of patients cared for by competent level nurses. Cardiac and respiratory activities were therefore also ranked as the most important activities. Respondents identified that competency domains of teamwork and professional practice are performed with minimal supervision, whereas clinical problem solving requires supervision and assistance. PICU nurses are performing activities and caring for a breadth of complex patients within a year of entering the workforce. Using a practice analysis to define actual practice and expectations can assist in the identification and prioritisation of content for graduate and other educational programs. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Pressure area care: an exploration of Greek nurses' knowledge and practice.
Panagiotopoulou, Kalliopi; Kerr, Susan M
2002-11-01
Despite a plethora of information on the prevention of pressure sores, they remain a significant problem in both hospital and community settings. The need to reduce the incidence of pressure sores has been well documented; unfortunately there is little evidence to suggest improvement. The reasons for this lack of improvement have been explored, but the picture remains unclear. While some studies have suggested that nurses have the appropriate knowledge to prevent pressure sores developing (but do not use their knowledge), others suggest that nurses' knowledge of preventive strategies is deficient. In Greece, similarly to the United Kingdom (UK), the incidence of pressure sores is high. There is currently no evidence on Greek nurses' knowledge and practice and therefore no baseline on which to build, in terms of improving practice. The purpose of this study was to explore Greek nurses' knowledge of 'risk factors', 'areas at risk' and 'recommended preventive strategies' in relation to pressure area care. In addition, information was sought on nurses' 'current preventive practice' and any barriers to 'good practice'. The study was exploratory and descriptive, adopting a cross-sectional survey approach. The sample was drawn from the population of nurses working in a military hospital near Athens. The data were collected over a 4-week period in June 2000, using a self-completed questionnaire. Although the knowledge-base of many of the nurses was good in relation to 'risk factors' and 'areas at risk', a significant proportion were unaware that methods such as 'massage' and 'donuts' are no longer recommended. This lack of knowledge influenced practice with these methods commonly being used. In relation to barriers to good practice, a significant proportion of nurses reported that they could not access, read or understand research findings. This has obvious implications for the implementation of evidence-based practice. The results of this study suggest that the knowledge and practice of participants could be improved. It is of particular concern that methods known to be detrimental were in common use. Finally, there is a need to improve the research skills of Greek nurses in order to provide them with the appropriate knowledge to use research findings.
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Following the funding trail: Financing, nurses and teamwork in Australian general practice
2011-01-01
Background Across the globe the emphasis on roles and responsibilities of primary care teams is under scrutiny. This paper begins with a review of general practice financing in Australia, and how nurses are currently funded. We then examine the influence on funding structures on the role of the nurse. We set out three dilemmas for policy-makers in this area: lack of an evidence base for incentives, possible untoward impacts on interdisciplinary functioning, and the substitution/enhancement debate. Methods This three year, multimethod study undertook rapid appraisal of 25 general practices and year-long studies in seven practices where a change was introduced to the role of the nurse. Data collected included interviews with nurses (n = 36), doctors (n = 24), and managers (n = 22), structured observation of the practice nurse (51 hours of observation), and detailed case studies of the change process in the seven year-long studies. Results Despite specific fee-for-service funding being available, only 6% of nurse activities generated such a fee. Yet the influence of the funding was to focus nurse activity on areas that they perceived were peripheral to their roles within the practice. Conclusions Interprofessional relationships and organisational climate in general practices are highly influential in terms of nursing role and the ability of practices to respond to and utilise funding mechanisms. These factors need to be considered, and the development of optimal teamwork supported in the design and implementation of further initiatives that financially support nursing in general practice. PMID:21329506
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Rituals in nursing: intramuscular injections.
Greenway, Kathleen
2014-12-01
To consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how evidence-based practice should be considered and applied to the nursing practice of this essential skill. The notion of rituals within nursing and the value or futile impact they afford to this essential nursing skill will be critically reviewed. Discursive paper. Literature review from 2002-2013 to review the current position of intramuscular injection injections. Within the literature review, it became clear that there are several actions within the administration of an intramuscular injection that could be perceived as ritualistic and require consideration for contemporary nursing practice. The essential nursing skill of intramuscular injection often appears to fit into the description of a ritualised practice. By providing evidence-based care, nurses will find themselves empowered to make informed decisions based on clinical need and using their clinical judgement. For key learning, it will outline with rationale how site selection, needle selection, insertion technique and aspiration can be cited as examples of routinised or ritualistic practice and why these should be rejected in favour of an evidence-based approach. The effect on some student nurses of experiencing differing practices between what is taught at university and what is often seen in clinical practice will also be discussed. © 2014 John Wiley & Sons Ltd.
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"Sign here": nursing value and the process of informed consent.
Cook, Wesley E
2014-01-01
Protecting patient autonomy is a key nursing role. The Code of Ethics (American Nurses Association, 2010), contextualizes the nurse's call to advocacy within the doctrine of informed consent. This article offers a primer on the legal, ethical, and practical aspects of procedural informed consent and examines the value of nursing's role within the process. The theory of nursing's value is sound, but the literature lacks data. Higher levels of evidence are necessary to make sound decisions about best practice for the process of informed consent. As such, this article concludes that adding nursing research to the current discourse should prove most valuable to patients, providers, and the nursing profession as a whole.
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The nurse theorists: 21st-century updates--Madeleine M. Leininger.
Fawcett, Jacqueline
2002-04-01
This edited transcript of an interview with Madeleine Leininger presents Leininger's recent thoughts about the development and current state of the discipline of nursing, the development of the theory of culture care diversity and universality, methods for nursing research, mentorship, and transcultural nursing practice.
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Hsiao, Chiu-Yueh; Lee, Shu-Hsin; Chen, Suh-Jen; Lin, Shu-Chin
2013-08-01
Advances in genetics have had a profound impact on health care. Yet, many nurses, as well as other health care providers, have limited genetic knowledge and feel uncomfortable integrating genetics into their practice. Very little is known about perceived genetic knowledge and clinical comfort among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program. To examine perceived knowledge and clinical comfort with genetics among Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program and to assess how genetics has been integrated into their past and current nursing programs. The study also sought to examine correlations among perceived knowledge, integration of genetics into the nursing curriculum, and clinical comfort with genetics. A descriptive, cross-sectional study. Taiwanese nurses enrolled in a Registered Nurse to Bachelor of Science in Nursing program were recruited. A total of 190 of 220 nurses returned the completed survey (86.36% response rate). Descriptive statistics and the Pearson product-moment correlation were used for data analysis. Most nurses indicated limited perceived knowledge and clinical comfort with genetics. Curricular hours focused on genetics in a current nursing program were greater than those in past nursing programs. The use of genetic materials, attendance at genetic workshops and conferences, and clinically relevant genetics in nursing practice significantly related with perceived knowledge and clinical comfort with genetics. However, there were no correlations between prior genetic-based health care, perceived knowledge, and clinical comfort with genetics. This study demonstrated the need for emphasizing genetic education and practice to ensure health-related professionals become knowledgeable about genetic information. Given the rapidly developing genetic revolution, nurses and other health care providers need to utilize genetic discoveries to optimize health outcomes. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Happell, Brenda; McAllister, Margaret
2014-05-01
Criticisms about the mental health nursing content of Bachelor of Nursing programs have been common since the introduction of comprehensive nursing education in Australia. Most criticism has come from the mental health nursing sector and the views of key stakeholders have not been systematically reported. Heads of Schools of Nursing have considerable influence over the content of nursing programs, and their perspectives must be part of ongoing discussions about the educational preparation of nurses. This article reports the findings of a qualitative exploratory study, involving in-depth interviews with Heads of Schools of Nursing from Queensland, Australia. Thematic data analysis revealed two main themes: Realising the Goal? and Influencing Factors. Overall, participants did not believe current programs were preparing graduates for beginning level practice in mental health settings. In particular, participants believed that the quality of mental health content was influenced by the overcrowded curriculum, the availability of quality clinical placements, the strength of the mental health team, and the degree of consumer focus. The findings suggest the current model of nursing education in Australia does not provide an adequate foundation for mental health nursing practice and alternative approaches should be pursued as a matter of urgency.
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Community-oriented primary care: a model for public health nursing.
Cashman, S B; Bushnell, F K; Fulmer, H S
2001-06-01
The American Public Health Association defines public health nursing as the "practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences." In 1993, celebrating the centennial anniversary of its founding, nurse leaders recognized systemic changes have required nurses to function in clinical, illness-oriented roles rather than in their more traditional community and public health roles. With nurses' public health skills atrophying, these leaders urged members of the profession to eschew specialization and return to their generalist roots founded on the principles of community-based prevention and health promotion. Soon the Public Health Functions Project, designed in part to identify skills and curriculum needs of an array of practicing public health workers, examined the public health nursing profession. Its recommendations seek to ensure that public health nurses are trained to respond to current challenges that face public health. In this essay, we describe how a fellowship program that predated this national project by almost a decade anticipated the recommendations for shaping public health nursing by enrolling midcareer nurses in a program that taught the principles and practice of community-oriented primary care. Such principles represent a merger of clinical care with population health sciences; its more recent expressions teach clinicians to work as partners with communities to identify and address health problems. In reporting on this program, we show how nurses in practice can embrace their generalist roots, meet current challenges, and play a lead role in realizing the nation's goals for the year 2010. These aims incorporate recent recommendations for preparing public health nurses for change in the health care system.
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Phillips, Leah; Neumeier, Melanie
2018-03-23
In Canada, all nurses are required to engage in evidence-based practice (EBP) as an entry-to-practice competency; however, there is little research that examines Licensed Practical Nurses' (LPNs') information seeking behaviors or preferred sources of knowledge to conduct EBP. Due to the differences in education and roles of LPNs and Registered Nurses (RNs), it is both necessary and important to gain an understanding of how LPNs utilize evidence in their unique nursing practice. The purpose of this study was to investigate how LPNs source knowledge for their nursing practice. A descriptive, cross-sectional survey of LPNs from Alberta, Canada asked participants to rank sources of knowledge that inform their practice. Responses were correlated with age and years of practice. Analysis of variance was used to determine if there were significant mean differences between average scores and place of employment. LPN participants used similar sources of knowledge as RNs. The top source of knowledge for both RNs and LPNs was the information they learn about each individual client and the least utilized sources of knowledge were articles published in nursing, medical, and research journals, tradition, and popular media. This finding is consistent with previous studies on RNs that found nurses do not often access current research evidence to inform their practice. Since relatively few LPNs access nursing and research journals, it is important to tailor EBP education information to the workplace context. Future avenues of research might explore the potential of using in-services and webinars to disseminate information and skills training on EBP to the LPNs, as this was a popular source of practice knowledge. © 2018 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International The Honor Society of Nursing.
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Managed care. What is its impact on nursing education and practice?
Malloy, C
1997-08-01
Market forces present the nursing profession with an urgency to prepare gerontological nurses to assume significant roles in the managed care industry. An understanding of the current managed care environment underscores the need for training. Nurses require a "managed care" skill-set encompassing a firm grasp of the organization, financing, delivery, and policy implications of managed care as well as advanced practice clinical skills and a sound business orientation. The importance of the consumer as a significant player in managed care is highlighted.
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Toward a North-South dialogue: revisiting nursing theory (from the South).
Santos Salas, Anna
2005-01-01
In nursing, the current world situation calls us to revisit our knowledge schemes and revise the extent to which they assist us in improving the health of the world peoples. In this discussion, I offer a Latin American nursing perspective to knowledge development in our discipline. I suggest that a persistent concern to develop elaborate conceptualizations has distracted our attention from the realities practicing nurses face throughout the world. In their abstractness, (North) American nursing theories have conveyed a view that presumingly universal imposes itself as hegemonic in the international nursing community. Yet the exportation of these theories to other countries introduces a view that is foreign to practicing nurses. The world situation as well as the disparate and concurrent human paths that we witness and experience calls for approaches that are more in tune with the local realities of nursing practices.
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The who, what, and how of evaluation within online nursing education: state of the science.
Russell, Bedelia H
2015-01-01
The resource capacity in nursing programs has a direct impact on student admissions and number of graduates who enter the nursing workforce. Online delivery of nursing education is identified as a solution to expand nursing program capacity. As nursing programs continue to address capacity with online course delivery, it is essential that nurse educators maintain consistent evaluation practices to ensure successful and positive outcomes, compared with traditional models. Evaluation is a central component to determine program quality and mastery of learning outcomes. This article examines the state of the science around the current evaluation of educational practices, instructional strategies, and outcomes within the context of online nursing education. Thirty-six articles met the inclusion criteria. Despite substantive contributions to the state of the science, the findings reflect evaluation practices that are diffuse and superficial and serve as the basis for future recommendations and research opportunities. Copyright 2015, SLACK Incorporated.
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Technology in Nursing Classrooms: A Qualitative Phenomenological Interpretative Study
ERIC Educational Resources Information Center
Martinez, Ose G.
2016-01-01
Nursing students have to learn how to critically think and pass a licensure examination to practice their profession. Current students seem to be bored by lecture strategies most commonly applied by seasoned nurse educators. A gap in the literature regarding lived experiences of seasoned nursing faculty members applying technological applications…
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Development of a Quantitative Measure of Holistic Nursing Care.
Kinchen, Elizabeth
2015-09-01
Holistic care has long been a defining attribute of nursing practice. From the earliest years of its formal history, nursing has favored a holistic approach in the care of patients, and such an approach has become more important over time. The expansion of nursing's responsibility in delivering comprehensive primary care, the recognition of the importance of relationship-centered care, and the need for evidence-based legitimation of holistic nursing care and practices to insurance companies, policy-makers, health care providers, and patients highlight the need to examine the holistic properties of nursing care. The Holistic Caring Inventory is a theoretically sound, valid, and reliable tool; however, it does not comprehensively address attributes that have come to define holistic nursing care, necessitating the development of a more current instrument to measure the elements of a holistic perspective in nursing care. The development of a current and more comprehensive measure of holistic nursing care may be critical in demonstrating the importance of a holistic approach to patient care that reflects the principles of relationship-based care, shared decision-making, authentic presence, and pattern recognition. © The Author(s) 2014.
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Woman-Centered Maternity Nursing Education and Practice
Giarratano, Gloria
2003-01-01
The purpose of this Heideggerian phenomenological study was to uncover the meanings of the clinical experiences of registered nurses working in maternity settings after they studied maternity nursing from a woman-centered, feminist perspective in a generic baccalaureate nursing program. Purposeful sampling was conducted to locate and recruit nurses who had graduated from this nursing program between the December 1996 and December 1998 semesters and were currently working in a maternal-newborn clinical setting. Each participant had taken the required woman-centered, maternity-nursing course during her/his undergraduate education. Data collection included an individual, open-ended interview that focused on the nurses' descriptions of their everyday practices as maternity nurses. Nineteen maternal-newborn nurses between the ages of 23 and 43 years who had been in practice from six months to three years were interviewed. The constitutive patterns identified from the interviews were: “Otherness,” “Being and Becoming Woman-Centered,” and “Tensions in Practicing Woman-Centered Care.” Findings revealed that the nurses had a raised awareness of oppressive maternity care practices and applied ideology of woman-centeredness as a framework for providing more humanistic care. Creating woman-centered maternity care meant negotiating tensions and barriers in medically focused maternity settings and looking for opportunities for advocacy and woman-empowerment. The barriers the nurses faced in implementing woman-centered care exposed limitations to childbearing choices and nursing practices that remain problematic in maternity care. PMID:17273327
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Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.
André, Beate; Aune, Anne G; Brænd, Jorunn A
2016-05-01
Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Moore, Lora
2017-10-01
Implementation of evidence-based practice (EBP) at the bedside has been difficult to achieve. Significant gaps between current research and actual practice have been identified and must be addressed in effort to increase utilization of EBP. The purpose of this study was to evaluate the efficacy of an online EBP educational intervention and to examine the relationship between educational preparation and years of nursing experience on nurses' practice, attitudes, and knowledge and skills of EBP. An experimental pretest-posttest design study with three randomized groups utilizing the EBPQ instrument was conducted. No significant differences were noted in EBPQ subscale scores of practice, attitude, or knowledge and skills from pre- to posttest. In addition, no statistical difference in EBPQ subscale scores regarding educational preparation or years of experience were noted. While nurses report positive attitudes toward EBP, their perceptions of practice and knowledge and skills score much lower. Educational interventions are needed for practicing nurses to overcome this knowledge deficit to successfully implement EBP. However, the use of online, independent, computer-based learning modules, while cost-efficient and offer several benefits when educating nurses, may not necessarily be the most effective method for teaching EBP knowledge and skills to practicing nurses. © 2017 Sigma Theta Tau International.
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Promoting Evidence-Based Practice at a Primary Stroke Center: A Nurse Education Strategy.
Case, Christina Anne
Promoting a culture of evidence-based practice within a health care facility is a priority for health care leaders and nursing professionals; however, tangible methods to promote translation of evidence to bedside practice are lacking. The purpose of this quality improvement project was to design and implement a nursing education intervention demonstrating to the bedside nurse how current evidence-based guidelines are used when creating standardized stroke order sets at a primary stroke center, thereby increasing confidence in the use of standardized order sets at the point of care and supporting evidence-based culture within the health care facility. This educational intervention took place at a 286-bed community hospital certified by the Joint Commission as a primary stroke center. Bedside registered nurse (RN) staff from 4 units received a poster presentation linking the American Heart Association's and American Stroke Association's current evidence-based clinical practice guidelines to standardized stroke order sets and bedside nursing care. The 90-second oral poster presentation was delivered by a graduate nursing student during preshift huddle. The poster and supplemental materials remained in the unit break room for 1 week for RN viewing. After the pilot unit, a pdf of the poster was also delivered via an e-mail attachment to all RNs on the participating unit. A preintervention online survey measured nurses' self-perceived likelihood of performing an ordered intervention based on whether they were confident the order was evidence based. The preintervention survey also measured nurses' self-reported confidence in their ability to explain how the standardized order sets are derived from current evidence. The postintervention online survey again measured nurses' self-reported confidence level. However, the postintervention survey was modified midway through data collection, allowing for the final 20 survey respondents to retrospectively rate their confidence before and after the educational intervention. This modification ensured that the responses for each individual participant in this group were matched. Registered nurses reported a significant increase in perceived confidence in ability to explain how standardized stroke order sets reflect current evidence after the intervention (n = 20, P < .001). This sample was matched for each individual respondent. No significant change was shown in unmatched group mean self-reported confidence ratings overall after the intervention or separately by unit for the progressive care unit, critical care unit, or intensive care unit (n = 89 preintervention, n = 43 postintervention). However, the emergency department demonstrated a significant increase in group mean perceived confidence scores (n = 20 preintervention, n = 11 postintervention, P = .020). Registered nurses reported a significantly higher self-perceived likelihood of performing an ordered nursing intervention when they were confident that the order was evidence based compared with if they were unsure the order was evidence based (n = 88, P < .001). This nurse education strategy increased RNs' confidence in ability to explain the path from evidence to bedside nursing care by demonstrating how evidence-based clinical practice guidelines provide current evidence used to create standardized order sets. Although further evaluation of the intervention's effectiveness is needed, this educational intervention has the potential for generalization to different types of standardized order sets to increase nurse confidence in utilization of evidence-based practice.
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Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija
2015-12-01
The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.
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[A case study on duty of care in professional nursing].
Huang, Hui-Man; Liao, Chi-Chun
2013-08-01
Nurses are expected to discharge their duty of care effectively and professionally to prevent medical negligence. Only three articles have previously focused on medical negligence. Duty of care and medical negligence in nursing are topics that have been neglected in Taiwan. (1) Classify the duty of care of professional nurses; (2) Investigate the facts and disputes in the current case; (3) Clarify the legal issues involved with regard to duty-of-care violations in the current case; (4) Explore the causal relationships in a legal context between nurses' duty-of-care violations and patient harm / injury. Literature analysis and a case study are used to analyze Supreme Court Verdict No.5550 (2010). Duty of care for nursing professionals may be classified into seven broad categories. Each category has its distinct correlatives. In nursing practice, every nursing behavior has a corresponding duty. In this case, the case study nurse did not discharge her obstetric professional duty and failed to inform the doctor in a timely manner. Negligence resulted in prenatal death and the case study nurse was found guilty. In order to prevent committing a crime, nurses should gain a better understanding of their duty of care and adequately discharge these duties in daily practice.
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Falk, Nancy L; Garrison, Kenneth F; Brown, Mary-Michael; Pintz, Christine; Bocchino, Joseph
2015-01-01
Strategic planning and thinking skills are essential for today's nurse leaders. Doctor of nursing practice (DNP) programs provide an opportunity for developing effective nurse strategists. A well-designed strategy course can stimulate intellectual growth at all levels of Bloom's Taxonomy. Discussion forums in online education provide new opportunities for rich interaction among peers en route to development of well-informed strategic plans. An interprofessional perspective adds a rich and vital aspect to doctoral nursing education and it serves to inform strategic plan development. A roadmap for teaching strategic planning to current and future nursing leaders will guide the integration of essential content into DNP programs.
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The state of readiness for evidence-based practice among nurses: An integrative review.
Saunders, Hannele; Vehviläinen-Julkunen, Katri
2016-04-01
To review factors related to nurses' individual readiness for evidence-based practice and to determine the current state of nurses' evidence-based practice competencies. An integrative review study. Thirty-seven (37) primary research studies on nurses' readiness for evidence-based practice, of which 30 were descriptive cross-sectional surveys, 5 were pretest-posttest studies, and one study each was an experimental pilot study and a descriptive qualitative study. Included studies were published from the beginning of 2004 through end of January 2015. The integrative review study used thematic synthesis, in which the quantitative studies were analyzed deductively and the qualitative studies inductively. Outcomes related to nurses' readiness for evidence-based practice were grouped according to the four main themes that emerged from the thematic synthesis: (1) nurses' familiarity with evidence-based practice (EBP); (2) nurses' attitudes toward and beliefs about evidence-based practice; (3) nurses' evidence-based practice knowledge and skills; and (4) nurses' use of research in practice. Methodological quality of the included studies was evaluated with Joanna Briggs Institute critical appraisal tools. Although nurses were familiar with, had positive attitudes toward, and believed in the value of EBP in improving care quality and patient outcomes, they perceived their own evidence-based practice knowledge and skills insufficient for employing evidence-based practice, and did not use best evidence in practice. The vast majority (81%) of included studies were descriptive cross-sectional surveys, 84% used a non-probability sampling method, sample sizes were small, and response rates low. Most included studies were of modest quality. More robust, theoretically-based and psychometrically sound nursing research studies are needed to test and evaluate the effectiveness of interventions designed to advance nurses' evidence-based practice competencies, especially teaching them how to integrate evidence-based practice into clinical decision-making. All efforts should be focused on systematically using knowledge transformation strategies shown to be effective in rigorous studies, to translate best evidence into practice-friendly, readily usable forms that are easily accessible to nurses to integrate into their clinical practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Ending disruptive behavior: staff nurse recommendations to nurse educators.
Lux, Kathleen M; Hutcheson, Jane B; Peden, Ann R
2014-01-01
The purpose of this qualitative descriptive study was to identify educational strategies that can prepare new graduates to manage disruptive behavior (DB) in the workplace. DB is any inappropriate behavior, confrontation, or conflict - ranging from verbal abuse to sexual harassment - that harms or intimidates others to the extent that quality of care or patient safety could be compromised. Individual interviews were conducted with nine staff nurses currently in practice in acute care settings in the United States. Staff nurses recommended educational strategies that focused on communication skills for professional practice. These included learning how to communicate with hostile individuals, and giving and receiving constructive criticism. Descriptions that participants provided about their work culture were an unexpected finding that has relevance for nurse educators as they prepare students for transition to practice Nurses described lack of management support and intervention for DB situations, personality clashes with coworkers, and devaluation of nursing work as affecting professional practice. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Nurse-physician communication - An integrated review.
Tan, Tit-Chai; Zhou, Huaqiong; Kelly, Michelle
2017-12-01
To present a comprehensive review of current evidence on the factors which impact on nurse-physician communication and interventions developed to improve nurse-physician communication. The challenges in nurse-physician communication persist since the term 'nurse-doctor game' was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse-physician communication. An integrative review was conducted following a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Five electronic databases were searched from 2005 to April 2016 using key search terms: "improve*," "nurse-physician," "nurse," "physician" and "communication" in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus. A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse-physician communication; barriers to effective nurse-physician communication; and interventions to improve nurse-physician communication. This integrative review suggests that nurse-physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies. Cross-training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of nurses and physicians to communicate effectively. Further research is needed to determine the feasibility and generalisability of interventions, such as localising physicians and using communication tools, to improve nurse-physician communication. Organisational and cultural changes are needed to overcome ingrained practices impeding nurse-physician communication. © 2017 John Wiley & Sons Ltd.
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The History of Preconception Care: Evolving Guidelines and Standards
Moos, Merry-K.; Curtis, Michele
2006-01-01
This article explores the history of the preconception movement in the United States and the current status of professional practice guidelines and standards. Professionals with varying backgrounds (nurses, nurse practitioners, family practice physicians, pediatricians, nurse midwives, obstetricians/gynecologists) are in a position to provide preconception health services; standards and guidelines for numerous professional organizations, therefore, are explored. The professional nursing organization with the most highly developed preconception health standards is the American Academy of Nurse Midwives (ACNM); for physicians, it is the American College of Obstetricians and Gynecologists (ACOG). These guidelines and standards are discussed in detail. PMID:16710764
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Maximizing nursing staff development. The learning laboratory.
Kleinknecht, M K; Hefferin, E A
1990-01-01
To survive in today's cost-conscious medical-center environment, nursing education must show how it contributes effectively to promoting and maintaining the currency and competency of nursing staff practice, the quality of patient care, and the overall functioning of the medical center. In the face of limited resources, nursing education increasingly must promote staff's self-assessment of their own knowledge and skill deficiencies and use of self-study mechanisms to meet established performance standards. This survey explored the current use of learning laboratory centers used by nursing education for maximizing staff access to and use of needed remedial and practice update learning opportunities.
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Parrone, Joyce; Sedrl, Darlene; Donaubauer, Carolyn; Phillips, Marge; Miller, Marilyn
2008-01-01
Eighty-two percent of practicing RNs are located in metropolitan areas in which the predominant employment setting is the hospital according to the National Sample Survey of Registered Nurses (Services, 2000). However, despite current trends toward moderate increased enrollment in nursing schools, a 2001American Hospital Survey (AHA) among 715 member hospitals revealed that 126,000 registered nurse positions across America remain unfilled. As a result, hospitals have adopted creative solutions to ease the nursing shortage. One creative solution is to import foreign nurses. According to the Commission on Graduates of Foreign Nursing Schools (CGFNS) many come from the Philippines, are single, female and between 23-27 years of age. The foreign nurse will encounter many barriers and practice problems no matter his/her level of skill. This article explores seven areas of clinical competency that nurses from the Philippines will encounter and must surmount as well as some of the implications for nursing practice that veteran and newly graduated nurses might want to be aware of when working with foreign nurses.
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Eskandari, Fatemeh; Abdullah, Khatijah Lim; Zainal, Nor Zuraida; Wong, Li Ping
2017-12-01
To investigate the knowledge, attitude, intention and practice of nurses towards physical restraint and factors influencing these variables. A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals. A cross-sectional study was used. A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses (n = 309) in twelve wards of a teaching hospital in Kuala Lumpur. Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint. Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint. This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint. Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals. © 2017 John Wiley & Sons Ltd.
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An investigation of nurse educator's perceptions and experiences of undertaking clinical practice.
Williams, Angela; Taylor, Cathy
2008-11-01
Educational policy (DOH, 1999. Making a difference: strengthening the nursing, midwifery and health visiting contribution to health and healthcare. Department of Health, London; UKCC, 1999. Fitness for Practice. United Kingdom Central Council for Nursing, Midwifery and Health Visiting, London; Nursing and Midwifery Council, 2006. Standards to support learning and assessment in practice. Nursing and Midwifery Council, London) and current nursing literature (Griscti, O., Jacono, B., Jacono, J., 2005. The nurse educator's clinical role. Journal of Advanced Nursing 50 (1), 84-92; Owen, S., Ferguson, K., Baguley, I., 2005. The clinical activity of mental health nurse lecturers. Journal of Psychiatric and Mental Health Nursing 12, 310-316), place increasing emphasis on nurse educators undertaking clinical practice to facilitate their clinical confidence and competence. This study investigated nurse educators' perceptions and experiences of undertaking clinical practice. A qualitative design and descriptive, exploratory approach were used. A purposive sample of 11 nurse educators in one nursing department, took part in two focus group interviews, one with 5 and the other with 6 respondents, to identify and discuss their perceptions and experiences of undertaking clinical practice. A process of thematic content analysis revealed three broad themes relating to the meaning and importance of clinical practice, perceived benefits and barriers which are examined and discussed. The paper concludes that despite policy recommendations, barriers highlighted in this study such as insufficient time, heavy workload and a lack of valuing of the clinical role have been raised over the past few decades. The effect of undertaking clinical practice, particularly on the quality of teaching is argued to be valuable armoury in the battle to secure sufficient resources to support engagement in clinical practice. Financial and organisational commitment; valuing of clinical practice and research evidence are crucial to realising clinical practice for nurse educators. Alternative interpretations of what may constitute the clinical role such as joint research projects and supporting and supervising students are offered, which need to be assessed against clear, specific and realistic aims for the clinical role of the nurse educator.
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Work engagement in professional nursing practice: A systematic review.
Keyko, Kacey; Cummings, Greta G; Yonge, Olive; Wong, Carol A
2016-09-01
Work engagement in professional nursing practice is critically important to consider when addressing key challenges of health systems, including the global nursing shortage, pressures to reduce health care spending, and increasing demands for quality care and positive outcomes for patients. However, research on work engagement in professional nursing practice has not yet been synthesized and therefore, does not provide a sufficient foundation of knowledge to guide practice and further research. The overall aim of this systematic review is to determine what is currently known about the antecedents and outcomes of work engagement in professional nursing practice. Systematic review. The search strategy included eight electronic databases: CINAHL, MEDLINE, PsycINFO, PROQUEST, SCOPUS, Web of Science, EMBASE, and Business Source Complete. The search was conducted in October 2013. Quantitative and qualitative research that examined relationships between work engagement and antecedent or outcome factors was included. Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were synthesized through descriptive and narrative synthesis. Content analysis was used to categorize factors into themes and categories. 3621 titles and abstracts were screened and yielded 113 manuscripts for full text review. Full text review resulted in 18 included studies. All factors examined were grouped into either influences or outcomes of work engagement. A total of 77 influencing factors were categorized into 6 themes: organizational climate, job resources, professional resources, personal resources, job demands, and demographic variables. A total of 17 outcomes of work engagement were categorized into 3 themes: performance and care outcomes, professional outcomes, and personal outcomes. Based on the results, we adapted the Job Demands-Resources (JD-R) model and developed the Nursing Job Demands-Resources (NJD-R) model for work engagement in professional nursing practice, which reflects key adaptations related to organizational climate and professional resources. Our findings indicate that a wide range of antecedents, at multiple levels, are related to registered nurses' work engagement. Positive outcomes of work engagement are valuable to both performance and the individual nurse. The NJD-R model offers nursing science a valuable beginning framework to understand the current evidence, further direct nursing research, and begin to guide practice and policy. The results offer opportunities for nurse leaders to promote work engagement in professional nurses through action on organizational level resources. Copyright © 2016 Elsevier Ltd. All rights reserved.
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North Dakota Statewide Nursing Study, Phase III. Final Report and Recommendations.
ERIC Educational Resources Information Center
Clark, Neil; Smith, David
The process, outcomes, and recommendations resulting from a project to develop a statewide nursing resource planning system are examined. Phase 1 of the project investigated nursing manpower demands for 1984 and 1986, while phase 2 studied the current scope of nursing practice. In addition to summarizing the findings of these investigations,…
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Akese, M I; Adejumo, P O; Ilesanmi, R E; Obilor, H N
2014-09-01
The increase in the prevalence of pressure ulcer among patients with impaired physical mobility has currently been associated with nurses' inadequate knowledge of preventive interventions. To assess nurses' knowledge of pressure ulcer identification/staging, risk factors and evidence-based preventive practices. This descriptive study was carried out at the University Teaching Hospital Maiduguri (UMTH), Borno State, Nigeria. Total sampling technique was utilized in the recruitment of the study participants. An adapted 75-item-pressure ulcer questionnaire was used for data collection. The data were analyzed using SPSS version 16. The hypotheses on nurses' knowledge were tested at 0.05 level of significance using Chi square test. A total of 219 nurses participated in this study with response rate of 68.0%. The nurses' years of professional practice ranged from 1 to 35 years with a mean of 11.7 (± 7.8) years. Approximately, 73% of the nurses demonstrated a low level of knowledge of pressure ulcer identification/staging, 69.4% demonstrated an average level of knowledge of risk factors and 79.9% demonstrated high level of knowledge of preventive practices. The relationship between nurses' knowledge of risk factors and knowledge of preventive practices (p = 0.37) was not significant. Nurses demonstrated a knowledge deficit in core areas on pressure ulcer identification/staging, risk factors' assessment and evidence-based preventive practices. In order to address this dearth, there is a need to institute an educational-based practice-guideline on pressure ulcer prevention for nurses.
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ERIC Educational Resources Information Center
Johnson, C. Frances; Hales, Loyde W.
A study examined the effectiveness of the current inservice training process used to teach newly employed nurses at Bess Kaiser Medical Center to transfer nursing process theory to practice. Eighty-two of 102 recently hired registered nurses were included in the audit sample. The newly hired nurses, whose previous experience varied from less than…
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Skillman, Susan M; Palazzo, Lorella; Hart, L Gary; Keepnews, David
2010-01-01
Little is known about RNs who drop their licenses and their potential re-entry into the nursing workforce. The results of this study provide insight into reasons nurses leave their careers and the barriers to re-entry, all important indicators of the current professional climate for nursing. While representing only one state, these findings suggest that RNs who allow their licenses to expire do so because they have reached retirement age or, among those who do not cite age as a factor, because many are unable or unwilling to work in the field. Inactive nurses who might otherwise appear to be likely candidates for re-entry into the profession may not be easily encouraged to practice nursing again without significant changes in their personal circumstances or the health care work environment. Effective ways to address current and pending RN workforce shortages include expanding RN education capacity to produce more RNs who can contribute to the workforce across the coming decades, and promote work environments in which RNs want to, and are able to, practice across a long nursing career.
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Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.
Galbany-Estragués, Paola; Comas-d'Argemir, Dolors
2017-10-01
Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.
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Slemon, Allie; Jenkins, Emily; Bungay, Vicky
2017-10-01
The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm. To illustrate this growing concern in mental health nursing care, we provide four exemplars of risk management strategies utilized in psychiatric inpatient settings: close observations, seclusion, door locking and defensive nursing practice. The use of these strategies demonstrates the necessity to shift perspectives on safety and risk in nursing care. We suggest that to re-centre meaningful support and treatment of clients, nurses should provide individualized, flexible care that incorporates safety measures while also fundamentally re-evaluating the risk management culture that gives rise to and legitimizes harmful practices. © 2017 The Authors Nursing Inquiry published by John Wiley & Sons Ltd.
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Halcomb, Elizabeth J; Salamonson, Yenna; Davidson, Patricia M; Kaur, Rajneesh; Young, Samantha Am
2014-03-25
Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. In the nascence of the expansion of the role of nurses in Australian general practice (2003-2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009-2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses' role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses' role in general practice was slightly decreased over time. This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce.
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Jairath, Nalini N; Peden-McAlpine, Cynthia J; Sullivan, Mary C; Vessey, Judith A; Henly, Susan J
Articles from three landmark symposia on theory for nursing-published in Nursing Research in 1968-1969-served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory. The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue. The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory, big data, and doctoral education. Using a dialogue format, the editors discussed these core questions. The classic nursing metaparadigm (health, person, environment, nursing) was viewed as a continuing unifying element for the discipline but is in need of revision in today's scientific and practice climates. Practice theory and precision healthcare jointly arise from an emphasis on individualization. Big data and the methods of e-science are challenging the assumptions on which nursing theory development was originally based. Doctoral education for nursing scholarship requires changes to ensure that tomorrow's scholars are prepared to steward the discipline by advancing (not reifying) past approaches to nursing theory. Ongoing reexamination of theory is needed to clarify the domain of nursing, guide nursing science and practice, and direct and communicate the unique and essential contributions of nursing science to the broader health research effort and of nursing to healthcare.
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Craft, Judy A; Hudson, Peter B; Plenderleith, Mark B; Gordon, Christopher J
2017-06-01
To explore new graduate registered nurses' reflections of bioscience courses during their nursing programme and the relationship between bioscience content and their clinical practice. Undergraduate nursing students internationally find bioscience courses challenging, which may be due to the volume of content and level of difficulty of these courses. Such challenges may be exacerbated by insufficient integration between bioscience theory and nursing clinical practice. A descriptive, cross-sectional mixed methods study was conducted. A 30-item questionnaire with five written response questions which explored recently registered nurses' reflections on bioscience courses during their nursing degree was employed. Descriptive analyses were reported for individual items. Thematic analysis of qualitative responses was grouped to reveal emerging themes. Registered nurses' (n = 22) reflections revealed that bioscience courses were a significant challenge during their undergraduate programme, and they lacked confidence explaining the biological basis of nursing. Participants would like improved knowledge of the relevant bioscience for nursing and agreed that bioscience courses should be extended into the undergraduate final year. The importance of relating bioscience content to nursing practice was elaborated extensively throughout written responses. Although registered nurses reflected that bioscience courses were difficult with large volumes of content, having more bioscience with greater relevance to nursing applications was considered important in their current clinical practice. It is suggested that bioscience academics develop greater contextual links between bioscience content and clinical practice relevant to nursing. After working as a registered nurse, there was appreciation of bioscience relevance for clinical practice, and the nurses believed they would have benefitted from more nursing-related bioscience during their undergraduate programme. Focussed integration of bioscience with clinical nursing courses should be driven by academics, nurse educators and clinical nurses to provide a biological basis for patient care to nursing students. © 2016 John Wiley & Sons Ltd.
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Mobile technology and its use in clinical nursing education: a literature review.
O'Connor, Siobhan; Andrews, Tom
2015-03-01
Nursing students face a variety of challenges to learning in clinical practice, from the theory-practice gap, to a lack of clinical supervision and the ad hoc nature of learning in clinical environments. Mobile technology is proposed as one way to address these challenges. This article comprehensively summarizes and critically reviews the available literature on mobile technology used in undergraduate clinical nursing education. It identifies the lack of clear definitions and theory in the current body of evidence; the variety of mobile devices and applications used; the benefits of mobile platforms in nursing education; and the complexity of sociotechnical factors, such as the cost, usability, portability, and quality of mobile tools, that affect their use in undergraduate clinical nursing education. Implications for nursing education and practice are outlined, and recommendations for future research are discussed. Copyright 2015, SLACK Incorporated.
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Towards a strong virtue ethics for nursing practice.
Armstrong, Alan E
2006-07-01
Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse-patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.
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Teaching science content in nursing programs in Australia: a cross-sectional survey of academics.
Birks, Melanie; Ralph, Nicholas; Cant, Robyn; Hillman, Elspeth; Chun Tie, Ylona
2015-01-01
Professional nursing practice is informed by biological, social and behavioural sciences. In undergraduate pre-registration nursing programs, biological sciences typically include anatomy, physiology, microbiology, chemistry, physics and pharmacology. The current gap in the literature results in a lack of information about the content and depth of biological sciences being taught in nursing curricula. The aim of this study was to establish what priority is given to the teaching of science topics in these programs in order to inform an understanding of the relative importance placed on this subject area in contemporary nursing education. This study employed a cross-sectional survey method. This paper reports on the first phase of a larger project examining science content in nursing programs. An existing questionnaire was modified and delivered online for completion by academics who teach science to nurses in these programs. This paper reports on the relative priority given by respondents to the teaching of 177 topics contained in the questionnaire. Of the relatively small population of academics who teach science to nursing students, thirty (n = 30) completed the survey. Findings indicate strong support for the teaching of science in these programs, with particular priority given to the basic concepts of bioscience and gross system anatomy. Of concern, most science subject areas outside of these domains were ranked as being of moderate or low priority. While the small sample size limited the conclusions able to be drawn from this study, the findings supported previous studies that indicated inadequacies in the teaching of science content in nursing curricula. Nevertheless, these findings have raised questions about the current philosophy that underpins nursing education in Australia and whether existing practices are clearly focused on preparing students for the demands of contemporary nursing practice. Academics responsible for the design and implementation of nursing curricula are encouraged to review the content of current programs in light of the findings of this research.
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A National Survey of the Nursing Care of Infants With Prenatal Substance Exposure in Canadian NICUs.
Marcellus, Lenora; Loutit, Tara; Cross, Shannon
2015-10-01
Many communities are reporting increases in the number of infants requiring NICU care. Practices continue to vary and there is limited available evidence about nursing care. The purpose of this study was to describe current nursing care practices for infants with prenatal substance exposure in the NICU setting and during transition to the community. Findings from this study were compared with an earlier Canadian survey (by Marcellus in 2002) to identify shifts in clinical nursing practice for this population. This was a cross-sectional descriptive survey design. A 68-item survey composed of multiple-choice and open-ended questions was administered through FluidSurveys online software. A convenience sample of 62 clinical managers or clinical educators in hospitals with active maternal-infant clinical units with 500 deliveries or more annually and/or pediatric hospitals with a separate designated neonatal service (ie, Level 2 and 3 units) was chosen. A greater number of NICUs are using clinical guidelines to support the standardization of quality care. Improvements in nursing practice were identified and these included the consistent use of a withdrawal scoring tool and provision of education for team members in orientation. A decline in routine discharge planning meetings and routine parent teaching plans was discovered. This survey has improved understanding of the current state of nursing care for infants with prenatal substance exposure and their families during this critical time of transition. The purpose of the survey was to compare findings with the 2002 study by Marcellus to identify any improved practices and describe current state nursing care practices in the NICU. Practice changes over the last decade have included keeping mothers and infants together, expanding concepts of the team, integrating programs and services across hospital and community settings, and creating opportunities for NICU teams to learn more about substance use, mental health, violence, and trauma. Focus on discharge planning, parent teaching, and creation and implementation of national/hospital guidelines is essential for consistent evidence-based quality patient care.
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Characteristics of nurses providing diabetes community and outpatient care in Auckland.
Daly, Barbara; Arroll, Bruce; Sheridan, Nicolette; Kenealy, Timothy; Scragg, Robert
2013-03-01
There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006-2008. Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access.
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Hetland, Breanna; Guttormson, Jill; Tracy, Mary Fran; Chlan, Linda
2018-05-01
Critical care nurses are responsible for administering sedative medications to mechanically ventilated patients. With significant advancements in the understanding of the impact of sedative exposure on physiological and psychological outcomes of ventilated patients, updated practice guidelines for assessment and management of pain, agitation, and delirium in the intensive care unit were released in 2013. The primary aim of this qualitative study was to identify and describe themes derived from critical care nurses' comments regarding sedation administration practices with mechanically ventilated patients. This is a qualitative content analysis of secondary text data captured through a national electronic survey of members of the American Association of Critical-Care Nurses. A subsample (n = 67) of nurses responded to a single, open-ended item at the end of a survey that evaluated nurses' perceptions of current sedation administration practices. Multiple factors guided sedation administration practices, including individual patient needs, nurses' synthesis of clinical evidence, application of best practices, and various personal and professional practice perspectives. Our results also indicated nurses desire additional resources to improve their sedation administration practices including more training, better communication tools, and adequate staffing. Critical care nurses endorse recommendations to minimise sedation administration when possible, but a variety of factors, including personal perspectives, impact sedation administration in the intensive care unit and need to be considered. Critical care nurses continue to encounter numerous challenges when assessing and managing sedation of mechanically ventilated patients. Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
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Newell, Mary E
2013-01-01
School nursing in the United States has been in existence for many decades but has become increasingly more complex, as student health needs have escalated and the role itself has expanded in scope of practice. Given the changes in health care delivery mandated by the Patient Safety and Affordable Care Reform Act, and the increasing complexity of school nursing practice, it is important to determine whether nurses who enter this area of practice are educationally prepared to do so. The objective of this study was to determine the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and whether they felt adequately prepared to effectively practice as a school nurse. The survey The Perceptions of School Nurses' Educational Preparation: Survey of Washington State School Nurses was sent to school nurses in Washington State. This was a descriptive, quantitative online survey that asked school nurses to assess their initial nursing education and whether their baccalaureate preparation adequately prepared them for this specialty role. There are a total of 17 school nurse standards, and 8 of the standards (47%) were identified as minimally achieved upon graduation. In addition, school nurses self-assessed gaps in their ongoing continuing educational needs, such as needing additional education regarding special education laws (81%), 504 accommodations (90.5%), diabetic care (76%), and delegation skills (68.6%). The findings from this study have illustrated the need for additional didactic and clinical practicum components that could be incorporated into baccalaureate nursing programs to better prepare graduates for school nursing practice in Washington State. Participants were able to identify areas in need of further education within their baccalaureate program, and also during their orientation to the role and responsibilities of a school nurse. Nurse executives must be able to use this knowledge to support staff nurses with an understanding of school nurses' increasing responsibilities to improve both inpatient care and outpatient support.
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The impact of informatics on nursing education: a review of the literature.
Ainsley, Bonnie; Brown, Abbie
2009-05-01
On the basis of a study by the Institute of Medicine, the current health care system is facing several challenges that may be addressed by changes in health professions education. The study focused on integration of five core competencies into health professions education, one of which was informatics. This critical analysis investigates current use of technology and online instructional strategies in nursing education. It also explores the potential impact of integration of informatics into nursing education to increase the cognitive skills of nurses to promote evidence-based nursing. Advantages and disadvantages of using online education in the instruction of nursing students and recommendations for best online practices in nursing education are discussed.
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Nurses' scope of practice and the implication for quality nursing care.
Lubbe, J C Irene; Roets, Lizeth
2014-01-01
This article provides an overview of the implications for patients' health status and care needs when assessments are performed by nurses not licensed or competent to perform this task. The Waterlow scale (Judy Waterlow, The Nook, Stroke Road, Henlade, TAUNTON, TA3 5LX) scenario is used as a practice example to illustrate this case. The international nursing regulatory bodies, in South Africa called the South African Nursing Council, set the scope of practice wherein nurses are allowed to practice. Different categories of nurses are allowed to practice according to specified competencies, in alignment with their scope of practice. A retrospective quantitative study was utilized. A checklist was used to perform an audit on a random sample of 157 out of an accessible population of 849 patient files. Data were gathered in May 2012, and the analysis was done using frequencies and percentages for categorical data. Reliability and validity were ensured, and all ethical principles were adhered to. Eighty percent of risk assessments were performed by nurses not licensed or enrolled to perform this task unsupervised. Areas such as tissue malnutrition, neurological deficits, and medication were inaccurately scored, resulting in 50% of the Waterlow risk-assessment scales, as an example, being incorrectly interpreted. This has implications for quality nursing care and might put the patient and the institution at risk. Lower-category nurses and student nurses should be allowed to perform only tasks within their scope of practice for which they are licensed or enrolled. Nurses with limited formal theoretical training are not adequately prepared to perform tasks unsupervised, even in the current global nursing shortage scenario. To optimize and ensure safe and quality patient care, risk assessments should be done by a registered professional nurse, who will then coordinate the nursing care of the patient with the assistance of the lower category of nurses. © 2013 The Authors. Journal of Nursing Scholarship published by Wiley Periodicals, Inc. on behalf of Sigma Theta Tau International.
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Ethical vulnerabilities in nursing history: conflicting loyalties and the patient as 'other'.
Lagerwey, Mary Deane
2010-09-01
The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing's past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as 'other'. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the nursing profession. First of all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession's past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today.
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Lin, Shou-Ju; Huang, Lain-Hua
2014-08-01
The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.
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Ancient Ethical Practices of Dualism and Ethical Implications for Future Paradigms in Nursing.
Milton, Constance L
2016-07-01
Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing. © The Author(s) 2016.
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Predictors and enablers of mental health nurses' family-focused practice.
Grant, Anne; Reupert, Andrea; Maybery, Darryl; Goodyear, Melinda
2018-06-27
Family-focused practice improves outcomes for families where parents have a mental illness. However, there is limited understanding regarding the factors that predict and enable these practices. This study aimed to identify factors that predict and enable mental health nurses' family-focused practice. A sequential mixed methods design was used. A total of 343 mental health nurses, practicing in 12 mental health services (in acute inpatient and community settings), throughout Ireland completed the Family Focused Mental Health Practice Questionnaire, measuring family-focused behaviours and other factors that impact family-focused activities. Hierarchical multiple regression identified 14 predictors of family-focused practice. The most important predictors noted were nurses' skill and knowledge, own parenting experience, and work setting (i.e. community). Fourteen nurses, who achieved high scores on the questionnaire, subsequently participated in semistructured interviews to elaborate on enablers of family-focused practice. Participants described drawing on their parenting experiences to normalize parenting challenges, encouraging service users to disclose parenting concerns, and promoting trust. The opportunity to visit a service user's home allowed them to observe how the parent was coping and forge a close relationship with them. Nurses' personal characteristics and work setting are key factors in determining family-focused practice. This study extends current research by clearly highlighting predictors of family-focused practice and reporting how various enablers promoted family-focused practice. The capacity of nurses to support families has training, organizational and policy implications within adult mental health services in Ireland and elsewhere. © 2018 Australian College of Mental Health Nurses Inc.
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[The ethic dimension of daily tasks in the formation process of nurses].
Fernandes, Josicélia Dumêt; Rosa, Darci de Oliveira Santa; Vieira, Therezinha Teixeira; Sadigursky, Dora
2008-06-01
This theoretical article had as its object of study the ethic dimension of the formation process of nurses taking in consideration the National Curricular Directives for Nursing Courses. It was based on the presuppositions of ethics and their relationship with the implementation of changes in the formation process of nurses, using as reference elements of ethical behavior in the formation and attempting to bring the reflection to current times and thus contribute to define a direction to Nursing education. It was concluded that the ethical dimension in the formation of nurses involves values that permeate the relations between the subjects of this process and nature itself. The study points out the need to transform the practices of students and teachers and change the current curriculum framework, highlighting elements that indicate that the concern with ethics when developing the curriculum framework is not limited to how a discipline is taught, but pass through as practices that take place in the education process.
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A survey of physical assessment techniques performed by RNs: lessons for nursing education.
Giddens, Jean F
2007-02-01
There is ongoing concern about the adequacy of the educational preparation of nursing graduates; at the same time, there is concern regarding excessive content within nursing curricula. The purpose of this study was to identify physical examination skills performed by practicing nurses to better understand the competencies needed by graduates of nursing programs. A sample of 193 nurses completed a survey indicating the frequency they performed various physical assessment techniques. Thirty skills routinely performed by nurses were identified; the remaining skills were reportedly performed occasionally or were not performed. The fact that only 30 skills were reportedly performed regularly by the sample raises questions about the depth at which examinations should be conducted in the clinical setting and the depth at which physical examination skills should be taught in nursing programs. Nurse educators should assess the skills currently taught in nursing programs and consider what skills graduates actually need to enter nursing practice.
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Current Continuing Professional Education Practice among Malaysian Nurses
Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim
2014-01-01
Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements. PMID:24523961
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Nurse manager succession planning: synthesis of the evidence.
Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria
2013-10-01
The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
US Department of Education, 2010
2010-01-01
The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) accredits institutions and programs that prepare nurses to become practicing nurse anesthetists. Currently the agency accredits 105 programs located in 35 states, the District of Columbia and Puerto Rico, including three single purpose freestanding institutions. The…
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Responsive BScN Programming at Nipissing University: The Continuing Education of Ontario Nurses
ERIC Educational Resources Information Center
Fitzgerald, Scott; Beattie, Beverley; Carter, Lorraine; Caswell, Wenda
2014-01-01
Nipissing University in North Bay, Ontario, is currently the only post-secondary institution in that province to offer a part-time Baccalaureate of Science in Nursing (BScN) program for Registered Practical Nurses (RPNs) through a blended learning model. This program represents a "bridge" from the nurse's college diploma and offers a…
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Curran, Mary K
2014-05-01
The American Nurses Association advocates for nursing professional development (NPD) specialists to have an earned graduate degree, as well as educational and clinical expertise. However, many NPD specialists have limited exposure to adult learning theory. Limited exposure to adult learning theory may affect NPD educational practices, learning outcomes, organizational knowledge transfer, and subsequently, the professional development of the nurses they serve and quality of nursing care. An examination of current teaching practices may reveal opportunities for NPD specialists to enhance educational methods to promote learning, learning transfer, and organizational knowledge and excellence. This article, the first in a two-part series, examines best practices of adult learning theories, nursing professional development, curriculum design, and knowledge transfer. Part II details the results of a correlational study that examined the effects of four variables on the use of adult learning theory to guide curriculum development for NPD specialists in hospitals. Copyright 2014, SLACK Incorporated.
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Plastic apron wear during direct patient care.
Candlin, Josie; Stark, Sheila
To identify factors that influence nurses' practice in apron use during direct patient care. A small-scale documentary analysis of a purposive sample of 15 journal articles relating to nurses' apron use during patient care was undertaken. The analysis sought to address what factors affect nurses' decisions in relation to apron use. Nurses' decisions regarding apron use during patient care tend to be ritualistic rather than evidence-based. Their knowledge of infection control is limited. Although there is current literature available on infection control, as well as health and safety regulations, if local policy regarding apron use in nursing care is scant this can result in inconsistent and, perhaps, less desirable practices.
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de Souza, Juliana Martins; Veríssimo, Maria De La Ó Ramallo
2013-02-01
Identify and analyze the NANDA-I diagnoses and the focus terms of the International Classification for Nursing Practices (ICNP) related to child development. Literature, reflections about clinical experience, and a model case. DATA SYNTHESE: The current diagnoses proposed by NANDA-I and the ICNP focus terms do not encompass the extent of the child development phenomenon. It is necessary studying the child development concept to improve the definition of the ICNP focus terms and the accuracy of NANDA-I diagnoses. Discussing the nursing classifications can improve their understanding and use. © 2012, The Authors. International Journal of Nursing Knowledge © 2012, NANDA International.
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Personal data assistants: using new technology to enhance nursing practice.
Lewis, Judith A; Sommers, Catherine O
2003-01-01
This article explains how the new technology of personal data assistants can be used to enhance and augment comprehensive nursing care. Nurses are constantly challenged in their need for current, reliable, and accurate information at the point of patient care. Professional books and journals, by the very nature of their print format, have been prepared long before they can be actually used in practice. More current information is available from the World Wide Web, but it is often impractical for a nurse to access a computer during a patient encounter. Personal data assistants [PDAs] allow clinicians to access and document absolutely current information at the moment the patient is being seen. There are many general applications for PDAs that nurses might use such as keeping electronic calendars, address books, and reminder lists. In addition, however, there are even more actual healthcare applications, including patient tracking systems, access to pharmacologic databases, and a variety of clinical decision-making support tools. This article describes the wide variety of PDAs, along with the factors a nurse should consider in the decision of whether to purchase a PDA, and which type of device is best suited for which application.
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Using the Delphi method to develop nursing-sensitive quality indicators for the NICU.
Chen, Lin; Huang, Li-Hua; Xing, Mei-Yuan; Feng, Zhi-Xian; Shao, Le-Wen; Zhang, Mei-Yun; Shao, Rong-Ya
2017-02-01
To develop nursing-sensitive quality indicators consistent with current medical practices in Chinese neonatal intensive care units. The development of nursing-sensitive quality indicators has become a top priority in nursing management. To the best of our knowledge, there has been no objective, scientific and sensitive evaluation of the quality of neonatal intensive care unit nursing in China. A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of quality care in neonatal intensive care unit nursing. Based on a literature review, we identified 21 indicators of nursing-sensitive quality in the neonatal intensive care unit. Our group of 11 consultants chose 13 indicators to be discussed using the Delphi method. In October and November 2014, 39 neonatal intensive care unit experts in 18 tertiary hospitals spread across six provinces participated in two rounds of Delphi panels. Of the 13 indicators discussed, 11 were identified as indicators of nursing-sensitive quality in the neonatal intensive care unit: rate of nosocomial infections, rate of accidental endotracheal extubation, rate of errors in medication administration, rate of treatment for pain, rate of peripheral venous extravasation, rate of compliance with handwashing techniques, incidence of pressure ulcers, incidence of noise, the bed-to-care ratio, the proportion of nurses with greater than five years neonatal intensive care unit experience and incidence of retinopathy. The 11 neonatal intensive care unit nursing-sensitive indicators identified by the Delphi method integrated with basic Chinese practices provide a basis for nursing management and the monitoring of nursing quality. This study identified nursing-sensitive quality indicators for neonatal intensive care unit care that are suitable for current clinical practice in China. © 2016 John Wiley & Sons Ltd.
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Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran
2017-09-01
To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. . Descriptive, cross-sectional study. . Rambam Health Care Campus in northern Israel. . A convenience sample of 434 hospital nurses with varied oncology experience. . Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. . Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse. . Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices. . A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. . Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.
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Lifestyle practices and the health promoting environment of hospital nurses.
Hope, A; Kelleher, C C; O'Connor, M
1998-08-01
Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.
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Using the Practice Environment Scale of the Nursing Work Index on Asian nurses.
Liou, Shwu-Ru; Cheng, Ching-Yu
2009-01-01
Researchers have used the Practice Environment Scale of the Nursing Work Index (PES-NWI) to examine the perception of practice environment among U.S. nurses in general; however, the scale has not been used to measure perceptions specifically among Asian nurses working in the United States, the largest group of international nurses in the nation. The purpose of this study was to test the reliability and the validity of the PES-NWI scale when applied to Asian nurses working in the United States. The study used a cross-sectional design with snowball sampling. Data from 230 Asian nurses who were born in Far Eastern countries and had worked at least 6 months in their current job at a U.S. hospital were analyzed, using Cronbach's alpha, item-total and interitem correlation, and factor analysis. The Cronbach's alpha for the PES-NWI was.96, and the item-total correlation coefficients ranged from.49 to.79. Five factors, which explained 59.12% of variance in the perception of practice environment, emerged: Nurse Participation and Development; Nurse Manager Ability, Leadership, and Support of Nurses; Nursing Foundations for Quality of Care; Staffing and Resource Adequacy; and Collegial Nurse-Physician Relations. Four derived factors were reconstructed, and one factor was renamed based on the meanings of scale items that were included in the factor. Study findings demonstrate that the PES-NWI is a reliable and a valid scale when applied to Asian nurses working in the United States. Findings also indicate that Asian nurses perceive practice environments differently than do American nurses, most likely due to dissimilar cultural beliefs. A better understanding of these differences may help develop more individualized support for Asian nurses as they adapt to working in the United States.
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Whitehead, Dean
2008-04-01
To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. Nursing has often been maligned and criticized, both inside and outside of the profession, for its ability to understand and conduct effective health promotion and health education-related activities. In the absence of an expert-based consensus, nurses may find it difficult to progress beyond the current situation. In the absence of any previously published nursing-related consensus research, this study seeks to fill that knowledge-gap. A two-round Delphi technique via email correspondence. A first-round qualitative questionnaire used open-ended questions for defining health promotion and health education. This was both in general terms and as participants believed these concepts related to the clinical, theoretical (academic/educational) and the policy (political) setting in nursing. Line-by-line qualitative content and thematic analysis of the first-round data generated 13 specific categories. These categories contained 134 statement items. The second-round questionnaire comprised the identified 134 statements. Using a five-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree) participants scored and rated their level of agreement/disagreement against the listed items. Data from the second-round was descriptively analysed according to distribution and central tendency measures. An expert consensus was reached on 65 of the original 134 statements. While some minor contradiction was demonstrated, strong consensus emerged around the issues of defining health promotion and health education and the emergence of a wider health promotion and health education role for nursing. No consensus was reached on only one of the 13 identified topic categories - that of 'nurses working with other disciplines and agencies in a health education and health promotion role.' This study provides a hitherto previously absent expert consensus on the current position of health promotion and health education, in nursing and predictions for their future course. Its findings represent an important step for nurses as they seek to become increasingly active and influential within wider health promotion and health education arenas. Relevance to clinical practice. Delphi studies do not necessarily offer indisputable fact. This study, however, with its strong consensus on the majority of original statements is a good indicator as to how nursing experts currently view health promotion and health education constructs. Expert consensus offers a useful form of measure against current and future clinical practice and helps to build a firm foundation for change. Nurses, then, are advised here to refer to the findings presented, that they remain contextually and conceptually clear, as they embark on current and future health promotion-related activities.
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42 CFR 405.2401 - Scope and definitions.
Code of Federal Regulations, 2010 CFR
2010-10-01
... to time, but usually not less frequently than once every 60 days. Nurse-midwife means a registered professional nurse who meets the following requirements: (1) Is currently licensed to practice in the State as a registered professional nurse. (2) Is legally authorized under State law or regulations to...
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Manthorpe, Jill; Hussein, Shereen; Moriarty, Jo
2005-07-01
Social work education in England underwent significant change in its move to degree status in 2003. It is hoped that the result will be increased professional standing for social workers, an improvement in the current widespread problems with recruitment, and assurance that all newly qualified social workers meet the National Occupational Standards for Social Work (Available from: http://www.topssengland.net/files/cd/). This change has pre-occupied social work educators and debate within the profession has concentrated on the practicalities and expectations of reform. This paper suggests that those working in nurse education may observe a number of similarities with its own earlier reforms and with current debates on whether nursing should move to an all-graduate profession. It then highlights three aspects of the new requirements for social work training: service user involvement, the place of research-minded practice, and the primacy of practice--that may be of interest and relevance to nursing colleagues.
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The Future of Gero-Oncology Nursing.
Kagan, Sarah H
2016-02-01
To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.
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[The development and current status of men in the nursing profession].
Huang, Chun-Che; Kuo, Ying-Ling
2011-12-01
Nursing has been a quintessentially female-dominated occupation throughout much of its history. Today, educational developments, changes in healthcare service models and promotion of gender equality in education and employment have opened the doors to males to play increasingly important roles in the healthcare services as nursing professionals. The responsibilities of male nursing staff are expected to continue to increase. It remains difficult for male nurses to escape traditional gender stereotypes in nursing. The impact of personal characteristics, occupational roles, and professional identification in real practice are major issues of concern. This study reviewed relevant literature to identify factors of influence on male nursing staff professional practice. We hope this study can be a reference for future research on male nursing staff development, and that male nurses will increasingly create personal core values in a multi-discipline, cross-professional healthcare team, and exercise their abilities as a complement to female nurses.
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McCorkell, Gillian; Brown, Geraldine; Michaelides, Bernie; Coates, Vivien
2015-03-01
The project aims to assess current specialist practice in relation to the new and ever-changing healthcare climate and explore some of the issues that specialist nurses encounter. The current financial recession is driving a range of economic policy changes and consequently service provision, in particular the work and impact of nurses working in a specialist role, being examined. This has resulted in many specialist nurses feeling very vulnerable. A cross sectional survey was completed by nurses working in specialist roles (n = 96) in a large health and social care setting in the United Kingdom. A response rate of 62% was achieved: 44% provide nurse led clinics and 42% are nurse prescribers. The mean length of time qualified as a registered nurse was 27 years. Less than a third felt that the current computer system for activity recording reflected their current workload and 65% needed administrative support. This study demonstrates the insufficient resources available to specialist nurses resulting in inappropriate but necessary, use of time and restricted opportunities for learning and development. © 2013 John Wiley & Sons Ltd.
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Pain: A content review of undergraduate pre-registration nurse education in the United Kingdom.
Mackintosh-Franklin, Carolyn
2017-01-01
Pain is a global health issue with poor assessment and management of pain associated with serious disability and detrimental socio economic consequences. Pain is also a closely associated symptom of the three major causes of death in the developed world; Coronary Heart Disease, Stroke and Cancer. There is a significant body of work which indicates that current nursing practice has failed to address pain as a priority, resulting in poor practice and unnecessary patient suffering. Additionally nurse education appears to lack focus or emphasis on the importance of pain assessment and its management. A three step online search process was carried out across 71 Higher Education Institutes (HEIs) in the United Kingdom (UK) which deliver approved undergraduate nurse education programmes. Step one to find detailed programme documentation, step 2 to find reference to pain in the detailed documents and step 3 to find reference to pain in nursing curricula across all UK HEI websites, using Google and each HEIs site specific search tool. The word pain featured minimally in programme documents with 9 (13%) documents making reference to it, this includes 3 occurrences which were not relevant to the programme content. The word pain also featured minimally in the content of programmes/modules on the website search, with no references at all to pain in undergraduate pre-registration nursing programmes. Those references found during the website search were for continuing professional development (CPD) or Masters level programmes. In spite of the global importance of pain as a major health issue both in its own right, and as a significant symptom of leading causes of death and illness, pain appears to be a neglected area within the undergraduate nursing curriculum. Evidence suggests that improving nurse education in this area can have positive impacts on clinical practice, however without educational input the current levels of poor practice are unlikely to improve and unnecessary patient suffering will continue. Undergraduate nurse education in the UK needs to review its current approach to content and ensure that pain is appropriately and prominently featured within pre-registration nurse education. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Goossen, W T; Epping, P J; Abraham, I L
1996-03-01
The development of nursing information systems (NIS) is often hampered by the fact that nursing lacks a unified nursing terminology and classification system. Currently there exist various initiatives in this area. We address the question as to how current initiatives in the development of nursing terminology and classification systems can contribute towards the development of NIS. First, the rationale behind the formalization of nursing knowledge is discussed. Next, using a framework for nursing information processing, the most important developments in the field of nursing on formalization, terminology and classification are critically reviewed. The initiatives discussed include nursing terminology projects in several countries, and the International Classification of Nursing Practice. Suggestions for further developments in the area are discussed. Finally, implications for NIS are presented, as well as the relationships of these components to other sections of an integrated computerized patient record.
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Colostomy irrigation: current knowledge and practice of WOC nurses.
Cobb, Martha D; Grant, Marcia; Tallman, Nancy J; Wendel, Christopher S; Colwell, Janice; McCorkle, Ruth; Krouse, Robert S
2015-01-01
This study builds on the authors' previous studies that demonstrate that persons living with a colostomy who practice colostomy irrigation (CI) experience quality-of-life benefits. Studies also reveal that patients may not be taught about CI. The purpose of this study was to determine current knowledge, attitudes, and practices of WOC nurses on CI. The target population was ostomy nurses who were members of the Wound, Ostomy and Continence Nurse's Society. Nine hundred eighty-five nurses out of a possible pool of 4191 members responded, providing a response rate of 24%. Their average age was 53 years (range, 25-79 years). Respondents averaged 12 years' experience as a WOC nurse (range, 1-40 years) and 90% (n = 875) were certified. Participants practiced in a variety of settings, including acute and long-term care facilities, home health, and ambulatory clinics. They saw an average of 37 ± 60.5 (mean ± SD) ostomy patients per year (range, 0-1100). A 1-time online survey (SurveyMonkey) of members of the Wound, Ostomy and Continence Nurses (WOCN) Society was conducted. In addition to demographic and educational information, questions also included (1) CI advantages and disadvantages; (2) CI content routinely taught; (3) challenges in assisting patients to learn CI; and (4) where preparation was received for teaching this procedure. Nurses were asked whether they believe CI is evidence-based. More than half identified irrigation as an evidence-based practice (59%), but half indicated they do not routinely teach CI. Multiple factors correlated with nurses' decisions to teach CI, including years of experience (P = .03), specific CI education (P < .001), and considering the intervention evidence-based (P < .001). Factors influencing CI instruction are multifactorial; they include nurses' attitudes, experience base, education, medical indications, setting characteristics, and patient interest and physical abilities. Education on this procedure is urgently needed for ostomy nurses unprepared and/or unfamiliar with CI, as well as staff nurses in acute care units who could offer accurate information and additional resources to patients to increase their informed decisions.
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Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based healthcare.
Norlyk, Annelise; Haahr, Anita; Dreyer, Pia; Martinsen, Bente
2017-07-01
Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously. The other is a course of democratization based on patients' involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence-based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence-based medicine are being lost in the transformation into the current evidence-based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as 'one best way'. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patient participation thus preventing a practice of 'McNursing'. © 2017 John Wiley & Sons Ltd.
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Nursing Fatigue: An Evidence-Based Practice Review for Oncology Nurses .
Ferris, Jordan
2015-12-01
Nursing fatigue is a current and well-researched topic. Many negative outcomes and consequences exist for patients and nurses that have been linked to nursing fatigue. Medical errors are one such consequence, and these errors have become one of the top three preventable deaths in the United States. Oncology nurses are not immune to fatigue, and the consequences of their fatigue can be much more harmful to patients.
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State of the art: nursing knowledge and electroconvulsive therapy.
Froimson, L; Creed, P; Mathew, L
1995-09-01
Nursing services attempting to develop standards for their own facilities will find limited literature specific to nursing and electroconvulsive therapy (ECT) in American publications. From 1966 to December 1994, there were only 19 publications in American nursing journals that provide a specific focus on nursing and ECT. Only one of these articles reported research findings. Twenty-seven citations in Convulsive Therapy included nurse contributors. While the APA Task Force on the Practice of ECT has addressed educational needs of nursing and technical elements of the procedure, there do not currently exist specific standards for nursing practice in ECT. Concerns salient to nursing that have generated articles by nurses include instruction of patients, support to patients and families, safety of patients, assessment of clinical status, informed consent, and nurses' and patients' attitudes about ECT. Nurses are encouraged to join their physician-colleagues in developing and disseminating the information needed for the field of nursing to contribute its own expertise to the care of patients receiving ECT.
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Nursing Admission Practices to Discern "Fit": A Case Study Exemplar
ERIC Educational Resources Information Center
Sinutko, Jaime M.
2014-01-01
Admission to a baccalaureate nursing school in the United States is currently a challenging proposition for a variety of reasons. This research explored a holistic nursing school admission process at a small, private, baccalaureate college using a retrospective, mixed-method, approach. The holistic method included multiple admission criteria, both…
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Readiness for evidence-based practice: information literacy needs of nurses in the United States.
Tanner, Annelle; Pierce, Susan; Pravikoff, Diane
2004-01-01
In this paper U.S. nurses' readiness to provide Evidence-Based Practice (EBP) as measured by their information literacy knowledge and skills is described. The Institute of Medicine directed health care providers to use EBP as a means to improve patient safety, efficiency and effectiveness of health care services. Information literacy has been identified as a nursing informatics competency for the basic nurse. As such, information literacy is an essential component in the application of EBP. The importance of developing information literacy skills is enhancement of the nurse's ability to use current best available research literature in the conduct of EBP with subsequent improvement in nursing sensitive patient outcomes. This study describes the level of nurses' information literacy knowledge and gaps in their skills for identifying, accessing, retrieving, evaluating and utilizing research evidence to provide best care for patients. The value of this study is to increase awareness among nurse administrators, educators, and clinicians of the need for information literacy education to enable evidence-based nursing practice and to guide development of supportive curricula and professional continuing education.
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Standardized Predictive Testing: Practices, Policies, and Outcomes
ERIC Educational Resources Information Center
Barton, Lisette; Willson, Pamela; Langford, Rae; Schreiner, Barbara
2014-01-01
The aims of this study were to describe current policy practice related to the use of the HESI™ Exit Exam in schools of nursing and to determine which policies result in higher HESI Exit Scores. Deans and directors of nursing schools that administered Elsevier HESI Exit Exam to students during the 2010 academic year were queried. Data were…
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The role of quality assurance in future midwifery practice.
Dawson, J
1993-08-01
Recent recommendations have been made which would give midwives a more central role in maternity care and a greater degree of independence than they currently enjoy. This paper argues that midwives' current attitudes to quality assurance are incompatible with this enhanced role. Research conducted in three health districts is described, which explored the perceptions of nurses, midwives and managers towards quality assurance. The findings indicate that quality assurance (in whatever form that concept is operationalized) is a demonstration of accountability. For managers this accountability is primarily for the service as a whole, whilst nurses and midwives view their accountability as being owed to patients/clients. The main methodology which the study identified as being used for monitoring nursing care was the development and auditing of explicit standards. This approach has been actively promoted by the Royal College of Nursing, enabling nurses to regain control of the purely professional aspects of the nursing profession. Midwives in the study districts showed a marked reluctance to adopt such a strategy, taking the view that as independent practitioners consensus standards would be unacceptable. It is argued that this attitude is inconsistent with the basic principle that professionals are accountable for both demonstrating and developing the quality of professional practice. It is further suggested that midwives currently have an opportunity to regain professional control of midwifery practice, which will be lost unless they are prepared to take responsibility for evaluating the standards for which they are accountable.
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A case study exploring the current issues faced by diploma-prepared nurses.
Droskinis, Amy
2013-01-01
Nursing is a dynamic and rapidly progressing field. As the profession changes over time, it is vital to study how these transformations influence the workforce. In this study, the aim was to explore how diploma-prepared nurses are functioning in the acute care setting and how modifications in educational requirements and technological advancement have affected their nursing practice.
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Graduate education in geropsychiatric nursing: findings from a national survey.
Kurlowicz, Lenore H; Puentes, William J; Evans, Lois K; Spool, Monda M; Ratcliffe, Sarah J
2007-01-01
By 2030, the numbers of older adults with mental illness will strain our health care system. Sufficient advanced practice nurses (APNs) with specialized knowledge to provide care will be critical. All 339 graduate nursing programs in the US were surveyed regarding the extent and nature of geropsychiatric nursing (GPN) content in their curricula. Of 206 schools responding, 15 reported having a GPN subspecialty. Regarding the 60 schools with a psychiatric/mental health nursing (PMHN) graduate program, only one third (n = 23) included some GPN content, while more than half (n = 116) of all schools reported integration of GPN content in a non-psychiatric nurse practitioner program. Thus, currently, the greatest numbers of APNs receiving education on mental health needs of older adults are prepared in non-psychiatric nurse practitioner programs. This article discusses the implications for nursing education and practice.
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Linder, Lauri
2010-01-01
As the scope of pediatric hematology and oncology nursing expands, nurses are challenged with staying current in the evidence guiding their practice. Nurse-reported barriers to accessing and utilizing research include lack of time as well as difficulty in accessing, understanding, and synthesizing findings. Journal clubs provide a process to guide nurses in the review of current literature related to their practice and promote utilization of research and evidence-based practice among nurses. This article describes the transition of an in-person journal club to an electronically delivered "Article of the Month." The "Article of the Month" is offered six times each year and is posted on the service line's password-protected intranet website. Oversight of the "Article of the Month" is provided by the service line clinical nurse specialist who selects articles based on an annual learning needs assessment and develops a quiz to assess learning and promote critical thinking among nursing staff. Outcomes include anecdotal reports of increased staff confidence in managing emergent patient care needs and greater appreciation of nursing care issues for children with cancer. Areas for future development include exploring options for increasing in-person discussion of issues addressed in the "Article of the Month" among staff members, extending the "Article of the Month" to nurses in other service areas who care for children with cancer, and increasing staff participation in article selection and quiz item development. An ultimate goal is to develop formal evaluation strategies to link this educational strategy to clinical outcomes.
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Kopp, Mary K; Hornberger, Cynthia
2008-02-01
Additional efforts are needed to assist public health, school, and clinic-based pediatric nurses in identifying the prevalence of obesity among Kansas Medicaid-eligible children, 21 years or younger. A Proper Exercise and Nutrition (PEN) tool kit was mailed to 500 public health nurses who performed KAN Be Healthy (KBH) assessments. KBH nurses were provided an expanded training curriculum on growth, nutrition, and obesity along with appropriate screening tools. Nurses were surveyed about their current assessment practices and general knowledge of obese clients. After the PEN tool kit distribution, nurses reported an increased use of screening tools and standardized referral parameters. This program intervention was successful in changing nursing practice, resulting in evidence-based understanding of obesity screening and assessment.
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Revisiting nurse turnover costs: adjusting for inflation.
Jones, Cheryl Bland
2008-01-01
Organizational knowledge of nurse turnover costs is important, but gathering these data frequently may not always be feasible in today's fast-paced and complex healthcare environment. The author presents a method to inflation adjust baseline nurse turnover costs using the Consumer Price Index. This approach allows nurse executives to gain current knowledge of organizational nurse turnover costs when primary data collection is not practical and to determine costs and potential savings if nurse retention investments are made.
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Bender, Miriam
2018-04-10
Jacqueline Fawcett's nursing metaparadigm-the domains of person, health, environment, and nursing-remains popular in nursing curricula, despite having been repeatedly challenged as a logical philosophy of nursing. Fawcett appropriated the word "metaparadigm" (indirectly) from Margaret Masterman and Thomas Kuhn as a devise that allowed her to organize then-current areas of nursing interest into a philosophical "hierarchy of knowledge," and thereby claim nursing inquiry and practice as rigorously "scientific." Scholars have consistently rejected the logic of Fawcett's metaparadigm, but have not yet proposed a substantially agreed-upon alternative. Through an analysis of articles introducing and critiquing Fawcett's metaparadigm, I argue for a re-conceptualized metaparadigm that articulates nursing's ontology. What exists for the nursing discipline are not already-demarcated metaparadigm domains, but rather interdependent, dynamic relations that constitute people, including nurses, in their health/environment circumstance. The nursing discipline aims to skillfully access this dynamic relationality as the basis for action and reflection to produce both positive health trajectories and knowledge that facilitates future action and reflection. Further inquiry into the onto-epistemology of nursing will produce a more robust understanding of nursing practice, science, and philosophy, and clarify its unique contribution to health and healthcare. © 2018 John Wiley & Sons Ltd.
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Ellerbe, Suellyn; Regen, Debra
2012-01-01
The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates.
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Knowing for Nursing Practice: Patterns of Knowledge and Their Emulation in Expert Systems
Abraham, Ivo L.; Fitzpatrick, Joyce J.
1987-01-01
This paper addresses the issue of clinical knowledge in nursing, and the feasibility of emulating this knowledge into expert system technology. The perspective on patterns of knowing for nursing practice, advanced by Carper (1978), serves as point of departure. The four patterns of knowing -- empirics, esthetics, ethics, personal knowledge -- are evaluated as to the extent to which they can be emulated in clinical expert systems, given constraints imposed by the current technology of these systems.
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Vital signs monitoring to detect patient deterioration: An integrative literature review.
Mok, Wen Qi; Wang, Wenru; Liaw, Sok Ying
2015-05-01
Vital signs monitoring is an important nursing assessment. Yet, nurses seem to be doing it as part of a routine and often overlooking their significance in detecting patient deterioration. An integrative literature review was conducted to explore factors surrounding ward nursing practice of vital signs monitoring in detecting and reporting deterioration. Twenty papers were included. The structural component of a Nursing Role Effectiveness Model framework, which comprises of patient, nurse and organizational variables, was used to synthesize the review. Patient variables include signs of deterioration displayed by patients which include physical cues and abnormal vital signs. Nursing variables include clinical knowledge, roles and responsibilities, and reporting of deteriorating vital signs. Organizational variables include heavy workload, technology, and observation chart design. This review has highlighted current nursing practice in vital signs monitoring. A myriad of factors were found to surround ward practice of vital signs monitoring in detecting and reporting deterioration. © 2015 Wiley Publishing Asia Pty Ltd.
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Twenty years of staffing, practice environment, and outcomes research in military nursing.
Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski
Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.
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An evidence based approach to undergraduate physical assessment practicum course development.
Anderson, Brenda; Nix, Elizabeth; Norman, Bilinda; McPike, H Dawn
2014-05-01
Physical assessment is an important component of professional nursing practice. New nurse graduates experience difficulty transitioning the traditional head to toe physical assessment into real world nursing practice. This study was conducted to provide current data concerning physical assessment competencies utilized consistently by registered nurses. This quantitative study used a 126 item survey mailed to 900 Registered Nurses. Participants used a Likert-type scale to report frequency of use for physical assessment competencies. Thirty seven competencies were determined to be essential components of the physical assessment, 18 were determined supplemental, and 71 were determined to be non-essential. Transition of the new graduate nurse into professional practice can be enhanced by focusing content in physical assessment practicum courses on the essential competencies of physical assessment. Faculty for the university has analyzed data from this study to support evidence based changes to the undergraduate nursing program physical assessment practicum course. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Operationalizing a Nursing Innovation Center Within a Health Care System.
Albert, Nancy M
In nursing, the terms "innovation" and "innovative" are used freely, especially when individuals or groups either develop something new or improve upon current practice. Innovation is often considered adjunct work, not part of foundational work that aims to meet the vision, mission, and values of the organization. Nurse leaders must include innovation as an important theme of this foundational work. Innovation must become a core expectation of all nurses and nursing team members. Team members can provide ideas that lead to innovations. They can also carry out roles that enhance or cultivate ideas, promote prototyping, ensure innovative ideas are efficacious and effective, and facilitate dissemination and diffusion into practice. To ensure that innovation is incorporated as part of nursing practice and then sustained over time, horizontal (elemental) and vertical (global) infrastructure and processes are needed. In this article, operationalization of a Nursing Innovation Center is described and rationale for specific horizontal and vertical services and features is discussed.
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The impact of funding changes on the implementation of primary health care policy.
Finlayson, Mary P; Sheridan, Nicolette F; Cumming, Jacqueline M; Fowler, Sandra
2012-04-01
To ascertain how new funding arrangements, introduced in New Zealand's 2001 Primary Health Care (PHC) Strategy, have impacted on the expansion of nurses' role in general practice. Nurses are central to the new policy that was designed to improve the health status of New Zealanders and reduce inequalities in health. Nurses were to be a crucial part of the PHC team, expanding their current roles to provide increased access to appropriate services. This paper investigates how the new funding arrangements, introduced as part of the policy, have impacted on the expansion of nurses' roles and consequently the realisation of the policy goals. Semi-structured interviews were undertaken with 128 key stakeholders five years after the introduction of the PHC Strategy, and surveys were completed by practice nurses, general practitioners and practice managers in purposively selected practices within the 20 participating Primary Health Organisations. There has been substantial growth in the development of nursing roles for some nurses in general practice; however, this expansion has not been universal and one of the main reasons for this is the way funding devolves at the practice level. One of the consequences of the policymakers not taking into account the business model of the majority of general practices, is the resulting overarching goal of the strategy not being realised, and inequalities in health status remaining.
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Moments of speaking and silencing: Nurses share their experiences of manual handling in healthcare.
Kay, Kate; Evans, Alicia; Glass, Nel
2015-01-01
Nursing care involves complex patient handling tasks, resulting in high musculoskeletal injury rates. Epidemiological studies from the 1980s estimated a lifetime prevalence of lower back injuries for nurses between 35 and 80%. National and international studies continue to mirror these findings. Despite the development of programs intended to reduce manual handling injuries, sustainable solutions remain elusive. This paper reports on a study of nurses speaking about their perspectives on current manual handling practices. Qualitative research conducted in 2012 investigated nurses' perceptions and experiences relating to manual handling in the healthcare context and their participation in injury prevention programs. There were two research methods: semi-structured interviews and researcher reflective journaling. The research was framed in critical emancipatory methodology. Thirteen nurses from two Australian states participated in the study. Thematic analysis revealed an overarching theme of 'power relations' with a subcategory of '(mis)power' that comprised two subthemes, these being 'how to practice' and 'voicing practice issues'. Specifically, this paper explores nurses verbalising their views in the workplace and responses which left them feeling silenced, punished and disillusioned. The findings suggest that the sociopolitical context within which nurses practice impacts upon their ability to voice concerns or ideas related to manual handling. Inclusion of nurses in the manual handling dialogue may generate an expanded understanding of, and the potential to transform, manual handling practices in healthcare environments.
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Pain assessment in children: theoretical and empirical validity.
Villarruel, A M; Denyes, M J
1991-12-01
Valid assessment of pain in children is foundational for both the nursing practice and research domains, yet few validated methods of pain measurement are currently available for young children. This article describes an innovative research approach used in the development of photographic instruments to measure pain intensity in young African-American and Hispanic children. The instruments were designed to enable children to participate actively in their own care and to do so in ways that are congruent with their developmental and cultural heritage. Conceptualization of the instruments, methodological development, and validation processes grounded in Orem's Self-Care Deficit Theory of Nursing are described. The authors discuss the ways in which the gaps between nursing theory, research, and practice are narrowed when development of instruments to measure clinical nursing phenomena are grounded in nursing theory, validated through research and utilized in practice settings.
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LPN perspectives of factors that affect nurse mobility in Canada.
Harris, Alexandra; Hall, Linda McGillis; Price, Sheri; Lalonde, Michelle; Andrews, Gavin; MacDonald-Rencz, Sandra
2013-01-01
Although the licensed practical nurse (LPN) workforce represents an ever-growing and valuable human resource, very little is known about reasons for practical nurse mobility. The purpose of this study was to describe LPN perspectives regarding motives for inter-provincial/territorial (P/T) movement in Canada. Participants included 200 LPNs from nine P/T, and data were analyzed using a qualitative descriptive approach. Three primary themes were identified regarding motivators for LPN migration, including (a) scope of practice, (b) education and advancement opportunities and (c) professional respect and recognition. Although current economic forces have a strong influence on nurse mobility, these findings emphasize that there are other equally important factors influencing LPNs to move between jurisdictions. As such, policy makers, administrators and researchers should further explore and address these themes in order to strengthen Canada's nursing workforce.
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Anderson, Lori S; Enge, Karmin J
2012-10-01
School nurses care for children with a variety of health-related conditions and they need information about managing these conditions, which is accessible, current, and useful. The goal of this literature review was to gather and synthesize information on technology-supported resources and to determine which met the educational needs of school nurses. Successful online educational programs were interactive and self-directed. The most common barriers were lack of time to find educational information, lack of knowledge about computers, technology, the Internet and specific programs, and lack of administrative support from school officials to use technology to access information and evidence for practice. Recommendations for successful use of technology to meet practicing school nurse's educational needs are offered.
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Case management: developing practice through action research.
Smith, Annetta; Mackay, Seonaid; McCulloch, Kathleen
2013-09-01
This article is a report of an action research study carried out with community nurses to help develop case management within their practice. Using action research principles, nurses reviewed and analysed their current practice and developed recommendations for further embedding case management as a means of supporting patients with complex care needs in their own homes. Findings indicate that a number of factors can influence the community nurse's ability to implement case management. These factors include approaches to case finding, availability of resources and interprofessional working. Important considerations for nurses were the influence of the context of care, the geographical location and the health needs of the local patient population, which meant that case management may need to be adapted to meet local circumstances.
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Rohde, Emily; Domm, Elizabeth
2018-02-01
To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that supports safe medication practice. There was minimal evidence clearly articulating nurses' clinical reasoning used to support medication safety. This review focused on finding evidence of nurses' clinical reasoning that supported safe medication administration. © 2017 John Wiley & Sons Ltd.
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A curriculum vitae that gives you a competitive edge.
Hinck, S M
1997-07-01
All nurses with advancing careers should maintain a current curriculum vitae (CV) to chronicle professional accomplishments. Whatever the work setting, a CV can showcase skills and achievements. It is used when applying for a new position, but also within one's current situation to inform other professionals of specific interests and abilities. This article reviews nursing literature regarding preparation of a CV and suggests a format for the advanced practice nurse to use when writing a CV.
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Factors influencing organizational participation in the Clinical Nurse Leader project.
Sherman, Rose O
2008-01-01
When the American Association of Colleges of Nursing introduced the Clinical Nurse Leader"s (CNL) pilot project in 2004, it was the first time in more than 40 years that an attempt was made to introduce a new role to the profession. This new role was designed to address many challenges related to patient care in the current health care delivery system including a need for more effective clinical problem solving, better coordination at the point of care, stronger interdisciplinary relationships, and more rapid implementation of evidenced-based practice findings at the patient-provider interface. Critics from both academic and practice settings have questioned the need and wisdom of introducing a new role to the profession at this time. The factors that led some nursing leaders in early stages of this project to be proactive and involve their organizations as early adopters of the CNL role were examined in this study. Five major factors were identified from the research to form a framework designed to explain organizational participation: organizational needs, a desire to improve patient care, an opportunity to redesign care delivery, the promotion of the professional development of nursing staff, and the potential to enhance physician-nurse relationships. The ability of academic and service partners to forge the types of relationships and promote best practices as is occurring in the CNL project may be a critical success factor in confronting the current and impending nursing shortage.
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Lynn, Andrew; Brownie, Sonya
2015-01-01
The aim of this study was to obtain Perioperative Nurse Surgeon's Assistants' views about their emerging new role in contemporary nursing practice in Australia. Internationally advanced practice nursing has led to a range of specialist roles aimed at delivering higher quality, efficient nursing care. In 2005 an Australian university developed the Perioperative Nurse Surgeon's Assistant graduate education and training program to provide nurses with an opportunity to gain advanced practice knowledge and extended skills specifically in the perioperative setting. This study was a qualitative research design that used online surveys and in-depth interviews to explore the issues and challenges associated with the introduction of the (currently non-accredited) Perioperative Nurse Surgeon's Assistant role in Australia. Experienced Australia perioperative nurses who had undertaken graduate education and training in this field were recruited for this study. Data were collected between August and October 2011. An inductive thematic analysis was used to interpret the findings. Eighteen nurses completed the online survey and six were interviewed (n = 24). Nurses cited their commitment to professional development and the delivery of high quality patient care, along with surgeons' encouragement for them to complete specialist clinical training, as key reasons for undertaking Perioperative Nurse Surgeon's Assistant education and training. The Perioperative Nurse Surgeon's Assistant role led to greater job satisfaction and autonomy, and assisted nurses to better meet the needs of patients, surgeons and clinical perioperative teams. Without formal recognition of the Perioperative Nurse Surgeon's Assistant role its future in the Australian health care system is under threat.
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Osman, Ibrahim H; Berbary, Lynn N; Sidani, Yusuf; Al-Ayoubi, Baydaa; Emrouznejad, Ali
2011-10-01
The appraisal and relative performance evaluation of nurses are very important and beneficial for both nurses and employers in an era of clinical governance, increased accountability and high standards of health care services. They enhance and consolidate the knowledge and practical skills of nurses by identification of training and career development plans as well as improvement in health care quality services, increase in job satisfaction and use of cost-effective resources. In this paper, a data envelopment analysis (DEA) model is proposed for the appraisal and relative performance evaluation of nurses. The model is validated on thirty-two nurses working at an Intensive Care Unit (ICU) at one of the most recognized hospitals in Lebanon. The DEA was able to classify nurses into efficient and inefficient ones. The set of efficient nurses was used to establish an internal best practice benchmark to project career development plans for improving the performance of other inefficient nurses. The DEA result confirmed the ranking of some nurses and highlighted injustice in other cases that were produced by the currently practiced appraisal system. Further, the DEA model is shown to be an effective talent management and motivational tool as it can provide clear managerial plans related to promoting, training and development activities from the perspective of nurses, hence increasing their satisfaction, motivation and acceptance of appraisal results. Due to such features, the model is currently being considered for implementation at ICU. Finally, the ratio of the number DEA units to the number of input/output measures is revisited with new suggested values on its upper and lower limits depending on the type of DEA models and the desired number of efficient units from a managerial perspective.
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Is anybody listening? A qualitative study of nurses' reflections on practice.
Huntington, Annette; Gilmour, Jean; Tuckett, Anthony; Neville, Stephen; Wilson, Denise; Turner, Catherine
2011-05-01
To explore nurses' perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work-life balance and health of nurses. Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint. Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses. Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around 'care' as the organising construct. Four themes emerged: 'embodied care' which discusses the impact of work on the nurse's physical and emotional health; 'quantity/quality care' which addresses increasing pressures of work and ability to provide quality care; 'organisational (non)care' raising the seeming lack of support from management; and '(un)collegial/self care' where bullying and professional relationships were raised. Issues raised by participants have been discussed in the nursing literature for several years yet nurses still experience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory-practice gap, resulting in nurses intending to leave the profession. Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care. © 2011 Blackwell Publishing Ltd.
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Adhikari, Radha; Tocher, Jennifer; Smith, Pam; Corcoran, Janet; MacArthur, Juliet
2014-02-01
Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in pharmacological knowledge to junior nursing staff and pre-registration nursing students. This paper argues that the 'five rights' principle during medication administration is not enough for holistic medication safety and explains two reasons why there is a need for strengthened multi-disciplinary team-work to achieve greater patient safety. To accomplish this, nurses need to have sufficient knowledge of pharmacology and medication safety issues. These findings have important educational implications and point to the requirement for the incorporation of medication management and pharmacology in to the teaching curriculum for nursing students. There is also a call for continuing professional development opportunities for nurses working in clinical settings. © 2014.
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Bergström, Peter; Lindh, Viveca
2018-01-01
This paper reports on a research study conducted with a group of nurses in Sweden enrolled in a newly developed blended learning master's programme to become advanced practice nurses (APNs). As background, the paper presents the regional needs the programme is intended to address and describes how the programme was designed. The aim was to understand how, from students' perspective, the nurse master's programme structured knowledge for their future position as APNs. The research question focuses on how the master's programme prepares students by meeting their diverse needs for knowledge. Empirical material was collected at two times during the students' first and second years of study through semi-structured qualitative interviews. The findings highlight the process in which these master's students gained a more advanced identity of becoming APNs. This process demonstrates how students perceive their current position as nurses based on a discourse of knowledge in relation to the practical and theoretical knowledge they encounter in the master's programme. This article concludes by recommending that attention should be paid to developing APN role models in the current Swedish healthcare system. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Updating the definition and role of public health nursing to advance and guide the specialty.
Bekemeier, Betty; Walker Linderman, Tessa; Kneipp, Shawn; Zahner, Susan J
2015-01-01
National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. © 2014 Wiley Periodicals, Inc.
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Educating Nurses in the United States about Pressure Injuries.
Ayello, Elizabeth A; Zulkowski, Karen; Capezuti, Elizabeth; Jicman, Wendy Harris; Sibbald, R Gary
2017-02-01
To provide information about the current state of educating nurses about wound care and pressure injuries with recommendations for the future. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Discuss the importance of pressure injury education and wound care for nurses and identify the current state of nursing education on the subject. 2. Identify strategies that can be used to put improved wound care and pressure injury education into practice. Wound care nursing requires knowledge and skill to operationalize clinical guidelines. Recent surveys and studies have revealed gaps in nurses' knowledge of wound care and pressure injuries and their desire for more education, both in their undergraduate programs and throughout their careers. Data from baccalaureate programs in the United States can pinpoint areas for improvement in nursing curriculum content. Lifelong learning about wound care and pressure injuries starts with undergraduate nursing education but continues through the novice-to-expert Benner categories that are facilitated by continuing professional development. This article introduces a pressure injury competency skills checklist and educational strategies based on Adult Learning principles to support knowledge acquisition (in school) and translation (into clinical settings). The responsibility for lifelong learning is part of every nurse's professional practice.
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The meaning of empowerment within Italian nursing care settings.
Rega, Maria Luisa; Diano, Pasquale; Damiani, Gianfranco; De Vito, Corrado; Galletti, Caterina; Talucci, Carlo
2017-11-01
To examine the current state of empowerment of nurses in Italy. Empowerment is a broad concept that is also relevant to the field of nursing practice. Its comprehension and use are important because empowerment allows nurses to take control of their own practice. A clear understanding of empowerment is necessary for nurses to take advantage of this important tool. Focus groups were conducted. A literature review was performed, and two focus groups were selected between January and February 2014. Sixteen nurses participated in the research. Empowerment is seen as being strongly connected to autonomy and is not associated with power, as the word itself suggests. Italian nurses define empowerment as the creation of conditions that help to establish the possibility for people to develop and express their value and potential. Empowerment is defined as a condition in which the individual nurse takes control of his/her own practice and thereby provides awareness and confidence to a group. Italian nurses need to feel appreciated and supported by their own organisations. If warranted, empowerment would allow them to contribute to enhance care, which is the core of the nursing profession. © 2017 John Wiley & Sons Ltd.
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Situational Transitions and Military Nurses: A Concept Analysis Using the Evolutionary Method.
Chargualaf, Katie A
2016-04-01
Situational transitions in nursing remain a significant issue for both new graduates and experienced nurses. Although frequently discussed in current nursing literature, nursing research has exclusively focused on the transition experience of civilian (nonmilitary) nurses. With differing role and practice expectations, altered practice environments, and the risk of deployment, the outcome of negative transition experiences for military nurses is significant. The purpose of this analysis is to clarify the concept of transition, in a situational context, as it relates to military nurses by investigating the attributes, antecedents, and consequences. Rodgers' evolutionary method served as the framework to this study. The sample included 41 studies, published in English, between 2000 and 2013. Data were retrieved from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, ProQuest, Ovid, and PsycINFO databases. Antecedents of situational transitions include any change in work roles or work environments. Attributes of situational transitions include journey, disequilibrium, finding balance, conditional, and pervasive. Consequences of transition range from successful to unsuccessful. Additional research that investigates the specific needs and challenges unique to nurses practicing in a military environment is needed. © 2015 Wiley Periodicals, Inc.
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Hawai‘i's Nursing Workforce: Keeping Pace with Healthcare
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
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In Health-Related Tasks, Where Does the School Nurse Function?
ERIC Educational Resources Information Center
Berg, Beryl; And Others
1973-01-01
The study provided a composite picture of health-related tasks performed in one school district. Nurses were able to evaluate their current practices and recommend specific improvements in nursing actions. Other school districts seeking a profile of their involvement in health-related tasks may request copies of the questionnaire or the entire…
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5-years later - have faculty integrated medical genetics into nurse practitioner curriculum?
Maradiegue, Ann H; Edwards, Quannetta T; Seibert, Diane
2013-10-31
Abstract Many genetic/genomic educational opportunities are available to assist nursing faculty in their knowledge and understanding of genetic/genomics. This study was conducted to assess advance practice nursing faculty members' current knowledge of medical genetics/genomics, their integration of genetics/genomics content into advance practice nursing curricula, any prior formal training/education in genetics/genomics, and their comfort level in teaching genetics/genomic content. A secondary aim was to conduct a comparative analysis of the 2010 data to a previous study conducted in 2005, to determine changes that have taken place during that time period. During a national nurse practitioner faculty conference, 85 nurse practitioner faculty voluntarily completed surveys. Approximately 70% of the 2010 faculty felt comfortable teaching basic genetic/genomic concepts compared to 50% in 2005. However, there continue to be education gaps in the genetic/genomic content taught to advance practice nursing students. If nurses are going to be a crucial member of the health-care team, they must achieve the requisite competencies to deliver the increasingly complex care patients require.
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Long, Tony; Hale, Claire; Sanderson, Linda; Tomlinson, Peter; Carr, Kristina
2008-02-01
This paper reports the findings of a study which was carried out to evaluate the educational preparation of cancer and palliative care nurses in England. The study was carried out in three stages and covered the following areas; documentary analysis of curriculae, assessment of practice, patients and professionals views of threshold and expert practice. The findings suggested that although there was widespread compliance with a national standard for cancer nursing, this was not the case for palliative care nursing. There was uncertainty about what should be assessed in practice and ambiguity about what was actually assessed. Partnership with children and their parents, clinical skills, multi-disciplinary working, and personal attributes were the main foci for expectations of threshold practice but an expert panel had difficulty in describing the attributes of higher level practice. The paper also describes how some of recommendations from the study are being taken forward in current policy and practice.
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Just Care: Learning from and with Graduate Students in a Doctor of Nursing Practice Program
ERIC Educational Resources Information Center
Boquet, Elizabeth; Kazer, Meredith; Manister, Nancy; Lucas, Owen; Shaw, Michael; Madaffari, Valerie; Gannett, Cinthia
2015-01-01
In 2010, Fairfield University, a Jesuit Carnegie Masters Level 1 University located in the Northeast, established its first doctoral-level program: the Doctorate of Nursing Practice (DNP). In a developing program such as the DNP, some of the most pressing concerns of current rhetoric and writing in the disciplines align and interact with the…
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Forster, Marc
2013-10-01
Information Literacy is essential to 'evidence-based practice'; without the ability to locate evidence, evidence-based practice is rendered extremely difficult if not impossible. There is currently little evidence to show how Information Literacy is experienced by nurses or what its parameters are within evidence-based practice and therefore whether Information Literacy educational interventions are actually promoting the correct knowledge and skills. Using phenomenographic interviews the author will attempt to discover how nurses experience Information Literacy. Insights from the findings will be used to map out its parameters and to put forward a theoretical model for a course or module to develop it effectively. This article presents preliminary findings, including 7 draft categories of description of how Information Literacy is experienced in nursing. This pilot study indicates that the complete findings may be of significant potential value in the promotion and development of Information Literacy education in nursing. It is argued that such insights into how nurses actually experience the phenomenon of Information Literacy can be used to develop potentially more effective, research-based, educational interventions. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Computers and information technologies in psychiatric nursing.
Repique, Renee John R
2007-04-01
There is an assumption that psychiatric nurses are late adopters of technology because psychiatric nursing has been traditionally viewed as a nontechnological nursing specialty. This article will review current nursing literature to outline the value and significance of computers and information technologies to psychiatric nursing. Existing bodies of research literature related to computers and information technology for psychiatric nurses. Three areas of psychiatric nursing are identified and the specific advantages and benefits of computers and information technologies in each of these areas are discussed. In addition, the importance of informatics competencies for psychiatric nursing practice is reiterated in order to accelerate its acquisition.
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Du, Na; Guo, Chenglin; Yang, Mei; Ji, Yanli; Wang, Wei; Li, Jie; Li, Chuan; Liu, Lunxu; Che, Guowei
2017-03-20
Though the concept of enhanced recovery after surgery (ERAS) has been progressively known by the surgeons and applied clinically, the current status of its cognition among thoracic surgeons and application in thoracic surgery is still unknown. Based on the analysis of a survey of thoracic surgeons and nurses on chest ERAS during a national conference, we aimed to analyze the status and difficulties of the application of ERAS in thoracic surgery. A total of 773 questionnaires were collected during the first West China chest ERAS Forum and analyzed. The content of the questionnaire can be divided into two parts, including the respondents' institute and personal information, 10 questions on ERAS. (1) Current status of clinical application of ERAS is the concept rather than the practice: 69.6% of the surgeons and 58.7% of the nurses agreed with this view; in addition, 88.5% of the doctors and 85.7% of the nurses believed that the concept of ERAS may be applicable to every branches of surgery; (2) 55.6% of the doctors and 69.1% of the nurses believed that the reason of poor clinical application of ERAS included no mature procedure, lack of consensus and specifications; (3) The best team for the clinical practice of ERAS should be based on surgeon-centered multidisciplinary cooperation and integration of medical care: 62.1% of the surgeons and 70.7% of nurses agreed with this view; (4) 73.7% of the surgeons and 81.9% of the nurses agreed that mean hospital stay, patients' experience in hospital and social satisfaction should be the evaluation standard of ERAS practice. The application of ERAS in thoracic surgery is still the concept rather than the practice. The reason included the lack of clinical applicable specifications and scheme.
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Using mass media within health-promoting practice: a nursing perspective.
Whitehead, D
2000-10-01
For some time health professionals have recognized the growing importance of utilizing mass media strategies as part of their health-promoting practice. The ever-evolving climate of technology and increasing reliance on mass communications has further reinforced the position of mass media initiatives. The enormous potential for mass media resources to reach certain audiences and influence their health-related behaviours has become particularly well established. Despite these facts, however, it is argued that the nursing profession has been less than pro-active in acknowledging, accommodating and adopting such practices. Consequently, the incorporation of health-related mass media initiatives into nursing's health-promotional role remains an elusive exercise. The maintenance of such a position, it is claimed, is potentially damaging for the profession as a whole. In light of this state of affairs, this paper seeks to review the literature surrounding the nature and processes of mass media strategies, their relevance to health promotion and nursing, how they are currently utilized and how they can be incorporated further into nursing practice. In conclusion, it is argued that nursing should seek to become a more active user of mass communication/media technology--especially in relation to its health-promotional practices.
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Advanced nursing training in health policy: designing and implementing a new program.
Harrington, Charlene; Crider, Mark C; Benner, Patricia E; Malone, Ruth E
2005-05-01
Although the nursing profession has a growing role in the health policy arena, the rapidly changing health care environment means that clinicians need a sophisticated understanding of health policy. Nurses are assuming leadership roles in advocacy, research, analysis, and policy development, implementation, and evaluation, contributing to a growing need to educate nurses to specialize in health policy research and analysis. This article provides an overview of a new master's and doctoral educational program specializing in health policy for advanced practice nurses who are culturally diverse and sensitive to issues of diversity. The program, currently in its third year of operation at the University of California San Francisco, School of Nursing, is addressing the gap in nursing education and practice expertise in health policy. The program is supported through funding by the Department of Health and Human Services Health Resources and Services Administration, Advanced Nurse Training program.
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A comparison of policies on nurse faculty workload in the United States.
Ellis, Peggy A
2013-01-01
This article describes nurse faculty workload policies from across the nation in order to assess current practice. There is a well-documented shortage of nursing faculty leading to an increase in workload demands. Increases in faculty workload results in difficulties with work-life balance and dissatisfaction threatening to make nursing education less attractive to young faculty. In order to begin an examination of faculty workload in nursing, existing workloads must be known. Faculty workload data were solicited from nursing programs nationwide and analyzed to determine the current workloads. The most common faculty teaching workload reported overall for nursing is 12 credit hours per semester; however, some variations exist. Consideration should be given to the multiple components of the faculty workload. Research is needed to address the most effective and efficient workload allocation for nursing faculty.
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Austin, Wendy J
2011-07-01
Corporate and commercial values are inducing some healthcare organizations to prescribe a customer service model that reframes the provision of nursing care. In this paper it is argued that such a model is incommensurable with nursing conceived as a moral practice and ultimately places nurses at risk. Based upon understanding from ongoing research on compassion fatigue, it is proposed that compassion fatigue as currently experienced by nurses may not arise predominantly from too great a demand for compassion, but rather from barriers to enacting compassionate care. These barriers are often systemic. The paradigm shift in which healthcare environments are viewed as marketplaces rather than moral communities has the potential to radically affect the evolution of nursing as a discipline. © 2011 Blackwell Publishing Ltd.
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Community mental health nurses' perspectives of recovery-oriented practice.
Gale, J; Marshall-Lucette, S
2012-05-01
Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery. © 2011 Blackwell Publishing.
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Spectators & spectacles: nurses, midwives and visuality.
Barnard, Alan G; Sinclair, Marlene
2006-09-01
In this paper we reflect on how linear perspective vision influences the practice of nurses and midwives and to advance understanding of clinical practice in technologically intensive environments through examination of drawings by nurses and midwives and through critical analysis. There is increasing emphasis on vision in Western culture, and both nurses and midwives spend a great deal of time observing their clinical environment(s). Healthcare practitioners work increasingly in image-based realities and nurses rely on visual skills. Vision and visual representation are central to our practice and are important to examine because we look often at technology to assess people and care. The world in which we practise is one of meaning(s). Technological development is transformative in nature and produces changes that alter the way(s) we give care. Amongst all this change, it is unclear how we practise in environments characterized by increasing technology and it is unknown how nursing and midwifery practice alter as a result. Simple drawings included in this paper highlight an important and shared experience of clinical practice(s). They emphasize the importance and scope of the visual sense and expose practitioner behaviour that has enormous implications for current and future professional development and person-focussed care provision. Experiences described in this paper require further examination and highlight substantial changes to nurse-patient relationships, health care and the way we practise.
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Enhancing nurses' empowerment: the role of supervisors' empowering management practices.
Montani, Francesco; Courcy, François; Giorgi, Gabriele; Boilard, Amélie
2015-09-01
This study tests a theoretical model where: (a) nurses' dispositional resistance to change is indirectly negatively related to behavioural empowerment through the mediating role of psychological empowerment; and (b) supervisors' empowering management practices buffer both the negative relationship between dispositional resistance to change and psychological empowerment and the indirect negative relationship between resistance to change and behavioural empowerment via psychological empowerment. Promoting a high level of empowerment among nursing personnel is important to ensure their effectiveness in the context of organizational change. It is thus essential to advance our current understanding of the factors that hamper nurses' psychological and behavioural expressions of empowerment and to clarify supervisor practices that can overcome such barriers. A cross-sectional research design. We collected survey data during 2012 from a sample of 197 nurses from a Canadian hospital undergoing a major organizational change. Results from moderated mediation analyses provided evidence for an indirect negative relationship between dispositional resistance to change and behavioural empowerment through psychological empowerment, and for a moderating (buffering) effect of supervisors' empowering management practices on this mediated relationship. These findings provided support for our hypotheses. Supervisors' empowering management practices represent an important contextual buffer against the negative effects of dispositional resistance to change on nurses' empowerment. Organizations should develop empowering management skills among nurses' supervisors to counteract the detrimental effects of dispositional resistance to change and to sustain an empowered nursing workforce. © 2015 John Wiley & Sons Ltd.
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McNamara, Martin S
2010-03-01
To elicit the languages of legitimation of senior nursing academics and national leaders and to investigate the extent to which distinctive disciplinary identities and discourses are embedded in them. Over six years after Irish nursing education became established in the higher education sector, an investigation into the disciplinary maturity of the field is overdue. A constructivist-structuralist research design was used; data were elicited by means of naturalistic professional conversations and subjected to critical discourse analytic methods to interrogate their structuring and structured character. The focus here is on the latter. The languages of legitimation of Irish nursing's key disciplinary custodians were elicited and subjected to a critical discourse analysis informed by a theoretical framework that helps to explicate the bases of claims to academic legitimacy embedded in these languages. Clinical practice figures as a problematic component of Irish nursing's academic identity and disciplinary discourse. Yet a focus on clinical practice is seen as central to the autonomy, integrity and distinctiveness of nursing as an academic discipline as well as to the legitimacy and credibility of those who claim to profess it. The overall consensus on the state of academic nursing in Ireland is that of a field characterised by low autonomy, high density, weak specialisation and disciplinary immaturity. The analysis highlights the need for academic nursing to reconfigure its relationships with clinical nursing, increase its intellectual autonomy, enhance its internal coherence, strengthen the epistemic power of its knowledge base and critically evaluate the ways the past should inform current and future practices and identities. The production and dissemination of knowledge for nursing policy and practice provides the foundation for nursing education. If clinical practice is not central to the educational and research activities of nurse academics, the relevance of academic nursing to its professional base and its status and future trajectory as a distinct presence in academia, will continue to be questioned.
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Evidence-based nursing practice: both state of the art in general and specific to pressure sores.
Buss, I C; Halfens, R J; Abu-Saad, H H; Kok, G
1999-01-01
The importance of research-based practice in nursing has been frequently stressed, and a number of nursing studies have been conducted whose results enable nursing to improve knowledge and practice. This study reports a literature review in which the current status of knowledge and research utilization with regard to pressure sores is described. This review first gives an overview of studies on knowledge utilization in general and shows that the spontaneous diffusion of knowledge is inappropriate. Furthermore, an overview of planned research utilization activities focusing on pressure sore prevention and treatment in nursing is presented. The results of these studies show that planned research utilization activities performed in individual organizations lead to positive outcomes in almost all cases. Therefore, it could be concluded that implementing planned research utilization activities in individual health care institutions seems to be an effective strategy to decrease pressure sore incidence and prevalence rates.
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Prescriptive Authority and Nursing: a comparative analysis of Brazil and Canada
Bellaguarda, Maria Lígia dos Reis; Nelson, Sioban; Padilha, Maria Itayra; Caravaca-Morera, Jaime Alonso
2015-01-01
Objective: to analyse the differences between medication prescriptions by nurses in Brazil and Ontario, Canada. Methods: a comparative study between two different scenarios; this comparison was not performed between the two countries because Canada does not standardize this practice, which is legally established and is considered as an advanced professional knowledge area in Brazil. Results: prescription is a professional position to be occupied by nurses. However, there is tension surrounding this practice because it is perceived as a threat to privileges or traditions of other health professionals. Prescibing medication by nurses in Brazil and Ontario follows current legislation and training proccess in each context. Conclusions: there are some challenges to be overcome in ensuring the visibility and consolidation of the practice by nurses in these realities: guarantee of professional competence, credibility, acceptability, and the respectability of clientele in your professional scope by other health professionals. PMID:26625997
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Rational suicide in the terminally ill.
Fontana, Joyce S
2002-01-01
To examine the current debate over the right to die specific to the rational suicide of terminally ill patients. Literature was reviewed for information concerning historical end-of-life practices and the past acceptance of suicide. Another review showed philosophical opinions and perspectives that spanned from ancient Greece and the Roman Empire to modern philosophical discourse. A case study of a terminally ill woman who chose suicide is presented to apply the history and philosophy to nursing care today. As more nursing care is delivered in patients' homes, nurses will face this situation with increasing frequency. A call is made for organizations to provide guidelines for nursing practice.
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Community-based child health nurses: an exploration of current practice.
Borrow, Stephanie; Munns, Ailsa; Henderson, Saras
2011-12-01
The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: More physical resources be allocated to community-based child health nursing More resources allocated to assist community-based child health nurses to support culturally and linguistically diverse families Mapping of child health nurses' workloads The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale Specific staff development opportunities to reflect the increased workload complexity Managerial support for the implementation of formal clinical (reflective) supervision Additional clerical assistance with non-nursing duties.
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Cutting edge technology to enhance nursing classroom instruction at Coppin State University.
Black, Crystal Day; Watties-Daniels, A Denyce
2006-01-01
Educational technologies have changed the paradigm of the teacher-student relationship in nursing education. Nursing students expect to use and to learn from cutting edge technology during their academic careers. Varied technology, from specified software programs (Tegrity and Blackboard) to the use of the Internet as a research medium, can enhance student learning. The authors provide an overview of current cutting edge technologies in nursing classroom instruction and its impact on future nursing practice.
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The virtue of nursing: the covenant of care.
Bradshaw, A
1999-01-01
It is argued that the current confusion about the role and purpose of the British nurse is a consequence of the modern rejection and consequent fragmentation of the inherited nursing tradition. The nature of this tradition, in which nurses were inducted into the moral virtues of care, is examined and its relevance to patient welfare is demonstrated. Practical suggestions are made as to how this moral tradition might be reappropriated and reinvigorated for modern nursing. PMID:10635502
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Sperhac, A M; Goodwin, L D
2000-01-01
As nurses gain more experience, they often question the basis of nursing practice and want to find the most current and accepted methods of providing nursing care. Attending seminars, conferences, and continuing education programs is often difficult because of financial and staffing constraints. The authors describe the design and implementation of two funded programs--the Prince Scholars and Sabbatical Programs--that support continuing nursing education in a pediatric tertiary hospital.
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New, Karen; Bogossian, Fiona; East, Christine; Davies, Mark William
2010-06-01
The incubator environment is essential for optimal physiological functioning and development of the premature infant but the infant is ultimately required to make a successful transfer from incubator to open cot in order to be discharged from hospital. Criteria for transfer lack a systematic approach because no clear, specific guideline predominates in clinical practice. Practice variation exists between continents, regions and nurseries in the same countries, but there is no recent review of current practices utilised for transferring premature infants from incubators to open cots. To document current practice for transferring premature infants to open cots in neonatal nurseries. A descriptive, cross-sectional survey. Twenty-two neonatal intensive care units and fifty-six high dependency special care baby units located in public hospitals in Australia and New Zealand. A sample of 78 key clinical nursing leaders (nurse unit managers, clinical nurse consultants or clinical nurse specialists) within neonatal nurseries identified through email or telephone contact. Data were collected using a web-based survey on practice, decision-making and strategies utilised for transferring premature infants from incubators to open cots. Descriptive statistics (frequencies and crosstabs) were used to analyse data. Comparisons between groups were tested for statistical significance using Chi-squared or Fisher's exact test. Significant practice variation between countries was found for only one variable, nursing infants clothed (p=0.011). Processes and practices undertaken similarly in both countries include use of incubator air control mode, current weight criterion, thermal challenging, single-walled incubators and heated mattress systems. Practice variation was significant between neonatal intensive care units and special care baby units for weight range (p=0.005), evidence-based practice (p=0.004), historical nursery practice (p=0.029) and incubator air control mode (p=0.001). Differences in these variables were also found between nurseries in metropolitan and rural locations. Practice variation exists however; many practices are uniformly performed throughout neonatal nurseries in Australian and New Zealand. Commonality was seen between countries and in nurseries with a neonatal intensive care unit. Variation was significant between neonatal intensive care units and special care baby units and nurseries in metropolitan and rural locations. (c) 2009 Elsevier Ltd. All rights reserved.
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In defense of genuine ignorance: supporting vitality and relevance in graduate curricula.
Goren, S; Peter, L; Fischer, S
1992-01-01
Genuine ignorance, defined by John Dewey as curiosity and openmindedness in opposition to repetition of catch phrases and familiar propositions, is nurtured in graduate nursing curricula in which the educational process is congruent with course content. Preparation for advanced practice in the mental health environment of the foreseeable future required abandonment of the familiar medical model in favor of conceptual models consistent with current thinking in psychiatric nursing and exposure to current problems (homelessness, family violence, AIDS) and current problem solving strategies (brief treatment, family preservation). Involvement in practice-based research and operationalizing new perspectives on familiar clinical problems, are suggested as strategies for developing the advanced practitioner. Two of the authors, former graduate students, describe the impact of changed perspectives and research activity on their own practice.
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Mandate for the Nursing Profession to Address Climate Change Through Nursing Education.
Leffers, Jeanne; Levy, Ruth McDermott; Nicholas, Patrice K; Sweeney, Casey F
2017-11-01
The adverse health effects from climate change demand action from the nursing profession. This article examines the calls to action, the status of climate change in nursing education, and challenges and recommendations for nursing education related to climate change and human health. Discussion paper. The integration of climate change into nursing education is essential so that knowledge, skills, and insights critical for clinical practice in our climate-changing world are incorporated in curricula, practice, research, and policy. Our Ecological Planetary Health Model offers a framework for nursing to integrate relevant climate change education into nursing curricula and professional nursing education. Nursing education can offer a leadership role to address the mitigation, adaptation, and resilience strategies for climate change. An ecological framework is valuable for nursing education regarding climate change through its consideration of political, cultural, economic, and environmental interrelationships on human health and the health of the planet. Knowledge of climate change is important for integration into basic and advanced nursing education, as well as professional education for nurses to address adverse health impacts, climate change responses policy, and advocacy roles. For current and future nurses to provide care within a climate-changing environment, nursing education has a mandate to integrate knowledge about climate change issues across all levels of nursing education. Competence in nursing practice follows from knowledge and skill acquisition gained from integration of climate change content into nursing education. © 2017 Sigma Theta Tau International.
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Psychiatric nurses' beliefs, attitudes, and perceived barriers about medical emergency teams.
Herisko, Camellia; Puskar, Kathryn; Mitchell, Ann M
2013-10-01
A literature review of nurses' attitudes, beliefs, and barriers regarding the medical emergency team (MET) process is limited to medical hospitals. How psychiatric nurses view the MET process and their prior experiences with METs are important because they are often the ones assessing the need for, and then calling, the MET. This article examines psychiatric nurses' attitudes, beliefs, and barriers toward the MET process in a 310-bed psychiatric hospital that is part of an urban academic medical center. Through the use of key informant interviews, nurses were asked for their feedback and input regarding the current MET practices. The results may be useful in improving the current operating system.
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Uncovering the features of negotiation in developing the patient-nurse relationship.
Stoddart, Kathleen; Bugge, Carol
2012-02-01
This article describes a study that set out to explore the interaction between patients and nurses in community practice settings, in order to understand the social meanings and understandings brought to the interaction and at play within it. The study used a grounded theory methodology with traditional procedures. Driven by constant comparative analysis, data were collected by non-participant observation and informal and semi-structured interviews in four community health centres. Eighteen patients and 18 registered practice nurses participated. Negotiation was found to be a fundamental process in patient- nurse interaction. Navigation, socio-cultural characteristics and power and control were found to be key properties of negotiation. The negotiation processes for developing understanding required patients and nurses to draw upon social meanings and understandings generated from within and beyond their current interaction. Social meanings and understandings created within and beyond the health-care setting influence negotiation. The developmental nature of negotiation in interaction is an important dimension of the patient- nurse relationship in community practice.
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Academic dishonesty today, unethical practices tomorrow?
LaDuke, Rebekah D
2013-01-01
The purpose of this article was to review the most current published literature on the topics of academic dishonesty, unethical professional practices, and research that studied the correlation between these 2 areas of interest. Literature was retrieved by utilizing key words such as academic dishonesty, cheating, workplace dishonesty, and unethical behavior. Multiple research databases were used and a reference librarian in locating relevant research studies resulting in 16 research articles reviewed and 7 articles referenced within the literature review. Upon completion, it became apparent that nursing educators should be concerned that nursing students found to be academically dishonest today may have a higher incidence of displaying unethical practices as a registered nurse tomorrow. It also became clear that the nursing profession needs to conduct its own research in this field to verify findings discovered by other professions such as engineering, business, and psychology. Finally, recommendations were given on how nursing educators should handle the topic of ethics in nursing programs. Copyright © 2013 Elsevier Inc. All rights reserved.
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Do calculation errors by nurses cause medication errors in clinical practice? A literature review.
Wright, Kerri
2010-01-01
This review aims to examine the literature available to ascertain whether medication errors in clinical practice are the result of nurses' miscalculating drug dosages. The research studies highlighting poor calculation skills of nurses and student nurses have been tested using written drug calculation tests in formal classroom settings [Kapborg, I., 1994. Calculation and administration of drug dosage by Swedish nurses, student nurses and physicians. International Journal for Quality in Health Care 6(4): 389 -395; Hutton, M., 1998. Nursing Mathematics: the importance of application Nursing Standard 13(11): 35-38; Weeks, K., Lynne, P., Torrance, C., 2000. Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach. Clinical Effectiveness in Nursing 4, 20-29]; Wright, K., 2004. Investigation to find strategies to improve student nurses' maths skills. British Journal Nursing 13(21) 1280-1287; Wright, K., 2005. An exploration into the most effective way to teach drug calculation skills to nursing students. Nurse Education Today 25, 430-436], but there have been no reviews of the literature on medication errors in practice that specifically look to see whether the medication errors are caused by nurses' poor calculation skills. The databases Medline, CINAHL, British Nursing Index (BNI), Journal of American Medical Association (JAMA) and Archives and Cochrane reviews were searched for research studies or systematic reviews which reported on the incidence or causes of drug errors in clinical practice. In total 33 articles met the criteria for this review. There were no studies that examined nurses' drug calculation errors in practice. As a result studies and systematic reviews that investigated the types and causes of drug errors were examined to establish whether miscalculations by nurses were the causes of errors. The review found insufficient evidence to suggest that medication errors are caused by nurses' poor calculation skills. Of the 33 studies reviewed only five articles specifically recorded information relating to calculation errors and only two of these detected errors using the direct observational approach. The literature suggests that there are other more pressing aspects of nurses' preparation and administration of medications which are contributing to medication errors in practice that require more urgent attention and calls into question the current focus on calculation and numeracy skills of pre registration and qualified nurses (NMC 2008). However, more research is required into the calculation errors in practice. In particular there is a need for a direct observational study on paediatric nurses as there are presently none examining this area of practice.
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Merritt, Alan; Boogaerts, Marina
2014-01-01
Nursing students undertake clinical placements in a wide range of clinical areas as part of their preparation for professional practice, offering students the opportunity to learn about the clinical context and the work that nurses do. This descriptive study explores the implicit learnings that occur for students in a community nursing placement and whether they transfer the knowledge they gain in the community setting into practice in other settings. Participants in this research study described implicit learning from a community nursing context which they were able to utilise in their current practice. Three major themes emerged. Firstly, participants recognised that power relationships manifest differently in a community based setting. This manifest in a recognition of patient autonomy and a creative approach to enhancing the patient's power. The second, related theme involved the enabling of self-determination through collaborative decision making between nurse and the person receiving care. The third theme was the development of an understanding of self-management which manifest in appropriate referrals and what the participants considered high quality discharge planning. This recognition of practice beyond technical, rationalist manifestations suggests that students grasped the unarticulated, implicit dimensions of the community nurse role through their experiences in a community nursing placement.
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Smoking behavior and patient education practices of oncology nurses in six countries.
Lally, Robin M; Chalmers, Karen I; Johnson, Judith; Kojima, Misako; Endo, Emiko; Suzuki, Shizue; Lai, Yeur-Hur; Yang, Young-Hee; Degner, Lesley; Anderson, Elsie; Molassiotis, Alexander
2008-09-01
Worldwide, tobacco is the leading cause of preventable death, resulting in approximately 5 million deaths annually. Nurses are keenly positioned to work toward reducing tobacco-related illness and deaths. Therefore, guided by the health belief model, the purpose of this study was to explore the smoking behavior, beliefs, smoking cessation education practices, and existing smoking policies at the institutions of a sample of practicing oncology nurses in Canada, Japan, Korea, Taiwan, United Kingdom, and the United States. A 27-item structured survey, designed for this study in English and translated and reverse translated by the Asian countries, was distributed to a convenience sample of nurses attending oncology meetings in each country. Totally 759 surveys were completed and analyzed using descriptive statistics. Principle findings indicate that 4.5% of these nurses currently smoke, although 23.3% reported smoking previously. While many nurses (74%) reported frequently assessing the smoking status of patients, only 50% reported discussing cessation with their patients that smoke. Although the majority (80%) reported feeling comfortable with asking their patients about smoking, only 23% felt it was the nurse's role. The findings indicate that while internationally oncology nurses recognize the importance of smoking cessation, significant room for improvement exists in translating this into practice.
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Raup, Glenn H
2008-10-01
Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.
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2014-01-01
Background Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. Methods In the nascence of the expansion of the role of nurses in Australian general practice (2003–2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009–2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Results Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses’ role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses’ role in general practice was slightly decreased over time. Conclusions This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce. PMID:24666420
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Boyer, Susan A; Mann-Salinas, Elizabeth A; Valdez-Delgado, Krystal K
The clinical transition framework (CTF) is a competency-based practice development system used by nursing professional development practitioners to support nurses' initial orientation or transition to a new specialty. The CTF is applicable for both new graduate and proficient nurses. The current framework and tools evolved from 18 years of performance improvement and research projects engaged in both acute and community care environments in urban and rural settings. This article shares core CTF concepts, a description of coaching plans, and a professional accountability statement as experienced within the framework.
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Empowerment: reformulation of a non-Rogerian concept.
Crawford Shearer, Nelma B; Reed, Pamela G
2004-07-01
The authors present a reformulation of empowerment based upon historical and current perspectives of empowerment and a synthesis of existing literature and Rogerian thought. Reformulation of non-Rogerian concepts familiar to nurses is proposed as a strategy to accelerate the mainstreaming of Rogerian thought into nursing practice and research. The reformulation of empowerment as a participatory process of well-being inherent among human beings may provide nurses with new insights for practice. This paper may also serve as a model for reformulating other non-Rogerian concepts and theories for wider dissemination across the discipline.
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Integrating Systems Thinking Into Nursing Education.
Phillips, Janet M; Stalter, Ann M
2016-09-01
A critical need exists for nursing leadership in current complex health care settings. Systems thinking can be incorporated into nursing education at all levels by using evidence-based principles in education. Teaching tips are provided using a systems awareness model to guide nurse educators in the assessment and integration of systems thinking and engaging learners in interprofessional education and practice. J Contin Educ Nurs. 2016;47(9):395-397. Copyright 2016, SLACK Incorporated.
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Meeting the policy agenda, part 1: the role of the modern district nurse.
Dickson, Caroline A W; Gough, Helen; Bain, Heather
2011-10-01
The challenges posed by the current context of health and social care offer opportunities for different models of care delivery. District nursing has evolved, and continues to evolve to meet these challenges. The traditional reactive role of district nursing has developed as contemporary practice expects district nurses to meet both planned and unplanned care required by practice populations. Modern anticipatory care approaches to care are being adopted, while care and case management is being facilitated and delivered to patients and families with complex health and social care needs. Additionally, district nurses are recognizing the need to further develop management and leadership skills as the teams delivering care consist of a skill mix of nurses and other disciplines. They are also charged with evidencing the impact of what they do and influencing care delivery at every level of healthcare organizations. This first paper of two will explore the current UK policy context and ways in which district nursing services within each country are changing to meet the challenges posed. A second article will argue the need to ensure the district nursing workforce is underpinned by robust educational standards that ensure protection of the public. The influences of education and development from professional and organizational perspectives will be examined.
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Willmer, Marian
2005-11-01
This paper is about work-based learning in information management for student nurses. It seeks, through a literature review, to make a case for and promote Information and Communications Technology capability development in student nurses within their clinical environment. The profession of nursing, like many other jobs, is facing the increasing usage of information technology in day-to-day operations. Admission and discharges of patients have been held on computer databases since at least the 1980s. With the new Labour Government in 1997, increasing focus was placed on the effectiveness of the National Health Service and using computers as one way to assist in achieving greater effectiveness. Nurse education therefore needed to reflect this need and support trainee nurses to acquire skills in Information and Communications Technology. This paper is part of an ongoing professional doctorate inquiry into Information and Communications Technology capability development in student nurses. A literature search was conducted on teaching information and technology skills via Cumulative Index to Nursing and Allied Health Literature. Most of the available studies were neither based on the UK nor were they about student nurses. As there is a dearth of published work in this specific area, relevant, related and tangential literature was reviewed. It is argued that current practice and published work on Information and Communications Technology capability development by student nurses hardly exists. The literature confirmed that success in this area requires sound change management, an understanding of National Health Service culture, and effective people leadership skills. Nurse educators and managers need to pay more attention to understand how organizations work, particularly organizations where student nurses carry out their work. As the search revealed a significant gap in the literature in this area, a practical conceptual framework to fully analyse, develop and implement sustained Information and Communications Technology capability in student nurses is proposed.
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ERIC Educational Resources Information Center
Camiah, Sada
1998-01-01
Observations of and interviews with 41 British nurse educators found that they are expected to spend more time doing clinical teaching, developing links with clinical staff, supporting the development of the clinical learning environment, and participating in educational audits. (SK)
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ERIC Educational Resources Information Center
Belock, Shirley
The planning and design of a course for the inactive registered nurse desiring to return to active practice is reported in this practicum paper. Current literature was reviewed with emphasis on the needs in rural states, such as Vermont, and characteristics of the target group. The first three modules of the course were developed, entitled: The…
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The journey toward shared governance: the lived experience of nurse managers and staff nurses.
Ott, Joyce; Ross, Carl
2014-09-01
The purpose of the study was to explore the lived experience of nurse managers and staff nurses in shared governance. Shared governance refers to systems and services aligned in partnership. The information gained by studying the lived experience of nurse managers and staff nurses in shared governance is valuable for providing knowledge of empowerment. A qualitative design was used. Data were collected through a semi-structured interview using five questions with 11 Registered Nurses. Data were analysed through thematic analysis. Four themes emerged from data analysis. Nurse managers identified the journey of patient satisfaction; journey of empowerment; journey of self-management and journey of wellness. Staff nurses identified the journey of development and implementation of best practice; journey to provide quality patient care, journey to a new culture of nursing; and journey of a variety of challenges. This study supports the idea that collaboration between nurse managers and staff nurses develops a journey toward shared governance. Nursing management can use findings to empower nurses to collaborate with nurse managers toward best practice. This adds to current knowledge that partnership of nurse managers and staff nurses, supports and encourages ownership in shared governance. © 2013 John Wiley & Sons Ltd.
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Nurses who work outside nursing.
Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M
2004-09-01
The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.
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Current Trends in Nursing Informatics: Results of an International Survey.
Peltonen, Laura-Maria; Alhuwail, Dari; Ali, Samira; Badger, Martha K; Eler, Gabrielle Jacklin; Georgsson, Mattias; Islam, Tasneem; Jeon, Eunjoo; Jung, Hyunggu; Kuo, Chiu-Hsiang; Lewis, Adrienne; Pruinelli, Lisiane; Ronquillo, Charlene; Sarmiento, Raymond Francis; Sommer, Janine; Tayaben, Jude L; Topaz, Maxim
2016-01-01
Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice.
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A comparison of salary-wage and hourly-wage acute care nursing units: a pilot study.
Hickey, Rosa G; Buchko, Barbara L; Coe, Paula F; Woods, Anne B
2015-05-01
This pilot study examined differences in RN perception of the professional practice environment and financial indicators between salary-wage and hourly-wage compensation models. There is a dearth of current information regarding use of salary-wage models for compensation for direct care nurses. A descriptive, comparative design was used to examine the Revised Professional Practice Environment Scale (RPPE) and financial indicators of nurses in a nonprofit healthcare system over a 6-month period. Mean scores on the RPPE were significantly lower for hourly-wage RNs, and the hourly-wage model resulted in a 1.2% additional cost for overtime hours compared with the fixed cost of the salary-wage model. Nurses in an hourly-wage unit reported a significantly lower perception of the clinical practice environment than did their peers in a salary-wage unit, indicating that professional practice perceptions in a salary-wage unit may provide a more effective professional practice environment. Financial analysis resulted in a budget-neutral impact.
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McGilton, Katherine S; Bowers, Barbara J; Heath, Hazel; Shannon, Kay; Dellefield, Mary Ellen; Prentice, Dawn; Siegel, Elena O; Meyer, Julienne; Chu, Charlene H; Ploeg, Jenny; Boscart, Veronique M; Corazzini, Kirsten N; Anderson, Ruth A; Mueller, Christine A
2016-02-01
In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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Merrick, Eamon; Duffield, Christine; Baldwin, Richard; Fry, Margaret
2012-03-01
This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia. Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support. Over a 8-month period in 2008 practice, nurses employed in general practice in the State of New South Wales were invited to complete a 26-item self-administered online questionnaire utilizing constructs from Karaseks (1998) Job Content Questionnaire (valid n = 160). Confirmatory Factor Analysis indicated that all scales demonstrated acceptable levels of internal consistency. Sequential regression models revealed that social support exerts a weak influence on decision latitude (R(2) = 0·07); the addition of self-identity through work significantly improved the predictive ability of the model (R(2) = 0·16). Social support and self-identity through work exerted a negative influence on created skill (R(2) = 0·347), whereas social support was effective in predicting self-identity through work (R(2) = 0·148). Collegial and supervisory support in the work environment predicts organizational possibilities for practice nurse decision-making. © 2011 Blackwell Publishing Ltd.
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Jung, Dukyoo; Lee, Soon Hee; Kang, Sook Jung; Kim, Jung-Hee
2017-02-01
New nursing graduates have revealed that they perceive a gap between theory and practice with reference to their education and the real workplace setting. Additionally, many nurses experience a reality shock when they participate in clinical practice. The purpose of this study was to develop and test the effects of a scenario-based simulation training program on new graduate nurses' competency, critical thinking dispositions, and interpersonal communication skills. This pilot multi-site study used a pretest-posttest control group design. It was conducted at four sites of a university-affiliated simulation center in Korea. Participants were recruited utilizing a convenience sample from four tertiary hospitals in Korea. Twenty-four new graduate nurses participated in this study. At the three-month follow-up, the levels of communication skills used in practice among the intervention group were statistically significantly higher than those of the control group participants (U=151.50, p=.005). However, there were no significant differences between the groups in changes in nursing competency (U=287.50, p=.992) or critical thinking disposition scores (U=269.50, p=.702). The participants' mean rating scores concerning the objectives, intentions, and recommendations for other nurses were positive and high. The involvement of current practicing of nursing in certain scenarios and the implementation of simulation learning could enhance the readiness of new graduate nurses. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Defining the paramedic process.
Carter, Holly; Thompson, James
2015-01-01
The use of a 'process of care' is well established in several health professions, most evidently within the field of nursing. Now ingrained within methods of care delivery, it offers a logical approach to problem solving and ensures an appropriate delivery of interventions that are specifically suited to the individual patient. Paramedicine is a rapidly advancing profession despite a wide acknowledgement of limited research provisions. This frequently results in the borrowing of evidence from other disciplines. While this has often been useful, there are many concerns relating to the acceptable limit of evidence transcription between professions. To date, there is no formally recognised 'process of care'-defining activity within the pre-hospital arena. With much current focus on the professional classification of paramedic work, it is considered timely to formally define a formula that underpins other professional roles such as nursing. It is hypothesised that defined processes of care, particularly the nursing process, may have features that would readily translate to pre-hospital practice. The literature analysed was obtained through systematic searches of a range of databases, including Ovid MEDLINE, Cumulative Index to Nursing and Allied Health. The results demonstrated that the defined process of care provides nursing with more than just a structure for practice, but also has implications for education, clinical governance and professional standing. The current nursing process does not directly articulate to the complex and often unstructured role of the paramedic; however, it has many principles that offer value to the paramedic in their practice. Expanding the nursing process model to include the stages of Dispatch Considerations, Scene Assessment, First Impressions, Patient History, Physical Examination, Clinical Decision-Making, Interventions, Re-evaluation, Transport Decisions, Handover and Reflection would provide an appropriate model for pre-hospital practices.
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Stephen, Catherine
2016-08-01
Hypertension is currently the most frequently seen condition in Australian general practice (Britt et al. 2015). Of the 4.6 million Australians living with hypertension, many struggle to keep their blood pressure under control and are at increased risk of renal failure, cardiovascular disease and premature death (Australian Institute of Health and Welfare, 2015; Cadilhac et al. 2012). The General Practice Nurse (GPN) has a significant role to play in supporting self-management and lifestyle risk factor reduction.
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Strengthening Moral Courage Among Nurse Leaders.
Edmonson, Cole
2015-02-17
Moral distress among practicing nurses is frequently discussed in the nursing literature, along with well-developed recommendations for increasing moral courage in practicing nurses. Implementing these recommendations depends on nurse leaders being morally fit to lead and to create an environment in which moral courage actions can emerge. The literature is lacking pertaining to nurse leaders' preparation to lead in a morally courageous and transformational manner in our current corporate environments and hierarchies of healthcare. In this article, the author reviews the literature addressing moral distress and moral courage among direct care nurses; describes the development of an intervention to strengthen the moral courage of nurse leaders; reports a study that involved implementing this intervention; presents the findings of this study; evaluates the effectiveness of the intervention; and discusses the findings in terms of lessons learned and future directions. He concludes with a call for healthcare leaders to demonstrate moral courage and create environments that promote morally courageous acts that enable nurses to remain centered on the patients, families, and communities we serve.
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Promoting the nurse practitioner by using a marketing approach.
Gallagher, S M
1996-03-01
Being good at what you do is not enough. Despite strong evidence that the nurse practitioner delivers cost-efficient and outcome-based care, few consumers really understand the nurse practitioner's scope of practice. With the current rapidly changing status of health care, the nurse practitioner is presented with many opportunities. Strategies that ensure survival and growth are critical to longevity. Marketing strategies can offer solutions to these challenges. The 4 P's of marketing are discussed as an approach to promote the role of the nurse practitioner.
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The metaphor of nurse as guest with ethical implications for nursing and healthcare.
Milton, Constance L
2005-10-01
Current healthcare advertising and customer relations terminology acknowledge that healthcare providers, including nurses, are to act as hosts for persons who enter into healthcare agencies and institutions. Indeed, much has been written aligning nursing and other healthcare services with consumer-oriented roles of the hospitality service industry commonly associated with hotels and restaurants. From a human becoming perspective, this article discusses possible ethical, administrative, and practice implications of nurses acting as guests entering into the lives of those we serve.
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Critical thinking of nurse managers related to staff RNs' perceptions of the practice environment.
Zori, Susan; Nosek, Laura J; Musil, Carol M
2010-09-01
BACKGROUND INFORMATION AND SIGNIFICANCE: Critical thinking (CT) skills and the inclination to engage in critical thinking are essential for nurse managers to function as transformational leaders capable of influencing staff to align with organizational goals. In an extensive literature review, numerous studies were found examining the concept of CT in students and no studies were found exploring CT in nurse managers. Identifying the attributes, such as CT, that lead to success in the nurse manager role is useful when preparing nurse managers to lead effectively in the current healthcare climate. Is there a difference between nurse managers' CT dispositions and their respective staff nurses' perceptions of the practice environment? A convenience sample of 12 nurse managers and a random sample of 132 of their respective staff registered nurses (RNs) participated in this descriptive study. CT in nurse managers was measured by the California Critical Thinking Disposition Inventory (CCTDI). Staff RNs' perceptions of the practice environment were measured by the Practice Environment Scale (PES). The research question was answered using a t test. Significant (p < .001) differences were found between specific nurse managers' CCTDI scores for open-mindedness, analyticity, and critical thinking confidence, and significant differences (p < .01) were found for systematicity when compared with their respective staff RNs' mean subscale and overall PES scores. Results of the study support the positive relationship between strength in critical thinking dispositions of nurse managers and their respective staff RNs' perceptions of the practice environment. Nurse managers with stronger CT dispositions may be better able to create positive practice environments that are conducive to job satisfaction and thus the retention of staff RNs. Inclusion of strategies to support the development and use of CT in nurse managers is recommended. CT and other leadership attributes and skills including emotional and social intelligence and management of change through an appreciative inquiry process may provide opportunities to improve leadership effectiveness in nurse managers. Enhancing critical thinking skills and dispositions of nurse managers may help to create positive work environments for staff RNs. Staff RNs who work in an environment perceived to be positive may be in a better position to deliver high quality, safe patient care.
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The practice of certified community health CNSs.
Logan, Leanne
2005-01-01
This study explored the practice of clinical nurse specialists (CNSs) certified in Community Health nursing in the United States and described demographic and employment characteristics and perspectives about professional practice. The survey method was used. Of the 209 Community Health CNSs certified by American Nurses Credentialing Center (ANCC) invited to complete the investigator-designed mail questionnaire, 111 (53%) returned a completed questionnaire. The questionnaire contained 27 items about employment, income, years in practice, certification, career satisfaction, and educational preparation, and asked participants to indicate the fit between the Community Health CNS role and the traditional CNS subroles model described by the American Nurses Association (ANA) (The Role of the Clinical Nurse Specialist, 1986) and the updated National Association of Clinical Nurse Specialists (NACNS) CNS practice model (Statement on Clinical Nurse Specialist Practice and Education, 1998). Content validity was established by Community Health CNS reviewer feedback. Quantifiable data were tallied and analyzed using standard spreadsheet computer software. Qualitative data were summarized for content themes. The majority of participants were white, middle-aged females who reported being satisfied with their careers as Community Health CNSs. Most indicated that they were respected by colleagues, that they had been adequately prepared by their education, and that their current work made good use of their education and expertise. When asked to identify, by percentage of effort, the fit between their job responsibilities and the traditional subroles model of practice, the mean of reported fit was as follows: educator, 35%; administrator/leader, 22%; clinician, 21%; consultant, 14%; and researcher, 8%. The fit between job responsibilities and the spheres of influence in the NACNS model of practice was reported to average 39% for patient/client, 35% for organization/network, and 25% for nurses/ nursing practice. Community Health CNS is a viable specialty practice with long-term career options. The subrole functions-described by ANA-of clinician, educator, administrator/leader, consultant, and to a lesser extent researcher apply to the role. The more intergraded updated model offered by NACNS also fits Community Health CNS practice with more emphasis on patient/client and organization/ network spheres than on nurses/nursing practice sphere. Schools of nursing should continue to offer the Community Health CNS programs and incorporate both the traditional functions and newer practice model into their curricula, with a greater emphasis on diversity of students to help ensure a more diverse CNS population. Further research is needed to explore the outcomes of Community Health CNS practice and the factors that contribute to role satisfaction.
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Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S
2013-10-01
Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.
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Developing the green house nursing care team: variations on development and implementation.
Bowers, Barbara J; Nolet, Kimberly
2014-02-01
A core component of the Green House nursing home model is an altered supervisory relationship between the nurse and direct care workers. Some have expressed concern that the Green House model might weaken professional nursing oversight, threatening the quality of clinical care. This qualitative research study explores the role of the nurse as implemented in the Green House model, focusing on how variations in the nursing team influence clinical care practices. Dimensional analysis, a "second generation" grounded theory methodology, was used to conduct this study. Data were collected through observations and interviews with 37 nurses, 68 CNAs, and 11 Guides working at 11 Green House sites. Implementation of the nursing role within the Green House model varied both within and across sites. Four nursing model types were identified: Traditional, Visitor, Parallel, and Integrated. Care processes, CNA/Shahbaz skill development, and worker stress varied with each nursing model. Government policies have been enacted to support culture change. However, there is currently little guidance for regulators, providers, or consumers regarding variability in how culture change practices are implemented and consequences of these variations. This article outlines the importance of understanding these practices at a level of detail that distinguishes and supports those that are most promising.
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Developing the Green House Nursing Care Team: Variations on Development and Implementation
Bowers, Barbara J.
2014-01-01
Purpose of the Study: A core component of the Green House nursing home model is an altered supervisory relationship between the nurse and direct care workers. Some have expressed concern that the Green House model might weaken professional nursing oversight, threatening the quality of clinical care. This qualitative research study explores the role of the nurse as implemented in the Green House model, focusing on how variations in the nursing team influence clinical care practices. Design and Methods: Dimensional analysis, a “second generation” grounded theory methodology, was used to conduct this study. Data were collected through observations and interviews with 37 nurses, 68 CNAs, and 11 Guides working at 11 Green House sites. Results: Implementation of the nursing role within the Green House model varied both within and across sites. Four nursing model types were identified: Traditional, Visitor, Parallel, and Integrated. Care processes, CNA/Shahbaz skill development, and worker stress varied with each nursing model. Implications: Government policies have been enacted to support culture change. However, there is currently little guidance for regulators, providers, or consumers regarding variability in how culture change practices are implemented and consequences of these variations. This article outlines the importance of understanding these practices at a level of detail that distinguishes and supports those that are most promising. PMID:24443606
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Priority setting in clinical nursing practice: literature review.
Hendry, Charles; Walker, Anne
2004-08-01
Time is a valuable resource. When nurses experience demands on their services which exceed their available time, then 'rationing' must occur. In clinical practice such rationing requires practitioners to set priorities for care. The aim of this paper is establish what is currently known about priority setting in nursing, including how nurses set priorities and what factors influence this. CINAHL, Medline, ASSIA, and PsychLit databases for the years 1982-2002 were searched, using the terms (clinical decision-making or problem-solving or planning) and (setting priorities or prioriti*). The publications found were used in a selective, descriptive review. Priority setting is an important skill in nursing, and a skill deficit can have serious consequences for patients. Recent studies have suggested that it is a difficult skill for newly qualified nurses to acquire and may not be given sufficient attention in nurse education. Priority setting can be defined as the ordering of nursing problems using notions of urgency and/or importance, in order to establish a preferential order for nursing actions. A number of factors that may impact on priority setting have been identified in the literature. These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities. However, very little empirical work has been conducted in this area. Further study of priority setting in a range of clinical practice settings is necessary. This could inform both practice and education, promote better use of limited resources and maximize patient outcomes.
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Review: the legal duty of care for nurses and other health professionals.
Young, Andy
2009-11-01
To explore the nature and extent of the legal duty of care in relation to contemporary healthcare practice. The paper seeks to re-frame and update the legal duty of care for clinical nursing practice in the 21st century, taking into account collaborative and partnership working in healthcare practice. Doctrinal legal 'approach'. 'Black letter' legal research methodology used for data collection and analysis. Literature search using Westlaw and LexisNexis database(s) to identify recent common law decisions. There has been a perceptible doctrinal shift away from paternalism and toward patient empowerment and autonomy in the last decade. This has implications for nurses and other healthcare professionals in terms of consenting patients and acting reasonably to ensure quality patient care. A number of experienced nurses are currently assuming extended roles and some are completing medical tasks, traditionally allocated to doctors. These specialist practitioners must remember that additional responsibility invariably means increased professional risk and accountability. Therefore, it is essential that those engaging in advanced nursing practice, fully understand the nature and reach of their professional duty of care and the significance of statutory and common law developments. Nurses and other healthcare professionals must update their clinical skills and practice within a legal framework and to certain standards. The cases cited and discussed are relevant to all branches of nursing and indeed to all health professions.
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Exploring the Pursuit of Doctoral Education by Nurses Seeking or Intending to Stay in Faculty Roles.
Dreifuerst, Kristina Thomas; McNelis, Angela M; Weaver, Michael T; Broome, Marion E; Draucker, Claire Burke; Fedko, Andrea S
2016-01-01
The purpose of this study was to describe the factors influencing the pursuit and completion of doctoral education by nurses intending to seek or retain faculty roles. Traditionally, doctoral education evolved to focus on the preparation of nurses to conduct scientific research, primarily through the doctor of philosophy programs. Most recently, the doctor of nursing practice degree emerged and was designed for advanced practice nurses to be clinical leaders who translate research into practice and policy. Nurses who pursue doctoral education in order to assume or maintain faculty roles must choose between these degrees if they desire a doctorate within the discipline; however, factors influencing their decisions and the intended outcomes of their choice are not clear. During this study, 548 nurses (current students or recent graduates of doctoral programs) completed a comprehensive survey to generate critical evidence about the factors influencing the choices made. Principal findings are related to the issues of time, money, and program selection. These findings can be used to develop strategies to increase enrollment and, therefore, the number of doctorally prepared faculty who are specifically prepared to excel as nursing faculty. Copyright © 2016 Elsevier Inc. All rights reserved.
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The Nurse Project: an analysis for nurses to take back our work.
Rankin, Janet M
2009-12-01
This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can 'talk back' and 'act back' to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches to understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work.
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Haslinger-Baumann, Elisabeth; Lang, Gert; Müller, Gerhard
2014-01-01
In nursing practice, research results have to undergo a systematic process of transformation. Currently in Austria, there is no empirical data available concerning the actual implementation of research results. An English validated questionnaire was translated into German and tested for validity and reliability. A survey of 178 registered nurses (n = 178) was conducted in a multicenter, quantitative, cross-sectional study in Austria in 2011. Cronbach's alpha values (.82-.92) were calculated for 4 variables ("use," "attitude," "availability," "support") after the reduction of 7 irrelevant items. Exploratory factor analysis was calculated with Kaiser-Meyer-Olkin (KMO) ranging from .78 to .92; the total variance ranged from 46% to 56%. A validated German questionnaire concerning the implementation of research results is now available for the nursing practice.
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Medical robotics: the impact on perioperative nursing practice.
Francis, Paula; Winfield, Howard N
2006-04-01
Robotic technology and the increased use of minimally invasive surgery approaches is altering the environment in which operating room personnel work and affecting how nurses must care for patients. An understanding of the history of robotics, current applications of the technology, and perioperative nursing responsibilities is needed to assure quality patient care in the wake of continued advances in technology.
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ERIC Educational Resources Information Center
Smith, Elaine Lois
2012-01-01
Quality and safety in healthcare is a national concern. It has been proposed that nurses and other clinicians need to develop a new set of competencies in order to make significant improvements in the quality and safety of patient care. These new competencies include: patient-centered care; teamwork and collaboration; evidence-based practice;…
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Pioneering a new role: the beginning, current practice and future of the Clinical Nurse Leader.
Poulin-Tabor, Danielle; Quirk, Rebecca L; Wilson, Lauri; Orff, Sonja; Gallant, Paulette; Swan, Nina; Manchester, Nicole
2008-07-01
To discuss the development of a new nursing role in response to the health care crisis in the United States. The nursing shortage and fragmentation of care has contributed to the need for nurses who are prepared to laterally integrate care, bring evidence-based practice to the bedside and provide continuity of care to patients and families. The CNLs review the literature, share their experiences, and discuss outcomes related to improved quality of care. Having clinical nurses with a global perspective acting as facilitators and integrators of care is essential to maintaining a high standard of care. Organizational and management support is critical. The more CNLs that can be embedded in an institution, the more successful the role can be. The varied utilization of the CNLs in this practice setting has proven its value in a short period of time and facilitated better communication and collaboration among patients and their health care team. The flexibility and broad scope of this role allows for its use in any practice setting to realize gains in quality outcomes, cost savings, improved patient flow, increased safety, nurse satisfaction and increasing organizational capacity.
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Pediatric nurse practitioners: influences on career choice.
Freed, Gary L; Dunham, Kelly M; Martyn, Kristy; Martin, Jean; Moran, Lauren M; Spera, Laura
2014-01-01
The demand for hiring pediatric nurse practitioners (PNPs) is strong. However, the number of newly educated PNPs has remained relatively flat during the past several years. Understanding the rationale and timing for the decision to pursue this profession is essential to having a positive impact on increasing the future workforce. A mail survey of all new PNPs certified between January 2009 and July 2011 (N = 1040) was conducted. The response rate was 79.9%. Nearly half of all respondents (45%, N = 314) reported that they work in outpatient general pediatrics, 26% (N = 184) in outpatient subspecialty pediatrics, and 22% (N = 152) in inpatient settings. More than one third (36%, N = 253) spend most of their time in a private practice. Forty percent (N = 307) reported that they decided to pursue education as an advanced practice nurse while in practice as a registered nurse (RN), and 38% (N = 289) made the decision before pursuing RN education. Efforts to increase the PNP pipeline will need to be directed both to students during their RN education and to creating opportunities for current RNs to pursue advanced practice nurse education that is focused on children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
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Turnover intention among hospital-based registered nurses in the Eastern Caribbean.
Lansiquot, Beverley Anne; Tullai-McGuinness, Susan; Madigan, Elizabeth
2012-06-01
Vacancy rates for nurses in the English-speaking Caribbean are estimated at 30% with turnover typically associated with migration. The purpose of this study was to describe the characteristics of hospital-based registered nurses (RNs) in the sub-region, their practice environment and turnover intention in two and five years, respectively, and to determine the relationships among practice environment characteristics and turnover intention. A descriptive correlational design was used with self-reported questionnaires from a convenience sample of 301 RNs working in hospitals in four English speaking Eastern Caribbean countries. Single-item visual analog scales (VAS) were used to measure turnover intention in 2 years and 5 years. The Practice Environment Scale of the Nursing Work Index (PES-NWI) measured the characteristics in the practice environment. The mean age of the nurses was 32.5 (SD = 6.75) years. Most nurses (58.8%) were single and 91.4% had relatives living abroad. Nurses scored three PES-NWI subscales < 2.5, indicating a less positive practice environment: resource adequacy, nurse participation in hospital affairs, and nurse managers' ability, leadership, and support. The subscale for collegial nurse-physician relations received the best rating (mean = 2.61, SD = .62). For 2-year intention to leave, the mean rating on the 100-mm VAS was 63.2, while that for the 5-year intention to leave was 65.6. No significant correlations were found among four of the five PES-NWI subscales and turnover intention in 2 and 5 years. The practice environment, while generally unfavorable, is not associated with the nurses' intention to leave their jobs. These findings support the current policy position that calls for managing turnover among nurses. Nursing and health system administrators should assess, plan, and implement workforce policies to slow the outflow of nurses. Initiatives to improve the work environment and the delivery of high-quality care are important to RNs in the Eastern Caribbean. Managing the negative impact of continuous outflow of nurses through turnover requires long-term coordinated policy and human resource development and management initiatives to sustain the supply of RNs in the subregion. © 2012 Sigma Theta Tau International.
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Anolak, Helena; Coleman, Andrew; Sugden, Paul
2018-07-01
Rural Australian health services face significant challenges such as aging populations, access and retention of services and health practitioners as well as difficulties with staff training due to geographic isolation. Educational pedagogy, through a 'flipped' or 'flipped' classroom method has become popular in nursing literature whereby discussion surrounding its effectiveness, ability to increase performance, address learning outcomes and resolve the education-clinical practice divide is currently being explored. Several reviews that look specifically at the validity and implementation of the flipped classroom pedagogy into nursing education demonstrate a need for further scientific research. Current literature examines the in-class on campus implementation of the methodology but rarely does it consider the advantages or ways of implementing such a method in a rural off campus nursing learning environment. The use of technology is not the solution unless supported by interaction to develop practical situational skills. The authors consider advantages and disadvantages and identify central problems for the effective implementation of 'flipped' in off-campus rural nursing education. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Work and personal well-being of nurses in Queensland: Does rurality make a difference?
Hegney, Desley; Eley, Robert; Osseiran-Moisson, Rebecca; Francis, Karen
2015-12-01
This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. This paper was performed on a prospective, self-report cross-sectional on-line survey. The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia. Participants of this study were 1608 registered and enrolled nurses and assistants in nursing, current members of the Queensland Nurses Union in 2013 and who provided a workplace postcode. One thousand eight of these participants worked in major cities, while 382 in rural locations and 238 in remote areas. None. Scores of well-being as determined by the following scales: the Depression, Anxiety and Stress Scale, the Professional Quality of Life Scale version 5, the Connor-Davidson Resilience Scale and of the Professional Practice Environment using the Practice Environment Scale - Nursing Work Index Revised. Nurses employed in major cities perceived 'nursing foundations for quality care' more favourably than those from other settings. Remote area nurses had lower levels of secondary traumatic stress than nurses in major cities and rural areas. There was no difference between nurses across their geographical locations for stress, anxiety, depression, compassion satisfaction, burnout, resilience and the four other measures of the Practice Environment Scale. The study findings provide new data suggesting that, with the exception of secondary traumatic stress, the personal well-being of nurses does not differ across geographical settings. Similarly, with the exception of the subscale of 'nursing foundations for quality care' there was no difference in perceptions of the professional practice environment. As secondary traumatic stress is associated with burnout, this finding needs to be investigated further. © 2015 National Rural Health Alliance Inc.
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MacLaren, Julie-Ann
2018-01-01
Supervised practice as a mentor is currently an integral component of nurse mentor education. However, workplace education literature tends to focus on dyadic mentor-student relationships rather than developmental relationships between colleagues. This paper explores the supportive relationships of nurses undertaking a mentorship qualification, using the novel technique of constellation development to determine the nature of workplace support for this group. Semi-structured interviews were conducted with three recently qualified nurse mentors. All participants developed a mentorship constellation identifying colleagues significant to their own learning in practice. These significant others were also interviewed alongside practice education, and nurse education leads. Constellations were analysed in relation to network size, breadth, strength of relationships, and attributes of individuals. Findings suggest that dyadic forms of supervisory mentorship may not offer the range of skills and attributes that developing mentors require. Redundancy of mentorship attributes within the constellation (overlapping attributes between members) may counteract problems caused when one mentor attempts to fulfil all mentorship roles. Wider nursing teams are well placed to provide the support and supervision required by mentors in training. Where wider and stronger networks were not available to mentorship students, mentorship learning was at risk. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
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Spear, Marcia
2010-01-01
There has been a steady increase in the number of individuals who undergo dermal fillers and botulinum toxin Type A injections. The majority of these procedures are performed by nurse providers. The purpose of this study was to collect national data on the current practice among nursing providers within the American Society of Plastic Surgical Nurses (ASPSN). The goal was to utilize the national data and develop a document of the necessary competencies to guide the practice of providers of dermal fillers and botulinum toxin Type A injections. A survey tool was developed and validated for content by expert nursing providers among the membership of the ASPSN and disseminated via e-mail to the membership of the ASPSN. In addition, data from investigator training, mentoring, and evidence from a review of the literature were also incorporated into the competency document utilizing the Competency Outcomes and Performance Assessment (COPA) model. Common core issues became apparent that included contraindications for the use of botulinum toxin Type A and dermal fillers, postprocedure complications as well as strategies in terms of managing complications. The data also revealed that there is no common method providers are taught to assess the aesthetic patient and a lack of a collaborative relationship in current practice. Overwhelmingly, the respondents supported the need for defined practice competencies. A competency document to guide the practice of providers of dermal fillers and botulinum toxin Type A has been developed for completion of this DNP project.
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Six ways of experiencing information literacy in nursing: the findings of a phenomenographic study.
Forster, Marc
2015-01-01
Information literacy plays a vital role in evidence-based practice in nursing. However there is currently little evidence to show how being information literate is actually experienced by nurses and therefore information literacy educational interventions are not genuinely evidence-based. Are they promoting the appropriate knowledge and skills to help nurses find and use the research evidence they need? To investigate how being information literate is experienced by nurses. To use the insights obtained to develop a description of the parameters of information literacy in nursing, including those of its role and value in evidence-based practice. Phenomenography. 41 UK nurses of varying experience, specialism and background. Open-ended interviews. 7 contexts in which information literacy is experienced, were mapped out and 6 representative ways of being an information literate nurse, in increasing levels of depth and sophistication, were described. These findings may form the basis of future evidence-based information literacy education programmes. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Dementia with Lewy bodies: a comprehensive review for nurses.
Ajon Gealogo, Gretchel
2013-12-01
Much of the current nursing literature on dementia focuses on Alzheimer disease (AD), the dementia subtype most commonly diagnosed in the older adults. There is a paucity of nursing literature on dementia with Lewy bodies (DLB), the second most common subtype of dementia, which is closely associated with Parkinson disease with dementia (PDD), considered the third most common dementia subtype. Both are aging-related disorders attributed to Lewy bodies, abnormal protein aggregates or "clumps" found to cause cumulative neurodegeneration over time. DLB is defined as dementia onset that is preceded by Parkinsonian symptoms for 1 year or less, whereas in PDD, 2 or more years of Parkinsonian symptoms precede dementia onset. Although basic science knowledge of DLB has increased exponentially, the lack of nursing research on DLB indicates that this knowledge excludes the nursing perspective and its implications for nursing practice. The purpose of this article is to provide nurses with a comprehensive overview of DLB as it compares with PDD and Alzheimer disease and to propose key nursing interventions for clinical practice.
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Morrall, Peter; Goodman, Benny
2013-09-01
When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Enhancing undergraduate community placements: a critical review of current literature.
Dickson, Caroline A W; Morris, Gillian; Gable, Clare
2015-04-01
In the face of the UK-wide policy shift to increased home care, inspiring and enabling the next generation of community nurses is more urgent than ever. The quality of the pre-registration practice learning experience is highly influential on career choices at the point of qualification. Given that 50% of learning by pre-registration students takes place in practice, mentors have a crucial role to play in preparing the next generation of nurses to work in the community. This article discusses the findings of a systematic and critical literature review of pre-registration placements that was funded by the Queen's Nursing Institute Scotland. The review found that students' experiences of learning in community settings are variable, and perceptions of students and mentors are misaligned in terms of what a quality placement should look like. Although there is no clear definition of what constitutes a community placement and there is some underuse of learning environments in areas such as general practice nursing, there are also a number of examples of new and imaginative placements. While these innovations provide 'whole experience' placements, they are currently lacking robust evaluation, despite their potential usefulness on a larger scale. Mentors have the opportunity to provide students with a range of learning opportunities that increase preparedness for working in the community, allowing final year students in particular greater influence over their learning experience. Students undertaking community practice learning, where they have a managed level of autonomy, are more likely to feel confident to take on community nursing roles.
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The Health Promoting Prison (HPP) and its imperative for nursing.
Whitehead, Dean
2006-01-01
The World Health Organisation's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Prison (HPP) movement emerged. Here, an extensive review of the available prison-related health literature provides the basis for critical discussion and recommendations for nursing services and prison-related health care. The findings suggest that current prison-based nursing services are seriously neglected and woefully lacking in structure and resources. This article recommends strategies for reform that includes nurses who practice in all settings, and not just prison-based nurses. If nurses wish to be at the forefront of future HPP strategies, they must first embrace the radical health promotion reforms that are emerging from the current literature. Building sustainable group capacity into prison-based health care, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasise the health promotion role of nursing.
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Ironside, Pamela M
This article provides a review of current disciplinary understanding of Narrative Pedagogy and describes the implications for ongoing transformation in nursing education. Narrative Pedagogy has been enacted and investigated by teachers around the world for more than 15 years. Few nursing educational innovations or pedagogies in nursing have been adopted in such an array of settings/levels. A review of the nursing literature was conducted to locate reports of research on and teaching innovations derived from Narrative Pedagogy. Narrative Pedagogy has an extensive and longitudinal body of research describing how the approach contributes to the educational transformation the discipline seeks. Narrative Pedagogy and the growing literature describing how it is enacted provides a way for teachers and students to persist in questioning their current understanding of nursing, the ways they think about the situations they encounter, and how their practice can best be learned.
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Feminism and nurse-midwifery. Historical overview and current issues.
McCool, W F; McCool, S J
1989-01-01
Despite the fact that the profession of nurse-midwifery and feminism are both disciplines concerned with women and issues affecting women's lives, there has been little investigation or acknowledgement of relationships between their two paradigms. The work presented here is an attempt to discover both similarities and differences between nurse-midwifery and feminist thought. Using a historical approach, it is shown that despite the common goal of improving and maintaining women's status in the world, whether in general or more specifically with regard to health, feminist theorists and nurse-midwives, to a large degree, have worked separately from each other, rarely acknowledging in any formal way the importance of the other discipline. Current issues that have an effect on the practice of nurse-midwifery today--lay midwifery, the profession of nursing, and nurse-midwifery research--are presented in relation to contemporary feminist thought.
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Nursing education at Western Governors University: a modern, disruptive approach.
Jones-Schenk, Jan
2014-01-01
Over 1 million working registered nurses (RNs) currently do not have a bachelor's degree in nursing and comprise the critical group needing to return to school in order to achieve the Institute of Medicine's goal of 80% bachelors of science in nursing (BSNs) by 2020. Western Governors University (WGU) has developed a transformative educational model, incorporating 4 operational pillars (competency-based learning, technology, disaggregated faculty roles, and a student-centric management system), to revolutionize RN-BSN education. This article describes a successful contemporary model, disrupting most all of the traditional aspects of university education for professional nursing practice. The program design is of particular value to working adults and addresses the flexibility they need to accommodate academic advancement. The WGU nursing program currently serves over 5,000 students seeking BSN and Master of Science in Nursing degrees in all 50 states. © 2014.
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Nurse-midwifery: art and science.
Dole, Debora M; Nypaver, Cynthia F
2012-06-01
The gap in the health of the nations' people seems to be widening and reflects existing social inequalities affecting the ongoing health of individuals. From a historical and practical perspective, certified nurse-midwives (CNMs) are one group of advanced practice registered nurses uniquely situated to address existing disparities related to maternal-child health. This article provides an overview of the historical development, current status, and use of CNMs in the United States health care system; the impact of CNMs on maternal-child health outcomes; and future trends in the education of CNMs. Copyright © 2012 Elsevier Inc. All rights reserved.
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A review of the literature regarding stress among nursing students during their clinical education.
Alzayyat, A; Al-Gamal, E
2014-09-01
There has been increased attention in the literature about stress among nursing students. It has been evident that clinical education is the most stressful experience for nursing students. The aim of this paper was to critically review studies related to degrees of stress and the type of stressors that can be found among undergraduate nursing students during their clinical education. The search strategy involved the utilization of the following databases: MEDLINE (Medical Literature on-Line), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO (Psychology Information) and PubMed. Keywords were stress, undergraduate nursing students, clinical practice. The review included those studies published between 2002 and 2013, conducted in any country as long as reported in English, and including a focus on the clinical practice experience of nursing students. Thirteen studies met the eligibility criteria. Four themes were identified: initial clinical experience, comparison between different academic years, cross-cultural comparison, and eustress aspects of clinical experience. This review expands current knowledge in the area of stress in clinical settings and calls for further research. Nursing teachers should utilize the findings of this review to direct their students during clinical practice. Moreover, hospital administrators need to promote policies to promote a training environment where students are supported and inspired. © 2014 International Council of Nurses.
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Evaluation of a Novel Disaster Nursing Education Method.
Levoy, Kristin; DeBastiani, Summer D; McCabe, Brian E
2018-02-21
A common method of disaster training is needed to improve disaster nursing education and facilitate better communication among interprofessional disaster responders. To inform the development of disaster nursing curricula, a novel disaster nursing education method consistent with Homeland Security Exercise and Evaluation Program (HSEEP) and the International Council of Nurses (ICN) framework was developed to improve disaster nursing competencies in a baccalaureate nursing program. In total, 89 undergraduate nursing students participated. Perceived disaster nursing knowledge, confidence, and training/response were assessed with 14 items before and after the education. Exploratory factor analysis showed 3 factors, knowledge, confidence, and training/response, explained 71% of variation in items. Nursing students showed large improvements in perceived disaster nursing knowledge (t=11.95, P<0.001, Cohen's d=1.76), moderate increases in perceived confidence (t=4.54, P<0.001, d=0.67), and no change in disaster training and response (t=0.94, P=0.351, d=0.13). Results show preliminary evidence supporting the effectiveness of disaster nursing education informed by HSEEP. This training has the potential to fill current practice gaps in disaster nursing knowledge and build confidence to use those skills in practice. (Disaster Med Public Health Preparedness. 2018;page 1 of 8).
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Healey, Emma L; Main, Chris J; Ryan, Sarah; McHugh, Gretl A; Porcheret, Mark; Finney, Andrew G; Morden, Andrew; Dziedzic, Krysia S
2016-12-21
Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general population consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity for practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting patients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline core recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic, and secondly to describe the development, key learning objectives, content and impact of the training to support its delivery. A training programme was developed and delivered to provide practice nurses with the knowledge and skill set needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA management was evaluated using case report forms and pre and post training questionnaires. The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they should be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to feel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical management patients received in the nurse-led OA clinics. A significant gap between what is recommended and what practice nurses feel they can currently provide in terms of OA management was evident. The development of a nurse training programme goes some way to develop a system in primary care for delivering the core recommendations by NICE. The cluster trial linked to this training was conducted from May 2012 through February 2014 by the Arthritis Research UK Primary Care Centre, Keele University, UK (Trial registration number ISRCTN06984617 ).
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van der Goot, Wieke E; Keers, Joost C; Kuipers, Ruud; Nieweg, Roos M B; de Groot, Martijn
2018-04-01
The Dutch professional nursing standard of 2012 stipulates that Dutch nursing practices are to be evidence-based. Not all practicing nurses can satisfy these requirements, therefore, an educational programme about Evidence-Based Practice (EBP) was developed for a Dutch teaching hospital. The aim of this study was to measure the effects of a six month in-house EBP programme on knowledge, skills, attitudes, and perceived barriers of nurses (four European Credits equals two US Credit Hours). A multiple-cohort study was conducted with a pre-post-test design. In the period of 2011-2015, a total of 58 nurses (9 cohorts) followed the programme. Baseline and follow-up assessments consisted of three questionnaires each: the Dutch Modified Fresno, the two subscales of the McColl questionnaire, and the BARRIER scale to assess knowledge and skills, attitudes, and perceived barriers, respectively. Fifty nurses completed both assessments. The results demonstrated that actual knowledge and skills significantly increased by approximately 40%. Self-perceived knowledge increased significantly, while attitudes towards EBP remained (moderately) positive. Perceived barriers did not notably change except for the Research subscale which received many "no opinion" responses prior to the programme but fewer afterwards. Our multifaceted in-house EBP programme led to a significant improvement of approximately 40% in EBP knowledge and skills of participating nurses. Most nurses who followed the EBP programme are currently applying their knowledge and skills in practice. Managerial support and allocated time for EBP are important facilitators for its implementation. Furthermore, to maintain and expand nurses' EBP knowledge and skills and translate them into practice, follow-up interventions, such as journal clubs, may well be beneficial. Based on the positive results of our programme, we will implement it throughout the hospital with an emphasis on training more groups of nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Setting up recovery clinics and promoting service user involvement.
John, Thomas
2017-06-22
Service user involvement in mental health has gained considerable momentum. Evidence from the literature suggests that it remains largely theoretical rather than being put into practice. The current nature of acute inpatient mental health units creates various challenges for nurses to put this concept into practice. Recovery clinics were introduced to bridge this gap and to promote service user involvement practice within the current care delivery model at Kent and Medway NHS and Social Care Partnership Trust. It has shaped new ways of working for nurses with a person-centred approach as its philosophy. Service users and nurses were involved in implementing a needs-led and bottom-up initiative using Kotter's change model. Initial results suggest that it has been successful in meeting its objectives evidenced through increased meaningful interactions and involvement in care by service users and carers. The clinics have gained wide recognition and have highlighted a need for further research into care delivery models to promote service user involvement in these units.
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Taylor, Anita; Staruchowicz, Lynda
This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much informed by the experiences of the United States and United Kingdom and for the most part there exists a parallel between the international experience and the Australian experience of nurse practitioners.This review will focus on orthopaedic nurse practitioners in an international context. However the local context of the primary reviewer which informs this review is Australian. Australia has mirrored the trends around nurse practitioner practice found elsewhere. In the last 20 years (post implementation of the 1986 Australian nursing career structure), the debate around advanced nursing practice and nurse practitioners, in an Australian context, has developed. The inaugural 'legal & policy' nurse practitioner framework was developed in New South Wales (NSW) in 1998, with the first Australian nurse practitioner authorised to practise in NSW in 2000. It is posited that evaluation of emerging roles began to be seen in the research literature from 1990 onwards. In response to a need for creative workforce re-engineering and against a context of limited health resources, nurse practitioners in Australia over the last 20 years have emerged as an alternative model of health care delivery. For the last 10 years there has been a proliferation of influential 'reports' written by nurse researchers, generated to review the progress of Australia's nurse practitioners, commissioned by the health departments of respective state governments and other service planners to guide health workforce planning.In a national context the Australian Nursing & Midwifery Council (ANMC) as the peak national nursing body, defines a nurse practitioner as a Registered Nurse (RN) who is educated and authorised to practice autonomously and collaboratively in an advanced and extended clinical role. The ANMC Competency Standards for the Nurse Practitioner encompass three generic standards which are further defined by nine competencies. The competency standards provide a framework for practice and licensure of nurse practitioners in Australia. In order for the nurse practitioner to be endorsed by the Australian Health Practitioner Regulation Agency (AHPRA) to practise as a nurse practitioner they must have met the competency standards and be endorsed to practise by the Nursing and Midwifery Board of Australia (NMBA) as a nurse practitioner under section 95 of the National Law. The nurse practitioner's endorsement in Australia is contextualised by their scope of practice, as is the case internationally.At September 2011, 450 endorsed nurse practitioners were nationally registered with AHPRA; 54 of these were endorsed to practise in South Australia. The first orthopaedic nurse practitioner was authorised in South Australia in 2005. To date there are eight endorsed orthopaedic nurse practitioners in Australia authorised to practise in a diverse range of orthopaedic settings that include acute care, community care, outpatient settings, rehabilitation, private practice and rural settings. The current scope of practice for Australian orthopaedic nurse practitioners spans the clinical range of trauma, arthroplasty, fragility fracture and ortho-geriatric care, surgical care: spinal/neurology and paediatric care. Orthopaedic nurse practitioners work within contemporary orthopaedic/musculoskeletal client disease models. These clinical models of care articulate the health care needs of populations living with musculoskeletal conditions, disorders and disease. Osteoarthritis and osteoporosis are 'highly prevalent long term [musculoskeletal] conditions known to predominantly affect the elderly and comprise the most common cause of disability in Australia'. Musculoskeletal trauma or injury as a result of an 'external force' such as vehicle accident, a fall, industrial or home environment accident or assault comprises a leading cause of hospital admission that requires orthopaedic management and care.There is some evidence to suggest that orthopaedic nursing is a 'specialty under threat' as orthopaedic-specific hospital wards are increasingly being absorbed into general surgical units; a trend observed in the United States in the mid 1990's in response to the American experience of 'downsizing' orthopaedic nursing services. Despite a limited evidence base, early citations with specific reference to orthopaedic nurses in the American context in particular started to populate the literature on or around this time. Several proponents of the specialty began to refer to a core nursing skill set that was 'highly orthopaedic' when describing 'specialist' orthopaedic nursing practice. More recently commentators point to differences in certain variables when patients are 'outlied' or managed in a non-orthopaedic ward environment by non-orthopaedic nurses.Despite 'in-principle' support for expanded scopes of practice for various health practitioner roles, the observation exists from within the specialty of orthopaedic nursing that progress in establishing the orthopaedic nurse practitioner role for this group of specialist clinicians has been slow and their journey has not been without challenge. The majority of orthopaedic nurse practitioners in Australia at least have emerged from extended practice roles similar to the generally well established experience of other nurse practitioners emerging from their own practice interest. The orthopaedic nurse practitioner is considered a 'pioneer' as they fill a 'gap' in clinical need and develop an orthopaedic nurse practitioner role. An emerging evidence base suggests that barriers such as a lack of role understanding, lack of 'team' support and a lack of resources at a system, organisational and practice level, constrain nurse practitioner practice and integration of the role into practice settings. Nurse practitioners function in an advanced clinical role. Some attempts have been made at quantifying the work of nurse practitioners. For example, Gardner et al in 2010 divided the work of nurse practitioners into three domains of practice: direct care, indirect care and service-related activities. Within these domains nurse practitioners perform a variety of tasks. Reporting on such activity by way of performance outcome measures is a variable practice amongst nurse practitioners however numbers seen/occasions of service, waiting times, effectiveness of interventions, referral patterns, patient/client satisfaction, clinical quality of care indicators are typical of the data maintained and reported by nurse practitioners to either justify their existence, embed their role service wide and/or contribute to workforce planning. Furthermore the orthopaedic nurse practitioner must effectively define and characterise the patient population to which they deliver care within the nurse practitioner's own scope of practice, ultimately to form an 'indicator' for the nurse practitioner role.The international literature pertaining to nurse practitioners or advanced practice nurses resonates with the many challenges faced by these nurses when it comes to role development and role implementation. Furthermore there is a body of evidence that validates the effectiveness of these roles. This becomes increasingly important in a context of building the health workforce of the future: a redefined workforce that must ensure adequate numbers of suitably qualified health workers who provide 'care the first time and every time'.A search of the Joanna Briggs Institute (JBI) Library of Systematic Reviews, Cochrane Library, PubMed and CINAHL has shown there are no existing or systematic reviews underway on this topic. The JBI undertook a systematic review commissioned by the Department of Health South Australia on Advanced Practice in Nursing and Midwifery and recommended a framework for advanced practice in a report released in early 2008. The framework defined advanced practice, levels of advanced practice, scope of practice, credentialing, education, preparation and regulation of advanced practitioners. The search identified a published systematic review protocol in the JBI Library for a qualitative systematic review by Ramis looking broadly at the experience of advanced practice nurses working in acute settings. The JBI Library of Systematic Reviews also contains a systematic review examining the effectiveness of nurse practitioners in residential aged care. Whilst these publications provide valuable context to this review neither specifically examines the clinical practice of orthopaedic nurse practitioners.Similarly a search of the Cochrane Library revealed a review on the topic of substitution of doctors by nurses in primary care. The focus of this particular intervention review was neither specific to nurse practitioners nor the acute care setting, but the topic of 'doctor substitution' complements the practice of nurse practitioners and may be a consideration in this review. Doctor substitution or care provided by a nurse other than an orthopaedic nurse practitioner is a natural comparator when examining the role and practice of orthopaedic nurse practitioners.Given the breadth of this topic a comprehensive approach has been chosen to systematically review the evidence as it relates to orthopaedic nurse practitioner role and practice.
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McCarthy, Carey F; Voss, Joachim; Verani, Andre R; Vidot, Peggy; Salmon, Marla E; Riley, Patricia L
2013-01-01
Introduction Shifting HIV treatment tasks from physicians to nurses and midwives is essential to scaling-up HIV services in sub-Saharan Africa. Updating nursing and midwifery regulations to include task shifting and pre-service education reform can help facilitate reaching new HIV targets. Donor-supported initiatives to update nursing and midwifery regulations are increasing. However, there are gaps in our knowledge of current practice and education regulations and a lack of information to target and implement regulation strengthening efforts. We conducted a survey of national nursing and midwifery councils to describe current nursing and midwifery regulations in 13 African countries. Methods A 30-item survey was administered to a convenience sample of 13 national nursing and midwifery regulatory body leaders in attendance at the PEPFAR-supported African Health Profession Regulatory Collaborative meeting in Nairobi, Kenya on 28 February, 2011. The survey contained questions on task shifting and regulations such as registration, licensure, scope of practice, pre-service education accreditation, continuing professional development and use of international guidelines. Survey data were analyzed to present country-level, comparative and regional findings. Results Task shifting to nurses and midwives was reported in 11 of the 13 countries. Eight countries updated their scope of practice within the last five years; only one reported their regulations to reflect task shifting. Countries vary with regard to licensure, pre-service accreditation and continuing professional development regulations in place. There was no consistency in terms of what standards were used to design national practice and education regulations. Discussion Many opportunities exist to assist countries to modernise regulations to incorporate important advancements from task shifting and pre-service reform. Appropriate, revised regulations can help sustain successful health workforce strategies and contribute to further scale-up HIV services and other global health priorities. Conclusions This study provides fundamental information from which to articulate goals and to measure the impact of regulation strengthening efforts. PMID:23531276
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Synchronous Videoconferencing in Distance Education for Pre-Licensure Nursing
ERIC Educational Resources Information Center
Scarbrough, John E.
2015-01-01
Current nursing education practices typically include methodologies for providing access to students located at a distance from the hosting institution. The majority of methodologies make use of asynchronous formatting in which communication occurs without the benefit of simultaneous, synchronous interaction. The increasing worldwide availability…
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Groen, Kara Mills
2007-01-01
The primary focus of this paper is to describe current trends in pain assessment in end of life care with a secondary focus on music therapy techniques commonly used to address pain for hospice patients. These trends were determined through a survey of 72 board certified music therapists and 92 hospice and palliative nurses. Survey results indicate that most music therapists in the hospice setting incorporate formal pain assessment into their practice; both nursing professionals and music therapists surveyed utilize multiple assessment tools to assess patient pain. Although there are currently a variety of pain assessment tools used, this study indicates that nursing professionals most frequently use the Numerical Rating Scale (NRS) and FACES scales, and identified them as appropriate for use by nonnursing members of the interdisciplinary hospice team. This paper also describes music therapy techniques most often utilized by music therapists with hospice patients to address acute and chronic pain symptoms.
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Fox, Mary T; Butler, Jeffrey I
2016-11-01
To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities. Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care. Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed. Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency. Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context. The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency. © 2016 John Wiley & Sons Ltd.
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Emotional intelligence and nursing: an integrative literature review.
Bulmer Smith, Karen; Profetto-McGrath, Joanne; Cummings, Greta G
2009-12-01
The purpose of this paper is to present findings of an integrative literature review related to emotional intelligence (EI) and nursing. A large body of knowledge related to EI exists outside nursing. EI theory and research within nursing is a more recent phenomenon. A broad understanding of the nature and direction of theory and research related to EI is crucial to building knowledge within this field of inquiry. A broad search of computerized databases focusing on articles published in English during 1995-2007 was completed. Extensive screening sought to determine current literature themes and empirical research evidence completed in nursing focused specifically on emotional intelligence. 39 articles are included in this integrative literature review (theoretical, n=21; editorial, n=5; opinion, n=4 and empirical, n=9). The literature focuses on EI and nursing education, EI and nursing practice, EI and clinical decision-making, and EI and clinical leadership. Research that links EI and nursing are mostly correlation designs using small sample sizes. This literature reveals widespread support of EI concepts in nursing. Theoretical and editorial literature confirms EI concepts are central to nursing practice. EI needs to be explicit within nursing education as EI might impact the quality of student learning, ethical decision-making, critical thinking, evidence and knowledge use in practice. Emotionally intelligent leaders influence employee retention, quality of patient care and patient outcomes. EI research in nursing requires development and careful consideration of criticisms related to EI outside nursing is recommended.
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Seeing the big picture in nursing: a source of human and professional pride.
Sørensen, Erik E; Hall, Elisabeth O C
2011-10-01
This article presents a discussion of the meaning of the phenomenon of seeing the big picture in nursing. Seeing the big picture is a frequent expression among Danish nurses. It is used when trying to understand a situation in its wider context. However, it has a rather imprecise meaning that might lead to misunderstandings. This paper draws on studies undertaken in the mid 1990s and the early 2000s, but with the current discussion developed in the context of contemporary nursing. Seeing the big picture indicates a desire to do good for patients' and staff. This desire expressed through saying 'I need to see the big picture' is discussed to be a backbone in nursing and nursing leadership and a source of human and professional pride. There is, however, a dilemma if nurses overlook needs of patients that require immediate actions and if a nurse leader does not intercept staff members in crisis. The pride is oscillating between seeing the here-and-now and seeing the long-term in the big picture. We assumed seeing the big picture had to do with practical knowledge. Wonder and reasoning, however, brought us to virtues. Seeing the big picture as mentioned among nursing leaders and clinical nurses demonstrates human and professional pride. The study is useful in organizational, clinical and educational settings in updating policies for nursing, enlarging nurses understanding of practice and training students in understanding nursing practice. © 2011 Blackwell Publishing Ltd.
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ET nursing education in Australia.
Thompson, J M; English, E
1996-05-01
Australia is comparable in size to the United States, but its population is far smaller, approximately 17 million. Australia is technologically advanced and has a high standard of health care, in which ET nursing has always been considered a specialist nursing role. Although Australia is historically linked with England, formation of closer ties with geographic neighbors, such as Southeast Asia, New Zealand, and the Pacific nations, is ongoing. This article describes some relevant aspects of the Australian context and considers the past, present, and expected future trends for ET nurse education in Australia, from the first program in 1971 to current World Council of Enterostomal Therapy-recognized programs teaching students from as far away as Japan, Israel, Singapore, Malaysia, New Zealand, China, Russia, and New Guinea. The content of the programs has progressively broadened in recognition of the expanded scope of practice, and this trend will undoubtedly continue. ET nursing should remain, however, a distinct nursing specialty practice in Australia.
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Taylor, Darlene; Ho, Anita; Mâsse, Louise C.; Van Borek, Natasha; Li, Neville; Patterson, Michelle; Ogilvie, Gina; Buxton, Jane A.
2016-01-01
This qualitative study explored the current practice that nurses use to assess capacity to consent to health care (CTC-HC) in street outreach settings. Key informant interviews were conducted with a purposive sample of nurses from each of British Columbia’s five regional health authorities, allowing nurses to describe their lived experiences with assessing CTC-HC. Content analysis was used to summarize information captured in the data. A total of 19 nurses participated in the study. Five themes emerged from the data: (a) internal guiding forces that contribute to the nurses’ assessment, (b) external influences that contribute to the nurses’ assessment, (c) measures that are important for assessing CTC-HC, (d) threshold setting, and (e) context (physical and interpersonal) within which assessment of capacity takes place. These elements will be incorporated into a capacity assessment tool that can be used in nursing best practices. PMID:28462344
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Shannon, Robin Adair; Kubelka, Suzanne
2013-07-01
School nurses are challenged by federal civil rights laws and the standards of school nursing practice to care for a burgeoning population of students with special health care needs. Due to the realities of current school nurse-to-student ratios, school nurses are frequently responsible for directing unlicensed assistive personnel (UAPs) to support the health and safety needs of students, where State Nurse Practice Acts, state legislation, and local policy mandates allow. The delegation of health care tasks to UAPs poses many professional, ethical, and legal dilemmas for school nurses. One strategy to reduce the risks of delegation is through the use of procedure skills checklists, as highlighted by the experience of one large urban school district. Part 1 of this two-part article will explore the scope of the problem and the principles of delegation, including legal and ethical considerations.
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Cultural competence: a constructivist definition.
Blanchet Garneau, Amélie; Pepin, Jacinthe
2015-01-01
In nursing education, most of the current teaching practices perpetuate an essentialist perspective of culture and make it imperative to refresh the concept of cultural competence in nursing. The purpose of this article is to propose a constructivist definition of cultural competence that stems from the conclusions of an extensive critical review of the literature on the concepts of culture, cultural competence, and cultural safety among nurses and other health professionals. The proposed constructivist definition is situated in the unitary-transformative paradigm in nursing as defined by Newman and colleagues. It makes the connection between the field of competency-based education and the nursing discipline. Cultural competence in a constructivist paradigm that is oriented toward critical, reflective practice can help us develop knowledge about the role of nurses in reducing health inequalities and lead to a comprehensive ethical reflection about the social mandate of health care professionals. © The Author(s) 2014.
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Integrity and moral residue: nurses as participants in a moral community.
Hardingham, Lorraine B
2004-07-01
This paper will examine the concepts of integrity and moral residue as they relate to nursing practice in the current health care environment. I will begin with my definition and conception of ethical practice, and, based on that, will go on to argue for the importance of recognizing that nurses often find themselves in the position of compromising their moral integrity in order to maintain their self-survival in the hospital or health care environment. I will argue that moral integrity is necessary to a moral life, and is relational in nature. When integrity is threatened, the result is moral distress, moral residue, and in some cases, abandonment of the profession. The solution will require more than teaching bioethics to nursing students and nurses. It will require changes in the health care environment, organizational culture and the education of nurses, with an emphasis on building a moral community as an environment in which to practise ethically.
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Hsiao, Ya-Chu; Chiang, Hui-Ying; Lee, Hsiang-Chun; Chen, Su-Hui
2012-12-01
Numerous studies have indicated an association between spirituality and health outcomes. However, little information is available about interventions that have been shown to enhance spiritual health and decrease stress. This study examined the effects of a spiritual learning program (SLP) on nursing student-perceived spiritual health and clinical practice stress. A convenience sample of nursing students currently enrolled at a nursing school in northern Taiwan were recruited to participate in this quasiexperimental study as participants to experimental and control groups via simple random sampling. Results from a spiritual health scale and a perceived clinical practice stress scale, together with the score for clinical nursing practice, were compared between the groups. Baseline data were collected from all participants. The experimental group participated in 8 weeks of 50-minute per week SLP, which included lectures, discussion, reflection, and spiritual practices. A second data set was collected from all participants after the intervention. A third data set was collected after all participants had performed 4 weeks of nursing clinical practice. Participants were all women. Average age was 19.4 years (SD = 1.3 years). Generalized estimating equation analysis showed SLP to have a significant short-term effect on improving the total score for spiritual health (p < .01). Significantly greater improvement in clinical practice stress scores was also seen in the experimental group as compared with the control group (all p < .05). The experimental group obtained a higher score of the final clinical practice than the control group (t = 3.771, p < .001). The SLP may encourage participants to see stressors as meaningful events that are connected to individual life purposes. The program developed in this study may be used to improve spiritual health and reduce stress in nursing students' clinical practice. This SLP may be referenced when designing similar spirituality-related courses and applied to nursing student counseling.
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Oncology nurses and the experience of participation in an evidence-based practice project.
Fridman, Mary; Frederickson, Keville
2014-07-01
To illuminate the experiences of oncology nurses who participated in an evidence-based practice (EBP) project in an institution with an EBP organizational structure. A descriptive phenomenologic approach and in-depth interviews with each participant. An oncology-focused academic medical center with an established organizational infrastructure for EBP. 12 RNs working in an oncology setting who participated in an EBP project. Descriptive, qualitative phenomenologic approach through use of interviews and analysis of interview text. Four essential themes (i.e., support, challenges, evolution, and empowerment) and 11 subthemes emerged that reflected nurses' professional and personal growth, as well as the creation of a culture of EBP in the workplace. The participants described the EBP project as a positive, empowering personal and professional evolutionary experience with supports and challenges that resulted in improvements in patient care. To the authors' knowledge, the current study is the first qualitative study to demonstrate improved nursing outcomes (e.g., professional growth, improved nursing performance) and nurses' perception of improved patient outcomes (e.g., ongoing healthcare collaboration, evidence-based changes in practice).
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Matthew-Maich, Nancy; Ploeg, Jenny; Dobbins, Maureen; Jack, Susan
2013-05-01
There is a current push to use best practice guidelines (BPGs) in health care to enhance client care and outcomes. Even though intensive resources have been invested internationally to develop BPGs, a gap in knowledge exists about how to consistently and efficiently move them into practice. Constructivist grounded theory was used to explore the complex processes of a breastfeeding BPG implementation and uptake in three acute care hospitals. Interviews (n = 120) with 112 participants representing clients, nurses, lactation consultants, midwives, physicians, managers, administrators, and nurse educators as well as document and field note analysis informed this study. Data were analyzed using constant comparison and coding steps outlined by Charmaz: initial coding, selective (focused) coding, then theoretical coding. Triangulation of data types and sources were used as well as theoretical sampling. Data were collected from 2009 to 2010. Two sites showed BPG uptake while one did not. Factors present in the uptake sites included, ongoing passionate frontline leaders, the use of multifaceted strategies, and processes that occurred at organizational, leadership, individual and social levels. Particularly noteworthy was the transformation of individual nurses to believing in and using the BPG. Impacts occurred at client, nurse, unit, inter-professional, organizational and system levels. A conceptual framework: Supporting the Uptake of Nursing Guidelines, was developed that reveals essential processes used to facilitate BPG uptake into nursing practice and a process of nurse transformation to believing in and using the BPG. © Sigma Theta Tau International.
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Mental health nursing and stress: maintaining balance.
Ward, Louise
2011-04-01
The recruitment and retention of mental health nurses within acute inpatient mental health facilities continues to be an ongoing issue. Literature and current research highlight an environment fraught with pressure and stress, identifying several key factors contributing to job dissatisfaction. These factors include greater patient acuity, unpredictable and challenging workspaces, violence, increased paperwork, and reduced managerial support. This qualitative, critical, feminist exploration investigated the lived experiences of 13 female mental health nurses working in inpatient services. They were asked about their practice and perceptions of workplace culture, and they shared their thoughts on stress management and professional well-being. Positive workplace practice was highlighted, and the participants revealed an environment they were proud to be a part of. Individual interviews, focus groups, and reflective practice were all used to collect data. The findings from the investigation unanimously support current literature that clearly confirms mental health nursing to be stressful. Interestingly, however, the findings also clearly identified that the way in which the nurse participants managed their stress was intrinsically linked to their job satisfaction. The major theme identified throughout the present study revealed that the female participants' ability to manage an at times complex workspace through the notions of teamwork, diversity, and creativity. All of the participants considered these elements as significant to providing a high standard in patient care. This research might provide an opportunity for others to view mental health nursing from a different perspective, and through the lived experiences of the participants, embrace the positive and rewarding aspects of the role. © 2011 The Author. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.
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[Advanced nursing practice: a must for the quality of care and mental health services].
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 supported the development of new models of advanced practice in mental health. These developments have been particularly significant in the United States and Australia. In United States, during the 1990s, at least four models of advanced practice in mental health nursing have been developed leading to wide variations in the roles, education, job titles, scope of practice and legal authorizations. Consequently, a consensus model of uniform standards of practice, accreditation and education has been proposed. This LACE model (Licensure, Accreditation, Certification, Education) will be in effect in 2015. Australia has adopted a more systematic approach, unified and progressive to facilitate the development of advanced mental health nursing practice. Australia who, through their many publications, retains more attention since a clear definition of the role of the nurse practitioner in mental health and a legal framework has been adopted at the national level. The Australian experience and the finding from studies suggest that mental health nurse practitioners and nurses who are specialized in mental health have the potential to make a significant contribution to enhancing access to and quality of mental health care through flexible an innovative approaches. So there are more and more evidence and indications that Quebec should invest in enhancing the skills of mental health nurses through the development of advanced nursing practice and integration of this new model in primary care. In addition, researches, funded by the Canadian Services Research Foundation (CHSRF, 2010), shows that the contribution of advanced nursing practice has never been stronger and there is a broad consensus to its value for the Canadian health care system (Dicenso.et Lukosius-Briant, 2010). The implementation of advanced practice nursing role in mental health is part of best practices required to improve care and mental health services and should be taken into account in future Action Plan 2014-2020.
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Students' perspectives on basic nursing care education.
Huisman-de Waal, Getty; Feo, Rebecca; Vermeulen, Hester; Heinen, Maud
2018-02-05
The aim of the study is to explore the perspectives of nursing students on their education concerning basic nursing care, learned either during theoretical education or clinical placement, with a specific focus on nutrition and communication. Basic care activities lie at the core of nursing, but are ill-informed by evidence and often poorly delivered. Nursing students' education on basic care might be lacking, and the question remains how they learn to deliver basic care in clinical practice. Descriptive study, using an online questionnaire. Nursing students at the vocational and bachelor level of six nursing schools in the Netherlands were invited to complete an online questionnaire regarding their perception of basic nursing care education in general (both theoretical education and clinical placement), and specifically in relation to nutrition and communication. Nursing students (n=226 bachelor students, n=30 vocational students) completed the questionnaire. Most students reported that they learned more about basic nursing care during clinical placement than during theoretical education. Vocational students also reported learning more about basic nursing care in both theoretical education and clinical practice than bachelor students. In terms of nutrition, low numbers of students from both education levels reported learning about nutrition protocols and guidelines during theoretical education. In terms of communication, vocational students indicated that they learned more about different aspects of communication during clinical practice than theoretical education, and were also more likely to learn about communication (in both theoretical education and clinical practice) than were bachelor students. Basic nursing care seems to be largely invisible in nursing education, especially at the bachelor level and during theoretical education. Improved basic nursing care will enhance nurse sensitive outcomes and patient satisfaction and will contribute to lower healthcare costs. This study shows that there is scope within current nurse education in the Netherlands to focus more systematically and explicitly on basic nursing care. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Understanding nursing scope of practice: a qualitative study.
Schluter, Jessica; Seaton, Philippa; Chaboyer, Wendy
2011-10-01
The past decade has seen increased patient acuity and shortened lengths of stays in acute care hospitals resulting in an intensification of the work undertaken by nursing staff in hospitals. This has ultimately led to a reconsideration of how nursing staff manage their work. The aim of this study was to understand how medical and surgical nurses from two Australian hospitals conceive their scope of practice in response to the available grade and skill mix of nurses and availability of unlicensed health care workers and other health care professionals. By exploring these meanings, this study aimed to build an understanding of how nursing work patterns were shifting in the face of changing patient acuity, patient profiles and nursing skill mix. A constructivist methodology, using critical incident technique (CIT) was used to explore nurses' role and scope of practice. Twenty nurses, 16 registered nurses (RNs) and four enrolled nurses (ENs), discussed significant events during which they perceived they were undertaking either patient care activities they should be undertaking, or activities that should have either been delegated or undertaken by a higher level of care provider. Five themes emerged from the data: (1) good nurses work in proximity to patients providing total patient care; (2) safeguarding patients; (3) picking up the slack to ensure patient safety; (4) developing teamwork strategies; and (5) privileging patients without mental illness or cognitive impairment. A pattern woven throughout these themes was the idea of negotiation. RNs were struggling with the notions that direct patient care was sometimes not the best use of their time, and delegation did not equate with laziness. Negotiation has become a fundamental aspect of nursing practice given the variety of nursing care providers currently employed in acute care settings. Negotiation has allowed nurses to redefine appropriate nurse-patient proximity, promote patient safety and find innovative ways of working in nursing teams. Copyright © 2011 Elsevier Ltd. All rights reserved.
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McKown, Terri; McKeon, Leslie; McKown, Leslie; Webb, Sherry
2011-12-01
Gaps exist in health professional education versus the demands of current practice. Leveraging front-line nurses to teach students exemplary practice in a Dedicated Education Unit (DEU) may narrow this gap. The DEU is an innovative model for experiential learning, capitalizing on the expertise of staff nurses as clinical teachers. This study evaluated the effectiveness of a new academic-practice DEU in facilitating quality and safety competency achievement among students. Six clinical teachers received education in clinical teaching and use of Quality and Safety Education for Nurses (QSEN) competencies to guide acquisition of essential knowledge, skills, and attitudes for continuous health care improvement. Twelve students assigned to the six teachers completed daily logs for the 10-week practicum. Findings suggest that DEU students achieved QSEN competencies through clinical teacher mentoring in interdisciplinary collaboration, using electronic information for best practice and patient teaching, patient/family decision making, quality improvement, and resolution of safety issues.
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Payne, J L; Baumgartner, R G
1996-01-01
THE CNS ROLE has been actualized in a variety of ways. Flexibility-inherent in the role-and the revolution in health care consciousness tend to place the CNS at risk for criticism regarding value to the organization. At Vanderbilt University Medical Center, a CNS task force evaluated the current reality of CNS practice and recommended role changes to include the financial analysis of patient care. After incorporating a financial perspective into our present practice, we have embarked on an interesting journey of post-Master's degree study, that of the tertiary care nurse practitioner. This practice option could elevated the clinical and financial aspects of providing cost-effective health care to a more autonomous role form; however, the transition has been challenging. Since 1990, the American Nurses Association has recommended that nursing school curricula change to meet the needs of the health care environment and provide increased career flexibility through creating one advanced degree incorporating both CNS and NP functions. Swiftly moving past differences and toward similarities will bridge the gap for advanced practice nurses in the future.
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Development of a Self-Report Checklist to Assess Dementia Care by Nurses in Hospital Settings.
Ikegami, Chikako; Ota, Katsumasa
2018-03-01
Nurses working at general hospitals face difficulties in providing dementia care. The current study examined aged care nurses' dementia care practices in the hospital setting and developed a dementia care checklist that nurses can use to review their own care practice. A self-administered questionnaire was given to 676 participants; responses were collected from 595 participants. Exploratory factor analysis identified six factors (e.g., patient understanding prompted by concern and interest for the patient, respect for patients' voluntary behavior, early detection of abnormalities) among the questionnaire's 28 items. This analysis provided a framework for the checklist and verified that it had satisfactory internal consistency and construct validity. The frequency of care practices varied with participants' knowledge of dementia care requirements, satisfaction with their own dementia care practice, confidence in their ability to judge patients' physical condition, and cooperation with colleagues. This checklist might improve dementia care in hospital settings. [Res Gerontol Nurs. 2018; 11(2):91-102.]. © 2018 Ikegami and Ota.
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Perspectives on academic misconduct: implications for education and practice.
Klainberg, Marilyn B; McCrink, Andrea; Eckardt, Patricia; Schecter, Rose; Bongiorno, Anne; Sedhom, Laila
2014-01-01
From Harvard to high school, concern related to academic misconduct, specifically cheating and its impact on societal issues, has become a great concern for educational communities. While a significant number of studies on ethical behaviors in practice in other professions such as business have been published, little research exists on registered nurses in practice. Even fewer studies have, for registered nurses, addressed if there is an association between perceived academic misconduct as students and perceived unethical behaviors in the workplace. The purpose of this study was to determine the relationship between perceptions of registered professional nurses' (RNs) current workplace behaviors and the RNs' retrospective perceptions of their academic misconduct as students. A convenience sample of 1 66 RNs enrolled in master's degree programs at four university schools of nursing completed questionnaires regarding their beliefs and behaviors. The outcome of this study was significant. Results revealed a strong relationship between unethical behaviors of the RN in practice and their prior academic misconduct when they were students.
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Day, T; Wainwright, S P; Wilson-Barnett, J
2001-09-01
Endotracheal suctioning is a frequently performed procedure that has many associated risks and complications. It is imperative that nurses are aware of these risks and are able to practise according to current research recommendations. This study was designed to examine to what extent intensive care nurses' knowledge and practice of endotracheal suctioning is based on research evidence, to investigate the relationships between knowledge and practice, and to evaluate the effectiveness of a research-based teaching programme. This quasi-experimental study was a randomized, controlled, single-blinded comparison of two research-based teaching programmes, with 16 intensive care nurses, using non-participant observation and a self-report questionnaire. Initial baseline data revealed a low level of knowledge for many participants, which was also reflected in practice, as suctioning was performed against many of the research recommendations. Following teaching, significant improvements were seen in both knowledge and practice. Four weeks later these differences were generally sustained, and provide evidence of the effectiveness of the educational intervention. The study raised concern about all aspects of endotracheal suctioning and highlighted the need for changes in nursing practice, with clinical guidelines and focused practice-based education.
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Creedon, Sile A; Cummins, Ann Maria
2012-05-01
Experiences gained from delivering a Health Informatics for Nurses course in a school of nursing and midwifery in a university teaching hospital in Ireland suggest that Web-based courses may facilitate an enhanced understanding of course content. Nursing education must recognize the importance of information and communication technology in nursing to prepare the nursing and midwifery profession to embrace current advances in information and communication technology in healthcare in Ireland, and ultimately to benefit patient care.
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Can sociology help to improve nursing practice?
Matthews, David
The first in a five-part series on sociology offers an overview of the debate about the relationship between sociology and nursing. Although sociological education is currently limited within nurse education, there is a long-held argument for its relevance. With a growing emphasis on preventative and public healthcare, sociology may yet prove its usefulness. Subsequent articles cover four of the key social factors affecting health.
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[Nursing audit as a professional marketing strategy].
Costa, Maria Suêuda; Forte, Benedita Pessoa; Alves, Maria Dalva Santos; Viana, Jamille Forte; Oriá, Mônica Oliveira Batista
2004-01-01
This study relates an audit experience with an interdisciplinary team in public health services at Fortaleza-CE and aims to describe the functional dimension of these audit actions and the its importance for nursing; to define a model with a professional marketing strategy for the nurse. Theoretical bases of contemporary Administration were used to converge with the audit practice experiences. One proposes a new audit nursing strategy in favor of the professional significance, because the nurse currently conducts actions with a scientific marketing identity, but at the unconscious level.
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Educating nurses to protect the past or to advance health care?: A polemic.
Nay, R; Pearson, A
2001-01-01
Internationally, nursing is challenged by recruitment and retention issues. On the one hand nursing is expanding and extending practice whilst on the other, lesser skilled workers are undertaking many roles which were previously fulfilled by nurses. This opinion paper contextualises the current debate and outlines many of the reasons that have been proffered for the apparent shortage. It then progresses to suggest strategies that may ensure nursing remains relevant to contemporary health care. Essentially a presentation of the authors' views, the intent of the paper is to generate debate.
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Sherman, Rose; Dyess, Susan; Hannah, Ed; Prestia, Angela
2013-01-01
A global nursing leadership shortage is projected by the end of this decade. There is an urgent need to begin developing emerging nurse leaders now. This article describes the work of an academic-practice partnership collaborative of nurse leaders. The goal of the partnership is to develop and promote an innovative enhanced nursing administration master's program targeted to young emerging nurse leaders, who have not yet moved into formal leadership roles. An action research design is being used in program development and evaluation. Qualities needed by emerging leaders identified through research included a need to be politically astute, competency with business skills required of nurse leaders today, comfort with ambiguity, use of a caring approach, and leadership from a posture of innovation. The current curriculum was revised to include clinical immersion with a nurse leader from the first semester in the program, a change from all online to online/hybrid courses, innovative assignments, and a strong mentorship component. Eighteen young emerging nurse leaders began the program in January 2012. Early outcomes are positive. The emerging nurse leaders may be uniquely positioned, given the right skills sets, to be nurse leaders in the new age.
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Climate change and ecological public health.
Goodman, Benny
2015-02-17
Climate change has been identified as a serious threat to human health, associated with the sustainability of current practices and lifestyles. Nurses should expand their health promotion role to address current and emerging threats to health from climate change and to address ecological public health. This article briefly outlines climate change and the concept of ecological public health, and discusses a 2012 review of the role of the nurse in health promotion.
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Cardona-Morrell, M; Prgomet, M; Lake, R; Nicholson, M; Harrison, R; Long, J; Westbrook, J; Braithwaite, J; Hillman, K
2016-04-01
High profile safety failures have demonstrated that recognising early warning signs of clinical and physiological deterioration can prevent or reduce harm resulting from serious adverse events. Early warning scoring systems are now routinely used in many places to detect and escalate deteriorating patients. Timely and accurate vital signs monitoring are critical for ensuring patient safety through providing data for early warning scoring systems, but little is known about current monitoring practices. To establish a profile of nurses' vital signs monitoring practices, related dialogue, and adherence to health service protocol in New South Wales, Australia. Direct observations of nurses' working practices were conducted in two wards. The observations focused on times of the day when vital signs were generally measured. Patient interactions were recorded if occurring any time during the observation periods. Participants (n=42) included nursing staff on one chronic disease medical and one acute surgical ward in a large urban teaching hospital in New South Wales. We observed 441 patient interactions. Measurement of vital signs occurred in 52% of interactions. The minimum five vital signs measures required by New South Wales Health policy were taken in only 6-21% of instances of vital signs monitoring. Vital signs were documented immediately on 93% of vitals-taking occasions and documented according to the policy in the patient's chart on 89% of these occasions. Nurse-patient interactions were initiated for the purpose of taking vital signs in 49% of interactions, with nurse-patient discourse observed during 88% of all interactions. Nurse-patient dialogue led to additional care being provided to patients in 12% of interactions. The selection of appropriate vital signs measured and responses to these appears to rely on nurses' clinical judgement or time availability rather than on policy-mandated frequency. The prevalence of incomplete sets of vital signs may limit identification of deteriorating patients. The findings from this study present an important baseline profile against which to evaluate the impact of introducing continuous monitoring approaches on current hospital practice. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Flying Lessons for Clinicians: Developing System 2 Practice.
Gregoire, Jerome N; Alfes, Celeste M; Reimer, Andrew P; Terhaar, Mary F
There is a long history of adopting lessons learned from aviation to improve health care practice. Two of the major practices that have successfully transferred include using a checklist and simulation. Training and simulation technology is currently underdeveloped for nurses and health care providers entering critical care transport. This article describes a pedagogical approach adopted from aviation to develop a new simulation platform and program of research to develop the science of critical care transport nursing education. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.
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Perceived benefits and barriers of implementing nursing residency programs in Jordan.
AbuAlRub, R F; Abu Alhaija'a, M G
2018-03-02
To explore the challenges that face Jordanian nurses in the first year of employment; and understand the benefits and barriers of implementing a Nursing Residency Program from the perspectives of nurses and key informants. Many researchers reported that novice nurses do not have an adequate level of competence needed in the real clinical practice to meet the increasing demands of healthcare systems. A descriptive qualitative approach using individual interviews and focus group discussions was utilized. The sample was a purposive one that consisted of 30 Jordanian nurses and six key informants. Data were recorded and then transcribed. Content analysis was used to analyze the data. The results revealed several challenges that face nurses in their first year of experience such as reality shock, lack of self-confidence, and burnout and intent to leave. Some of the perceived barriers of implementing the Program were issues concerned with the responsible regulatory body, payment, and monitoring and evaluation. The findings asserted that the implementation of the Nursing Residency Program for new practicing nurses would enhance their competencies and self- confidence; and decrease the rate of reality shock and turnover within the first year of employment. Policy makers, nurse educators, and nurse administrators and clinical nurses need to collaborate to develop a formal system with binding policies and regulations concerning the implementation of Nursing Residency Program. There is also a need to address and modify current orientation programmes offered by hospitals for novice nurses to enhance their transition into clinical practice. © 2018 International Council of Nurses.
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Gap analysis: a method to assess core competency development in the curriculum.
Fater, Kerry H
2013-01-01
To determine the extent to which safety and quality improvement core competency development occurs in an undergraduate nursing program. Rapid change and increased complexity of health care environments demands that health care professionals are adequately prepared to provide high quality, safe care. A gap analysis compared the present state of competency development to a desirable (ideal) state. The core competencies, Nurse of the Future Nursing Core Competencies, reflect the ideal state and represent minimal expectations for entry into practice from pre-licensure programs. Findings from the gap analysis suggest significant strengths in numerous competency domains, deficiencies in two competency domains, and areas of redundancy in the curriculum. Gap analysis provides valuable data to direct curriculum revision. Opportunities for competency development were identified, and strategies were created jointly with the practice partner, thereby enhancing relevant knowledge, attitudes, and skills nurses need for clinical practice currently and in the future.
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Validation of holistic nursing competencies: role-delineation study, 2012.
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.
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The essence of nursing in the shifting reality of Israel today.
Ben Natan, Merav; Oren, Meir
2011-05-23
Israel's healthcare system is undergoing constant transformation; nurses' roles and education are changing accordingly. Israel's severe shortage of physicians has led to an increase in nurses' authority and responsibilities. The nursing profession is addressing many questions particularly in light of its expanded responsibilities and the current lack of legislation related to the practice of nursing. Additionally Israel is coping with an increasing shortage of nurses and the rapid development of innovative technologies. This article describes Israel's shifting reality and the nation's responses to these changing conditions. Responses include increasing financial support, enhancing educational opportunities, expanding the nursing role, and using new technologies.
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Coleman, Bernice; Blumenthal, Nancy; Currey, Judy; Dobbels, Fabienne; Velleca, Angela; Grady, Kathleen L; Kugler, Christiane; Murks, Catherine; Ohler, Linda; Sumbi, Christine; Luu, Minh; Dark, John; Kobashigawa, Jon; White-Williams, Connie
2015-02-01
The role of nurses in cardiothoracic transplantation has evolved over the last 25 years. Transplant nurses work in a variety of roles in collaboration with multidisciplinary teams to manage complex pre- and post-transplantation issues. There is lack of clarity and consistency regarding required qualifications to practice transplant nursing, delineation of roles and adequate levels of staffing. A consensus conference with workgroup sessions, consisting of 77 nurse participants with clinical experience in cardiothoracic transplantation, was arranged. This was followed by subsequent discussion with the ISHLT Nursing, Health Science and Allied Health Council. Evidence and expert opinions regarding key issues were reviewed. A modified nominal group technique was used to reach consensus. Consensus reached included: (1) a minimum of 2 years nursing experience is required for transplant coordinators, nurse managers or advanced practice nurses; (2) a baccalaureate in nursing is the minimum education level required for a transplant coordinator; (3) transplant coordinator-specific certification is recommended; (4) nurse practitioners, clinical nurse specialists and nurse managers should hold at least a master's degree; and (5) strategies to retain transplant nurses include engaging donor call teams, mentoring programs, having flexible hours and offering career advancement support. Future research should focus on the relationships between staffing levels, nurse education and patient outcomes. Delineation of roles and guidelines for education, certification, licensure and staffing levels of transplant nurses are needed to support all nurses working at the fullest extent of their education and licensure. This consensus document provides such recommendations and draws attention to areas for future research. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
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Polish nurses' perceived barriers in using evidence-based practice in pain management.
Mędrzycka-Dąbrowska, W; Dąbrowski, S; Gutysz-Wojnicka, A; Basiński, A
2016-09-01
The aim of this work was to present current practices, perceived barriers and perceived facilitators of Polish nurses in using EBP in the assessment and management of acute pain during the postoperative period in elderly patients. Advances in the study of pain and the methods for its relief since the late 1980s have led to a rise in the role of the nurse in pain management and monitoring. The application of evidence-based practice associated with acute pain is on the increase in the world at large. Eleven hospitals participated in this study. The project involved 1300 nurses working on surgical hospital wards. In this study, case study research and qualitative content analysis were used. The study was conducted using a dedicated questionnaire. Access to journals on evidence-based practice on the assessment and management of pain in elderly patients was assessed as less important by the respondents. Knowledge drawn from the media, scientific and medical journals was assessed by the respondents as unsatisfactory. The greatest barrier to nurses was the fact that scientific articles were published in English. Nurses' awareness of evidence-based practice increases with their education. Among the key problems are the lack of available professional publications in Polish literature, ignorance of English, shortage of time and lack of support from chief physicians of the ward. There is a need for the introduction of innovative strategies of teaching and approaches to the problem of evidence-based practice in approach to pain management in elder people among the Polish nurses. It is necessary to promote these issues in Polish scientific literature. © 2016 International Council of Nurses.
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Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl
2018-03-01
To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.
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Alabdulaziz, Hawa; Moss, Cheryle; Copnell, Beverley
2017-04-01
Family-centred care is widely accepted as the underlying philosophy of paediatric nursing. Studies of family-centred care have mainly been conducted in western countries and little is known of its practice in other contexts. No studies have been undertaken in the Middle East. To explore family-centred care in the Saudi context from the perspectives of paediatric nurses. A mixed methodology was utilised with an explanatory sequential design. In the quantitative phase a convenience sample of 234 nurses from six hospitals in Jeddah, Saudi Arabia completed the Family Centred Care Questionnaire. The qualitative phase took place in one hospital and involved 140h of non-participant observation of paediatric nurses' practice. A convenience sample of 14 nurses was involved. Additionally, 10 face-to-face semi-structured interviews were conducted with key staff members. A purposeful sample of 10 nurses was involved. The findings from both phases were integrated in the final analysis. The survey results indicated that participants identified most elements of family-centred care as necessary for its practice. They were less likely to incorporate them into their practice (p<0.001, paired t-tests, all subscales). These findings were supported by the observation data, which revealed that, while several elements of family-centred care were frequently practised, others were implemented either inconsistently or not at all. Findings from the interview data indicated that participants had limited and superficial understanding of what family-centred care means as a model of care; rather, they worked with the elements as a set of core tasks. In the current study, there were similarities between what has been found in the Saudi context and findings from other studies using the same tool in western contexts. There is general agreement regarding the differences between theory and practice. Nurses do believe and acknowledge the importance of family-centred care; however, they struggle with practising this model in their everyday work. In the current study, many factors contributed to this issue, including language barriers, communication issues, cultural issues and hospital policies. Western concepts of family-centred care appear to be accepted by paediatric nurses in Saudi Arabia. However, full adoption of family-centred care in keeping with western values is likely not to be appropriate or successful in the Saudi context where both nurses and families have a non-western culture. The western model of family-centred care requires cultural modification and further development to fit Saudi and Middle Eastern cultures. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Flinkman, Mervi; Salanterä, Sanna
2015-11-01
To describe why young registered nurses (RNs) had previously left an organisation and why they intend to leave the profession. Currently, many young registered nurses, including those in Finland, are considering leaving their job or have an intention to leave the profession. An in-depth, descriptive approach was adopted. Data were collected in 2012 from interviews with 15 registered nurses (under the age of 30 years). The interviews were semi-structured and analysed using conventional content analysis. The main questions addressed were: 'Why had the young registered nurses left their previous organisation?' and 'Why do young registered nurses have an intention to leave the profession?' The findings centre on three themes: poor nursing practice environments; lack of support, orientation and mentoring, and nursing as a 'second best' or serendipitous career choice. The first years of nursing are particularly stressful for newly-graduated and inexperienced registered nurses. An in-depth, qualitative approach reveals more complex reasons behind the turnover of registered nurses and intention to leave the profession than questionnaire surveys. Young registered nurses need social support from nurse managers and experienced colleagues to successfully transition into nursing practice environments. Adequate orientation and mentoring programmes are needed to facilitate this transition. © 2014 John Wiley & Sons Ltd.
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Hinno, Saima; Partanen, Pirjo; Vehviläinen-Julkunen, Katri
2012-03-01
The working environment of nurses is receiving international interest, because there is a growing consensus that identifying opportunities for improving working conditions in hospitals is essential to maintain adequate staffing, high-quality care, nurses' job satisfaction and hence their retention. Thus, the aim of this study was to investigate the relationship between nurse work environment characteristics and nurse-reported job outcomes in hospital settings in Finland and the Netherlands and to compare these results. A comparative cross-sectional nurse survey was conducted. Data were collected from the two countries randomly sampling the countries' National Nurses Association' membership databases. In this paper, the results from Registered Nurses working in hospital settings are used. In total, 869 hospital nurses participated: 535 from Finland and 334 from the Netherlands with the response rate of 44.9 and 33.4%, respectively. Fifty-five items from the Nursing Work Index-Revised were used as a main tool for the practice environment. Exploratory factor analysis was used to identify a set of internally consistent subscales. Further, logistic regression analysis and T-tests were used. Three practice environment characteristics were identified: adequacy of resources, supportiveness of management and assurance of care quality via collaborative relationships. Favourable evaluations of the adequacy of resources and supportiveness of management were positively correlated with nurse-assessed quality of care and job-related positive feelings and negatively correlated with intentions to leave a unit, organization or the entire profession. In neither of the participating countries were adverse incidents affecting nurses related to nurses' evaluations of their current professional practice environment. Compared with Finland, in the Netherlands, RN appears to evaluate the majority of work environment characteristics more positively; nevertheless, to some extent, the results were uniform as adequacy of resources and supportiveness of management were main predictors for nurse-reported job outcomes considered. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
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The implementation of problem-based learning: changing pedagogy in nurse education.
Creedy, D; Hand, B
1994-10-01
Problem-based learning (PBL) employs approaches to teaching and learning in nurse education that develop meaningful links between theory and practice. The adoption of such approaches, however, may require changes in pedagogical beliefs and practices which reflect a student-centred approach to teaching and learning. This paper focuses on a group of volunteer nurse educators (n = 14) who attended a 7-month professional development programme centred on introducing pedagogical changes when adopting PBL. From this group, three nurse educators participated in an in-depth study which aimed to examine the processes of conceptual change associated with adopting PBL as part of alternative teaching strategies. These three participants held common concerns about the changes required to their current teaching practices when moving to a new pedagogical approach. On completion of the programme, varying degrees of change in existing instructional practices were evident. This change was found to result from engaging educators in reflection about practice, providing opportunities to implement the new approaches on a trial basis, and providing feedback and support throughout the change process.
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Tzeng, Huey-Ming
2006-05-01
This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system. In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis. In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study. The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities. These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening, which might lead to a serious situation that includes malpractice litigation. It is believed that the questionnaire used in this study may be used as a diagnostic tool for assessing a crisis management system within a hospital's nursing environment.
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Effectiveness of classroom response systems within an active learning environment.
Welch, Susan
2013-11-01
In nursing education, the inclusion of pedagogical tools is necessary to transform Millennial classrooms. One such pedagogical tool currently offered is classroom response systems (CRS). The purpose of this study was to evaluate the effectiveness of CRS as a pedagogical tool in improving nursing students' examination performance within an active learning environment. A pretest-posttest design was used to determine whether there was a relationship between the use of CRS (independent variable) and nursing students' examination performance in a first-year Professional Practice course (dependent variable). Paired t tests revealed no greater improvement in posttest scores. Therefore, the use of CRS technology was not effective in increasing nursing students' examination scores in the Professional Practice course. Additional research is needed to provide adequate understanding of the effectiveness of CRS within the nursing education classroom. Copyright 2013, SLACK Incorporated.
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Bladder catheterization in Greek nursing education: An audit of the skills taught.
Theofanidis, Dimitrios; Fountouki, Antigoni
2011-02-01
The auditing of nurse teaching is in its infancy in Greece. One area urgently in need of audit is the teaching of male catheterization. To assess the current educational model regarding male bladder catheterization at a sole tertiary education nursing establishment in a major Greek city and to improve nurse undergraduate training by implementing appropriate recommendations for change to the current educational module and support these changes in the long term. A systematic search of international databases for guidelines or best practice regarding bladder catheterization was conducted. Audit measures included direct observation of the teaching process and compilation of a checklist. The shortcomings are discussed under the following headings: patient pre-preparation, choice and quality of materials used, appropriate aseptic techniques, catheter withdrawal, connecting and handling the drainage bag, diminishing risk of Catheter Associated Urinary Track Infections (CAUTIs), no problem solving trouble-shooting training, textbook and educational resources, lack of national guidelines, setting of the educational experience. The main problem with the teaching process exposed by the audit is entrenched use of an outmoded textbook with little effort to enrich teaching with current evidence base practices. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Kataoka-Yahiro, Merle R; Richardson, Karol; Mobley, Joseph
2011-03-01
This study assessed distance learning needs among nurses on the Neighbor Islands in Hawaii. An exploratory study was conducted using a descriptive qualitative design. Of the 37 nurses who completed the study, 7 were nurse administrators and 30 were staff nurses. There were 18 focus groups of nurses recruited from six public hospitals on the Neighbor Islands. Three major themes related to distance learning emerged in this study: benefits, barriers, and intentions/desires. Each major theme had several linkages to categories and subcategories. Overall findings were as follows: (1) cost was mentioned more often in three major thematic areas (benefit, barriers, and intentions/desires); (2) the need to revisit and address current curriculum approaches and practices in distance learning programs was identified; and (3) strong recommendations were made for programs and organizational support for distance learning in hospital settings. These findings have implications for nursing research, education, and practice. Copyright 2011, SLACK Incorporated.
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[The profile and professional practice of nurses in a psychosocial care services].
Dias, Cristiane Bergues; Aranha e Silva, Ana Luisa
2010-06-01
This qualitative study was performed with fourteen nurses of eleven psychosocial care services. The objectives of the study were the following: to characterize the professional profile of the nurses who work in community psychiatric services and to verify those nurses' practice according to the current model of mental health care. there was a prevalence of females; most had over 10 years since their graduation; their entrance in the mental health area is late and is associated with the lack of job opportunities and the fact that the service is close to their home. One part of the nurses found it difficult to define their work at an extra-hospital environment. On the other hand, another group of nurses believes that the nursing work in mental health services is flexible and it is shared with other workers of the multidisciplinary team. Low salaries, poor infrastructure and the lack of team member acknowledgement generate dissatisfaction at work. The Brazilian Psychiatric Reform is associated with dehospitalization.
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Henry, Suzanne Bakken; Warren, Judith J.; Lange, Linda; Button, Patricia
1998-01-01
Building on the work of previous authors, the Computer-based Patient Record Institute (CPRI) Work Group on Codes and Structures has described features of a classification scheme for implementation within a computer-based patient record. The authors of the current study reviewed the evaluation literature related to six major nursing vocabularies (the North American Nursing Diagnosis Association Taxonomy 1, the Nursing Interventions Classification, the Nursing Outcomes Classification, the Home Health Care Classification, the Omaha System, and the International Classification for Nursing Practice) to determine the extent to which the vocabularies include the CPRI features. None of the vocabularies met all criteria. The Omaha System, Home Health Care Classification, and International Classification for Nursing Practice each included five features. Criteria not fully met by any systems were clear and non-redundant representation of concepts, administrative cross-references, syntax and grammar, synonyms, uncertainty, context-free identifiers, and language independence. PMID:9670127
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2015-02-01
with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1...the impact of an electronic innovation must include a description of the sociotechnical context as well as the process and outcome metrics for...dissemination, will have a positive effect on nursing knowledge, use of evidence-based practices, and the achievement of nurse-sensitive patient outcomes
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Oncology nurses and indoor tanning: stylish or risky behavior?
Leong, Christina Marie; Palos, Guadalupe R
2014-06-01
Being tan has become a social norm, and some nurses engage in that widely accepted lifestyle. Mounting evidence of the increased risk to melanoma and nonmelanoma skin cancers associated with indoor tanning supports the need for nurses to integrate skin cancer education, counseling, and referrals into routine practice. The current article presents an overview of the risks associated with indoor tanning, discusses its acceptance as a social norm, and offers strategies to support oncology nurses in changing the widespread trend.
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Stereotypes of professional roles.
Kaler, S R; Levy, D A; Schall, M
1989-01-01
To determine the current public image of the nursing profession, this survey investigated the nature of stereotyping. Subjects approached in a shopping mall (N = 110) were asked to rate the degree to which 12 characteristics typify individuals in 14 professions. The results indicate that the public image of the nurse continues to turn on feminine and nurturant characteristics. The need for increased public awareness that nurses are scholars and leaders is underscored. Asserting the right to practice may produce a new stereotype of the nurse as intelligent and autonomous.
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Nurse educators' experiences of case-based education in a South African nursing programme.
Daniels, Felicity M; Fakude, Lorraine P; Linda, Ntombizodwa S; Marie Modeste, Rugira R
2015-12-09
A school of nursing at a university in the Western Cape experienced an increase in student enrolments from an intake of 150 students to 300 students in the space of one year. This required a review of the teaching and learning approach to ensure that it was appropriate for effective facilitation of large classes. The case-based education (CBE) approach was adopted for the delivery of the Bachelor of Nursing programme in 2005. The aim of the study was to explore nurse educators' experiences, current practices and possible improvements to inform best practice of CBE at the nursing school in the Western Cape. A participatory action research method was applied in a two day workshop conducted with nurse educators in the undergraduate nursing programme. The nominal group technique was used to collect the data. Three themes emerged from the final synthesis of the findings, namely: teaching and learning related issues, student issues and teacher issues. Amongst other aspects, theory and practice integration, as well as the need for peer support in facilitation of CBE, were identified as requiring strengthening. It was concluded that case-based education should continue to be used in the school, however, more workshops should be arranged to keep educators updated and new staff orientated in respect of this teaching and learning approach.
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How is Primary Health Care conceptualised in nursing in Australia? A review of the literature.
Henderson, Julie; Koehne, Kristy; Verrall, Claire; Gebbie, Kristine; Fuller, Jeffrey
2014-07-01
Australia, in common with many other countries, is expanding the role of Primary Health Care (PHC) to manage the growing burden of chronic disease and prevent hospitalisation. Australia's First National Primary Health Care Strategy released in 2010 places general practice at the centre of care delivery, reflecting a constitutional division of labour in which the Commonwealth government's primary means of affecting care delivery in this sector is through rebates for services delivered from the universal healthcare system Medicare. A review of Australian nursing literature was undertaken for 2006-2011. This review explores three issues in relation to these changes: How PHC is conceptualised within Australian nursing literature; who is viewed as providing PHC; and barriers and enablers to the provision of comprehensive PHC. A review of the literature suggests that the terms 'PHC' and 'primary care' are used interchangeably and that PHC is now commonly associated with services provided by practice nurses. Four structural factors are identified for a shift away from comprehensive PHC, namely fiscal barriers, educational preparation for primary care practice, poor role definition and interprofessional relationships. The paper concludes that while moves towards increasing capacity in general practice have enhanced nursing roles, current policy and the nature of private business funding alongside some medical opposition limit opportunities for Australian nurses working in general practice. © 2013 John Wiley & Sons Ltd.
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[Current state of competence assessment in nursing].
Darmann-Finck, Ingrid; Reuschenbach, Bernd
2013-01-01
Competency measurement is central to the optimisation of outcome oriented educational processes in nursing, similar to the concept of evidence based practice. The classification of measurement tools provides the basis for describing the current state of research and development in relation to competence measurement in nursing science, and any gaps are identified. The article concludes with questioning the importance of outcome oriented quality orientation in order to achieve an increase in quality during training. Further methodological developments and qualitative studies are needed to examine the context specific processes of interaction and learning, beyond competence diagnostics. Copyright © 2012. Published by Elsevier GmbH.
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The Ottawa Model of Research Use: a guide to clinical innovation in the NICU.
Hogan, Debora L; Logan, Jo
2004-01-01
To improve performance of a neonatal transport team by implementing a research-based family assessment instrument. Objectives included providing a structure for evaluating families and fostering the healthcare relationship. Neonatal transports are associated with family crises. Transport teams require a comprehensive framework to accurately assess family responses to adversity and tools to guide their practice toward parental mastery of the event. Currently, there are no assessment tools that merge family nursing expertise with neonatal transport. A family assessment tool grounded in contemporary family nursing theory and research was developed by a clinical nurse specialist. The Ottawa Model of Research Use guided the process of piloting the innovation with members of a transport team. Focus groups, interviews, and surveys were conducted to create profiles of barriers and facilitators to research use by team members. Tailored research transfer strategies were enacted based on the profile results. Formative evaluations demonstrated improvements in team members' perceptions of their knowledge, family centeredness, and ability to assess and intervene with families. The family assessment tool is currently being incorporated into Clinical Practice Guidelines for Transport and thus will be considered standard care. Use of a family assessment tool is an effective way of appraising families and addressing suffering. The Ottawa Model of Research Use provided a framework for implementing the clinical innovation. A key role of the clinical nurse specialist is to influence nursing practice by fostering research use by practitioners. When developing and implementing a clinical innovation, input from end users and consumers is pivotal. Incorporating the innovation into a practice guideline provides a structure to imbed research evidence into practice.
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Trends in Mediation Analysis in Nursing Research: Improving Current Practice.
Hertzog, Melody
2018-06-01
The purpose of this study was to describe common approaches used by nursing researchers to test mediation models and evaluate them within the context of current methodological advances. MEDLINE was used to locate studies testing a mediation model and published from 2004 to 2015 in nursing journals. Design (experimental/correlation, cross-sectional/longitudinal, model complexity) and analysis (method, inclusion of test of mediated effect, violations/discussion of assumptions, sample size/power) characteristics were coded for 456 studies. General trends were identified using descriptive statistics. Consistent with findings of reviews in other disciplines, evidence was found that nursing researchers may not be aware of the strong assumptions and serious limitations of their analyses. Suggestions for strengthening the rigor of such studies and an overview of current methods for testing more complex models, including longitudinal mediation processes, are presented.
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Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret
2012-05-31
Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.
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Nurses' Spirituality Improves Caring Behavior
ERIC Educational Resources Information Center
Bakar, Abu; Nursalam; Adriani, Merryana; Kusnanto; Qomariah, Siti Nur; Hidayati, Laily; Pratiwi, Ika Nur; Ni'mah, Lailatun
2017-01-01
Caring is a behavior of giving holistic assistance to individuals. In fact, this important behavior still has not routinely performed in current nursing practice. Personality and sipirituality are important factors in forming one's caring behavior. Spirituality is a passion or impulse to perform noble action. The objective of this study was to…
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Breimaier, Helga E; Halfens, Ruud J G; Wilborn, Doris; Meesterberends, Esther; Haase Nielsen, Gunnar; Lohrmann, Christa
2013-01-01
Translating guidelines into nursing practice remains a considerable challenge. Until now, little attention has been paid to which interventions are used in practice to implement guidelines on changing clinical nursing practice. This cross-sectional study determined the current ranges and rates of implementation-related interventions in Austria, Germany, and The Netherlands and explored possible differences between these countries. An online questionnaire based on the conceptual framework of implementation interventions (professional, organizational, financial, and regulatory) from the Cochrane Effective Practice and Organization of Care (EPOC) data collection checklist was used to gather data from nursing homes and hospitals. Provision of written materials is the most frequently used professional implementation intervention (85%), whereas changes in the patient record system rank foremost among organisational interventions (78%). Financial incentives for nurses are rarely used. More interventions were used in Austria and Germany than in The Netherlands (20.3/20.2/17.3). Professional interventions are used more frequently in Germany and financial interventions more frequently in The Netherlands. Implementation efforts focus mainly on professional and organisational interventions. Nurse managers and other responsible personnel should direct their focus to a broader array of implementation interventions using the four different categories of EPOC's conceptual framework.
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Armstrong, Deborah K; McCurry, Mary; Dluhy, Nancy M
Transitioning into the role of nurse scientist requires the acquisition of new knowledge but also involves the development of new scholarly skills and the appropriation of the unique values and goals of the new role. Students engaged in doctor of philosophy education in all practice disciplines are confronted with a necessary shift in perspective and identity from that of the practice expert to the research scientist and experience a tension referred to as the research-practice dualism. The purpose of this article is to examine the ramifications of this identity shift in nursing doctor of philosophy education and to detail one program's strategy to address the inherent tension. This transition into the role of nurse scientist includes learning to value scholarly literature, expanding one's philosophical and disciplinary vocabulary, cultivating disciplinary inquisitiveness, learning scholarly communication and dissemination skills, and developing new collegial relationships. It is essential that this process of transitioning from clinician to scholar be purposively supported from the outset of the program. Faculty must critically examine current educational strategies and design new approaches to more effectively integrate the practice and science worlds, thereby enhancing program completion and graduating nurse scientists who are equipped to contribute to the knowledge of the discipline. Copyright © 2016 Elsevier Inc. All rights reserved.
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Nursing, art and science: revisiting the two cultures.
Darbyshire, P
1999-09-01
I begin this paper by setting out the importance of the Two Cultures debate, given that many nurse authors would agree with Closs's position that the art versus science debate should be closed finally. I suggest that issues are every bit as present and urgent in our current era as they were in the past. A brief tracing of the history of the Two Cultures debate highlights the relevance of the central features of the debate for nursing. I then focus on nursing's current understanding of science and art and attempt to defend science from some of the accusations levelled at it, while also questioning some of the claims made on behalf of the arts. In the latter sections of the paper, I make a case for the development of 'nursing humanities' and argue the vital importance of overcoming the Two Cultures divide for the everyday practices of nurses and midwives.
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Education for worksite monitors of impaired nurses.
Young, Linda J
2008-01-01
Boards of nursing sponsor programs, including those for alternatives to discipline, for recovering nurses. These programs rely on worksite monitors who are oftentimes other nurses or supervisors of nurses, to work with recovering nurses when they return to practice. The skills of these monitors vary with respect to understanding the monitor role and recognizing traits in chemical dependency and relapse. To determine the degree of content value and the best teaching method for monitors to learn program content, 17 currently active worksite monitors participated in a study to evaluate content value to 2 groups, new and experienced monitors, and to select the best method to teach 4 content topics. Results showed that current content was valued without necessary additions and that group instruction in urban areas was preferred over one-to-one instruction. Implementation of study outcomes yielded that issues of confidentiality made group instruction unsatisfactory.
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The work of nurses in Australian general practice: A national survey.
Joyce, Catherine M; Piterman, Leon
2011-01-01
Following recent reforms to Australia's health system, nurses now comprise a significant and growing sector of the Australian primary care workforce, but there is little data describing the services they provide. This study aimed to describe the patient consultations of nurses in Australian general practice, including patient characteristics, reasons for the consultation, treatments provided and other actions taken. The study was a national cross-sectional survey, with each participating nurse collecting information about 50 nurse-patient encounters. General practice settings in all regions of Australia. 108 nurses volunteered in response to advertisements and 104 returned completed study materials. Participants included Registered (Division 1) and Enrolled (Division 2) nurses working in a general practice setting. Data were collected between May 2007 and May 2008 using a profile questionnaire and a series of encounter forms. Information was gathered on reasons for encounter, patient characteristics, and actions taken. Data were classified using the International Classification of Primary Care. The final data set included 5,253 nurse-patient encounters. 37.2% of patients (95% CI 33.3-41.2) were aged 65 and over, and 57.1% were female (95% CI 54.9-59.5). The majority of encounters (90.7%) were with existing patients of the practice (95% CI 89.1-92.7). The most common reasons for encounter were general and unspecified problems (35.4 per 100 encounters; 95% CI 31.8-39.1), followed by skin-related problems (20.0; 95% CI 17.3-22.8), and cardiovascular problems (11.0; 95% CI 8.7-13.3). Common management actions included medical examinations (20.7 per 100 encounters), immunisations (22.5), diagnostic tests (10.6), and dressings (15.8). Approximately 30% of encounters involved advice-giving. The findings confirm the generalist nature of the General Practice Nurse role, with a wide range of patient types and clinical conditions. There is a clear influence of current funding and organisational arrangements on work patterns, with tasks that have specific funding (including immunisations and wound care) featuring prominently in nurses' work. Whilst nurses' rates for presenting conditions were similar to doctors at a general level, specific actions taken and problems managed differed. New policy reforms in Australia are supporting greater flexibility in the General Practice Nurse role, maximising efficient use of nurses' skills in the primary health care context. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Viswanathan, Kartik; Rosen, Tony; Mulcare, Mary R.; Clark, Sunday; Hayes, Jaime; Lachs, Mark S.; Flomenbaum, Neal
2015-01-01
BACKGROUND Indwelling Urinary Catheters (IUCs) are placed frequently in older adults in the emergency department (ED). While often a critical intervention, IUCs carry significant risks, particularly for geriatric patients, including infection, delirium, and falls. In addition, once placed, IUCs are rarely removed in the ED and may remain for an extended period after transfer of care, leading to poor outcomes. The purpose of this research was to examine the current knowledge, attitudes, and practice of ED nurses and other providers regarding IUC placement and management in older adults. METHODS We surveyed ED providers including nurses, attending physicians, Emergency Medicine (EM) residents, nurse practitioners (NPs), and physician assistants (PAs) at a large, urban, academic medical center. We developed comprehensive written questionnaires designed using items from previously validated instruments and questions created specifically for this study. In addition, we assessed providers' management of 25 unique clinical scenarios, each representing an established appropriate or inappropriate indication for IUC placement. RESULTS 127 ED providers participated: 43 nurses, 21 attending physicians, 47 residents, and 17 NP/PAs. 91% of nurses and 88% of other providers reported comfort with appropriate indications for IUC placement. Despite this, in the clinical vignettes nurses correctly identified the appropriate approach for IUC placement in only 40% of cases and other providers in only 37%. Reported practices were most divergent from accepted standards in delirium, with 3% of nurses and 1% of other providers appropriately avoiding IUC placement. Practice varied widely between individual providers, with the nurse participants reporting appropriate practice in 16%–64% of clinical scenarios and other providers in 8%–68%. Few nurses or other providers reported reassessing their patients for IUC removal at transfer to the hospital upstairs (28% of nurses and 7% of other providers), admission (24% and 14%), or shift change (14% and 8%). CONCLUSIONS Although ED nurses and other providers report comfort with appropriate indications for IUC placement, their reported practice patterns showed inconsistencies with established guidelines. Wide practice variation exists between individual providers. Moreover, nurses and other providers infrequently consider IUC removal after placement. Future research should focus on development of educational interventions and protocols to assist ED nurses and other providers with appropriate indications for and management of IUCs in older adults. PMID:25872970
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Hussey, Pamela A; Kennedy, Margaret Ann
2016-05-01
A discussion on how informatics knowledge and competencies can enable nursing to instantiate transition to integrated models of care. Costs of traditional models of care are no longer sustainable consequent to the spiralling incidence and costs of chronic illness. The international community looks towards technology-enabled solutions to support a shift towards integrated patient-centred models of care. Discussion paper. A search of the literature was performed dating from 2000-2015 and a purposeful data sample based on relevance to building the discussion was included. The holistic perspective of nursing knowledge can support and advance integrated healthcare models. Informatics skills are key for the profession to play a leadership role in design, implementation and operation of next generation health care. However, evidence suggests that nursing engagement with informatics strategic development for healthcare provision is currently variable. A statistically significant need exists to progress health care towards integrated models of care. Strategic and tactical plans that are robustly pragmatic with nursing insights and expertise are an essential component to achieve effective healthcare provision. To avoid exclusion in the discourse dominated by management and technology experts, nursing leaders must develop and actively promote the advancement of nursing informatics skills. For knowledge in nursing practice to flourish in contemporary health care, nurse leaders will need to incorporate informatics for optimal translation and interpretation. Defined nursing leadership roles informed by informatics are essential to generate concrete solutions sustaining nursing practice in integrated care models. © 2016 John Wiley & Sons Ltd.
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Gordon, Christopher J; Aggar, Christina; Williams, Anna M; Walker, Lynne; Willcock, Simon M; Bloomfield, Jacqueline
2014-01-01
This debate discusses the potential merits of a New Graduate Nurse Transition to Primary Health Care Program as an untested but potential nursing workforce development and sustainability strategy. Increasingly in Australia, health policy is focusing on the role of general practice and multidisciplinary teams in meeting the service needs of ageing populations in the community. Primary health care nurses who work in general practice are integral members of the multidisciplinary team - but this workforce is ageing and predicted to face increasing shortages in the future. At the same time, Australia is currently experiencing a surplus of and a corresponding lack of employment opportunities for new graduate nurses. This situation is likely to compound workforce shortages in the future. A national nursing workforce plan that addresses supply and demand issues of primary health care nurses is required. Innovative solutions are required to support and retain the current primary health care nursing workforce, whilst building a skilled and sustainable workforce for the future. This debate article discusses the primary health care nursing workforce dilemma currently facing policy makers in Australia and presents an argument for the potential value of a New Graduate Transition to Primary Health Care Program as a workforce development and sustainability strategy. An exploration of factors that may contribute or hinder transition program for new graduates in primary health care implementation is considered. A graduate transition program to primary health care may play an important role in addressing primary health care workforce shortages in the future. There are, however, a number of factors that need to be simultaneously addressed if a skilled and sustainable workforce for the future is to be realised. The development of a transition program to primary health care should be based on a number of core principles and be subjected to both a summative and cost-effectiveness evaluation involving all key stakeholders.
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Baird, Martha B; Whitney, Lucinda; Caedo, Cassie E
Telemental health (TMH) growth is driven by recent trends in health delivery systems and disparities in access to mental health services. There are currently no standard educational guidelines to prepare psychiatric mental health advanced practice nurses (PMH-APRNs) in TMH delivery. To survey practicing PMH-APRNs across the United States about their experiences and attitudes about use of TMH. Eighty-three participants from the American Psychiatric Nurses Association online discussion board completed a nine-item survey. Length of time practicing as a PMH-APRN, TMH use in practice, populations served, and TMH background. A majority had been practicing as a PMH-APRN for less than a decade and had used TMH, although most reported no prior education or training in this delivery method. Participants did indicate a desire for TMH education. This survey affirms the prevalence of TMH use among PMH-APRN providers, lack of formal training, and necessity for standardized educational guidelines in TMH delivery.
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Providing travel health care--the nurses' role: an international comparison.
Bauer, Irmgard; Hall, Sheila; Sato, Nahoko
2013-01-01
In many countries, the responsibility for travel health lies with medical practitioners who delegate certain tasks to nursing staff. Elsewhere, nurses have taken a leading role and work independently in private or hospital-based clinics, occupational health departments and general practices. The purpose of this study was to examine the roles and challenges faced by nurses providing travel health care in Australia, Japan and the UK, and to compare educational and professional needs. Nurses involved in travel health care were invited to complete an online questionnaire with multiple choice, open-ended, and Likert Scale questions. SurveyMonkey's statistical facilities analysed quantitative data; thematic content analysis was applied to qualitative responses. Differences and similarities between the three countries were conveyed by 474 participants focusing on current positions, work arrangements, and educational and practical concerns. Clinical practice issues, including vaccination and medication regulations, were highlighted with the differences between countries explained by the respective history of travel health care development and the involvement within their nursing profession. The call for more educational opportunities, including more support from employers, and a refinement of the role as travel health nurse appears to be international. Nurses require support networks within the field, and the development of a specialist "travel health nurse" would give a stronger voice to their concerns and needs for specific education and training in travel health care. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Foundations for a human science of nursing: Gadamer, Laing, and the hermeneutics of caring.
Rolfe, Gary
2015-07-01
The professions of nursing and nurse education are currently experiencing a crisis of confidence, particularly in the UK, where the Francis Report and other recent reviews have highlighted a number of cases of nurses who no longer appear willing or able to 'care'. The popular press, along with some elements of the nursing profession, has placed the blame for these failures firmly on the academy and particularly on the relatively recent move to all-graduate status in England for pre-registration student nurses. This has come to be known in the UK as the 'too-posh-to-wash' argument, that there is an incommensurability between being educated to degree level and performing basic nursing tasks. I will argue in this paper that the diagnosis of the problem is substantively correct, but the formulation and the prescription are misguided and dangerous. I will suggest that the growing emphasis on research-based and evidence-based practice is the logical conclusion of an inappropriate scientific paradigm for nursing which is underpinned by the social sciences, by technical rationality, and by a focus on people. In contrast, I will suggest that a more fruitful way of thinking about and practising nursing and nurse education is to consider it as a human science with a focus on persons in which evidence for practice derives largely from practice itself. The history of the idea of a human science is traced from its roots in nineteenth century hermeneutics to the work of Gadamer and R.D. Laing in the 1960s, and I attempt to imagine a paradigm for nursing practice, scholarship, and education based on Laing's 'existential-phenomenological' approach with a focus on the endeavour to understand and relate to individual persons rather than to make broad prescriptions for practice based on statistical and other generalizations. © 2014 John Wiley & Sons Ltd.
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Jansink, Renate; Braspenning, Jozé; Laurant, Miranda; Keizer, Ellen; Elwyn, Glyn; Weijden, Trudy van der; Grol, Richard
2013-03-28
The effectiveness of nurse-led motivational interviewing (MI) in routine diabetes care in general practice is inconclusive. Knowledge about the extent to which nurses apply MI skills and the factors that affect the usage can help to understand the black box of this intervention. The current study compared MI skills of trained versus non-trained general practice nurses in diabetes consultations. The nurses participated in a cluster randomized trial in which a comprehensive program (including MI training) was tested on improving clinical parameters, lifestyle, patients' readiness to change lifestyle, and quality of life. Fifty-eight general practices were randomly assigned to usual care (35 nurses) or the intervention (30 nurses). The ratings of applying 24 MI skills (primary outcome) were based on five consultation recordings per nurse at baseline and 14 months later. Two judges evaluated independently the MI skills and the consultation characteristics time, amount of nurse communication, amount of lifestyle discussion and patients' readiness to change. The effect of the training on the MI skills was analysed with a multilevel linear regression by comparing baseline and the one-year follow-up between the interventions with usual care group. The overall effect of the consultation characteristics on the MI skills was studied in a multilevel regression analyses. At one year follow up, it was demonstrated that the nurses improved on 2 of the 24 MI skills, namely, "inviting the patient to talk about behaviour change" (mean difference=0.39, p=0.009), and "assessing patient's confidence in changing their lifestyle" (mean difference=0.28, p=0.037). Consultation time and the amount of lifestyle discussion as well as the patients' readiness to change health behaviour was associated positively with applying MI skills. The maintenance of the MI skills one year after the training program was minimal. The question is whether the success of MI to change unhealthy behaviour must be doubted, whether the technique is less suitable for patients with a complex chronic disease, such as diabetes mellitus, or that nurses have problems with the acquisition and maintenance of MI skills in daily practice. Overall, performing MI skills during consultation increases, if there is more time, more lifestyle discussion, and the patients show more readiness to change. Current Controlled Trials ISRCTN68707773.
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Hall, Joanne M
2004-04-01
Marginalization has been used as a guiding concept for nursing research, theory and practice. Its properties have been identified and updated in 1994 and 1999, respectively. This article re-examines marginalization, considering it to be a concept that changes with pivotal historical events. The events of September 11, 2001, and the war between the US/UK and Iraq are such pivotal events. The notion of the linguistic habitus and symbolic violence as outlined by Bourdieu provide new insights about the dynamics of marginalization. Specifically noted is the marginalization of persons and cultures based on their designation by the current US administration, and as interpreted through mainstream media, as actual or potential 'terrorists'. A parallel situation in nursing is discussed, beginning with nursing's own marginality, related to the dynamics of symbolic violence. Nursing is argued to be vulnerable to having essential words and practices co-opted by dominant institutions and altered in meaning, that is, made incongruent with the discipline's emphasis on core values of confidentiality, equity and care. In response to marginalization and exteriorization those affected can use voice and testimony to 'recreate the centre'. Suggestions for protecting our practices and philosophy are included.
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Anderson, M; Jenkins, R
2006-12-01
Suicide is recognized as a global phenomenon and many countries now have national suicide prevention strategies. International guidance on suicide prevention and accepted epidemiological and treatment-based research underpins healthcare policy relating to suicide reduction. There has been an established comprehensive strategy in England since 2002. However, the rate of suicide continues to be a concern and nurses hold a key role in the implementation of national, regional and local policy into practice. The aim of this paper is to consider the current implications of the national suicide prevention strategy in England for nursing. This discussion paper draws upon both empirical evidence-based literature, governmental guidance and policy-related documentation. The national suicide prevention strategy for England currently continues to have a multifaceted impact on the nursing profession. This ranges from clinical practice issues such as risk assessment through to broader public health responsibilities. If nurses and allied health professionals are to be effective in their role within suicide prevention, they will need to be supported in building awareness of the wider context of the national policy. In particular, this will mean working effectively and collaboratively with the voluntary sector, service users and other non-medical agencies.
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Nelson, Joan M; Cook, Paul F; Raterink, Ginger
2013-01-01
The past several years have seen explosive growth in the number of doctor of nursing practice (DNP) degree programs offered by colleges of nursing in the United States. Through a process of trial and error since 2005, the faculty at the University of Colorado, College of Nursing, have revised the course structure and procedures related to the DNP capstone project to improve the quality and usefulness of these student projects. Efforts have focused on educating and involving all nursing faculty in the DNP capstone process, distinguishing between competencies for our PhD and DNP projects, clearly aligning the DNP capstone project with quality improvement methods rather than with research, working with our campus institutional review board to clarify regulatory review requirements for quality improvement studies, developing a review committee to oversee DNP students' projects, and structuring our sequential course requirements to encourage students' professional presentations and publications. Our current capstone process reflects 7 years of iterative work, which we summarize in this article in hopes that it will help institutions currently in the process of developing a DNP program. Copyright © 2013 Elsevier Inc. All rights reserved.
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Smith, Pam; Allan, T Helen
2010-04-01
In a classic paper, Menzies (1960) argued that nurses distanced themselves from patients in order to avoid direct engagement with them and as a means of managing their anxiety. Reflecting on the work 40years later Fabricius argued that in the move from hospital-based nurse education to universities, nurse educators had further entrenched this defence. It is from both these perspectives that we locate this paper to explore the position of nurse teachers today drawing on empirical data from a study set up to investigate who currently leads student nurse learning in the clinical areas and as a follow up to original research on the emotional labour of nursing (Smith, 1992). This paper presents findings from interviews with nurse teachers which are complemented by student nurse responses to a ward learning environment questionnaire, interviews with ward based nurses and documentary analysis. A major theme to emerge from the study was that there has been an uncoupling of education and practice as a consequence of the changes taking place in nurse education over the last two decades. This paper describes the range of emotions expressed as a consequence of this uncoupling such as increasing feelings of uncertainty over the nurse teacher's role in clinical practice and anxiety generated from working in a university system which appeared to devalue caring. The apparent impact of these feelings on nurse teachers was to reinforce the education/practice split and the projection of their anxiety onto students and practitioners. We suggest that nurse teachers and in particular the system in which they work need to recognise both split and projection so that they are able to bear their anxiety and manage it in their teaching.
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Happell, Brenda; McAllister, Margaret
2014-12-01
Preparation of nursing students for practice in mental health settings in Australia has been criticized since comprehensive education replaced preregistration specialist education. Current and projected workforce shortages have given rise to considering the reintroduction of specialization at preregistration level as a potential solution. Support of heads of schools of nursing would be essential for such an initiative to be considered. A qualitative exploratory study was undertaken involving in-depth telephone interviews with heads of schools of nursing in Queensland. Participants generally favoured the concept of specialization in mental health nursing at undergraduate level. Data analysis revealed the following themes: meeting workforce needs, improving quality of care, employability of graduates, an attractive option for students, and what would have to go. Participants identified many benefits to mental health service delivery and consumer outcomes. How the initiative could be developed within an already overcrowded curriculum was identified as the major barrier. This level of support is encouraging if necessary changes to the educational preparation for mental health nursing practice are to be considered. © 2014 Australian College of Mental Health Nurses Inc.
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Assessing the learning needs of oncology nurses.
Cannon, Carol A; Watson, Lisa K; Roth, Matt T; LaVergne, Shirley
2014-10-01
The Nurse Oncology Education Program (NOEP) is a nonprofit organization of the Texas Nurses Foundation that develops and provides education for nurses in all fields of practice on cancer prevention, detection, treatment, and survivorship. To meet the most current educational needs of nurses, NOEP conducts a biannual needs assessment survey to better understand its audience and inform its course development. The 2013 NOEP needs assessment survey used a convenience sample of licensed nurses throughout the United States. Nurses completed the online survey, and results revealed several priority areas for educational programs, including management of cancer symptoms and treatment side effects, complementary and alternative or integrative medicine, and screening recommendations. Time was noted as the largest barrier to educating patients and families about primary prevention practices. Results from this survey can be compared to those from previous surveys, particularly the 2009 and 2011 surveys, to determine changes in the demographics of NOEP's constituency, as well as consistencies in educational gaps. The results from the 2013 NOEP needs assessment survey offer valuable information about the learning needs of nurses across the country. The data can be used by the nurse educators and faculty who are responsible for providing cancer-specific education to nurses.
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Reinstating district nursing: A UK perspective.
Morris, Hannah
2017-09-01
As policy directives gather pace for service provision to be delivered in primary care, district nursing has not been recognised as a valuable asset to facilitate this agenda. Investment in district nursing and specialist district nursing education has fallen. This is concurrent with an ageing district nursing workforce, a lack of recruitment and growing caseloads, as district nursing adapts to meet the challenges of the complexities of contemporary healthcare in the community. The district nurse role is complex and multifaceted and includes working collaboratively and creatively to coordinate care. Redressing the shortages of specialist district nurse practitioners with increased numbers of health care support workers will not replace the skill, knowledge, experience required to meet the complex care needs of today's society. District nursing needs to be reinstated as the valuable asset it is, through renewed investment in the service, research development and in specialist practice education. To prevent extinction district nurses need to be able to demonstrate and articulate the complexities and dynamisms of the role to reinstate themselves to their commissioners as a valuable asset for contemporary practice that can meet current health and social care needs effectively. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
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Changes in nurse education: delivering the curriculum.
Carr, Graham
2008-01-01
The aim of this study is to examine changes in pre-registration nursing education through the personal accounts of nurse teachers. This paper is based on 37 in-depth interviews within a central London Healthcare Faculty. Each interview was subjected to a process of content analysis described by Miles and Huberman. The interviews took place between August 2003 and March 2004 and totalled 34.4 hours or 305,736 words. There were thirty female and seven male participants, who shared 1015 years of nursing experience, averaging at 27.4 years (min 7-max 42). These were supplemented by 552 years of teaching practice, the average being 15 years (min 0.5-max 29). This paper--delivering the nursing curriculum--identifies that the nature of nursing has changed as it has both expanded and contracted. Participants identified three major changes; the nature of nursing, selection of future nurses and the current impact that large cohorts have on our traditional model of person-centred education. The practice placements remain central to nursing education and it is the nursing role that should define the curriculum and the values of higher education should be supportive of this identity.
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[Nursing care systematization for outpatient treatment care of patients with multiple sclerosis].
Corso, Nair Assunta Antônia; Gondim, Ana Paula Soares; Dalmeida, Patrícia Chagas Rocha; Albuquerque, Maria Girlene de Freitas
2013-06-01
An experience report of nurses in the implementation of care systematization in ambulatory care in an interdisciplinary care center for patients with multiple sclerosis of a public hospital in Fortaleza, Ceará, Brazil. This implementation is based on the NANDA International, Inc., Nursing Interventions Classification, and Nursing Outcomes Classifications. One of the results concerns systemized nursing care, which has enabled the identification and understanding of the responses of MS patients to potential and current health problems. Systematization entails expanding knowledge through a practice based on approach and encourage further research scientific evidence, in addition to promoting the role of the nurse in acomprehensive approachand encourage further research.
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Canada, Amanda N
2016-04-01
HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Probing the Relationship Between Evidence-Based Practice Implementation Models and Critical Thinking in Applied Nursing Practice," found on pages 161-168, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until March 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. • Describe the key components and characteristics related to evidence-based practice and critical thinking. • Identify the relationship between evidence-based practice and critical thinking. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Evidence-based practice is not a new concept to the profession of nursing, yet its application and sustainability is inconsistent in nursing practice. Despite the expansion of efforts to teach evidence-based practice and practically apply evidence at the bedside, a research-practice gap still exists. Several critical factors contribute to the successful application of evidence into practice, including critical thinking. The purpose of this article is to discuss the relationship between critical thinking and the current evidence-based practice implementation models. Understanding this relationship will help nurse educators and clinicians in cultivating critical thinking skills in nursing staff to most effectively apply evidence at the bedside. Critical thinking is a key element and is essential to the learning and implementation of evidence-based practice, as demonstrated by its integration into evidence-based practice implementation models. Copyright 2016, SLACK Incorporated.
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'Do as say, but not as I do': are next generation nurses role models for health?
Blake, Holly; Malik, Sumaira; Mo, Phoenix K H; Pisano, Charlotte
2011-09-01
Promoting healthy lifestyles plays a key role in professional nursing yet nurses do not always practice what they preach. Efforts are currently being made to improve the health of NHS staff, yet little is known about the health and lifestyle behaviours of pre-registration nurses in the UK although these individuals are our next generation of NHS employees. The aim of this study was to investigate the health behaviours and wellbeing of pre-registration nurses based at an acute NHS teaching hospital in England. In this cross-sectional questionnaire survey, 325 pre-registration nurses (50% response rate) completed a health and lifestyle questionnaire, measuring levels of physical activity, smoking and alcohol behaviour, dietary practices and general health. Age ranged from 19-53 years, and 96% of the sample was female. More than half of the sample did not meet public health recommendations for physical activity. Just under one-fifth were current smokers and over three-quarters did not consume five servings of fruit/vegetables per day. Two-thirds reported exceeding the recommended maximum daily alcohol intake and around one third were classified as either overweight or obese. Those who were physically inactive were less likely to report good general health, good dietary practices and more sleep, and were more likely to report cigarette smoking and alcohol consumption than their active counterparts. This study indicates that the health profile of pre-registration nurses is relatively poor, and that those who are sedentary engage in other negative lifestyle behaviours also. Despite significant education relating to health promotion and health behaviours of patients being targeted at pre-registered nurses, it seems that this knowledge is not always transferred to their own behaviour. There is a need for timely intervention to establish healthy lifestyle behaviours amongst nurses early in their career.
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Bridging the gap in care for children through the clinical nurse leader.
O'Grady, Erin L; VanGraafeiland, Brigit
2012-01-01
Care coordination has been identified as a gap in the nursing care of children and families who experience an encounter within the health care system. The educational preparation of the clinical nurse leader (CNL) enables the CNL to address many gaps found in health care. Current evidence suggests various gaps in care, as reported by patients, families, nurses, and other health care providers. Identified gaps in care include problems with communication, coordination, education, research, advocacy, psychological and social support, and the needs of siblings. The CNL may improve quality of care for children through efficient care coordination by acting as a liaison and advocate between the patient, family, and health care team to bridge gaps in the current practices of care.
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A clinical ladder for occupational health nurses.
Lang, Yolanda C
2010-06-01
Occupational health nurses must have a growing, expanding knowledge base to remain current in practice. The American Board for Occupational Health Nurses, Inc. encourages advancement with the availability of certification examinations. Health care centers support clinical advancement programs for bedside nurses. Nurses who continue their education either through a degree program or via continuing education or certification advance up the clinical ladder, receiving a higher salary, recognition from their peers, and perhaps even financial assistance to continue climbing, yet occupational health nurses do not have their own clinical advancement ladder. This article examines the steps necessary to develop a clinical ladder and presents a clinical ladder specific to occupational health nursing developed by the author. Copyright 2010, SLACK Incorporated.
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Walking the talk: insights into dynamics of race and gender for nurses.
Choiniere, Jacqueline A; MacDonnell, Judith; Shamonda, Hope
2010-11-01
This article explores how the dynamics of violence and support for nurses are influenced by the intersections of race, gender, and other social relations in various practice settings. Utilizing a qualitative study design, situated in the naturalistic and critical paradigms, this article is grounded in the experiences of key informants (KIs), each possessing significant expertise on issues of equity and violence, as well as insight into the current practice settings in Ontario, Canada. The individual KI interviews were analyzed using conventional qualitative content analysis, with its focus on capturing emerging insights. The findings reflect the everyday nature of gendered and racialized violence, the influence of setting and the effectiveness of existing resources. Professional, organizational, and broader policy implications are discussed to support diversely situated nurses within their various practice environments.
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Chênevert, Denis; Jourdain, Geneviève; Vandenberghe, Christian
2016-01-01
The retention of young graduate nurses has become a major management challenge among hospitals in Western countries, which is amplified in a context of aging of populations and an increasing demand for services from patients. Moreover, as it has been reported that 50% of experienced nurses do not recommend a career in nursing, it is likely that retention problems occur not only at the level of the organization, but also at the level of the nursing profession. Although research has identified some predictors of nurse turnover, it is unclear which factors influence nurses' turnover from the organization and from the profession and how these factors interrelate with one another over time. The present study extends previous research on nurse turnover by looking at the combined effects of nurses' pre-entry expectations, perceived high-involvement work practices, and professional self-image, on intended and actual turnover from the organization and the profession. A prospective, longitudinal study of a sample of 160 graduated nurses affiliated with the Quebec Nurses' Association, Canada, was conducted. Participants were surveyed at three points in time, spread over a 3-year period. Graduated nurses' pre-entry expectations and professional self-image were surveyed at graduation (Time 1), while perceived high-involvement work practices, professional self-image, and intention to leave the organization and the profession were captured six months following nurses' entry into the labor market (Time 2). Finally, participants were surveyed with respect to organizational and professional turnover three years after the Time 2 survey (Time 3). Structural equations modeling was used to examine the structure of the measures and the relationships among the constructs. Although pre-entry expectations had no effect, perceived high-involvement work practices were positively related to Time 2, professional self-image (controlling for pre-entry professional self-image). Moreover, high-involvement work practices exerted an indirect, negative effect on organizational and professional turnover through intention to leave the organization, and an indirect negative effect on intention to leave the profession through professional self-image. Nonetheless, professional self-image did not affect turnover. The current study indicates that hospitals and nurse directors can take advantage of developing high-involvement work practices as these practices foster a stronger professional self-image among nurses, thereby contributing to their sense of value as care providers, and indirectly reduce intended and actual turnover from the organization and the profession. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Nursing Work in Long-Term Care: An Integrative Review.
Montayre, Jed; Montayre, Jasmine
2017-11-01
Evidence suggests that delivery of good nursing care in long-term care (LTC) facilities is reflected in nurses' descriptions of the factors and structures that affect their work. Understanding the contemporary nature of nursing work in aged care will influence policies for improving current work structures in this practice setting. The current review aims to present a contemporary perspective of RNs' work in LTC facilities. A comprehensive search and purposeful selection of the literature was conducted using CINAHL, PubMed, Medline, Scopus, and Google Scholar databases. Nine studies were eligible for review. Common themes revealed that nursing work in aged care settings is characterized by RNs providing indirect care tasks-primarily care coordination, engaging in non-nursing activities, and having an expanded and overlapping role. As care providers, aged care RNs do not always provide direct care as part of their nursing work. The scope of RN work beyond its clinical nature or performance of non-nursing tasks adds complexity in clarifying RN work roles in aged care. [Journal of Gerontological Nursing, 43(11), 41-49.]. Copyright 2017, SLACK Incorporated.
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Interdisciplinary team communication among forensic nurses and rape victim advocates.
Patterson, Debra
2014-01-01
Victim advocates and forensic nurses provide integrated care to address the complex legal, medical, and mental health needs of rape survivors. Research suggests that conflict exists between nurses and advocates, but it remains unknown how their communication patterns contribute to or resolve these conflicts. Utilizing a qualitative case study approach, the current study interviewed 24 nurses and advocates from a Midwest organization to better understand team communication patterns when addressing conflicts. The findings suggest that most nurses communicate concerns directly while advocates avoid direct communication. Factors that influenced direct and indirect communication and their implications for practice will be discussed.
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Ogata, Yasuko; Nagano, Midori; Fukuda, Takashi; Hashimoto, Michio
2011-06-01
The purpose of this study was to examine how the nursing practice environment affects job retention and the turnover rate among hospital nurses. The Practice Environment Scale of the Nursing Work Index (PES-NWI) was applied to investigate the nurse working environment from the viewpoint of hospital nurses in Japan. Methods A postal mail survey was conducted using the PES-NWI questionnaire targeting 2,211 nurses who were working at 91 wards in 5 hospitals situated in the Tokyo metropolitan area from February to March in 2008. In the questionnaire, hospital nurses were asked about characteristics such as sex, age and work experience as a nurse, whether they would work at the same hospital in the next year, the 31 items of the PES-NWI and job satisfaction. Nurse managers were asked to provide staff numbers to calculate the turnover rate of each ward. Logistic regression analyses were carried out, with "intention to retain or leave the workplace next year" as the dependent variable, with composite and 5 sub-scale scores of the PES-NWI and nurse characteristics as independent variables. Correlation coefficients were calculated to investigate the relationship between nurse turnover rates and nursing practice environments. A total of 1,067 full-time nurses (48.3%) from 5 hospitals responded. Almost all of them were men (95.9%), with an average age of 29.2 years old. They had an average of 7.0 years total work experience in hospitals and 5.8 years of experience at their current hospital. Cronbach's alpha coefficients were 0.75 for composite of the PES-NWI, and 0.77-0.85 for the sub-scales. All correlation coefficients between PES-NWI and job satisfaction were significant (P < 0.01). In the logistic regression analysis, a composite of PES-NWI, "Nurse Manager's Ability, Leadership, and Support of Nurses" and "Staffing and Resource Adequacy" among the 5 sub-scales correlated with the intention of nurses to stay on (P < 0.05). The means for turnover rate were 10.4% for nurses and 17.6% for newly hired nurses. These rates were significantly correlated to the composite and some sub-scales of the PES-NWI. The working environment for nurses is important in retaining nurses working at hospitals. We confirmed the reliability and the validity of the PES-NWI scale based on the magnitude of the Cronbach's alpha coefficient and correlation coefficient between the PES-NWI scale and job satisfaction in this study.
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Hill, Keith D.; Brand, Caroline A.; Livingston, Patricia M.; Botti, Mari
2017-01-01
There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; ‘falls alert’ signs; supervision of patients in the bathroom; ensuring patients’ walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients’ walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting issues to be addressed by the implementation plan. PMID:28199376
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Bassah, Nahyeni; Cox, Karen; Seymour, Jane
2016-03-31
Current evidence suggests that palliative care education can improve preregistration nursing students' competencies in palliative care. However, it is not known whether these competencies are translated into students' practice in the care of patients who are approaching the end of life. This paper seeks to contribute to the palliative care evidence base by examining how nursing students in receipt of education report transfer of learning to practice, and what the barriers and facilitators may be, in a resource-poor country. We utilised focus groups and individual critical incident interviews to explore nursing students' palliative care learning transfer. Three focus groups, consisting of 23 participants and 10 individual critical incident interviews were conducted with preregistration nursing student who had attended a palliative care course in Cameroon and had experience caring for a patient approaching the end of life. Data was analysed thematically, using the framework approach. The results suggest that nursing students in receipt of palliative care education can transfer their learning to practice. Students reported recognizing patients with palliative care needs, providing patients with physical, psychosocial and spiritual support and communicating patient information to the wider care team. They did however perceive some barriers to this transfer which were either related to themselves, qualified nurses, the practice setting or family caregivers and patients. The findings from this study suggest that nursing student in receipt of palliative care education can use their learning in practice to provide care to patients and their families approaching the end of life. Nevertheless, these findings need to be treated with some caution given the self-reported nature of the data. Demonstrating the link between preregistration palliative care education and patient care is vital to ensuring that newly acquired knowledge and skills are translated and embedded into clinical practice. This study also has implications for advocating for palliative care policies and adequately preparing clinical placement sites for students' learning and transfer of learning.
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Bioethics education for practicing nurses in Taiwan: Confucian-Western clash.
Yang, Wan-Ping; Chen, Ching-Huey; Chao, Co-Shi Chantal; Lai, Wei-Shu
2010-07-01
To understand the gaps between current bioethics education and the requirements of practicing nurses, a semistructured questionnaire was used to invite the directors of nursing departments at all 82 teaching hospitals in Taiwan to participate in this survey. The response rate was 64.6%. Through content analysis we obtained information about previous bioethical training, required themes and content, recommended teaching strategies, and difficulties with education and its application. The results suggest that Taiwanese nursing personnel need to be instilled with both self-cultivation of morality and mental cultivation to acquire nursing virtues and the right attitudes toward bioethical issues. Good communication skills to prevent damage to the harmonious relationships between patients, their families and medical team members, policies that support the provision of systematic formal knowledge of ethics, small group training, and clarification of values were also shown to be important in bioethics education.
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[Family groups in nursing graduation teaching practice].
de Assis, Aisllan Diego; da Silva, Priscila Patrícia; Claudino, Talita Xavier; de Oliveira, Alice Guimarães Bottaro
2010-09-01
The centers of psychosocial care (CAPS, acronym in Portuguese) are strategic devices for mental health care currently available in Brazil. Nurses are professionals required to compose the minimum staff of this device, which values the group activities involving users. This study presents a report of the experience of nursing undergraduates from Universidade Federal do Mato Grosso (UFMT) on their conducting waiting-room group sessions with relatives of users of a CAPS from Cuiabá, Mato Grosso state. This experience is justified by the fact that nursing students have few opportunities to develop group approach abilities during their graduation course, which focuses mainly on clinical individual care. The aim of the experience was to provide theoretical-practical learning of all the work stages of group work: recognizing the need and possibility of conducting the activity, planning, coordination and group evaluation. The results confirm the need and possibility of performing group experiences in mental health care and in nursing education.
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Drivers for renewal and reform of contemporary nursing curricula: a blueprint for change.
Waters, Cheryl Denise; Rochester, Suzanne Freda; McMillan, Margaret Anna
2012-06-01
The creation of a curriculum blueprint appropriate to the development of a professional nurse who is practice-ready for the current and future context of health service delivery must take account of the extant context as well as an unpredictable and sometimes ambiguous future. The curriculum renewal process itself ought to challenge existing long held ideals, practices, and sacred cows within the health and higher education sectors. There is much to consider and importantly curriculum developers need to be mindful of reform within the health sector and health workforce education, as well as the concomitant vision and requirements of the nursing profession. Curriculum must develop more than discipline knowledge and skills: it must provide an infrastructure for generic abilities both social and intellectual in order to better prepare students for the registered nurse role. This paper discusses a number of forces that are essential to consider in curriculum development in undergraduate nursing education.
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Euthanasia: the perceptions of nurses in India.
Poreddi, Vijayalakshmi; Nagarajaiah; Konduru, Reddemma; Math, Suresh Bada
2013-04-01
Euthanasia provokes controversies in various domains, such as the moral, ethical, legal, religious, scientific, and economic. India legalised passive euthanasia (withdrawal of life support) for patients with brain death or who are in a permanent vegetative state in 2011, but research on perceptions of euthanasia among people in India is limited. This study aimed to examine nurses' perceptions of the practice of euthanasia as well as factors influencing those perceptions. A non-probability quantitative, cross-sectional design was adopted for a sample of 214 nurses working at a tertiary care centre. Data was collected through self-reported questionnaires at the nurses workplace.The findings revealed mixed opinions on euthanasia among the nurses. However, the majority of the participants did not agree with the practice of euthanasia. Nonetheless, further research is needed on this issue across the country among various health professionals in the context of current legislation.
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Paparone, Pamela
2015-03-01
The leadership styles of healthcare organizations and the attitudes of nurses toward the adoption of evidence-based practice (EBP) were examined to provide a predictor of influenza vaccination intent (VI) and improve the current inadequate vaccination rate among nurses. Influenza is a costly and potentially serious disease. The United States has set a benchmark of a 90% influenza vaccination rate among healthcare personnel by 2020. A sample of 354 registered nurses completed a survey assessing demographic data, the leadership styles of their organization, their attitudes toward EBP, and their VI. A significant positive correlation was found between transformational leadership and VI, but not between transactional leadership and VI. Attitudes toward EBP correlated weakly, but insignificantly, with VI. Transformational leadership can predict and positively influence vaccination rates among nurses, thus decreasing vaccine preventable illness and improving patient outcomes.
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Staebler, Suzanne; Campbell, Jane; Cornelius, Patsy; Fallin-Bennett, Amanda; Fry-Bowers, Eileen; Kung, Ying Mai; LaFevers, David; Miller, Janice
To better understand policy/advocacy concepts and methodology utilized in all levels of nursing educational programs and develop clarity concerning structure of policy content and integration across all levels of education. Cross-sectional analysis of data obtained from a survey sent to 19,043 nursing faculty in the United States; 598 total responses; 514 complete responses. Quantitative data points were analyzed using SPSS and qualitative data was grouped and analyzed by theme. Barriers and perceptions of student engagement and student learning outcomes along with institutional and faculty development barriers were explored in baccalaureate, masters, and doctoral level nursing programs. Thirty-six percent of respondents reported having experience in development and implementation of policy, ranging from local to international spheres and 21% reported active involvement in current state and federal policy development. Seventy percent of respondents have advocated for the nursing profession through professional organizations while 44% report current activity in legislative advocacy. The value of nursing policy education, advocacy, and analysis must be valued in higher education. Copyright © 2017 Elsevier Inc. All rights reserved.
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Developing an organizing framework to guide nursing research in the Children’s Oncology Group (COG)
Kelly, Katherine Patterson; Hooke, Mary C.; Ruccione, Kathleen; Landier, Wendy; Haase, Joan
2014-01-01
Objectives To describe the development and application of an organizing research framework to guide COG Nursing research. Data Sources Research articles, reports and meeting minutes Conclusion An organizing research framework helps to outline research focus and articulate the scientific knowledge being produced by nurses in the pediatric cooperative group. Implication for Nursing Practice The use of an organizing framework for COG nursing research can facilitate clinical nurses’ understanding of how children and families sustain or regain optimal health when faced with a pediatric cancer diagnosis through interventions designed to promote individual and family resilience. The Children’s Oncology Group (COG) is the sole National Cancer Institute (NCI)-supported cooperative pediatric oncology clinical trials group and the largest organization in the world devoted exclusively to pediatric cancer research. It was founded in 2000 following the merger of the four legacy NCI-supported pediatric clinical trials groups (Children’s Cancer Group [CCG], Pediatric Oncology Group [POG], National Wilms Tumor Study Group, and Intergroup Rhabdomyosarcoma Study Group). The COG currently has over 200 member institutions across North America, Australia, New Zealand and Europe and a multidisciplinary membership of over 8,000 pediatric, radiation, and surgical oncologists, nurses, clinical research associates, pharmacists, behavioral scientists, pathologists, laboratory scientists, patient/parent advocates and other pediatric cancer specialists. The COG Nursing Discipline was formed from the merger of the legacy CCG and POG Nursing Committees, and current membership exceeds 2000 registered nurses. The discipline has a well-developed infrastructure that promotes nursing involvement throughout all levels of the organization, including representation on disease, protocol, scientific, executive and other administrative committees (e.g., nominating committee, data safety monitoring boards). COG nurses facilitate delivery of protocol-based treatments for children enrolled on COG protocols, and Nursing Discipline initiatives support nursing research, professional and patient/family education, evidence-based practice, and a patient-reported outcomes resource center. The research agenda of the Nursing Discipline is enacted through a well-established nursing scholar program. PMID:24559776
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Nurses' views on legalising assisted dying in New Zealand: A cross-sectional study.
Wilson, Michael; Oliver, Pam; Malpas, Phillipa
2018-04-15
This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying. A Bill for legalising assisted dying is currently before the New Zealand parliament. Of the 16 jurisdictions where assisted dying has been specifically legislated, only the Canadian federal statute provides nurses with explicit legal protection for their performance of assisted dying-related tasks. An absence of policy development and planning for safe nursing practice prior to legalisation of assisted dying results in a gap in professional support and guidance. Exploratory cross-sectional survey. A self-selected sample of 475 New Zealand nurses responded to an anonymous online survey disseminated through the newsletters and websites of relevant medical and nursing professional bodies. A sub-sample of nurses who expressed support for or ambivalence about legalisation (n = 356): rated their level of support for legalising assisted dying in New Zealand across a range of medical conditions, and their willingness to participate in a range of assisted dying tasks; identified barriers and facilitators to potential participation; and assessed the responsibility of the professional bodies to provide practice supports. Mixed-method approach using descriptive analysis of quantitative data; qualitative data were analysed thematically. Nurses supported legalisation at a rate (67%) significantly greater than that of doctors (37%) and for a diverse range of medical conditions. Most supporting nurses were willing to engage in the full range of relevant assisted dying roles. They identified several practical and ethical supports as essential to safe engagement, in particular practice guidelines, specific training, legal protections, clinical supervision and mentoring, and independent review of assisted dying service provision. They saw the facilitation of these supports as primarily the responsibility of their professional bodies. Nursing bodies should proactively facilitate workforce awareness and development of assisted dying policy and practice supports in anticipation of legalisation. This can be done through information campaigns and by adapting assisted dying policy, practice materials and systems already developed internationally. Nursing bodies need to engage in formulating legislation to ensure inclusion of explicit protections for participating nurses and to delegate relevant responsibilities to regulatory bodies. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Kilańska, D; Gaworska-Krzemińska, A; Grabowska, H; Gorzkowicz, B
2016-09-01
The development of a nursing practice, improvements in nurses' autonomy, and increased professional and personal responsibility for the medical services provided all require professional documentation with records of health status assessments, decisions undertaken, actions and their outcomes for each patient. The International Classification for Nursing Practice is a tool that meets all of these needs, and although it requires continuous evaluation, it offers professional documentation and communication in the practitioner and researcher community. The aim of this paper is to present a theoretical critique of an issue related to policy and experience of the current situation in Polish nursing - especially of the efforts to standardize nursing practices through the introduction and development of the Classification in Poland. Despite extensive promotion and training by International Council of Nurses members worldwide, there are still many countries where the Classification has not been implemented as a standard tool in healthcare facilities. Recently, a number of initiatives were undertaken in cooperation with the local and state authorities to disseminate the Classification in healthcare facilities. Thanks to intense efforts by the Polish Nurses Association and the International Council of Nurses Accredited Center for ICNP(®) Research & Development at the Medical University of Łódź, the Classification is known in Poland and has been tested at several centres. Nevertheless, an actual implementation that would allow for national and international interoperability requires strategic governmental decisions and close cooperation with information technology companies operating in the country. Discussing the barriers to the implementation of the Classification can improve understanding of it and its use. At a policy level, decision makers need to understand that use Classification in eHealth services and tools it is necessary to achieve interoperability. © 2016 International Council of Nurses.
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Applications of complex systems theory in nursing education, research, and practice.
Clancy, Thomas R; Effken, Judith A; Pesut, Daniel
2008-01-01
The clinical and administrative processes in today's healthcare environment are becoming increasingly complex. Multiple providers, new technology, competition, and the growing ubiquity of information all contribute to the notion of health care as a complex system. A complex system (CS) is characterized by a highly connected network of entities (e.g., physical objects, people or groups of people) from which higher order behavior emerges. Research in the transdisciplinary field of CS has focused on the use of computational modeling and simulation as a methodology for analyzing CS behavior. The creation of virtual worlds through computer simulation allows researchers to analyze multiple variables simultaneously and begin to understand behaviors that are common regardless of the discipline. The application of CS principles, mediated through computer simulation, informs nursing practice of the benefits and drawbacks of new procedures, protocols and practices before having to actually implement them. The inclusion of new computational tools and their applications in nursing education is also gaining attention. For example, education in CSs and applied computational applications has been endorsed by The Institute of Medicine, the American Organization of Nurse Executives and the American Association of Colleges of Nursing as essential training of nurse leaders. The purpose of this article is to review current research literature regarding CS science within the context of expert practice and implications for the education of nurse leadership roles. The article focuses on 3 broad areas: CS defined, literature review and exemplars from CS research and applications of CS theory in nursing leadership education. The article also highlights the key role nursing informaticists play in integrating emerging computational tools in the analysis of complex nursing systems.
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Lee, Ya-Fen; Yang, Yu-O; Tu, Chia-Ling
2013-06-01
The impact of general gender stereotypes on nursing is severe and influential, especially with regard to male nursing students working in obstetrics and gynecology wards. This study examined the experience of male nursing students in obstetrics and gynecology wards. We used a phenomenological qualitative research approach and a sample of 10 male nursing students currently studying at a nursing college in central Taiwan. All participants had obstetrics and gynecology ward experience. Individual interviews were transcribed into the procedural record. Colaizzi content analysis analyzed and categorized research data. Based on participants practical experiences in the obstetrics and gynecology ward, the main stages of participants professional development through their internship experience included: (1) Unbalanced self-role recognition; (2) being defined by the gender framework (gender stereotypes); (3) the difference between male doctor and male nurse; (4) learning appropriate communication techniques; (5) mutual and empathetic understanding of the female psychology during childbirth; (6) gaining sources for positive feedback; (7) releasing the shackles of gender and gaining full insight into and comprehension of nursing functions; and (8) given the opportunity to learn. Through ongoing examination and learning, participant internships in the obstetrics and gynecology wards were significant and essential learning experiences that validated their necessity. Nursing schools and internship institutions alike must realize the importance of gender-equality education to the nursing profession. Medical institutions are encouraged to offer equal learning opportunities to male and female nursing students and provide targeted assistance to males to help them master clinical nursing care practices in the obstetrics and gynecology department.
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Research priorities for specialized nursing practice in the United Arab Emirates.
Al-Yateem, N; Al-Tamimi, M; Brenner, M; Altawil, H; Ahmad, A; Brownie, S
2017-08-25
Globally, nurses are undertaking expanded and more specialized roles in healthcare planning and service delivery in response to changing patterns and levels of health service demand. This means the nursing profession is increasingly considered as leaders in health service policy, research and practice. The United Arab Emirates has strengthened nursing governance and practice by establishing a Nursing and Midwifery Council and increasing the activity of nursing specialization, service leadership and research. This study aimed to identify clinically relevant research priorities to facilitate nursing contributions to evidence-based care and strengthening health services in the country. A two-stage Delphi study design was used. The first round involved 783 participants. The second round involved 1116 participants, as more clinical settings were accessed. In total, 58 research priorities across a variety of nursing specialties (paediatrics, emergency care, intensive care, labour and maternity care, operating theatre and long-term care) were identified as highly important. These identified priorities will guide a more informed programme of research in each nursing specialty, with the aim of strengthening the evidence base to improving outcomes for patients and their families in the United Arab Emirates. The findings provide guidance on key areas for nurses to focus research contributions to enhance evidence-based care and strengthen health systems. The identified priorities may also guide researchers in academic institutions to conduct research informed by current, clinically relevant issues. The findings may help inform funders and policymakers to support allocation of funding to research that has potential to contribute to enhancing nursing care in specialist areas. © 2017 International Council of Nurses.
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Anderson, Joan M; Browne, Annette J; Reimer-Kirkham, Sheryl; Lynam, M Judith; Rodney, Paddy; Varcoe, Colleen; Wong, Sabrina; Tan, Elsie; Smye, Victoria; McDonald, Heather; Baumbusch, Jennifer; Khan, Koushambhi Basu; Reimer, Joanne; Peltonen, Adrienne; Brar, Anureet
2010-09-01
This article is based on a knowledge translation (KT) study of the transition of patients from hospital to home. It focuses on the lessons learned about the challenges of translating research-derived critical knowledge in practice settings. The authors situate the article in current discourses about KT; discuss their understanding of the nature of critical knowledge; and present themes from their body of research, which comprises the knowledge that was translated. The findings have the potential to guide future KT research that focuses on the uptake of critical knowledge in nursing practice.
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'Unladylike Commotion': Early feminism and nursing's role in gender/trans dialogue.
Fowler, Marsha D
2017-01-01
From nursing's history comes the impetus and grounding for our current voice in gender/trans dialogue. Modern nursing struggled its way into being against restrictive, unjust, and oppressive social structures. Many of the obstructions and constraints that nurses and nursing leaders faced were shared by the general populace of women, and yet nurses were different from other women. Nurses worked outside the home, caring for strangers, including unrelated men, in a period when women were otherwise confined to the home. Nurses fought for women's suffrage, for child labor laws, for the welfare of factory workers, for garment workers, for unionization, for vaccination, for housing reform, for the humane treatment of mentally ill persons, for access to birth control, for the amelioration of a panoramic terrain of terrible social injustices, and for the control of nursing education, registration, and practice. For 150 years, nursing has been intrinsically, practically, and politically feminist. The hard-fought gains would eventually position nursing in tension with emerging trans issues. And yet, its history is exactly what situates nursing for fruitful participation in the developing trans discourse and to address issues of transinvisibility and unjust social and health structures that impede dignified and respectful health care. © 2017 John Wiley & Sons Ltd.
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Morphet, Julia; Kent, Bridie; Plummer, Virginia; Considine, Julie
2015-11-01
To date, emergency nursing Transition to Specialty Practice Program (TSPP) evaluations have been single-site observational studies. The aim of this paper was to examine the professional development, recruitment and retention outcomes of Australian emergency nursing TSPPs. An explanatory sequential design was used. Data were collected via online surveys and interviews of emergency Nurse Unit Managers and Nurse Educators. Survey data from EDs with TSPPs and EDs without TSPPs were compared. Qualitative data were analysed using content analysis. Data were collected from 118 EDs, and 13 interviews. TSPPs were offered in 72.1% of EDs. EDs with TSPPs had higher proportions of nurses with postgraduate qualifications (Mdn 28.3% vs. 22.1%, p=0.45) and Clinical Specialists (Mdn 16.4% vs. 6.3%, p=0.04). The median proportion of currently rostered nurses with TSPP completion was 34.2% in EDs with TSPPs introduced in 2000-2005 indicating ED high levels of retention. Emergency nursing TSPPs have had a positive effect on nursing professional development, recruitment and retention. To ensure consistency in outcomes and optimise reliability of emergency nursing skills and knowledge, a national emergency nursing TSPP framework is needed. Copyright © 2015 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.
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Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services
Tung, Fabian Ling Ngai; Yan, Vincent Chun Man; Tai, Winnie Ling Yin; Chen, Jing Han; Chung, Joanne Wai-yee; Wong, Thomas Kwok Shing
2016-01-01
Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services. PMID:26959330
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The power of partnership to shape the future of nursing: the evolution of the clinical nurse leader.
Tornabeni, Jolene; Miller, Judith Fitzgerald
2008-07-01
This article describes the evolution of the clinical nurse leader role and demonstrates the vital nature of partnerships between academia and practice in the design and implementation of this new role. The health care system as it exists in the United States may put patients at risk in terms of safety and quality of care. Nursing leadership from across the US recognized a need for nursing practice and academia to work in partnership to develop workable and effective solutions. The vision was of a nurse generalist who would be prepared to address the complexities that make the current systems dysfunctional. Review, share experiences and discuss the benefits of engaging stakeholders with broad and diverse viewpoints. Engaging a group of stakeholders with diverse backgrounds, varied world views and experiences for the purpose of developing common mutually beneficial goals, creates synergy and greater commitment to the goals, which results in success. The power of partnership in the development and implementation of the CNL is evident. Old ways of trying to 'go it alone' are no longer viable in a complex health care environment. With continued collaboration, practice and academia can continue to confront challenges and develop effective solutions.
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Chang, Chia-Chi; Lin, Li-Min; Chen, I-Hui; Kang, Chun-Mei; Chang, Wen-Yin
2015-01-01
Although the benefits of preceptor training programs on the performance of nurse preceptors have been reported, research related to nurse preceptors' perceptions of and experiences with preceptor training courses is relatively limited. To explore nurse preceptors' perceptions of preceptor training courses and obtain information on their experiences in working as preceptors. A mixed method design was conducted. Nurse preceptors who currently work at one of eight hospitals in northern Taiwan were recruited to participate in this study. A questionnaire survey and focus group interviews were conducted. A training course perception scale was developed and generated based on the current nurse preceptor training programs offered in eight hospitals. Focus group interviews were conducted to obtain additional information on nurse preceptors' experiences in working as preceptors. The survey data were analyzed using descriptive statistics. Interview data were transcribed and analyzed using a qualitative content analysis approach. The results from the surveys of 386 nurse preceptors revealed that most courses included in the current preceptor training programs did not fulfill the learning needs of nurse preceptors and were clinically impractical. The most necessary and clinically useful course was the communication skills course, whereas the least useful course was the adult learning theory and principles course. Three themes were identified as problems based on the three focus group interviews conducted with 36 nurse preceptors: inadequate training was received before nurses were appointed as nurse preceptors, the courses were more theoretical rather than practical, and the preceptors experienced stress from multiple sources. The results revealed that the current preceptor training courses are impractical; therefore, the content of preceptor training courses must be altered to fulfill nurse preceptors' training needs. Furthermore, problems identified through the focus group interviews reinforce the survey results. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Past, present, and future trends of master's education in nursing.
Gerard, Sally O; Kazer, Meredith W; Babington, Lynn; Quell, Theresa T
2014-01-01
Nurses interested in pursuing careers in advanced practice are now being educated at the doctoral level through new doctorate of nursing practice degree programs. In light of this shift, master's programs for advanced practice nurses are in a tenuous position, and it is questionable whether the remaining master's level educational programs are meeting the needs of consumers, health care institutions, and students. Given the great need for clinical leadership in health care, it is essential to reexamine master's nursing education to ensure that educational institutions are meeting the needs of graduate nursing students, consumers, and health care systems. Research supports that the master's-prepared nurse of the future must be proficient in the development and management of accountable care systems using state-of-the-art technology. In addition, interprofessional models show improvement in health care delivery and health outcomes. The current demands in health care that impact nursing education will be discussed, including the movement toward interprofessional education and the broadened expertise, required of master's-prepared nurses working in an era of health care reform. While academic medical centers are actively advancing toward an interprofessional model, the majority of nurses in this country are educated in private and community settings. This article will examine the move toward interprofessional education at a private university, utilizing clinical partnerships to revise the master's program. The goal of this revision is to empower students with the expertise required in today's health care environment to improve the delivery of care. Copyright © 2014 Elsevier Inc. All rights reserved.
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A contemporary examination of workplace learning culture: an ethnomethodology study.
Newton, Jennifer M; Henderson, Amanda; Jolly, Brian; Greaves, Judith
2015-01-01
Creating and maintaining a sustainable workforce is currently an international concern. Extensive literature suggest that students and staff need to be 'engaged', that is they need to interact with the health team if they are to maximise learning opportunities. Despite many studies since the 1970s into what creates a 'good' learning environment, ongoing issues continue to challenge healthcare organisations and educators. A 'good' learning environment has been an intangible element for many professions as learning is hindered by the complexity of practice and by limitations on practitioners' time available to assist and guide novices. This study sought to explore the nature of the learning interactions and experiences in clinical nursing practice that enhance a 'good' workplace learning culture for both nursing students and qualified nurses. An ethnomethodology study. A range of clinical settings in Victoria and Queensland, Australia. Students and registered nurses (n=95). Fieldwork observations were carried out on student nurses and registered nurses, followed by an individual interview with each participant. An iterative approach to analysis was undertaken; field notes of observations were reviewed, interviews transcribed verbatim and entered into NVivo10. Major themes were then extracted. Three central themes: learning by doing, navigating through communication, and 'entrustability', emerged providing insights into common practices potentially enhancing or detracting from learning in the workplace. Students' and registered nurses' learning is constrained by a myriad of interactions and embedded workplace practices, which can either enhance the individual's opportunities for learning or detract from the richness of affordances that healthcare workplace settings have to offer. Until the culture/or routine practices of the healthcare workplace are challenged, the trust and meaningful communication essential to learning in practice, will be achievable only serendipitously. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Grundy, Quinn; Bero, Lisa A; Malone, Ruth E
2016-06-07
The mainstay for addressing conflicts of interest in health care is disclosure of personal financial ties to industry. However, this approach fails to capture the complexity of industry interactions that are built into clinical practice. Further, the policy climate focuses on physicians and traditional pharmaceutical marketing. To describe industry activities targeted at registered nurses. Qualitative, ethnographic study conducted from January 2012 to October 2014. Four acute care hospitals in a western U.S. city. A purposive sample of 72 participants with direct experience with industry, including staff nurses, administrators, and industry and supply chain professionals. Fieldwork, including observations (102 hours), semistructured in-depth interviews (n = 51), focus groups (n = 4), and documents analysis. Nurses' reported financial relationships with industry were similar to those reported by prescribers. However, nurses reported that their most significant interactions with industry occurred in daily practice. The current policy environment rendered these interactions invisible, leaving nurses with little guidance to ensure that the boundary between service and sales remained intact. This study could not determine the frequency or prevalence of nurse-industry interactions. The sample is not representative. Nurse-industry interactions may be common and influential, but they remain invisible in the current policy climate. Although some aspects of these interactions may be beneficial, others may pose financial risks to hospitals or safety risks to patients. Disclosure strategies alone do not provide health professionals with adequate support to manage day-to-day interactions. Management of industry interactions must include guidance for nurses. Agency for Healthcare Research and Quality; Canadian Institutes of Health Research; and University of California, San Francisco.
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Power and empowerment in nursing: looking backward to inform the future.
Manojlovich, Milisa
2007-01-31
There are compelling reasons to empower nurses. Powerless nurses are ineffective nurses. Powerless nurses are less satisfied with their jobs and more susceptible to burnout and depersonalization. This article will begin with an examination of the concept of power; move on to a historical review of nurses' power over nursing practice; describe the kinds of power over nursing care needed for nurses to make their optimum contribution; and conclude with a discussion on the current state of nursing empowerment related to nursing care. Empowerment for nurses may consist of three components: a workplace that has the requisite structures to promote empowerment; a psychological belief in one's ability to be empowered; and acknowledgement that there is power in the relationships and caring that nurses provide. A more thorough understanding of these three components may help nurses to become empowered and use their power for better patient care.
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Adhikari, Samaj; Paudel, Kumar; Aro, Arja R; Adhikari, Tara Ballav; Adhikari, Bipin; Mishra, Shiva Raj
2016-11-08
Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer's V value was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05. Our study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath (33 % of doctors and 51 % of nurses were unaware), Nuremberg code (90 % of both groups were unaware) and Helsinki Declaration (85 % of doctors and 88 % of nurses were unaware). A high percentage of respondents said that their major source of information on healthcare ethics were lectures (67.5 % doctors versus 56.6 % nurses), books (62.4 % doctors versus 89.2 % nurses), and journals (59 % doctors versus 89.2 % nurses). Attitude of doctors and nurses were significantly different (p < 0.05) in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula (97.4 % doctors versus 81.3 % nurses),paternalistic attitude of doctor was disagreed more by doctors (20.3 % doctors versus 9.3 % nurses). Notably, only few (9.3 % doctors versus 14.0 % nurses) doctors stood in support of physician-assisted dying. Significant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics.
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Complexities of policy-driven pre-registration nursing curricula.
McCarthy, Jilian; Holt, Maxine
This article discusses the challenges faced by two nurse educators when incorporating current health policy into a new pre-registration nursing curriculum, using public health and e-learning as examples. The article, which features the results of preliminary work from the authors' doctoral studies, includes summaries of students' discourses about e-learning and public health and how these subject areas are perceived by learners. Practical solutions to the challenges encountered are suggested.
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Improving Clinical Teaching: The ADN Experience. Pathways to Practice.
ERIC Educational Resources Information Center
Haase, Patricia T.; And Others
Three Florida associate degree in nursing (ADN) demonstration projects of the Nursing Curriculum Project (NCP) are described, and the history of the ADN program and current controversies are reviewed. In 1976, the NCP of the Southern Regional Education Board issued basic assumptions about the role of the ADN graduate, relating them to client…
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Enhancing Critical Thinking Via a Clinical Scholar Approach.
Simpson, Vicki; McComb, Sara A; Kirkpatrick, Jane M
2017-11-01
Safety, quality improvement, and a systems perspective are vital for nurses to provide quality evidence-based care. Responding to the call to prepare nurses with these perspectives, one school of nursing used a clinical scholar approach, enhanced by systems engineering to more intentionally develop the ability to clinically reason and apply evidence-based practice. A two-group, repeated-measures control trial was used to determine the effects of systems engineering content and support on nursing students' clinical judgment and critical thinking skills. Findings indicated this approach had a positive effects on student's clinical judgment and clinical reasoning skills. This approach helped students view health care issues from a broader perspective and use evidence to guide solution development, enhancing the focus on evidence-based practice, and quality improvement. Intentional integration of an evidence-based, systems perspective by nursing faculty supports development of nurses who can function safely and effectively in the current health care system. [J Nurs Educ. 2017;56(11):679-682.]. Copyright 2017, SLACK Incorporated.
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In defense of clinical conferences in clinical nursing education.
Vezeau, Toni M
2016-01-01
Clinical conferencing has been a consistent feature of clinical education, but the current clinical education environment poses many challenges to its continuance. The paper raises concern regarding the current state of clinical conferencing as part of clinical practice education in nursing. This topic is of great concern, but has there is little direction for clinical educators. The paper reviews the literature on conferencing and recommends avenues for future research. Copyright © 2015 Elsevier Ltd. All rights reserved.
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The relevance of globalization to nursing: a concept analysis.
Grootjans, J; Newman, S
2013-03-01
This paper emerged alongside the development of learning materials for a new unit of study on global health and nursing. The proposed unit was for inclusion in a graduate entry master of nursing course leading to registration. It became evident that there has been growing attention within the nursing literature to the demands of an increasingly globalized world and the subsequent challenges confronting nursing as a profession. At the same time, the literature is inconsistent and contains mixed messages with regard to how nurses and nursing might respond to these challenges. This paper aims to (i) present the findings of a narrative analysis of the current nursing discourse on globalization, and (ii) to identify directional cohesiveness for the nursing profession in the seemingly disparate literature. Concept analysis following extensive literature review. Several nursing authors argue that nurses globally are increasingly sharing concerns expressed by nurses at a local level. Concerns such as the future sustainability of the profession and more specifically practice concerns such as the continuing failure of nurses to adequately deal with social justice issues requires careful consideration by every nurse. While strategies recommended for dealing with these concerns lack a cohesive thread, some interesting themes and innovative recommendations have emerged. For example, the need for nurses to consider replacing environmental considerations with ecological considerations and that nurses consider preventative nursing practice beyond the immediate needs of clients and from a more global perspective. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.
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What do high school guidance counselors really think of nursing?
Bolan, Christine M; Grainger, Patricia
2005-03-01
With the increasing nursing shortage, it is imperative that nursing programs attract and retain students who will be successful in becoming competent, caring practitioners. High school guidance counselors can influence the career choices of students. To do so, these professionals must have an accurate understanding of the attributes that will facilitate a career in nursing, as well as the changing roles of nurses. This study determined the current perceptions of high school guidance counselors regarding nursing. Overall, guidance counselors had realistic perceptions of nursing and identified personal and cognitive attributes of students that would promote success in nursing. However, nurses involved in the recruitment of students need to ensure that guidance counselors have more accurate perceptions of the changing role of nurses, opportunities for practice outside hospital settings, and the importance of problem-solving abilities and leadership skills for nurses.
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Collaborating across services to advance evidence-based nursing practice.
Kenny, Deborah J; Richard, Maggie L; Ceniceros, Xochitl; Blaize, Kelli
2010-01-01
Military medical treatment facilities offer a unique environment in which to develop a culture of evidence-based practice (EBP). Distinctive issues arise in the context of changed patient care demographics because of a war-injured population. These issues offer an opportunity to enhance the quality of care through the use and adaptation of research findings in this special nursing environment. In addition, the colocation of two military medical centers offers the prospect of collaborative efforts to create a regional culture for nursing EBP. The purposes of this study were to describe the processes of a collaborative project to train nurses in EBP and to share resources in developing and implementing evidence-based clinical nursing guidelines in two large military medical centers in the Northeastern United States and to discuss the collective efforts of nurse researchers, leadership, advanced practice nurses, and staff nurses in each hospital to facilitate the EBP process. A description of the organizational structure and the climate for EBP of each facility is provided followed by discussion of training efforts and the inculcation of an organizational culture for EBP. Contextual barriers and facilitators were encountered throughout the project. The two nurse researchers leading the projects were able to overcome the barriers and capitalize on opportunities to promote EBP. Three evidence-based clinical practice guidelines were developed at each facility and are currently in various stages of implementation. Despite the barriers, EBP continues to be at the forefront of military nursing practice in the U.S. National Capital Region. Clear communication and regular meetings were essential to the success of the collaborative project within and between the two military hospitals. Military-specific barriers to EBP included high team attrition and turnover because of the war mission and the usual high staff turnover at military hospitals. Military facilitators included a common mission of providing high-quality care for war-injured service members. Lessons learned from this project can be generalized to civilian facilities.
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Stress management techniques in the prison setting.
Kristofersson, Gisli Kort; Kaas, Merrie J
2013-01-01
The percentage of incarcerated individuals in the United States is currently close to an all time high, and more stressful places than prisons are hard to find. Because registered nurses and advance practice nurses are often the only healthcare providers readily available to prison inmates, nurses need a repertoire of effective strategies to minimize prisoners' stress-related symptoms and behaviors. The purpose of this critical literature review was to identify the state of knowledge about using stress management techniques (SMTs) in the prison setting for reducing psychological problems and/or behavioral problems in male and female adult prison populations. A comprehensive, systematic integrated literature search was performed using multiple relevant databases to identify studies using various SMTs for incarcerated adults. Although clinical practice recommendations for the use of SMTs in the prison setting cannot be made with strong certainty, nurses working in the prison setting should continue to incorporate muscle relaxation, Transcendental Meditation, and certain Eastern meditative practices in the care of their clients because of the safety and possible positive impacts and practicality these methods have in this setting.
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The Careful Nursing philosophy and professional practice model.
Meehan, Therese C
2012-10-01
To present the Careful Nursing philosophy and professional practice model which has its source in the skilled practice of 19th century Irish nurses and to propose that its implementation could provide a relevant foundation for contemporary nursing practice. Nursing models are widely considered not relevant to nursing practice. Alarming instances of incompetent and insensitive nursing practice and experiences of powerlessness amongst nurses are being reported. Professional practice models that will inspire and strengthen nurses in practice and help them to address these challenges are needed. Nursing history has been suggested as a source of such models. Discursive. Content analysis of historical documents describing the thinking and practice of 19th century Irish nurses. Identification of emergent categories and subcategories as philosophical assumptions, concepts and dimensions of professional nursing practice. A philosophical approach to practise encompassing the nature and innate dignity of the person, the experience of an infinite transcendent reality in life processes and health as human flourishing. A professional practice model constructed from four concepts; therapeutic milieu, practice competence and excellence, management of practice and influence in health systems and professional authority; and their eighteen dimensions. As a philosophy and professional practice model, Careful Nursing can engage nurses and provide meaningful direction for practice. It could help decrease incidents of incompetent and insensitive practice and sustain already exemplary practice. As a basis for theory development, it could help close the relevance gap between nursing practice and nursing science. Careful Nursing highlights respect for the innate dignity of all persons and what this means for nurses in their relationships with patients. It balances attentive tenderness in nurse-patient relationships with clinical skill and judgement. It helps nurses to establish their professional practice boundaries and take authoritative responsibility for their practice. © 2012 Blackwell Publishing Ltd.
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Nursing overtime: why, how much, and under what working conditions?
Bae, Sung-Heui
2012-01-01
To provide the best care to patients, the physical wellness of nursing staff is essential. Current evidence indicates long work hours can lead to adverse nurse and patient outcomes. To provide quality and safe patient care, both staff nurses and nurse managers need to recognize the adverse effects of overtime, whether it is mandatory or voluntary. Results of this study showed overtime was not used more when there was an increase in nursing shortages. Further, overtime was not used to control shortages; rather, understaffing was an underlying condition of the nursing practice, at least in the study sample. Thus, efforts must be made not only to prevent nurses from working long hours, but also to resolve the problem of understaffing in order to retain qualified nurses in hospitals.
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2013-01-01
Background The effectiveness of nurse-led motivational interviewing (MI) in routine diabetes care in general practice is inconclusive. Knowledge about the extent to which nurses apply MI skills and the factors that affect the usage can help to understand the black box of this intervention. The current study compared MI skills of trained versus non-trained general practice nurses in diabetes consultations. The nurses participated in a cluster randomized trial in which a comprehensive program (including MI training) was tested on improving clinical parameters, lifestyle, patients’ readiness to change lifestyle, and quality of life. Methods Fifty-eight general practices were randomly assigned to usual care (35 nurses) or the intervention (30 nurses). The ratings of applying 24 MI skills (primary outcome) were based on five consultation recordings per nurse at baseline and 14 months later. Two judges evaluated independently the MI skills and the consultation characteristics time, amount of nurse communication, amount of lifestyle discussion and patients’ readiness to change. The effect of the training on the MI skills was analysed with a multilevel linear regression by comparing baseline and the one-year follow-up between the interventions with usual care group. The overall effect of the consultation characteristics on the MI skills was studied in a multilevel regression analyses. Results At one year follow up, it was demonstrated that the nurses improved on 2 of the 24 MI skills, namely, “inviting the patient to talk about behaviour change” (mean difference=0.39, p=0.009), and “assessing patient’s confidence in changing their lifestyle” (mean difference=0.28, p=0.037). Consultation time and the amount of lifestyle discussion as well as the patients’ readiness to change health behaviour was associated positively with applying MI skills. Conclusions The maintenance of the MI skills one year after the training program was minimal. The question is whether the success of MI to change unhealthy behaviour must be doubted, whether the technique is less suitable for patients with a complex chronic disease, such as diabetes mellitus, or that nurses have problems with the acquisition and maintenance of MI skills in daily practice. Overall, performing MI skills during consultation increases, if there is more time, more lifestyle discussion, and the patients show more readiness to change. Trial registration Current Controlled Trials ISRCTN68707773 PMID:23537327
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Advancing nursing practice: redefining the theoretical and practical integration of knowledge.
Christensen, Martin
2011-03-01
The aim of this paper is to offer an alternative knowing-how knowing-that framework of nursing knowledge, which in the past has been accepted as the provenance of advanced practice. The concept of advancing practice is central to the development of nursing practice and has been seen to take on many different forms depending on its use in context. To many it has become synonymous with the work of the advanced or expert practitioner; others have viewed it as a process of continuing professional development and skills acquisition. Moreover, it is becoming closely linked with practice development. However, there is much discussion as to what constitutes the knowledge necessary for advancing and advanced practice, and it has been suggested that theoretical and practical knowledge form the cornerstone of advanced knowledge. The design of this article takes a discursive approach as to the meaning and integration of knowledge within the context of advancing nursing practice. A thematic analysis of the current discourse relating to knowledge integration models in an advancing and advanced practice arena was used to identify concurrent themes relating to the knowing-how knowing-that framework which commonly used to classify the knowledge necessary for advanced nursing practice. There is a dichotomy as to what constitutes knowledge for advanced and advancing practice. Several authors have offered a variety of differing models, yet it is the application and integration of theoretical and practical knowledge that defines and develops the advancement of nursing practice. An alternative framework offered here may allow differences in the way that nursing knowledge important for advancing practice is perceived, developed and coordinated. What has inevitably been neglected is that there are various other variables which when transposed into the existing knowing-how knowing-that framework allows for advanced knowledge to be better defined. One of the more notable variables is pattern recognition, which became the focus of Benner's work on expert practice. Therefore, if this is included into the knowing-how knowing-that framework, the knowing-how becomes the knowledge that contributes to advancing and advanced practice and the knowing-that becomes the governing action based on a deeper understanding of the problem or issue. © 2011 Blackwell Publishing Ltd.
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Behavioral Economics: A New Lens for Understanding Genomic Decision Making.
Moore, Scott Emory; Ulbrich, Holley H; Hepburn, Kenneth; Holaday, Bonnie; Mayo, Rachel; Sharp, Julia; Pruitt, Rosanne H
2018-05-01
This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved. This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics. Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making. Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing. Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices. Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers. © 2018 Sigma Theta Tau International.
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Shaping nursing profession regulation through history - a systematic review.
Stievano, A; Caruso, R; Pittella, F; Shaffer, F A; Rocco, G; Fairman, J
2018-03-23
The aim of this systematic review was to provide a critical synthesis of the factors that historically shaped the advancements of nursing regulators worldwide. An in-depth examination of the different factors that moulded regulatory changes over time is pivotal to comprehend current issues in nursing. In the light of global health scenarios, the researchers explored the factors that historically influenced the socio-contextual circumstances upon which governments made regulatory changes. A systematic search was performed on the following databases: PubMed, CINAHL, Scopus, OpenGrey and ScienceDirect. The review included papers from January 2000 to October 2016 published in English. The authors used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and an inductive thematic approach for synthesis. Two main themes were identified: factors underpinning current challenges and historical and contextual triggers of regulation. The first theme was composed of three aspects: education, migration and internationalization, and policy and regulation; the second theme consisted of four attributes: demographics, economics, history of registration and wars, and historical changes in nursing practice. Factors that shaped nursing regulation were linked to changing demographics and economics, education, history of nursing registration, shifting patterns of migration and internationalization, nursing practice, policy and regulation and significant societal turns often prompted by wars. A deeper understanding of the developments of the nursing regulatory institutions provides the foundation for portable standards that can be applied across an array of jurisdictions to guarantee a better public safety. Understanding factors that socially, legislatively and politically have influenced the development of regulatory bodies over time helps to mould local, national and international policies that have a stronger impact on health worldwide. To achieve this, there must be effective cooperation among systems of nursing regulations globally. © 2018 International Council of Nurses.
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O'Brien-Pallas, Linda; Hayes, Laureen
2008-12-01
This paper draws upon empirical research and other published sources to discuss nursing workforce issues, the challenges of using health human resource research in policy decisions and the importance of evidence-based policies and practices for nursing care and outcomes. Increasing evidence points to the critical relationship between registered nurse care and improved patient outcomes. The negative impact that insufficient nurse staffing has on patient, nursing and system outcomes has influenced health human resource researchers to further examine nurses' work environments to determine factors that are amenable to policy change. Survey of literature was conducted. Electronic databases were searched using keywords. Sustained health human resource planning efforts by policy makers are difficult given changing governments and political agendas. The health human resource conceptual framework provides researchers and planners with a guide to decision-making that considers current circumstances as well as those factors that need to be accounted for in predicting future requirements. However, effective use of research depends on communication of findings between researchers and policymakers. Health care managers and other decision-makers in health care organisations often lack an understanding of the research process and do not always have easy access to current evidence. Also, managerial decisions are often constrained by organisational requirements such as resource availability and policies and procedures. Unless nursing workplace issues are addressed, the physiological and psychological stress in the work environments of nurses will continue. Effective health human resource policy and planning (at the macro level) and management strategies (at the micro level) would stabilise the nursing workforce and reduce job stress. Furthermore, the efficiency and cost-effectiveness of the health system could be enhanced through improved health outcomes of care providers and health care clients.
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Doolin, Christopher T; Quinn, Lisa D; Bryant, Lesley G; Lyons, Ann A; Kleinpell, Ruth M
2011-01-01
To provide advanced practice nurses (APNs) with the best available evidence for implementation of policies and procedures to allow family presence during cardiopulmonary resuscitation (CPR) in the acute care environment. A comprehensive review of research-based articles from Ebsco Host, CINAHL, Pre-CINAHL, and Medline Plus, as well as statement alerts from nursing credentialing bodies, and practice guidelines were reviewed. Kolcaba's Theory of Comfort and Lewin's Three Step Change Theory provide a framework for implementation of formal policies and procedures. Best available evidence showed more support in favor of allowing families at the bedside during CPR. Implementation of policies and procedures allowing family presence enables facilities to change and grow in a holistic and family-oriented atmosphere. With this evidence-based knowledge the APN will be able to disseminate information to facilitate collaborative change in current practices surrounding staff education, decision making, and self-governance. The APN can then address controversial changes when developing formal policies and procedures, which will increase patient satisfaction and outcomes. ©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.
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Leblanc, Judith; Rousseau, Alexandra; Hejblum, Gilles; Durand-Zaleski, Isabelle; de Truchis, Pierre; Lert, France; Costagliola, Dominique; Simon, Tabassome; Crémieux, Anne-Claude
2016-02-01
In 2010, to reduce late HIV diagnosis, the French national health agency endorsed non-targeted HIV screening in health care settings. Despite these recommendations, non-targeted screening has not been implemented and only physician-directed diagnostic testing is currently performed. A survey conducted in 2010 in 29 French Emergency Departments (EDs) showed that non-targeted nurse-driven screening was feasible though only a few new HIV diagnoses were identified, predominantly among high-risk groups. A strategy targeting high-risk groups combined with current practice could be shown to be feasible, more efficient and cost-effective than current practice alone. DICI-VIH (acronym for nurse-driven targeted HIV screening) is a multicentre, cluster-randomized, two-period crossover trial. The primary objective is to compare the effectiveness of 2 strategies for diagnosing HIV among adult patients visiting EDs: nurse-driven targeted HIV screening combined with current practice (physician-directed diagnostic testing) versus current practice alone. Main secondary objectives are to compare access to specialist consultation and how early HIV diagnosis occurs in the course of the disease between the 2 groups, and to evaluate the implementation, acceptability and cost-effectiveness of nurse-driven targeted screening. The 2 strategies take place during 2 randomly assigned periods in 8 EDs of metropolitan Paris, where 42 % of France's new HIV patients are diagnosed every year. All patients aged 18 to 64, not presenting secondary to HIV exposure are included. During the intervention period, patients are invited to fill a 7-item questionnaire (country of birth, sexual partners and injection drug use) in order to select individuals who are offered a rapid test. If the rapid test is reactive, a follow-up visit with an infectious disease specialist is scheduled within 72 h. Assuming an 80 % statistical power and a 5 % type 1 error, with 1.04 and 3.38 new diagnoses per 10,000 patients in the control and targeted groups respectively, a sample size of 140,000 patients was estimated corresponding to 8,750 patients per ED and per period. Inclusions started in June 2014. Results are expected by mid-2016. The DICI-VIH study is the first large randomized controlled trial designed to assess nurse-driven targeted HIV screening. This study can provide valuable information on HIV screening in health care settings. ClinicalTrials.gov: NCT02127424 (29 April 2014).
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It takes chutzpah: oncology nurse leaders.
Green, E
1999-01-01
Chutzpah, according to the Oxford Dictionary of Current English (1996) is a slang term from the Yiddish language which means shameless audacity. Chutzpah has been used to identify people with courage who take on situations that others avoid and somehow achieve the impossible. Tim Porter-O'Grady (1997) recently wrote that management is dead, and has been replaced by process leadership. Health care organizations have made shifts from hierarchical structures to process or program models where people have dual/multiple reporting/communication relationship. In this new orientation, management functions of controlling, directing, organizing and disciplining are replaced by process leadership functions of coordinating, facilitating, linking and sustaining (Porter O'Grady, 1997). Herein lies the challenge for oncology nurse leaders: "what lies behind us and what lies before us are tiny matters compared to what lies within us" (Ralph Waldo Emerson). Leadership is not a function of job title. The evidence for this is clear in current practice.... There are no/few positions of nurse leaders. Titles have changed to eliminate the professional discipline, and reflect a non-descript orientation. The new titles are process leaders, program leaders, professional practice leaders. Nurse leaders need new points of reference to take in the challenges of influencing, facilitating and linking. Those points of reference are: principle-centered leadership, integrity and chutzpah. This presentation will focus on examining current thinking, defining key characteristics and attributes, and using scenarios to illustrate the impact of leadership. We, as leaders in oncology nursing, must use chutzpah to make positive change and long-term gains for patient care and the profession of nursing.
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Shuman, Clayton J; Liu, Xuefeng; Aebersold, Michelle L; Tschannen, Dana; Banaszak-Holl, Jane; Titler, Marita G
2018-04-25
Nurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units. A multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05. Two hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit (p < .05) were significant but level of nursing education was not. Nurse managers are significantly related to unit climates for EBP implementation primarily through their leadership behaviors. Future implementation studies should consider the leadership of nurse managers in creating climates supportive of EBP implementation.
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Two approaches to bridging the knowledge-practice gap in oncology nursing.
Peek, Gloanna J
2015-01-01
The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).
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Professional ethics in nursing: an integrative review.
Kangasniemi, Mari; Pakkanen, Piiku; Korhonen, Anne
2015-08-01
To conduct an integrative review and synthesize current primary studies of professional ethics in nursing. Professional ethics is a familiar concept in nursing and provides an ethical code for nursing practice. However, little is known about how professional ethics has been defined and studied in nursing science. Systematic literature searches from 1948-February 2013, using the CINAHL, PubMed and Scopus electronic databases to look at previously published peer-reviewed studies. A modified version of Cooper's five-stage integrative review was used to review and synthesize current knowledge. Fourteen papers were included in this research. According to our synthesis, professional ethics is described as an intra-professional approach to care ethics and professionals commit to it voluntarily. Professional ethics consist of values, duties, rights and responsibilities, regulated by national legislation and international agreements and detailed in professional codes. Professional ethics is well established in nursing, but is constantly changing due to internal and external factors affecting the profession. Despite the obvious importance of professional ethics, it has not been studied much in nursing science. Greater knowledge of professional ethics is needed to understand and support nurses' moral decision-making and to respond to the challenges of current changes in health care and society. © 2015 John Wiley & Sons Ltd.
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Organizational climate and intensive care unit nurses' intention to leave.
Stone, Patricia W; Larson, Elaine L; Mooney-Kane, Cathy; Smolowitz, Janice; Lin, Susan X; Dick, Andrew W
2006-07-01
The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon. Cross-sectional design. Hospitals and critical care units. Registered nurses (RNs) employed in adult intensive care units. Organizational climate, nurse demographics, intention to leave, and reason for intending to leave were collected using a self-report survey. Nurses were categorized into two groups: a) those intending to leave due to working conditions; and b) others (e.g., those not leaving or retirees). The measure of organizational climate had seven subscales: professional practice, staffing/resource adequacy, nurse management, nursing process, nurse/physician collaboration, nurse competence, and positive scheduling climate. Setting characteristics came from American Hospital Association data and a survey of chief nursing officers. A total of 2,323 RNs from 66 hospitals and 110 critical care units were surveyed across the nation. On average, the RN was 39.5 yrs old (SD = 9.40), had 15.6 yrs (SD = 9.20) experience in health care, and had worked in his or her current position for 8.0 yrs (SD = 7.50). Seventeen percent (n = 391) of the respondents indicated intending to leave their position in the coming year. Of those, 52% (n = 202) reported that the reason was due to working conditions. Organizational climate factors that had an independent effect on intensive care unit nurse intention to leave due to working conditions were professional practice, nurse competence, and tenure (p < .05). Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.
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Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia.
Tolentino-DelosReyes, Arlene F; Ruppert, Susan D; Shiao, Shyang-Yun Pamela K
2007-01-01
To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia. Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses' practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30 degrees to 45 degrees , were observed in 99 intubated patients. After the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to <.001). The areas of most significant improvement were elevation of the head of the bed (P < .001), charting of the elevation of the head of the bed (P= .009), oral care (P= .009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P < .001), and limiting the wearing of rings (P < .001) and nail polish (P = .04). Even after the education sessions, the nurses' compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses' practices (P= .38). Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants' knowledge and subsequent clinical practice.
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Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting.
Anderson, Joel G; Friesen, Mary Ann; Swengros, Diane; Herbst, Anna; Mangione, Lucrezia
2017-03-01
Acute care nursing is currently undergoing unprecedented change, with health systems becoming more open to nonpharmacological approaches to patient care. Healing Touch (HT) may be a valuable intervention for acute care patients. Research has shown that HT helps both the patient and the caregiver; however, no study to date has examined the impact that the education of nurses in and their use of HT have on daily care delivery in the acute care setting. The purpose of the current qualitative study was to examine the use of HT by registered nurses in the acute care setting during their delivery of patient care, as well as the impact of education in and use of HT on the nurses themselves. Five themes were identified: (1) use of HT techniques, processes, and sequence; (2) outcomes related to HT; (3) integration of HT into acute care nursing practice; (4) perceptions of HT, from skepticism to openness; and (5) transformation through HT. Education in HT and delivery of this modality by nurses in the acute care setting provide nurses with a transformative tool to improve patient outcomes.
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Glasgow, Mary Ellen Smith; Weinstock, Beth; Lachman, Vicki; Suplee, Patricia Dunphy; Dreher, H Michael
2009-01-01
Despite attention given to the nursing shortage and now the nursing faculty shortage, what is perhaps less visible but equally critical are the pending retirements of most of the current cadre of academic nursing administrators in the next decade. With only 2.1% of current deans, directors, and department chairs in 2006 aged 45 years or younger, there may be a pending crisis in leadership development and succession planning in our nursing schools and colleges. This article describes an innovative leadership development program for largely new nursing academic administrators, which combined a formal campus-based leadership symposia and executive coaching. This article is particularly useful and practical in that actual case studies are described (albeit modified slightly to protect the identity of the individual administrator), providing a real-life narrative that rarely makes its way into the nursing academic administration literature. The executive coaching focus is very sparsely used in nursing academia, and this college's success using this professional development strategy is likely to become a template for other institutions to follow.
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Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies.
Ivory, Catherine H
2016-07-01
The use of standard terminologies is an essential component for using data to inform practice and conduct research; perinatal nursing data standardization is needed. This study explored whether 76 distinct process elements important for perinatal nursing were present in four American Nurses Association-recognized standard terminologies. The 76 process elements were taken from a valid paper-based perinatal nursing process measurement tool. Using terminology-supported browsers, the elements were manually mapped to the selected terminologies by the researcher. A five-member expert panel validated 100% of the mapping findings. The majority of the process elements (n = 63, 83%) were present in SNOMED-CT, 28% (n = 21) in LOINC, 34% (n = 26) in ICNP, and 15% (n = 11) in CCC. SNOMED-CT and LOINC are terminologies currently recommended for use to facilitate interoperability in the capture of assessment and problem data in certified electronic medical records. Study results suggest that SNOMED-CT and LOINC contain perinatal nursing process elements and are useful standard terminologies to support perinatal nursing practice in electronic health records. Terminology mapping is the first step toward incorporating traditional paper-based tools into electronic systems.
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Development of a nursing handoff tool: a web-based application to enhance patient safety.
Goldsmith, Denise; Boomhower, Marc; Lancaster, Diane R; Antonelli, Mary; Kenyon, Mary Anne Murphy; Benoit, Angela; Chang, Frank; Dykes, Patricia C
2010-11-13
Dynamic and complex clinical environments present many challenges for effective communication among health care providers. The omission of accurate, timely, easily accessible vital information by health care providers significantly increases risk of patient harm and can have devastating consequences for patient care. An effective nursing handoff supports the standardized transfer of accurate, timely, critical patient information, as well as continuity of care and treatment, resulting in enhanced patient safety. The Brigham and Women's/Faulkner Hospital Healthcare Information Technology Innovation Program (HIP) is supporting the development of a web based nursing handoff tool (NHT). The goal of this project is to develop a "proof of concept" handoff application to be evaluated by nurses on the inpatient intermediate care units. The handoff tool would enable nurses to use existing knowledge of evidence-based handoff methodology in their everyday practice to improve patient care and safety. In this paper, we discuss the results of nursing focus groups designed to identify the current state of handoff practice as well as the functional and data element requirements of a web based Nursing Handoff Tool (NHT).
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Shannon, Robin Adair; Kubelka, Suzanne
2013-09-01
School nurses are challenged by Federal Civil Rights Laws and the Standards of School Nursing Practice to care for a burgeoning population of students with special healthcare needs. Due to the realities of current school nurse-to-student ratios, school nurses are frequently responsible for directing unlicensed assistive personnel (UAPs) to support the health and safety needs of students, where State Nurse Practice Acts, state legislation, and local policy mandates allow. The delegation of health care tasks to UAPs poses many professional, ethical, and legal dilemmas for school nurses. One strategy to reduce the risks of delegation is through the use of procedure skills checklists, as highlighted by the experience of one large urban school district. Part 1 of this two-part article (Shannon & Kubelka, 2013) explored the scope of the problem and the principles of delegation, including legal and ethical considerations. Part 2 discusses the use of procedure skills checklists by school nurses as a strategy to reduce the risks of delegation of student special health care tasks to UAPs.
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Arthur, David; Drury, John; Sy-Sinda, Maria Teresita; Nakao, Ramonita; Lopez, Arsenia; Gloria, Grace; Turtal, Rowena; Luna, Evelyn
2006-01-01
Primary health care (PHC) nursing is widely practiced in the Philippines yet little is published about the nurses working in this field nor by these nurses. This paper describes a PHC nursing curriculum conducted in an island in the south of the Philippines and examines the experience of nurses working as faculty and simultaneously providing service to the local community. Data were collected from a convenience sample of faculty by interview and analysed using Huserrlian (descriptive) phenomenology and Colaizzi's method of data analysis. From 102 formulated meanings emerged four theme clusters: teaching PHC; external influences; the working reality and practicing PHC, and these are presented with exemplars from the interviews. The data gives a clear impression of the experience of implementing PHC and working with small communities and highlights the educational and clinical issues inherent in this unique model. The insights gained from the analysis of the interviews are contrasted with current literature and recommendations for future research are made.
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Bender, Miriam; Elias, Dina
The esthetic pattern of knowing is critical for nursing practice, yet remains weakly defined and understood. This gap has arguably relegated esthetic knowing to an "ineffable" creativity that resists transparency and understanding, which is a barrier to articulating its value for nursing and its importance in producing beneficial health outcomes. Current philosophy of science developments are synthesized to argue that esthetic knowing is an appropriate "object" of scientific inquiry. Examples of empirical scholarship that can be conceived as scientific inquiry into manifestations of esthetic knowing are highlighted. A program of research is outlined to advance a science of esthetic knowing.
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Smartphone applications: potential tools for use in preparing for CCRN certification examinations.
Curran, Claire
2014-06-01
Recent advances in smartphone technology now allow clinicians to use commercially produced applications when studying for nursing certification examinations. The quality of currently available CCRN review applications varies in this first generation of products. Most are limited to multiple-choice practice questions, although a few have additional elements such as study guides and reference charts. Weaknesses found in the applications evaluated include poorly written and edited content, questions limited to rote memorization rather than application and analysis of knowledge, and content too basic or outside the scope of experienced critical care nursing practice. A list of important factors for consumers to consider before purchase is provided. ©2014 American Association of Critical-Care Nurses.
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Pryse, Yvette; McDaniel, Anna; Schafer, John
2014-08-01
Those in nursing have been charged with practicing to the full extent of their education and training by the Institute of Medicine. Therefore, evidence-based practice (EBP) has never been more important to nursing than in the current healthcare environment. Frequently the burden of EBP is the responsibility of the bedside practitioner, but has been found to be a process that requires leadership and organizational support. A key underlying component of a strong EBP environment includes effective communications and collaboration among staff and nursing leadership. Developing measurement tools that examine the milieu and nursing leadership in which the staff nurse practices is an important component of understanding the factors that support or hinder EBP. The aim of this study is to report on the development and analysis of two new scales designed to explore leadership and organizational support for EBP. The EBP Nursing Leadership Scale (10 items) examines the staff nurses perception of support provided by the nurse manager for EBP, and the EBP Work Environment Scale (8 items) examines organizational support for EBP. Staff nurses who worked at least .5 FTE in direct patient care, from two inner city hospitals (n = 422) completed the scales. The scales were evaluated for internal consistency reliability with the Cronbach alpha technique, content validity using a panel of experts, and construct validity by The content validity index computed from expert rankings was .78 to 1.0 with an average of.96. Cronbach's alpha was .96 (n = 422) for the EBP Nursing Leadership Scale and .86 (n = 422) for the EBP Work Environment Scale. Factor analysis confirmed that each scale measured a unidimensional construct (p < .000). The EBP Nursing Leadership Scale and the EBP Work Environment Scale are psychometrically sound instruments to examine organizational influences on EBP. © 2014 Sigma Theta Tau International.
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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
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Palliative care for advanced dementia: Knowledge and attitudes of long-term care staff.
Chen, I-Hui; Lin, Kuan-Yu; Hu, Sophia H; Chuang, Yeu-Hui; Long, Carol O; Chang, Chia-Chi; Liu, Megan F
2018-02-01
To investigate the knowledge of and attitudes towards palliative care for advanced dementia and their associations with demographics among nursing staff, including nurses and nursing assistants, in long-term care settings. Nursing facilities are places where persons with dementia die; therefore, providing quality end-of-life care to residents with advanced dementia is crucial. To date, little attention has been paid to palliative care practice for patients with advanced dementia. A descriptive, cross-sectional, survey design was used. In total, a sample of 300 nurses (n = 125) and nursing assistants (n = 175) working in long-term care settings in Taiwan participated in this study. Two instruments were administered: demographic characteristics and responses to the Questionnaire of Palliative Care for Advanced Dementia. Descriptive statistics and multiple regression were used for data analysis. Overall, the nurses and nursing assistants had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Additionally, nursing staff who were nurses with greater work experience and those who had received palliative care and hospice training had greater knowledge of palliative care. In addition, nursing staff who had received dementia care training and who had worked in nursing homes had higher levels of positive attitudes towards palliative care. This study indicates the need to provide nurses and nursing assistants with more information about palliative care practice for people with advanced dementia. Particularly, providing education to those who are nursing assistants, who have less working experience, who have not received palliative and dementia care training, and who have not worked in nursing homes can improve overall nursing staff knowledge of and attitudes towards palliative care. Continuing education in principles of palliative care for advanced dementia is necessary for currently practicing nursing staff and should be developed according to their educational background and needs. © 2017 John Wiley & Sons Ltd.
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Zander, Britta; Dobler, Lydia; Busse, Reinhard
2013-02-01
As other countries which have introduced diagnosis-related groups (DRGs) to pay their hospitals Germany initially expected that quality of care could deteriorate. Less discussed were potential implications for nurses, who might feel the efficiency-increasing effects of DRGs on their daily work, which in turn may lead to an actual worsening of care quality. To analyze whether the DRG implementation in German acute hospitals (as well as other changes over the 10-year period) had measurable effects on (1) the nurse work environment (including e.g. an adequate number of nursing staff to provide quality patient care), (2) quality of patient care and safety (incl. confidence into patients' ability to manage care when discharged), and (3) whether the effects from (1) and (2)--if any--impacted on the nurses themselves (satisfaction with their current job and their choice of profession as well as emotional exhaustion). Two rounds of nurse surveys with the Practice Environment Scale of the Nursing Work Index (PES-NWI), five years before DRG implementation (i.e. in 1998/1999; n=2681 from 29 hospitals) and five years after (i.e. in 2009/2010; n=1511 from 49 hospitals). The analysis utilized 15 indicators as outcomes for (1) practice environment, (2) quality of patient care and safety, as well as (3) nurses' satisfaction and emotional exhaustion. Multivariate analyses were performed for all three sets of outcomes using SPSS version 20. Aspects of the practice environment (especially adequate staffing and supportive management) worsened within the examined time span of 10 years, which as a consequence had significant negative impact on the nurse-perceived quality of care (except for patient safety, which improved). Both the aspects of the practice environment and the quality aspects impacted substantially on satisfaction and emotional exhaustion among nurses. The DRG implementation in Germany has apparently had measurable negative effects on nurses and nurse-perceived patient outcomes, however, not as distinct as often assumed. Copyright © 2012 Elsevier Ltd. All rights reserved.
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The use of virtual reality computer simulation in learning Port-A cath injection.
Tsai, Sing-Ling; Chai, Sin-Kuo; Hsieh, Li-Feng; Lin, Shirling; Taur, Fang-Meei; Sung, Wen-Hsu; Doong, Ji-Liang
2008-03-01
Cost-benefit management trends in Taiwan healthcare settings have led nurses to perform more invasive skills, such as Port-A cath administration of medications. Accordingly, nurses must be well-prepared prior to teaching by the mentor and supervision method. The purpose of the current study was to develop a computer-assisted protocol using virtual reality (VR) in performing Port-A cath as a training program for novice nurses. A pre-tested and post-tested control group experimental design was used in this study. Seventy-seven novice nurses were invited from one large medical center hospital in North Taiwan. Thirty-seven and forty nurses were randomly assigned to experimental and control groups. First, we designed a 40 minute port-A cath injection VR simulation. Then, the experimental group practiced this simulation two times over 3 weeks. The control group attended the traditional class. The post-test 1 was right after completion of the simulation practice. The post-test 2 was after the second simulation practice in 3 weeks. The results showed that most novice nurses lacked Port-A cath experience both in the classroom and during the period of their practice training. The knowledge score regarding the Port-A cath technique was significantly higher in the nurses that participated in the simulation training than in the control group. The novice nurses were most satisfied with the reduction in their fear of performing the Port-A cath technique and their enhanced clinical skills. VR simulation significantly reduced error rates and increased correct equipment selection, showing that nurses who participated in the simulation may be better prepared for inserting Port-A cath.
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Nurses' perceptions of family presence during resuscitation.
Tudor, Kelly; Berger, Jill; Polivka, Barbara J; Chlebowy, Rachael; Thomas, Beena
2014-11-01
Although strong evidence indicates that the presence of a patient's family during resuscitation has a positive effect on the family, the practice is still controversial and is not consistently implemented. To explore nurses' experience with resuscitation, perceptions of the benefits and risks of having a patient's family members present, and self-confidence in having family presence at their workplace. Differences in demographic characteristics and relationships between nurses' perceptions of self-confidence and perceived risks and benefits of family presence were evaluated. The study was descriptive, with a cross-sectional survey design. A convenience sample of 154 nurses working in inpatient and outpatient units at an urban hospital were surveyed. The 63-item survey included 2 previously validated scales, demographic questions, and opinion questions. Nurses' self-confidence and perceived benefit of family presence were significantly related (r = 0.54; P < .001). Self-confidence was significantly greater in nurses who had completed training in Advanced Cardiac Life Support, had experienced 10 or more resuscitation events, were specialty certified, or were members of nurses' professional organizations. Barriers to family presence included fear of interference by the patient's family, lack of space, lack of support for the family members, fear of trauma to family members, and performance anxiety. Changing the practice of family presence will require strengthening current policy, identifying a team member to attend to the patient's family during resuscitation, and requiring nurses to complete education on evidence that supports family presence and changes in clinical practice. ©2014 American Association of Critical-Care Nurses.
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Preparing for practice: Nursing intern and faculty perceptions on clinical experiences.
AlThiga, Hanan; Mohidin, Sharifah; Park, Yoon Soo; Tekian, Ara
2017-04-01
Clinical experience and exposure to real patients are required elements of nursing education. Trainees in nursing are expected to be prepared adequately for the hard-working environment, increasing patient complexity, and higher-level competencies. This study investigates differences between nursing interns and clinical faculty on actual and perceived importance of educational preparation and development of clinical competencies, focusing on the nursing curriculum and transition to practice. A convenient sampling technique with a mixed-methods design was used to collect quantitative and qualitative data, by surveying and interviewing nursing interns and faculty members from King Abdul-Aziz University in Saudi Arabia; data collection occurred in December 2015. The survey (23 items) and focused interviews measured perceptions of clinical instruction and experience. Descriptive statistics and t-tests were used to analyze differences in mean ratings between actual and perceived importance. Themes collected from narrative interview data were summarized. Significant differences were found between nursing interns (n = 46) and faculty (n = 29) perceptions of actual clinical teaching and experiences and its importance including the clinical teaching and the development of clinical competence, p < .01. Moreover, nursing interns rated actual experiences of knowledge base and skills significantly lower than faculty perceptions, p = .001. Narrative data provided in-depth information on factors contributing and hindering the learning and teaching environment. Findings from this study call for clinical instruction and experiences to take a step further to meet current practice standards and to improve patient safety in the health professions education of nurses.
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Laws, R; Campbell, K J; van der Pligt, P; Ball, K; Lynch, J; Russell, G; Taylor, R; Denney-Wilson, E
2015-01-01
Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported. This mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0-5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles. Although nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation. While MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.
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[Illness, culture and religion--issues of intercultural medical ethics and nursing ethics].
Körtner, Ulrich H J
2007-01-01
Should modern medicine be allowed to do what it is capable of? And what role are religious norms and attitudes to play in both the medical course of life and the bioethical discourse of modern societies? Questions like these are subject of current intercultural medical and nursing ethics. Religious attitudes not only influence the cultural and political surroundings of medical research but also exert a practical influence on the health and illness attitudes of the individual. Coming before moral judgement should be the endeavour to understand one's counterpart, namely the patient, and his/her socio-cultural background. The question to be answered is how therapy and nursing can best be applied within the given socio-cultural framework without those responsible denying their own medical premises or their own concepts of nursing. Intercultural medical and nursing ethics provide an important contribution to the current debate on integration.
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The healthcare team's perception of the role of the perioperative nurse: A qualitative study.
Espinoza, Pilar; Galaz Letelier, Luz Maria; Cunill Leppe, María Dolores; Yercic Bravo, Margarita; Ferdinand, Constanza; Ferrer Lagunas, Lilian
2016-09-01
The surgical process requires the coordination of a number of professionals who understand their own roles and responsibilities, as well as those of the team. In the perioperative setting, expectations are established around behaviors and competencies of every team member. These expectations are influenced by knowledge, training and experience, and may ultimately influence results and the ability to adapt and respond to work demands. In Chile, there exists an ambiguity and lack of definition in the role of the nurse. The objective of this study was to examine the healthcare team's perception of the current role of the perioperative nurse, as well as the expected and desired characteristics of the role from the team's perspective. A qualitative, descriptive case study was carried out, using semi-structured interviews conducted with a purposive sample of surgeons, anaesthesiologists, professional nurses and technical nurses from three hospitals in Santiago, Chile. The accounts were analysed using an inductive, thematic format. It was found that the current perioperative nursing role, with a predominance of administrative charting, recordkeeping and guidelines for the management of safety, quality control and human and material resources, restricts direct patient care. Expected characteristics of the role included comprehensive theoretical and practical training and the development of relational skills for teamwork, direct patient care and advocacy in the surgical context. These results provided initial steps towards redefining the role of the perioperative nurse, strengthening collaborative efforts and optimising patient care during a time of high vulnerability. Copyright the Association for Perioperative Practice.
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[Private practice: a choice, but what challenges!].
de Montigny, F
1997-06-01
Recent changes in the Canadian health care system are having an impact on the way health care services are delivered. As a result, opportunities are opening up for a whole new generation of autonomous and independent nurses who choose to work directly with clients in a private practice setting. In part one of this two-part article, the author describes the main responsibilities of the nurse entrepreneur. Stressed are the areas of competency and the entrepreneurial spirit required. Administrative, professional, legal and fiscal aspects of independent practice are also outlined. Part two of the article focuses on the ethical responsibilities of the nurse entrepreneur and the regulations concerning fees, publicity, insurance, and office and file management. The author recommends keeping current on new developments and establishing a process whereby clients can evaluate the quality of care they receive.
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Chew-Graham, Carolyn; Dixon, Rebecca; Shaw, Jonathan W; Smyth, Nina; Lovell, Karina; Peters, Sarah
2009-01-01
Background NICE guidelines suggest that patients with Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) should be managed in Primary Care. Practice Nurses are increasingly being involved in the management of long-term conditions, so are likely to also have a growing role in managing CFS/ME. However their attitudes to, and experiences of patients with CFS/ME and its management must be explored to understand what barriers may exist in developing their role for this group of patients. The aim of this study was to explore Practice Nurses' understanding and beliefs about CFS/ME and its management. Methods Semi-structured interviews with 29 Practice Nurses. Interviews were transcribed verbatim and an iterative approach used to develop themes from the dataset. Results Practice nurses had limited understanding about CFS/ME which had been largely gained through contact with patients, friends, personal experiences and the media rather than formal training. They had difficulty seeing CFS/ME as a long term condition. They did identify a potential role they could have in management of CFS/ME but devalued their own skills in psychological intervention, and suggested counselling would be an appropriate therapeutic option. They recognised a need for further training and on going supervision from both medical and psychological colleagues. Some viewed the condition as contentious and held pejorative views about CFS/ME. Such scepticism and negative attitudes will be a significant barrier to the management of patients with CFS/ME in primary care. Conclusion The current role of Practice Nurses in the ongoing management of patients with CFS/ME is limited. Practice Nurses have little understanding of the evidence-base for treatment of CFS/ME, particularly psychological therapies, describing management options in terms of advice giving, self-help or counselling. Practice Nurses largely welcomed the potential development of their role in this area, but identified barriers and training needs which must be addressed to enable them to feel confident managing of patients with this condition. Training must begin by addressing negative attitudes to patients with CFS/ME. PMID:19161604
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Demystifying pediculosis: school nurses taking the lead.
Pontius, Deborah J
2014-01-01
The treatment of Pediculosis capitis, or head lice, is fraught with misinformation, myths, and mismanagement. Common myths include the need to exclude children from school, the need to remove all visible nits ("no-nit" policies), the need for massive environmental cleaning, that head lice live for long periods of time, and that schools are a common location for lice transmission. Head lice are a common childhood nuisance, causing embarrassment and emotional trauma in both children and families. This article explores and challenges the commonly held beliefs about the identification, management, and treatment of Pediculosis by presenting current recommended evidence-based practice. It also challenges pediatric nurses, and school nurses in particular, in alignment with the National Association of School Nurses (NASN) Position Statement on Pediculosis Management in the School Setting, to act as change agents for reasonable and effective school policies and practices.
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Resurfacing the care in nursing by telephone: lessons from ambulatory oncology.
Wilson, Rosemary; Hubert, John
2002-01-01
The practice of providing telephone mediated advice and assistance is often described as "telephone triage" in relevant literature. The decision-making processes required for priority-setting and the provision of advice have been found to be complex and multifaceted. Conceptualization of this valuable patient care activity as a linear "triage" function serves to make invisible the nursing care provided. This article explores the current practice of providing telephone mediated advice and assistance in the following 2 distinct nursing care settings: emergency departments and ambulatory oncology centers. Examination of this activity in these 2 settings provides a forum to discuss and critique legally and fiscally driven prescriptive protocol use to inform decision-making. The effectiveness of experiential knowledge coupled with the strengths of nurse-patient relationships suggests that a need exists to highlight the caring aspects of telephone mediated assistance.
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Navy Nurse Corps manpower management model.
Kinstler, Daniel P; Johnson, Raymond W; Richter, Anke; Kocher, Kathryn
2008-01-01
The Navy Nurse Corps is part of a team of professionals that provides high quality, economical health care to approximately 700,000 active duty Navy and Marine Corps members, as well as 2.6 million retired and family members. Navy Nurse Corps manpower management efficiency is critical to providing this care. This paper aims to focus on manpower planning in the Navy Nurse Corps. The Nurse Corps manages personnel primarily through the recruitment process, drawing on multiple hiring sources. Promotion rates at the lowest two ranks are mandated, but not at the higher ranks. Retention rates vary across pay grades. Using these promotion and attrition rates, a Markov model was constructed to model the personnel flow of junior nurse corps officers. Hiring sources were shown to have a statistically significant effect on promotion and retention rates. However, these effects were not found to be practically significant in the Markov model. Only small improvements in rank imbalances are possible given current recruiting guidelines. Allowing greater flexibility in recruiting practices, fewer recruits would generate a 25 percent reduction in rank imbalances, but result in understaffing. Recruiting different ranks at entry would generate a 65 percent reduction in rank imbalances without understaffing issues. Policies adjusting promotion and retention rates are more powerful in controlling personnel flows than adjusting hiring sources. These policies are the only means for addressing the fundamental sources of rank imbalances in the Navy Nurse Corps arising from current manpower guidelines. The paper shows that modeling to improve manpower management may enable the Navy Nurse Corps to more efficiently fulfill its mandate for high-quality healthcare.
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Gottlieb, Laurie N; Gottlieb, Bruce; Shamian, Judith
2012-06-01
The current healthcare system is slowly evolving into a new system built on a vision of health promotion, primary care and community-based home care, with hospitals still being a core pillar of the healthcare system but not its primary service. This transformation requires a new approach to practice, namely, Strengths-Based Nursing Care (SBC). SBC is about mobilizing, capitalizing and developing a person's strengths to promote health and facilitate healing. For nurses to practise SBNC requires strong nursing leadership that creates conditions to enable them to do so. Strengths-Based Nursing Leadership complements and acts in synergy with, SBNC. This paper describes eight principles of Strengths-Based Nursing Leadership to support SBNC.
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Pre-operative patient teaching in an acute care ward in Hong Kong: a case study.
Lee, David S; Chien, W T
2002-10-01
Many nurses have acknowledged that adequate pre-operative teaching can alleviate patients' anxiety, increase patient participation in their own care, and minimize post-operative complications. However, the organization and degree to which pre-operative patient teachingfeatured in nurses' practice varies in different acute care settings. A case study design was used to explore the practice of pre-operative teaching in a surgical ward of an acute general hospital in Hong Kong. Seventeen registered nurses working on the ward were interviewed and observed in order to explore how they conduct a pre-operative teaching program and the difficulties encountered by them in carrying out pre-operative teaching on this acute care setting. Thefindings of this study indicate that pre-operative teaching workshops are organized and conducted by nursesfrom the operating theatre, in the day surgery center. Ward nurses were not actively involved in this pre-operative teaching. The results of this study present some similarities to a study with the similar design in Australia. There are also issues unique to the Hong Kong context. This case study was to review Hong Kong nurses' current practices of pre-operative teaching and to understand the cultural, conceptual and managementfactors influencing the practice in pre-operative teaching.
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Varsi, Cecilie; Ekstedt, Mirjam; Gammon, Deede; Børøsund, Elin; Ruland, Cornelia M
2015-06-01
The role of nurse and physician managers is considered crucial for implementing eHealth interventions in clinical practice, but few studies have explored this. The aim of the current study was to examine the perceptions of nurse and physician managers regarding facilitators, barriers, management role, responsibility, and action taken in the implementation of an eHealth intervention called Choice into clinical practice. Individual qualitative interviews were conducted with six nurses and three physicians in management positions at five hospital units. The findings revealed that nurse managers reported conscientiously supporting the implementation, but workloads prevented them from participating in the process as closely as they wanted. Physician managers reported less contribution. The implementation process was influenced by facilitating factors such as perceptions of benefits from Choice and use of implementation strategies, along with barriers such as physician resistance, contextual factors and difficulties for front-line providers in learning a new way of communicating with the patients. The findings suggest that role descriptions for both nurse and physician managers should include implementation knowledge and implementation skills. Managers could benefit from an implementation toolkit. Implementation management should be included in management education for healthcare managers to prepare them for the constant need for implementation and improvement in clinical practice.
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Yu, Soyoung; Kim, Tae Gon
2015-05-01
This study aimed to evaluate registered nurse staffing levels and outcomes enforced by the current Korean nursing regulations. Registered nurse staffing levels are closely related to patient and nurse outcomes. Thus, the government's policy regarding nursing staffing has a practical impact, and better policies could lead to more appropriate nurse staffing. The actual evaluation of the government-recommended staffing levels in Korea is paramount for the establishment of a realistic and effective system that promotes quality care and patient safety. The participating hospital operated under the government-recommended staffing levels (Grade 2 of the Graded Fee of Nursing Management Inpatient System). For unit-level evaluations, one surgical unit was chosen and its staffing level was changed by assigning one additional registered nurse for 6 months. Length of hospitalisation, incidents of death, overtime hours and nursing job performance were measured prior to and after the addition of the extra staff. After 6 months, the length of patient hospitalisation and registered nurse overtime hours reduced and nurse job performance scores in the unit analysed improved. The results demonstrated that increasing the number of registered nurses beyond the current government-recommended staffing level improves patient and nurse outcomes. This indicates the importance and value of empirically assessing the need for changes in the recommended nurse staffing levels to develop appropriate, realistic and effective policies. © 2013 John Wiley & Sons Ltd.
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Comparison of administrators' and school nurses' perception of the school nurse role.
Green, Rebecca; Reffel, Jim
2009-02-01
The current tenuous status of public education funding requires that school nurses be proactive in advocacy efforts on behalf of their school nursing programs. Advocating for nursing practice within an educational setting presents unique challenges. Lack of state or national consensus for support of school nurse services creates an opportunity for school nurse advocates to develop quantitative tools to evaluate their school nurse program. Identifying commonalities and differences between school administrators' and school nurses' perceptions of the school nurse role will provide information that can be used to strengthen programs and facilitate the understanding of school personnel about what school nurses do. This study compared school administrator and school nurse perceptions of the role of the school nurse using a tool based on the National Association of School Nurses' "Advocacy Talking Points." Analysis of responses identified specific areas in which schools could improve their school nurse program and enhance school administrators' understanding of the school nurse role.
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High school students' perceptions of nursing as a career choice.
Kohler, P A; Edwards, T A
1990-01-01
Declining enrollments in nursing programs, coupled with the current shortage of practicing registered nurses, prompted this investigation of 306 high school students' beliefs about nurses and nursing. The study also identifies potential numbers of future nursing students from high school populations and their primary source of information about nursing. Using an investigator questionnaire, subjects responded to statements about educational requirements for registered nurses along with their working conditions, earning power, and social status. Findings reveal a projected continuing shortage of nurses based on the very small percentage of subjects even considering nursing as a career. Additional findings show that whereas some perceptions about nursing seem congruent with those of nurses themselves, other beliefs held by high school students are not consistent with the realities of professional nursing today. Results of this study can be used by nurse recruiters to correct misconceptions about nursing and to help high school students perceive the profession in a more positive way. Expanding the informational sources about nursing can facilitate the recruitment process.