Timmins, Fiona; Neill, Freda; Murphy, Maryanne; Begley, Thelma; Sheaf, Greg
Spirituality is receiving unprecedented attention in the nursing literature. Both the volume and scope of literature on the topic is expanding, and it is clear that this topic is of interest to nurses. There is consensus that the spiritual required by clients receiving health ought to be an integrated effort across the health care team. Although undergraduate nurses receive some education on the topic, this is ad hoc and inconsistent across universities. Textbooks are clearly a key resource in this area however the extent to which they form a comprehensive guide for nursing students and nurses is unclear. This study provides a hitherto unperformed analysis of core nursing textbooks to ascertain spirituality related content. 543 books were examined and this provides a range of useful information about inclusions and omissions in this field. Findings revealed that spirituality is not strongly portrayed as a component of holistic care and specific direction for the provision of spiritual care is lacking. Fundamental textbooks used by nurses and nursing students ought to inform and guide integrated spiritual care and reflect a more holistic approach to nursing care. The religious and/or spiritual needs of an increasingly diverse community need to be taken seriously within scholarly texts so that this commitment to individual clients' needs can be mirrored in practice.
Urology nursing has developed as a specialty over the past few decades in response to several factors, workload demands being a prime reason. Nurses are taking on additional roles and activities including procedures such as cystoscopy and prostate biopsy, and running nurse-led clinics for a variety of urological conditions. Audits of advanced urological nursing practice have shown this care to be of a high standard and investigative procedures performed by these nurses match the diagnostic quality of existing services. Professional urological nursing organizations support the professional needs of these nurses, but the provision of education and training for advanced practice activities remains an unaddressed need. A range of confusing advanced urology nursing titles exists, and uncertainty regarding the roles and scope of practice for these nurses remains a concern. Acceptance and support from medical colleagues is required for the success of advanced urological nursing practice, but opinions on these roles remain divided.
Smith, Mary Jane; Liehr, Patricia
Stories are a fundamental dimension of human experience and nursing practice. Story theory describes a narrative happening that occurs through intentional nurse-person dialogue. Seven inquiry phases are associated with story theory, including gathering the story, reconstructing the story, connecting it to the literature, naming the complicating health challenge, describing the story plot, identifying movement toward resolving, and gathering additional stories. This article describes the use of story theory to advance nursing practice scholarship in both academic and everyday nursing practice.
Rogers, Melanie; Wattis, John
Spirituality is an important aspect of holistic care that is frequently overlooked. This is because of difficulties in conceptualising spirituality and confusion about how it should be integrated into nursing care. This article explores what is meant by spirituality and spiritually competent practice. It examines attitudes to spirituality, describes factors that might affect the integration of spirituality into nursing care and offers practical guidance to equip nurses to incorporate spirituality into their practice.
As part of this year's centenary celebrations, the RCN is showcasing the best nursing practice, focusing on that which often goes unobserved. Nurses, healthcare assistants and nursing students are asked to share ideas and innovations for improving practice and patient care. These will contribute to the development of a library of good practice and the RCN will invest in a small number of the successful projects. The closing date is 31 December.
Byrne, Michelle M.
The portrayal of African Americans in nursing fundamentals textbooks was analyzed, resulting in 11 themes in the areas of history, culture, and physical assessment. Few African American leaders were included, and racial bias and stereotyping were apparent. Differences were often discussed using Eurocentric norms, and language tended to minimize…
Blozen, Barbara B
There are a number of anecdotal reports on demographic characteristics and academic success of accelerated-nursing students; yet few empirical studies have examined accelerated-nursing students NCLEX-RN success. Applying Knowles' adult learning theory as a guiding framework, the purpose of this qualitative study was to explore, from the accelerated-nursing students' perspective, the factors reported as contributing to their success on the NCLEX-RN. The research questions aimed to elicit participants' descriptions of their experiences and factors contributing to their success via individual interviews. The most significant finding the participants identified as the factor that contributed to their success was the practicing of NCLEX-RN questions. The findings of this study have several implications for educational policy and practice for universities and schools of nursing as the information gained from this study applies to recruitment and retention as well as curriculum and educational strategies in an accelerated-nursing program.
Feo, Rebecca; Conroy, Tiffany; Alderman, Jan; Kitson, Alison
Modern healthcare environments are becoming increasingly complex. Delivering high-quality fundamental care in these environments is challenging for nurses and has been the focus of recent media, policy, academic and public scrutiny. Much of this attention arises from evidence that fundamental care is being neglected or delivered inadequately. There are an increasing number of standards and approaches to the delivery of fundamental care, which may result in confusion and additional documentation for nurses to complete. This article provides nurses with an approach to reframe their thinking about fundamental care, to ensure they meet patients' care needs and deliver holistic, person-centred care.
Nursing knowledge has traditionally been examined and developed through the main research approaches based on the positivist, interpretive or phenomenological philosophies. These approaches are used either from a single and individual stance or combined to address particular research questions. They all, however, retain a focus that deals primarily or exclusively with what can be measured, observed or expressed as a fundamental unit of analysis to reconstruct, interpret and explain nursing practice. In this paper, Vince Ramprogus challenges the traditional approach to how nursing knowledge is defined and the common understanding of the purpose of nursing research. It is argued that adhering to empirical rigour while investigating or measuring nursing practice interferes with the very act and experience of nursing. Indeed, it becomes an either/or situation. It is also argued that nursing is not an empirical subject, and, therefore, the purpose of researching nursing is not about seeking the truth but about improving practice to achieve better patient care. The arguments are intended to provoke discussion and debate rather than to present a set position.
Empowering teaching strategies encourage leadership, critical thinking, problem solving, and collegiality and discourage passivity, isolation, and subordination. Empowerment prepares nurses for professional practice in hospitals. (SK)
Asheervath, J.; Blevins, D.R.
Written in outline format, this reference will help nurses further their understanding of advanced nursing procedures. Information is provided on the physiological, psychological, environmental, and safety considerations of nursing activities associated with diagnostic and therapeutic procedures. Special consideration is given to the areas of pediatric nursing, nursing assessment, and selected radiologic and nuclear medicine procedures for each system. Contents: Clinical Introduction. Clinical Nursing Practice: Focus on Basics. Focus on Cardiovascular Function. Focus on Respiratory Function. Focus on Gastrointestinal Function. Focus on Renal and Genito-Urological Function. Focus on Neuro-Skeletal and Muscular Function. Appendices.
Weese, Meghan M; Jakubik, Louise D; Eliades, Aris B; Huth, Jennifer J
Previous studies examining predictors of pediatric nurse protégé mentoring benefits demonstrated that protégé perception of quality was the single best predictor of mentoring benefits. The ability to identify the mentoring practices that predict specific benefits for individual nurses provides a better understanding of how mentoring relationships can be leveraged within health care organizations promoting mutual mentoring benefits. This descriptive correlational, non-experimental study of nurses at a northeast Ohio, Magnet® recognized, free-standing pediatric hospital advances nursing science by demonstrating how mentoring practices benefit pediatric nurse protégés.
Urzhumtsev, Alexandre; Afonine, Pavel V.; Adams, Paul D.
The Translation-Libration-Screw-rotation (TLS) model of rigid-body harmonic displacements introduced in crystallography by Schomaker & Trueblood (1968) is now a routine tool in macromolecular studies and is a feature of most modern crystallographic structure refinement packages. In this review we consider a number of simple examples that illustrate important features of the TLS model. Based on these examples simplified formulae are given for several special cases that may occur in structure modeling and refinement. The derivation of general TLS formulae from basic principles is also provided. This manuscript describes the principles of TLS modeling, as well as some select algorithmic details for practical application. An extensive list of applications references as examples of TLS in macromolecular crystallography refinement is provided. PMID:25249713
Urzhumtsev, Alexandre; Afonine, Pavel V; Adams, Paul D
The Translation-Libration-Screw-rotation (TLS) model of rigid-body harmonic displacements introduced in crystallography by Schomaker & Trueblood (1968) is now a routine tool in macromolecular studies and is a feature of most modern crystallographic structure refinement packages. In this review we consider a number of simple examples that illustrate important features of the TLS model. Based on these examples simplified formulae are given for several special cases that may occur in structure modeling and refinement. The derivation of general TLS formulae from basic principles is also provided. This manuscript describes the principles of TLS modeling, as well as some select algorithmic details for practical application. An extensive list of applications references as examples of TLS in macromolecular crystallography refinement is provided.
Caudle, Sharon L.
Discusses six fundamental information resources management (IRM) practices in successful organizations that can improve government service delivery performance. Highlights include directing changes, integrating IRM decision making into a strategic management process, performance management, maintaining an investment philosophy, using business…
Bishop, Christine E.; Squillace, Marie R.; Meagher, Jennifer; Anderson, Wayne L.; Wiener, Joshua M.
Purpose: To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Design and Methods: Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey,…
The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…
Kourkouta, Lambrini; Papathanasiou, Ioanna V.
Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient. To achieve this, however, nurses must understand and help their patients, demonstrating courtesy, kindness and sincerity. Also they should devote time to the patient to communicate with the necessary confidentiality, and must not forget that this communication includes persons who surround the sick person, which is why the language of communication should be understood by all those involved in it. Good communication also is not only based on the physical abilities of nurses, but also on education and experience. PMID:24757408
Frantz, Rita A
Fundamental to planning, implementing, and sustaining a quality Doctor of Nursing Practice (DNP) program is access to the resources needed to foster a learning environment that prepares nurses for advanced practice and leadership in the future redesigned health care system. This creates formidable challenges for schools and colleges of nursing as they endeavor to address the nation's need for an increased supply of advanced practice nurses to provide access to high-quality, cost-effective care for an aging population. This article describes the essential resources needed to support the delivery of a DNP program and the proposed strategies needed to address the resource challenges.
The main provisions of the European Convention on Human Rights were incorporated into UK law in the Human Rights Act 1998. Human Rights were described by Lord Hoffman in 'Matthews v Ministry of Defence'  as the rights essential to the life and dignity of the individual in a democratic society. The fundamental nature of the rights demand that district nurses must inform their practice with a clear understanding of the main provisions of the Act and how they apply to health care.
Ruth-Sahd, Lisa A; Schneider, Melissa A; Strouse, Abigail
This article focuses on the advancement of nursing education and practice through implementing "low-tech" simulation in a fundamentals nursing course to foster an awareness of scope of practice and interdisciplinary teamwork and collaboration to prepare student nurses for their critical care clinical experience. The integration of low-tech simulation during the students' first clinical course at 2 different times during the semester was utilized to accomplish this awareness. This article was added to the scant published articles that highlight the benefits of low-tech simulation in a fundamentals of nursing course.
This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale - a 'Good Samaritan' story - which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and moral agency. I then consider this relationship from the perspectives of two twentieth century philosophers: Emmanuel Levinas and Michel Foucault. Levinas' basic point is that the experience of ethical subjectivity is made possible through others: the demand to respond to the existence of others is the basic social structure that precedes individual freedom. If Levinas posits intersubjectivity as a fundamental or primitive feature of the moral realm, Foucault poses an even more basic question: how have moral subjects and relations of obligation been constituted? The aim of ethical inquiry, for Foucault, is to describe the network of discourses, institutions, relations, and practices through which certain kinds of subjects are constituted and constitute themselves, e.g. as a kind of person who can act morally. Finally, I consider some recent research in philosophy of nursing which illustrates how Levinasian and/or Foucauldian perspectives can deepen understanding of nurses' moral practices, specifically, the work of Norwegian public health nurses, Canadian pediatric nurses, and Irish midwives. I suggest that in spite of the instability of morality in general and the particular ethical challenges that face nurses, there are grounds for hope and possible strategies for living in unstable times.
Gray-Miceli, Deanna; de Cordova, Pamela B; Crane, Giles L; Quigley, Patricia; Ratcliffe, Sarah J
Reducing falls in nursing homes requires a knowledgeable nursing workforce. To test knowledge, 8 validated vignettes representing multifactorial fall causes were administered to 47 nurses from 3 nursing homes. Although licensed practical nurses scored higher than registered nurses in individual categories of falls, when we computed the average score of all 8 categories between groups of registered nurses and licensed practical nurses, registered nurses scored higher (F = 4.106; P < .05) in identifying 8 causal reasons for older adults to fall.
Clinton, Patricia; Sperhac, Arlene M
The purpose of this article was to provide the background and rationale for the practice doctorate in nursing. The American Association of Colleges of Nursing's Position Statement on the Practice Doctorate in Nursing, approved in October 2004, will be discussed. Outlined are some of the changes that will be needed in education, regulation, and advanced practice. Common questions and concerns that advanced practice nurses have, including titling, salary, and transitioning to the doctor of nursing practice degree, will be addressed.
Sherman, Deborah Witt
Describes the role and responsibilities of advanced-practice nurses in palliative care and nursing's initiative in promoting high-quality care through the educational preparation of these nurses. (JOW)
DeMarco, Rosanna F; Pulcini, Joyce; Haggerty, Lois A; Tang, Trinh
Recently, the American Association of Colleges of Nursing (AACN) resolved that a new practice degree, the doctorate in nursing practice (DNP), is to become the terminal practice degree and minimum education standard for advanced practice nurses by the year 2015(American Association of Colleges of Nursing. (2004). AACN position statement on the practice doctorate in nursing. Retrieved July 1, 2007, from http://www.aacn.nche.edu.html). The DNP will have a clinical-intensive focus. Advanced practice nurses potentially impacted by this resolution will include nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists. A task force at the William F. Connell School of Nursing at Boston College conducted an electronic survey in 2006 in an attempt to understand nurses' thoughts about doctoral preparation and the interest of nurses in Massachusetts in pursuing doctoral study. A self-selected group of 376 nurses participated in the study. Nurses identified both positive and negative perceptions related to the degree's viability and practicality, with a majority (55%) preferring the DNP as an educational option.
Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon
School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…
Gillette, V A
The perioperative nursing role has evolved from that of task-oriented specialists to patient-centered professionals. The concept of caring is significant to perioperative nurses and is manifested by the many caring behaviors perioperative nurses demonstrate toward surgical patients. This article describes how the element of caring is an essential function of perioperative nursing and relates the perioperative nursing role to the work of three nursing theorists (le, Florence Nightingale; Virginia Henderson, RN, AM; Carol L. Montgomery, RN, PhD).
Pieper, Barbara; Colwell, Janice
Advanced practice nursing education is at a crossroads. Societal changes, increased health care demands, and leadership nursing organizations have identified the need of a doctor of nursing practice (DNP) degree as the advanced practice degree. WOC nurses need to examine DNP programs when considering returning for an advanced practice degree. This article explores nursing education at the doctorate level and areas the WOC nurse should consider when making a decision about attending a program. The WOC nurse needs to understand the similarities and differences of the doctor of philosophy and the DNP, issues about each program and its completion, personal factors, and the application process. Although selecting a doctoral program is a daunting experience, the education will provide opportunities for the WOC nurse to excel as a scholar, thus influencing the profession and the practice.
Mitty, Ethel; Flores, Sandi
Admission assessment, generally conducted by a registered nurse, is autonomous, without opportunity for dialogue with colleagues and other health care professionals and bounded by the nurse's knowledge and skills, state regulations, facility practices, and marketing. The fact that some states permit admission and retention of nursing home level-of-care residents and provision of end-of-life care means that the assessment has to be able to predict the resident's likely trajectory of well-being as well as chronic illness exacerbation. The nurse must have a clear perspective on staff competencies and judge whether additional education or training will be necessary. This article reviews assessment standards of practice as put forth by the American Assisted Living Nurses Association as part of its application for recognition of assisted living nursing as specialty nursing practice by the American Nurses Association. The role of the Licensed Practical Nurse/Licensed Vocational Nurse in resident assessment is also discussed.
Dickerson, Pamela S
The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice.
In most states, the role of an advanced practice nurse is dependent on practice protocols that provide an organized method for analyzing and managing a disease or major symptom. They are also used to control the process of medical care and to specify steps in the delivery of that care. Creating appropriate practice protocols is one of the most important precursors to implementing the advanced practice role, because they virtually drive the clinician's ability to treat or manage clinical situations or disease states. This article outlines the steps involved in developing practice protocols and discusses the content that should be included in a protocol, providing an example of narrative and algorithm format protocols. Pros and cons, as well as legal issues related to practice protocols, are also presented.
Lim, Fidelindo A; Brown, Donald V; Jones, Henrietta
As the health care needs of the lesbian, gay, bisexual, and transgender (LGBT) population become increasingly important, health care professionals require appropriate academic and clinical training in preparation for the increased demand for culturally competent care. Nurses are of particular interest, as they are the core direct caregivers in many health care settings. This article explores the national climate around LGBT individuals and their related health needs. Educators and administrators who work with future nurses should strive to ensure they foster the development of knowledgeable practitioners who will be able to implement best practices in LGBT patient care. Attention should be paid to providing students with diverse clinical placements, access to LGBT interest groups, and clear expectations for LGBT-sensitive nursing care plans and course outcomes selection that promote cultural competence. Recommendations for nursing education and curricular reform are discussed.
The learning opportunities presented in nurses' storied accounts of practice are explored. This exploration is achieved through analysis and discussion of three nurse's stories documented in the literature, and uses Benner's (1991) narratives of learning theme as the conceptual framework. The narrative of learning sub themes: being open to experience, liberation, and disillusionment are examined. This examination suggests nurses stories can be used to: discover nursing knowledge, develop shared understandings of what it is to be a nurse, examine nursing's culture and ethics, document interactions for research, teaching and learning, and identify and preserve the practice of nursing. Whereas edited stories from the literature only begin to demonstrate the possibilities for learning that stories offer, through them alternative ways of learning about nursing, exploring nursing practice and developing nursing knowledge are presented.
Tarlier, Denise S; Browne, Annette J
Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.
Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica
Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.
Doody, Owen; Noonan, Maria
Ethics is fundamental to good research practice and the protection of society. From a historical point of view, research ethics has had a chequered past and without due cognisance there is always the potential for research to do harm. Research ethics is fundamental to research practice, nurse education and the development of evidence. In conducting research, it is important to plan for and anticipate any potential or actual risks. To engage in research, researchers need to develop an understanding and knowledge of research ethics and carefully plan how to address ethics within their research. This article aims to enhance students' and novice researchers' research ethics understanding and its application to nursing research.
Stanton, M P; Packa, D
Nursing case management is a blend of individual case- and/or disease-management activities used in urban hospitals or community health settings. The authors propose that in rural communities, a third form of case management is also used. Nursing case management in the rural community has a broader and more diverse scope of practice than nurse case managers practicing in urban settings.
Kooker, Barbara Molina; Shoultz, Jan; Codier, Estelle E
The National Center for Health Workforce Analysis projects that the shortage of registered nurses in the United States will double by 2010 and will nearly quadruple to 20% by 2015 (Bureau of Health Professionals Health Resources and Services Administration. . Projected supply, demand, and shortages of registered nurses, 2000-2020 [On-line]. Available: http:bhpr.hrsa.gov/healthworkforce/reports/rnprojects/report.htm). The purpose of this study was to use the conceptual framework of emotional intelligence to analyze nurses' stories about their practice to identify factors that could be related to improved nurse retention and patient/client outcomes. The stories reflected evidence of the competencies and domains of emotional intelligence and were related to nurse retention and improved outcomes. Nurses recognized their own strengths and limitations, displayed empathy and recognized client needs, nurtured relationships, used personal influence, and acted as change agents. Nurses were frustrated when organizational barriers conflicted with their knowledge/intuition about nursing practice, their communications were disregarded, or their attempts to create a shared vision and teamwork were ignored. Elements of professional nursing practice, such as autonomy, nurse satisfaction, respect, and the professional practice environment, were identified in the excerpts of the stories. The shortage of practicing nurses continues to be a national issue. The use of emotional intelligence concepts may provide fresh insights into ways to keep nurses engaged in practice and to improve nurse retention and patient/client outcomes.
Incivility in nursing education is a complicated problem which causes disruptions in the learning process and negatively affects future nursing practice. This mixed method research study described incivility as well as incivility's effects through extensive literature review and application of a modified Incivility in Nursing Education (INE) survey. The INE included six demographic items, four quantitative sections, and five open-ended questions. The survey examined emergency nurses' perceptions of incivility and how the experience affected their personal nursing practice. The INE was initially tested in a 2004 pilot study by Dr. Cynthia Clark. For this research study, modifications were made to examine specifically emergency nurse's perceptions of incivility and the effects on their practice. The population was a group of nurses who were members of the emergency nurses association in a Midwestern state. In the quantitative component of the Incivility in Nursing Education (INE) survey, the Likert scale questions indicated that the majority of the participants reported witnessing or experiencing the uncivil behaviors. In the qualitative section of the INE survey, the participants reported that although they have not seen incivility within their own academic career, they had observed faculty incivility with nursing students when the participants were assigned as preceptors as part of their emergency nursing practice.
Choi, JiSun; Flynn, Linda; Aiken, Linda H.
Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…
Praeger, Susan; Zimmerman, Barbara
The purpose of this article is to present a state-by-state summary of rules and regulations governing school nursing practice in the United States. Official government and agency sites were reviewed to determine providers of services in schools, criteria for becoming a school nurse, protection of titling, mandates for school nursing, and the…
Schaffer, Marjorie A; Anderson, Linda J W; Rising, Shannon
School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic survey on their use of public health interventions as defined by the wheel. Although 67% of the participants were not familiar with the Public Health Intervention Wheel, respondents reported conducting activities that were consistent with the Wheel interventions. Screening, referral and follow-up, case management, and health teaching were the most frequently performed interventions. Intervention use varied by educational level, age of nurse, years of practice, and student population. The Public Health Intervention Wheel is a relevant and useful framework that provides a language to explain population-based school nursing practice.
... Outlook Occupational Outlook Handbook Handbook of Methods Research Papers Copyright Information Contact & Help Economic Releases Latest Releases » ... and licensed vocational nurses may advance to supervisory positions. Some LPNs and LVNs advance to other healthcare ...
Sperhac, Arlene M; Clinton, Patricia
A great deal of work has been done during the past several years since the American Association of Colleges of Nursing voted in October 2004 to move advanced practice nursing to the doctoral level by 2015. Following the approval, task forces were formed to address curriculum issues and the strategies for transitioning advanced practice nursing education from the master's level to the doctorate of nursing practice (DNP). The DNP curriculum contains content on leadership, management, and other topics that are needed to address some of the issues in the health care system that traditionally have not been included in most master of science in nursing curricula, as well as additional essential content and nurse practitioner competencies. As pediatric nurse practitioners and other advanced practice nurses go forward in their careers, the DNP may have an impact on their role. In this article, the background of the DNP movement, changes in advanced practice nursing education, and the concerns of currently practicing pediatric nurse practitioners prepared at the master's level will be addressed.
This paper historicizes the taken-for-granted acceptance of reflection as a fundamental professional practice in nursing. It draws attention to the broad application of reflective practice, from pedagogy to practice to regulation, and explores the epistemological basis upon which the authority of reflective discourse rests. Previous work has provided a series of critiques of the logic and suitability of reflective practice across all domains of nursing. The goal of this paper is to commence a history of nursing's reflective identity. The paper begins with a discussion of Dewey and Schön then focuses on Habermas's Theory of Communicative Action as the epistemological basis of reflective practice's standing as a authoritative discourse in nursing.
Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda
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.
Kohlenberg, Eileen; Kennedy-Malone, Laurie; Crane, Patricia; Letvak, Susan
The inclusion of gerontology content in the nursing curriculum is paramount as our population of older adults grows. As one of 10 recipients of the John A. Hartford Foundation/AACN awards for Enhancing Gerontological and Geriatric Nursing Education for Advanced Practice Nursing Programs, we successfully integrated gerontological/ geriatric content throughout core courses for all concentrations taught at the master's level. The Nurse Practitioner and Clinical Nurse Specialist Competencies for Older Adult Care were used as a guide to integrate gerontological nursing content across the core courses. We present examples of content, strategies, and evaluation methods that demonstrate infusion of gerontology in a nursing theory course, research course, and healthcare law and policy course. Twenty-two of the competencies are addressed in these core courses and provide a foundation for further development in the support and specialty courses for the nurse practitioner, clinical nurse specialist, nursing administrator, nurse educator, and nurse anesthetist. We also present helpful Web-based resources for older adult care.
Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba
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.
Mackereth, C J
In the winter of 1992, a postal survey was conducted on all practice nurses in Gateshead, England. The aim of the research was to describe the work of practice nurses (nurses working with and employed by general practitioners), with particular reference to health promotion and communication, and to explore the practice nurses' perceptions of their roles. The research found little conformity about what practice nurses do, apart from practical tasks. This confirms the essentially practical nature of their work, with poor role definition with regard to screening, health promotion and prevention. Training was found to vary, indicating a need for improvement. Women's health and surveillance of the health of elderly people were used to illustrate these issues. A wide consensus was found about what tasks are appropriate to practice nurses, indicating either that the list of tasks used in the survey accurately describes their potential role or that they are prepared to perform most tasks. Practice nurses perceive themselves as the specialists in health promotion although it was not possible to gain an understanding of whether they had a conception of the wider issues involved, which illustrated a limitation of survey methods. The information obtained will be relevant in the debate about the future of practice nurses, as well as the future of primary health care services in general.
Abitz, Tracey L
The importance of cultural competence in every nursing practice setting in today's world cannot be understated. Unconscious bias can have detrimental effects on therapeutic relationships and health outcomes. Nursing models of cultural competence by Purnell, Leininger, and Campinha-Bacote are reviewed. The Kleinman Model and LEARN Model offer questions and guidelines to facilitate assessment of patients' understanding of illness and treatment. The Infusion Nursing Standards of Practice contains elements of diversity and cultural competence throughout. Self-reflection of one's own values, beliefs, biases, and practice as an infusion nurse will promote the development of cultural competence.
Stilos, Kalli; Moura, Shari L; Flint, Frances
Current nursing literature recognizes the need to honor the concept of ambiguity. Nurses experience uncertainty with handling or honoring complexity and ambiguity when confronted with times of struggle. Traditional models of care fall short as patients and families define their expectations of the healthcare system. Nurses bear witness to the discomfort caused by the unknown in their daily practice. They are challenged to address their feelings, unsure of what to anticipate, what to say, or how to respond to their patients. Uncertainty diminishes the opportunity for meaningful dialogue between nurses and other people. Nurses attempting to ease the discomfort of ambiguity by providing patients or families with reassurance, offering advice on how to fix problems, or avoiding talking about situations often express dissatisfaction. Nurses should be invited to explore ambiguity and seek understanding through dialogue and nursing knowledge. Encouraging nurses to define the meaningfulness in nursing practice that embraces human science theory will help relieve some of the ambiguity that exists in current practice. This article will explore the concept of ambiguity, highlight how nursing theory based on human science can support practice, and propose recommendations for practice.
Cantrell, Mary Ann
Pediatric oncology nursing practice must incorporate both the science and the art of the discipline to foster positive physical and psychosocial treatment outcomes for pediatric oncology patients, especially those outcomes related to their health-related quality of life. In this article, the art of nursing care is described within the context of scientifically based care, and the art of nursing practice is evident in the implementation of the scientific principles and standards for pediatric oncology nursing practice. The author proposes that the art of pediatric oncology nursing practice ought to be evident in care activities that the nurse provides within a therapeutic relationship that is steeped in nursing presence. Although the art of nursing care and the nature of an effective therapeutic relationship is tacit, valued knowledge among pediatric oncology nurses, as well as children and adolescents with cancer and their families, it is difficult to describe and challenging to quantify its effect on patient care outcomes. This article discusses the art of pediatric oncology nursing practice and its influence on treatment outcomes.
von Klitzing, Waltraut; Stoll, Hansruedi; Trachsel, Edith; Aldorf, Kurt; Bernhard, Annelis; Eze, Germaine; Spirig, Rebecca
A prerequisite to providing evidence-based care is the ability to comprehend the nursing research literature, most of which is published in English. To facilitate this understanding, a course on "reading the research literature for evidence-based practice in English" was developed by an interdisciplinary team for staff nurses at the University Hospital Basel. The pilot course was offered to nurses who specialized in cancer care. It was led by the oncology Advanced Practice Nurse (APN) from the Department of Medicine. Research articles focusing on the management of chronic illness and cancer pain management were assigned and read. The course consisted of ten 90 minute lessons. The evaluation was designed to address the following questions: 1. Did participation in the course improve the oncology related knowledge of the nurses? 2. Did participation in the course improve the nurses' English language skills? 3. At what level of difficulty did the nurse participants perceive the course to be? 4. Were course participants able to use their newly acquired knowledge to teach their nursing colleagues on the ward? The course evaluation demonstrated that the 15 participants significantly improved their oncology knowledge through this process but that their English skills did not improve. The participants were able to present lectures on their wards based on the course literature, which were positively evaluated by their colleagues and the APN course leader. The participants perceived the course as being sophisticated but also effective at demonstrating the use of English-language research literature for one's own nursing practice.
Lindh, Inga-Britt; Barbosa da Silva, António; Berg, Agneta; Severinsson, Elisabeth
This article aims to deepen the understanding of courage through a theoretical analysis of classical philosophers' work and a review of published and unpublished empirical research on courage in nursing. The authors sought answers to questions regarding how courage is understood from a philosophical viewpoint and how it is expressed in nursing actions. Four aspects were identified as relevant to a deeper understanding of courage in nursing practice: courage as an ontological concept, a moral virtue, a property of an ethical act, and a creative capacity. The literature review shed light on the complexity of the concept of courage and revealed some lack of clarity in its use. Consequently, if courage is to be used consciously to influence nurses' ethical actions it seems important to recognize its specific features. The results suggest it is imperative to foster courage among nurses and student nurses to prepare them for ethical, creative action and further the development of professional nursing practices.
Brady, Margaret A.
A description is provided of "Theories for Extended Pediatric Nursing Practice," a required course for pediatric and family nurse practitioner students in a California state university program. The course description presents information on the curricular placement of the course, prerequisites, in-class time allotments, and the focus of the course…
Hem, Marit Helene; Heggen, Kristin
The Norwegian Nurses' Association recently (2001) approved a new code of ethics that included compassion as one of the basic values in nursing care. This paper examines the idea of compassion in the context of the Bible story of the Good Samaritan using an analysis of qualitative data from nurses' clinical work with psychiatric patients. The aim is to show how the idea of compassion challenges nursing practice. Thereafter, the paper discusses the benefits of and premises for compassion in care work. The results show that nurses tend not to be guided by compassion in their work with patients. The organisation of the day-to-day work in the hospital ward, the division of labour between nurses and doctors, and the nurses' approach to nursing were identified as influencing this tendency. The study shows that compassion is a radical concept with a potential to promote greater respect for patients' dignity.
Canam, Connie J
Much emphasis has been placed on the importance of nurses' articulating what they do to counteract the invisibility of nursing practice. Yet there has been minimal focus on why nurses are silent. This article explores the link between technical and caring discourses and nurses' silence and suggests an alternative discourse that conceptualizes nursing as a knowledge-driven enterprise that shifts the focus from what nurses do to what nurses know by promoting nurses' practice knowledge as a language for articulating their practice.
Spiritual nursing care is increasingly being cited in the nursing literature as a fundamental ethical obligation. This obligation is based upon the argument that nurses provide holistic care, spirituality is a universal dimension of the person, and so nurses should care for the spiritual dimension. However, the literature on the spiritual dimension in nursing illustrates widely differing foundational assumptions about this important aspect of care. The philosophic categories of humanism, theism, and monism can be used to illustrate the different understandings of the spiritual dimension, and the implications of these understandings for the competence of the nurse and the nature of the nurse-patient interaction in the context of spiritual care.
Fitzgerald, Cynthia; Kantrowitz-Gordon, Ira; Katz, Janet; Hirsch, Anne
Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change. PMID:22220273
Paton, Brenda I
Significant research has been conducted and disseminated on preceptorship as an essential component in teaching and evaluating student learning in the final clinical practicum. The preceptorship triad-formally defined as an equilateral relationship among a nurse preceptor, faculty member, and undergraduate nursing student-overlooks the contextual challenges preceptors encounter. Preceptors develop relationships in the clinical setting to enhance teaching, and more importantly, to ensure student practice reflects the depth of clinical reasoning and skill acquisition necessary for safe and competent practice. Using descriptive surveys and qualitative focus groups, a research collaborative among academia, practice, and professional regulating bodies was established in southern Alberta, Canada, to research the types of knowledge nurses acquire and integrate to successfully assess, evaluate, and teach undergraduate nursing students in the clinical environment. This article describes the research findings and highlights the professional practice knowledge of nurse preceptors.
Velloso, Isabela Silva Câncio; Ceci, Christine; Alves, Marília
Reflections on power relations in nursing practice involves questions related to the daily practice of nursing staff as well the subjectivity of those involved in them. Nursing practice is more than a practice in itself. It assumes the dimension of meaning ascribed to it by different subjects who interact in the places where the practice takes place. We propose a reflection about power relations in nursing practice, considering their complexity, the many processes that constitute them and the circumstances that determine the ways of thinking about and acting in relation to them. Such reflection implies to think about the subject's subjectivity the way professional boundaries are established, and the effects of these relations upon the subjects involved, since power relations are in continuous transformations.
Moreira, Lilian Hortale de Oliveira; Loyola, Cristina Maria Douat
The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patient's needs or requests.
Simmonds, Anne H
Advocacy has been positioned as an ideal within the practice of nursing, with national guidelines and professional standards obliging nurses to respect patients' autonomous choices and to act as their advocates. However, the meaning of advocacy and autonomy is not well defined or understood, leading to uncertainty regarding what is required, expected and feasible for nurses in clinical practice. In this article, a feminist ethics perspective is used to examine how moral responsibilities are enacted in the perinatal nurse-patient relationship and to explore the interaction between the various threads that influence, and are in turn affected by, this relationship. This perspective allows for consideration of contextual and relational factors that impact on the way perinatal nursing care is given and received, and provides a framework for exploring the ways in which patient autonomy, advocacy and choice are experienced by childbearing women and their nurses during labour and birth.
Danbjørg, Dorthe Boe; Birkelund, Regner
This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories.
Roller, Maureen C.
Measuring the effect of a Process-Oriented Guided-Inquiry Learning (POGIL) implementation in a fundamental baccalaureate-nursing course is one way to determine its effectiveness. To date, the use of POGIL from a research perspective in fundamental nursing has not been documented in the literature. The purpose of the study was to measure the…
Wilson, J R
In this paper ergonomics is defined as a discipline in its own right, as the theoretical and fundamental understanding of human behaviour and performance in purposeful interacting socio-technical systems, and the application of that understanding to design of interactions in the context of real settings. This definition is justified in the financial, technicat, legal, organisational, social, political and professional contexts in which ergonomists work. On the basis of the history of ergonomics and contemporary contributions, it is proposed that it is one of the modern sciences, drawing as much from the field as from the laboratory, and including elements of an art and a craft as well. Justification for the new definition is provided by examining the interacting systems which are prevalent in the modern world and which are the domain best understood through the holistic approach of ergonomics. Finally a number of challenges for ergonomics are identified.
Watson, P.F.; Critser, J.K.; Mazur, P.
Human spermatozoa were first frozen successfully almost 40 years ago. While developments in packaging and storing have occurred in the intervening period, there is still little known specifically about how spermatozoa are adversely affected by freezing and thawing. This is largely due to the fact that sufficient cells survive the challenge to give a reasonable expectation of fertilization, but the shift to the exclusive use of cryopreserved semen for donor insemination, occasioned by the awareness of the risks particularly of AIDS transmission, has resulted in a renewed critical interest in the process of cryopreservation. This review will cover the more significant contributions over the past few years, and develop an argument for a sustained fundamental approach to sperm cryobiology.
Watson, P.F. ); Critser, J.K. ); Mazur, P. )
Human spermatozoa were first frozen successfully almost 40 years ago. While developments in packaging and storing have occurred in the intervening period, there is still little known specifically about how spermatozoa are adversely affected by freezing and thawing. This is largely due to the fact that sufficient cells survive the challenge to give a reasonable expectation of fertilization, but the shift to the exclusive use of cryopreserved semen for donor insemination, occasioned by the awareness of the risks particularly of AIDS transmission, has resulted in a renewed critical interest in the process of cryopreservation. This review will cover the more significant contributions over the past few years, and develop an argument for a sustained fundamental approach to sperm cryobiology.
Castner, Jessica; Ceravolo, Diane J; Foltz-Ramos, Kelly; Wu, Yow-Wu
Nurses' control over practice is essential to nursing care quality and fosters teamwork at the point of care delivery. This article describes a study to measure the impact of nurses' control over their practice from the perspective of teamwork. The purpose of this study was to measure the relationship of control over practice to the five following dimensions of teamwork: team structure, leadership, situation monitoring, mutual support, and communication. The study method was a secondary analysis of 456 surveys from registered nurses working in a five-hospital system. Study results demonstrated that the global measure of teamwork correlated with control over practice and nursing experience, but not with teamwork training. All five individual dimensions of teamwork were perceived as better for those who had a high level of control over practice compared to those who did not. In the discussion section, we consider situation monitoring since this dimension demonstrated an interaction effect between teamwork training and control over practice. Nursing control over practice demonstrates a positive relationship with teamwork and should be considered in future education, policy, and research efforts. Further study is needed to understand control over practice as a potential moderator or mediator of other predecessors of effective teamwork.
Rogers, Helen W.; And Others
This curriculum guide provides teachers with up-to-date information and skill-related applications needed by the practical nurse. The volume contains three sections and 24 instructional units: Personal Vocational Relationships (6 units), Nutrition (3 units), and Basic Nursing Principles and Applied Skills (15 units covering such topics as…
Bergren, Martha Dewey
This Question and Answer (Q&A) article addresses practice issues related to school health records and school nursing documentation that were posed by school nurses in the field. Specifically, the questions addressed concern the following: education records, medication privacy issues, sharing of sensitive health information, privacy of…
Davies, Jacqueline; Heyman, Bob; Bryar, Rosamund; Graffy, Jonathan; Gunnell, Caroline; Lamb, Bryony; Morris, Lana
Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and
Sofhauser, Cynthia D
In order to present the state of the science of hostility among and across disciplines, a review of the literature was completed. The knowledge gained may influence nursing practice. Scholarly works from nursing, medical and basic sciences, psychology, sociology, education, philosophy, business, communication, and criminology were reviewed. Similar patterns in the use of the concept were discovered. The patterns revealed five themes: hostility as a health-risk factor, hostility as a factor in family relationships, hostility as a factor in perceived challenge, hostility as a factor in criminal behavior, and hostility as a factor in the workplace. Based on the knowledge gained about hostility, implications for nursing practice related to changing the hostile working environment for nurses were suggested using modeling and role-modeling nursing theory.
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
Prepared by practical nursing educators, this document is intended to serve as a tool for (1) self-evaluation by educational programs in practical nursing, (2) evaluation for accreditation by the National League for Nursing, and (3) appraisal of plans for the development of new practical nursing programs. The statements, whcih are organized into…
Kirk, Timothy W
Understanding, shared meaning, and mutual trust lie at the heart of the therapeutic nurse-patient relationship. This article introduces the concept of clinical intimacy by applying the interpersonal process model of intimacy to the nurse-patient relationship. The distinction between complementary and reciprocal behaviours, and between intimate interactions and intimate relationships, addresses background concerns about the appropriateness of intimacy in nursing relationships. The mutual construction of meaning in the interactive process between nurses and patients is seen to lie at the heart of clinical intimacy as a hermeneutic enterprise. Intimacy is distinguished from empathy based on intentionality and the status and location of meaning. Reasons for continued investigation into clinical intimacy as an explanatory model for nursing as a hermeneutic practice are presented.
Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla
Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.
Lewallen, Lynne Porter
Self-evaluation is required for institutions of higher learning and the nursing programs within them. The literature provides information on evaluation models and instruments, and descriptions of how specific nursing education programs are evaluated. However, there are few discussions in the nursing education literature of the practical aspects of nursing education program evaluation: how to get started, how to keep track of data, who to involve in data collection, and how to manage challenging criteria. This article discusses the importance of program evaluation in the academic setting and provides information on practical ways to organize the evaluation process and aggregate data, and strategies for gathering data from students, graduates, alumni, and employers of graduates.
Chimner, N E; Easterling, A
A 528-bed community teaching hospital redesigned its patient care delivery system, implementing a collaborative practice model on the 30-bed inpatient rehabilitation unit in April 1990. This model is a patient-centered delivery model that encourages the healthcare team to facilitate the achievement of patient outcomes within effective time frames and with an appropriate use of resources. The collaborative practice model includes a nurse case manager's role for the staff nurse, which had as its frame-work the concept of nursing case management. Tested project management techniques were used to ensure a successful implementation process. Various strategies, such as using project teams and providing educational programs, were used to respond to the issues of role conflict and overlap, especially between social workers and nurse case managers. The implementation of this model provided a number of benefits, including improved interdisciplinary relationships and decreased length of stay.
Upchurch, Sandra; Brosnan, Christine A.; Grimes, Deanna E.
A process for teaching research synthesis to advanced practice nurses includes two courses: a first research applications course in which students build bibliographic databases, practice statistical analysis, and develop search skills; and a second course in which they complete literature reviews or meta analyses of research on clinical practice…
The purpose of this study was to examine the leadership practices perceived by nursing education leaders as measured by the Leadership Practices Inventory (LPI). The framework used was a contemporary transformational leadership model described in "The Leadership Challenge" ("4th ed.") by Dr. James Kouzes and Dr. Barry Posner,…
This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.
Callaghan, D; Williams, A
Discussion in this paper is based on findings drawn from research undertaken within a qualitative framework of analysis, and with the purpose of exploring people's perceptions of living with diabetes, including the nursing care they receive. A major theoretical concern is to demonstrate the importance of placing patients' and clients' experiences at the centre of nursing interest and practice. It is argued that understanding a disease process should of necessity include an understanding of the concerns of those who live with it. Findings related to the following research questions are discussed: first, what are the challenges of living with diabetes? and second, what are people's perceptions of the nursing care they receive?
Airth-Kindree, Norah; Vandenbark, R Todd
Students in an RN-BSN completion program capstone course investigated and critically evaluated mobile medical applications using an information literacy conceptual framework. Students also analyzed their potential usefulness as a resource in nursing practice. Student evaluations focused on usability and applicability when recommending the use of mobile applications as a point-of-care reference tools. This pilot assignment offers an innovative teaching strategy for integrating 1 aspect of informatics instruction into the nursing curriculum.
Phillips, Holly; Maw, Heather; Mee, Steve; Buckley, Alison; Corless, Louise
This series has explored the value of patient narratives in enabling nurses to reflect on how their practice is perceived by, and affects, patients and their families. This article describes how two student learning disability nurses used patient and carer narratives to highlight the effect of a hospital trust's lack of toilet provision for people with physical impairments, using the stories to persuade the trust to develop appropriate facilities.
McCann, Sue A.; Chase, Allister Benjamin; Tawa, Marianne C.
ABSTRACT Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. Stage IA and IB mycosis fungoides cutaneous T-cell lymphoma can be effectively controlled by skin-directed therapies such as the mechlorethamine gel approved by the Food and Drug Administration. Dermatology nurses play a key role in promoting good patient compliance through patient education about mycosis fungoides cutaneous T-cell lymphoma disease, proper administration of mechlorethamine gel, and connecting patients with patient assistance programs or other supportive services. This article provides the dermatology nurse with a background about early-stage mycosis fungoides cutaneous T-cell lymphoma, skin-directed treatment options, questions that a patient may ask about mycosis fungoides cutaneous T-cell lymphoma and mechlorethamine gel, and patient education tools such as questions dermatology nurses may ask of their patients and a patient handout outlining mechlorethamine gel administration.
Fenton, Mary V.; Brykczynski, Karen A.
A comparison of results of two studies regarding the actual practice of clinical nurse specialists and nurse practitioners revealed a shared core of advanced practice competencies as well as distinct differences between practice roles. (JOW)
D'Arruda, Kimberley A
1. A basic understanding of the judicial system will enable occupational health nurses to read court opinions and have a better understanding of whether or how they or their companies are affected by the decision. With this knowledge, occupational health nurses can help their organization avoid legal liability by ensuring that the company does not act contrary to the decisions of the controlling courts. 2. As they are often involved in the process of contracting for goods and services, occupational health nurses need to be aware of general contract terminology and negotiating techniques so they will be better able to protect their companies. In addition, occupational health nurses can also assist in the actual contract drafting process with knowledge of a few concepts, such as the description, caption, operative language of the agreement, and definitions, of a contract. 3. Occupational health nurses are often called upon to be expert witnesses and can play an integral part in the litigation process. Because of the importance of expert witnesses, occupational health nurses must have an understanding of how to effectively provide expert witness testimony.
Kramer, Marlene; Schmalenberg, Claudia; Maguire, Patricia; Brewer, Barbara B; Burke, Rebecca; Chmielewski, Linda; Cox, Karen; Kishner, Janice; Krugman, Mary; Meeks-Sjostrom, Diana; Waldo, Mary
This mixed-methods study uses interviews, participant observations, and the CWEQII empowerment tool to identify structures and attributes of structures that promote control over nursing practice (CNP). Nearly 3,000 staff nurses completed the Essentials of Magnetism (EOM), an instrument that measures CNP, one of the eight staff nurse-identified essential attributes of a productive work environment. Strategic sampling is used to identify 101 high CNP-scoring clinical units in 8 high-EOM scoring magnet hospitals. In addition to 446 staff nurses, managers, and physicians on these high-scoring units, chief nursing officers, chief operating officers, and representatives from other professional departments are interviewed; participant observations are made of all unit/departmental/hospital council and interdisciplinary meetings held during a 4 to 6 day site visit. Structures and components of viable shared governance structures that enabled CNP are identified through constant comparative analysis of interviews and observations, and through analysis of quantitative measures.
Chung, Seon Yoon; Staggers, Nancy
Informatics competencies are a necessity for contemporary nurses. However, few researchers have investigated informatics competencies for practicing nurses. A full set of Informatics competencies, an instrument to measure these competencies, and potential influencing factors have yet to be identified for practicing nurses. The Nursing Informatics Competencies Questionnaire was designed, tested for psychometrics, and used to measure beginning and experienced levels of practice. A pilot study using 54 nurses ensured item comprehension and clarity. Internal consistency and face and content validity were established. A cross-sectional survey was then conducted on 230 nurses in Seoul, Korea, to determine construct validity, describe a complete set of informatics competencies, and explore possible influencing factors on existing informatics competencies. Principal components analysis, descriptive statistics, and multiple regression were used for data analysis. Principal components analysis gives support for the Nursing Informatics Competencies Questionnaire construct validity. Survey results indicate that involvement in a managerial position and self-directed informatics-related education may be more influential for improving informatics competencies, whereas general clinical experience and workplace settings are not. This study provides a foundation for understanding how informatics competencies might be integrated throughout nurses' work lives and how to develop appropriate strategies to support nurses in their informatics practice in clinical settings.
Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa
Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.
This article calls upon Canadian nursing leaders to examine the merits and downsides of the new practice doctorate degree - the Doctor of Nursing Practice (DNP). The impetus for the DNP arose from within the American nursing profession in order to address the knowledge and skills needed by advanced practice nurses to work in today's complex healthcare environment. The DNP is the newest practice doctorate degree and in 2015 will be the entry to practice degree required of all new advanced practice nurses in the United States. Advanced practice nurses who will have the practice doctorate include clinical nurse specialists, nurse practitioners, nurse midwives and nurse anaesthetists. With the establishment and acceptance of the DNP in the United States, American advanced practice nurses will have a different knowledge base than Canadian advanced practice nurses. The evolution and state of advanced practice nursing in Canada are discussed in this article. Canadian nursing leaders must discuss the DNP, its merits and downsides within the Canadian context and begin to make informed decisions about whether or not the DNP should come to Canada.
Delack, Sandi; Martin, Jean; McCarthy, Ann Marie; Sperhac, Arlene M
Nurse residency programs for newly licensed RNs are a critical component in bridging the clinical practice gap between education and practice. In May 2013, the Institute of Pediatric Nursing invited leaders from pediatric nursing organizations and children's hospitals to attend a forum on nurse residency programs for pediatric nurses. This article presents a summary of the discussions that occurred during the forum and makes recommendations for addressing issues related to nurse residency programs.
District nurse (DN) care delivery has undergone substantial change in recent years due to changing demographics and service delivery demands that have called for a move of care delivery from secondary to primary care. The title District Nurse is recorded with the Nursing and Midwifery Council (NMC) on completion of the Specialist Practice Qualification in District Nursing (SPQ DN), which purports to be a 'transformational' course that prepares future caseload holders to manage their team and prioritise care delivery effectively. This article explores the need for assertiveness skills in this role in response to Australian research, and outlines the pedagogic interventions implemented during the SPQ DN course to enhance this skill. Assertiveness scores were monitored for the duration of the course and demonstrated a significant increase-a topic that is now the subject of a future, funded study.
Doody, Owen; Doody, Catriona M
Traditionally, nurses have been over-managed and led inadequately, yet today they face unprecedented challenges and opportunities. Organisations constantly face changes that require an increasingly adaptive and flexible leadership. This type of adaptive leadership is referred to as 'transformational'; under it, environments of shared responsibilities that influence new ways of knowing are created. Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas. This leads to followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is shared. This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration.
Guenther, Robin; Hall, Anna Gilmore
Mounting evidence indicates that buildings can be a significant cause of human illness and environmental degradation. According to the United States (US) Environmental Protection Agency, indoor air pollution is one of the top five environmental risks to public health in the US. This may be related, to a large extent, to the fact that US citizens spend as much as 95% of their time indoors. Health care leaders, designers, and architects, recognizing the connection between health and the buildings in which much time is spent, are engaging in sustainable design and construction for healthy, 'green' buildings. The purpose of this article is to assist nurses in understanding the impact that unhealthy buildings can have on nurses and nursing practice and to provide tools and resources to assist nurses in transforming the health care industry with the goal of creating healing environments and reducing the negative environmental impact of the health care industry. First definitions, current initiatives, and motivations related to sustainable designs will be presented. Next sustainable health care design strategies, such as site planning, clean transportation, water conservation, healthy materials selection, indoor environmental quality, and also the benefits of sustainable design will be discussed. The article will conclude by sharing a variety of resources nurses can use to create healing environments in health care settings.
Hudacek, Sharon Smith; DiMattio, Mary Jane K; Turkel, Marian C
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, "From Academic-Practice Partnership to Professional Nursing Practice Model," found on pages 104-112, 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 February 28, 2020. 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. OBJECTIVES Describe the benefits and barriers to participation in a community-based academic-practice partnership. Identify three
Kalischuk, Ruth Grant; Thorpe, Karran
Creative thinking is a critical link in the teaching-learning process, one that enhances problem solving in nursing practice. This article describes a conceptualization of creativity based on focus groups with 12 post-RN students and two nurse educators. Inherent within the major theme, striving for balance, were three subthemes-enhancing self-esteem, working within structure, and making time for reflection (i.e., process). When participants achieved balance, both personally and professionally, they experienced increased creative energy that resulted in creative expression, subsequently displayed in educational endeavors and clinical practice (i.e., product). Strategies for fostering creativity and criteria for evaluating creativity are offered, and implications for nurse educators, managers, and practitioners are examined.
Sportsman, Susan; Hawley, Linda J.; Pollock, Susan; Varnell, Gayle
An expert panel identified 20 business concepts important for a family nurse practitioner curriculum. A focus group of practitioners verified the concepts and clarified relevant information to be taught. The business concepts center on management and operations of a clinical practice. (SK)
Ohio State Univ., Columbus. Vocational Instructional Materials Lab.
Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for practical nursing. The list contains units (with and without subunits), competencies, and competency builders that…
Sportsman, S; Hawley, L J; Pollock, S; Varnell, G
The faculties of three schools of nursing involved in a collaborative family nurse practitioner (FNP) program designed a study to address issues involved in preparing the nurse practitioner for the challenges of practice management in the clinical environment. The purposes of the study were to (1) identify business concepts necessary to successfully manage a primary care practice; (2) determine which of these concepts should be incorporated into an FNP curriculum; and (3) clarify information to be taught regarding each identified concept. Fifty-four business concepts related to primary care were identified from a literature review. A survey was then developed to assess the extent to which the identified concepts were necessary for an FNP to effectively manage a practice. Seven experts and five FNP faculty responded to the survey. The Content Validity Index (CVI) defined by Lynn (1986) was applied and 20 concepts necessary for an FNP to effectively manage a practice were identified. A focus group that included nurse practitioners (both faculty and nonfaculty) from the three collaborative sites connected by interactive telecommunications determined that all 20 of the identified concepts should be included in an FNP curriculum. Additionally, the focus group clarified relevant information to be taught regarding each identified concept.
Holmes, Dave; Federman, Cary
This article presents the results of a nursing research that aimed at describing the practice of nursing in an extreme environment where social control and psychiatric nursing care are inextricably enmeshed with one another. The study results indicate that the Correctional Psychiatric Centre (CPC) is a site where two antagonistic discourses (that of the hospital and that of the prison) are contending for the human resources in place. Given that the asylum and the prison are as such two distinct institutions, the correctional psychiatric centre constitutes an ideological space that results from the fusion of both the psychiatric and penal apparatuses. However, characteristics commonly attributed to prisoners, such as 'lying', 'dangerous', 'monstrous' and 'manipulative' are superimposed on the nurses' common theoretical representation that a patient is a person to whom care is provided. Monstrosity was a term regularly employed to describe particular types of inmates. The literature on monsters in quite informative in order to understand the impact of such a representation of forensic psychiatric nursing practice.
Malina, Debra P; Izlar, Janice J
Of the recognized advanced practice registered nursing (APRN) specialties, Certified Registered Nurse Anesthetists (CRNAs) have historically experienced the most vigorous and organized resistance from outside entities regarding rights to practice to the full scope of their education and experience. Opposition to nurse anesthetists practicing to the full scope of their education and training is present in the clinical arena and educational milieu.
Ervin, Naomi E
The volume of evidence for nursing practice has increased as a result of research and scientific discoveries. Yet we are still struggling with the dilemma of how to get evidence into nursing practice. Estimates are that it takes 20 years before innovations are fully put into use. Research is one type of knowledge to be used in practice. Nursing and patient care would benefit from moving more toward knowledge based on research and evidence. This article reviews barriers to and facilitators of using evidence in nursing practice and discusses a model for promoting the systematic use of evidence in practice. The author also offers suggestions for increasing the evidence base of nursing practice. Using evidence in nursing practice is important for all nurses, but requires more that the attention of the individual nurse.
Holtrop, Jodi Summers; Baumann, Jeanne; Arnold, Anita K; Torres, Trissa
This study used nurses as practice change consultants to help primary care medical practices improve their delivery of health behavior services to patients. Nurse consultants worked with 20 practices from 2 healthcare systems. In each practice, the nurses helped clinicians and staff to develop a practice-specific protocol so that they could identify and intervene with the health behavior of their patients. As a result of the nurse consultant intervention, health behavior delivery was improved. This article describes the specific methods and the lessons learned through this study. We encourage practices to use nurse consultants as one way of improving quality of care.
This article charts the development of a project, funded by the Queen's Nursing Institute and Queen's Nursing Institute Scotland, to develop voluntary standards that reflect the contemporary and future practice of district nurses. The standards are designed to enhance, but not replace, the Nursing and Midwifery Council standards for district nurse specialist practice. The project encompassed the four UK countries and gathered data from a wide range of sources to inform the new standards that were launched in September 2015.
While it is claimed in the nursing literature that reflective thinking is the approach par excellence for learning and advancing the art and practice of nursing, few empirical studies have been undertaken in this area to date. Sense-Making, a qualitative research method, was utilized to obtain and analyse data from interviews with 10 registered nurses in order to study reflective thinking in actual nursing practice. Ten non-routine nursing situations were analysed for the presence of reflective thinking. Time-line interviews of the events resulted in a total of 59 micro-moments, each of which was explored in terms of the thinking processes utilized to make sense of the situation as well as the focus of their thought. 'Pre-perceptions' played an important part in how the respondents perceived their situation. Reflective thinking was extensively manifest, especially in moments of doubt and perplexity, and consisted of such cognitive activities as comparing and contrasting phenomena, recognizing patterns, categorizing perceptions, framing, and self-questioning in order to create meaning and understanding. Self-questioning was identified as a significant process within reflective thinking. By exploring and analysing the type of questions respondents were asking themselves, the study uncovered three hierarchical levels of reflective thinking. Respondents most often engaged in reflective thinking-for-action which centred on the here and now in order to act. Reflective thinking-for-evaluation focused on creating wholeness and contributed to the realization of multiple perceptions and multiple responses. Reflective thinking-for-critical-inquiry could not be demonstrated in the study sample. The findings of this study resulted in the development of a model of reflective thinking, which is discussed in terms of the implications for learning in nursing practice.
Martin, Kathleen D; Molitor-Kirsch, Shirley; Elgart, Heidi; Ruffolo, Daria C; Sicoutris, Corinna; Meredith, Denise
The need for advanced practice nurses (APN) has expanded over the past several decades as a result of the changing healthcare environment. Increased patient acuity and decreased resident work hours have lead to a need for additional clinical expertise at the bedside. APNs are becoming an integral part of the acute care delivery team in many trauma programs and intensive care units. To date little has been published regarding the role of the APN in Trauma Centers. This article outlines the wide variety of responsibilities and services provided by a select group of nurse practitioners who work in trauma centers throughout the United States.
MacDonald, Kathleen; Paterson, Kirstie; Wallar, Jessica
Clinical practice placements are an essential component of pre-registration nursing programmes. Integration into a new team in an unfamiliar setting, which has its own values, practices, culture and language, can be stressful for nursing students. This article presents and discusses students' reflections on preparing for, entering and leaving practice placements. Ten students who participated in fortnightly group reflective sessions, discussed and analysed their learning experiences while on practice placements in an acute hospital. The challenges the students encountered were deconstructed using a group narrative approach. The students experienced ethical dilemmas around patient dignity, consent and advocacy as well as factors external to the practice setting, such as navigating systems and processes to access information before starting practice placements, managing household duties and academic workloads while working long shifts, and managing fatigue and loneliness. The students devised recommendations for other students to enable them to navigate their practice placements effectively and enhance their learning experience. Raising awareness among academic and practice placement staff of the challenges students encounter before and during their practice placement is essential to assist students to succeed and maximise their learning potential.
Scheel, Merry Elisabeth; Pedersen, Birthe D; Rosenkrands, Vibeke
Nursing is often described from the point of view of either the natural or the human sciences. In contrast to this, the value foundation in Interactional nursing practice is understood from the point of view of the natural sciences as well as that of the human and social sciences. This article presents many-faceted practice-theory of nursing, which is situated in the dynamic field between these three sciences. The focus of the theory is on interaction and practice resulting in a caring practice. Here practice is based on Taylor's and MacIntyre's interpretation of this concept. Action in nursing is based on Habermas' three varied modes of action seen in the light of an understanding of the world as a system world and a life world. Nursing as an interactional practice-theory is presented with examples of interpretative nursing science, seen in the ethical action-oriented, socio-cultural framework of Taylor and Habermas. It is concluded that phenomenologic and socio-cultural research into caring practice as well as an in-depth, comprehensive interpretation of nursing practice are both highly suited to forming the fundamental theoretical framework in nursing, here seen as an interpretative nursing science. Finally, a comparison is drawn between Interactional nursing practice and Benner's theory of nursing practice.
Maeve, M K; Vaughn, M S
The number of incarcerated persons in the United States has been increasing dramatically over the last two decades. Incarcerated men and women have increased rates of serious and chronic physical and mental illnesses and therefore require substantial health care efforts. Caring for prisoners is a difficult and often unrewarding experience for health care providers, particularly within a social climate that encourages noncaring behaviors. This article critically analyzes three philosophic stances toward nursing care with prisoners and suggests their philosophic commensurability within traditional nursing practice. Implications for nursing practice, research, and education are discussed.
Houston, S; Luquire, R
Outcomes management as a patient management system has been designed to impact and improve select outcomes. Central to the development and implementation of best practice senario identified throughout outcomes management is the advanced practice nurse. SLEH has been in the forefront of development and implementation of an outcomes management program. This article describes the outcomes management position and shares the job description and performance evaluation used at this institution. The tools allow for measuring and quantifying the impact of the outcomes manager position on improving patient outcomes. The improvement of outcomes has increased the value of the advanced practice nurse and provided the institution with a solid future necessary for survival in a managed care market.
The USGS has a long and proud tradition of objective, unbiased science in service to the Nation. A reputation for impartiality and excellence is one of our most important assets. To help preserve this vital asset, in 2004 the Executive Leadership Team (ELT) of the USGS was charged by the Director to develop a set of fundamental science practices, philosophical premises, and operational principles as the foundation for all USGS research and monitoring activities. In a concept document, 'Fundamental Science Practices of the U.S. Geological Survey', the ELT proposed 'a set of fundamental principles to underlie USGS science practices.' The document noted that protecting the reputation of USGS science for quality and objectivity requires the following key elements: - Clearly articulated, Bureau-wide fundamental science practices. - A shared understanding at all levels of the organization that the health and future of the USGS depend on following these practices. - The investment of budget, time, and people to ensure that the USGS reputation and high-quality standards are maintained. The USGS Fundamental Science Practices (FSP) encompass all elements of research investigations, including data collection, experimentation, analysis, writing results, peer review, management review, and Bureau approval and publication of information products. The focus of FSP is on how science is carried out and how products are produced and disseminated. FSP is not designed to address the question of what work the USGS should do; that is addressed in USGS science planning handbooks and other documents. Building from longstanding existing USGS policies and the ELT concept document, in May 2006, FSP policies were developed with input from all parts of the organization and were subsequently incorporated into the Bureau's Survey Manual. In developing an implementation plan for FSP policy, the intent was to recognize and incorporate the best of USGS current practices to obtain the optimum
This paper discusses a definition of the content of the computerized nursing data base developed by the Nursing Department for the Clinical Center Medical Information System at the National Institutes of Health in Bethesda, Maryland. The author describes the theoretical framework for the content and presents a model to describe the organization of the nursing data components in relation to the process of nursing care delivery. Nursing documentation requirements of Nurse Practice Acts, American Nurses Association Standards of Practice and the Joint Commission on Accreditation of Hospitals are also addressed as they relate to this data base. The advantages and disadvantages of such an approach to computerized documentation are discussed.
Spetz, Joanne; Dyer, Wendy T; Chapman, Susan; Seago, Jean Ann
Despite evidence that hospital use of licensed practical nurses (LPNs) declined in the 1990s, the current registered nurse (RN) shortage has prompted interest in LPNs as substitutes for RNs. Hospitals, being the dominant employer of RNs, have an economic incentive to use less expensive LPNs as substitutes. Beside wages, there are several forces underlying hospital demand for LPNs. In this article, the authors model and estimate hospital demand for LPNs as a function of nurse wages and hospital, market, and patient characteristics using a longitudinal data set of short-term general hospitals in the United States. The authors find evidence that higher RN wages increase hospital demand for LPNs, both in levels and relative to RNs, suggesting that hospitals at least partially substitute RNs with LPNs.
Eickhoff, Mary Ann
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…
Reid, Jamee Noell
This document is a comprehensive guide for instructors to use in teaching the final phase of the practical nursing program. This revised volume contains information related to medical-surgical nursing, mental health nursing, and career success. The section on medical-surgical nursing is composed of many units, dealing with the following subjects:…
Manley, Kim; Hills, Val; Marriot, Sheila
This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle D, the provision of person-centred care.
Ip, Barry; Cavanna, Annlouise; Corbett, Beverley
This paper examines the recent development of a computer-assisted learning program--in Practice--at the School of Health Science, in the University of Wales Swansea. The project, which began in 2001, was developed in close collaboration with The Meningitis Trust, the aim being to produce a software package to increase nursing students' knowledge…
Swider, Susan M; Krothe, Joyce; Reyes, David; Cravetz, Michelle
This article describes the most recent efforts by the Quad Council of Public Health Nursing organizations to review and revise the competencies for PHN practice, and highlights the implications of these competencies for practice, education, and research. The Quad Council is a coalition of four nursing organizations with a focus on public health nursing and includes the Association of Community Health Nursing Educators; the Association of Public Health Nursing (known prior to July 1, 2012 as the Association of State and Territorial Directors of Nursing); the Public Health Nursing section of the American Public Health Association; and the Council on Economics and Practice of the American Nurses' Association. The Quad Council competencies are based on the Council on Linkages competencies for public health professionals and were designed to ensure that public health nursing fits in the domain of public health science and practice.
Rural hospitals will be affected by changes in nursing anticipated in the future. Welcome changes will be the maturity and life experiences new graduates will bring to the work setting, knowledge of computers, and a broadening database. New graduates will also know various methods of care delivery, including case management, and will be able to select the delivery system that best meets the needs of the patients and institution. They will be more autonomous and possess leadership and management skills. With their knowledge of community as well as institutional nursing, they will be able to draw upon the skills of both groups to bring the two areas of nursing into continuity of care for patients. A difficulty ahead for rural hospitals is recruitment of new graduates, the majority of whom will have established families and lives elsewhere. And the practice of developing their own employees for higher levels of nursing will be compounded by the doubling of time necessary to complete nursing programs in the future.
Carr, Ruby C.
The purpose of the study was to review the entire practical nursing program and to make recommendations for its long-term organization and objectives. Relevant information concerned (1) the history of practical nursing, (2) purpose, membership, and related information on four professional nursing organizations, (3) state and federal legislation…
This article offers a synthesis of the significant developments and progress of family nursing in Sweden. A review was conducted to locate Swedish family nursing research produced over the past 10 years. CINAHL, Medline, and PubMed were the primary databases used to locate approximately 75 family nursing studies conducted in Sweden. The majority of the studies used descriptive methods with data collected from surveys and interviews involving nurses and family members either together or individually. Only a few of the studies examined family nursing interventions. This article also reports the results of a recent survey of Swedish nurses that examined how family nursing is used in practice. After 10 years of creating a strong foundation for family-focused nursing in Sweden, there is still a need for nurse researchers, educators, and administrators to collaborate in the implementation of family nursing to practice.
Butcher, Diane L; MacKinnon, Karen A
Changes to practical nurse education (with expanded scopes of practice) align with the increasing need for nurses and assistive personnel in global acute care contexts. A case in point is this critical exploration of Canadian practical nursing literature, undertaken to reveal predominating discourses and relationships to nursing disciplinary knowledge. The objectives of this poststructural critical review were to identify dominant discourses in practical nurse education literature and to analyze these discourses to uncover underlying beliefs, constructed truths, assumptions, ambiguities and sources of knowledge within the discursive landscape. Predominant themes in the discourses surrounding practical nurse education included conversations about the nurse shortage, expanded roles, collaboration, evidence-based practice, role confusion, cost/efficiency, the history of practical nurse education and employer interests. The complex relationships between practical nursing and the disciplinary landscape of nursing are revealed in the analysis of discourses related to the purpose(s) of practical nurse education, curricula/educational programming, relationships between RN and PN education and the role of nursing knowledge. Power dynamics related to employer needs and interests, as well as educational silos and the nature of women's work, are also revealed within the intersection of various discourses.
McCormick, S A
Congestive heart failure (CHF) is an enormous burden on society and the health care system. The role of the advanced practice nurse (APN) in CHF is multifaceted and combines inpatient, outpatient, and community patient care skills. Case management and quality management have been traditional focuses, with a high level of practice impact on patient care. Outcomes management in the APN role for CHF care is the future for measurable outcomes and maximum impact on organizational values. Because outcomes management is an evolving field for the APN, focus on a chronic disease such as CHF is a very valuable tool for implementation.
Working in Partnership, the Department of Health's report on the 1994 review of mental health nursing, implies that mental health nurses should develop anti-oppressive approaches to nursing practice. There is a notable absence of articles within the nursing literature which specifically address this issue. This is possibly because the historical and ideological issues which have informed the development of mental health nursing are complex and difficult to unravel. However, an integration of the theories of David Cooper and Frantz Fanon may provide an appropriate starting point for the development of a theory of anti-oppressive practice which addresses some of the issues specific to mental health nursing.
Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.
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…
Rose, Donald N; Peter, Elizabeth; Gallop, Ruth; Angus, Jan E; Liaschenko, Joan
The context of forensic psychiatric nursing is distinct from other psychiatric settings as, it involves placement of patients in secure environments with restrictions determined by the courts. Previous literature has identified that nurses morally struggle with respecting patients who have committed heinous offences, which can lead to the patient being depersonalized and dehumanized. Although respect is fundamental to ethical nursing practice, it has not been adequately explored conceptually or empirically. As a result, little knowledge exists that identifies how nurses develop, maintain, and express respect for patients. The purpose of this study is to analyze the concept of respect systematically, from a forensic psychiatric nurse's perspective using the qualitative methodology of focused ethnography. Forensic psychiatric nurses were recruited from two medium secure forensic rehabilitation units. In the first interview, 13 registered nurses (RNs) and two registered practical nurses (RPNs) participated, and although all informants were invited to the second interview, six RNs were lost to follow-up. Despite this loss, saturation was achieved and the data were interpreted through a feminist philosophical lens. Respect was influenced by factors categorized into four themes: (1) emotive-cognitive reactions, (2) nonjudgmental approach, (3) social identity and power, and (4) context. The data from the themes indicate that forensic psychiatric nurses strike a practical compromise, in their understanding and enactment of respect in therapeutic relationships with forensic psychiatric patients.
Swartz, Martha K
In academic centers of nursing, faculty or academic practice has become more widespread and integrated into the expectations and criteria for appointment and promotion. Yet, the concept of academic practice is not fully embraced among all schools of nursing. Numerous models of academic nursing practice have evolved and vary widely according to the clinical site, the roles of the practitioners, and the systems for generating revenue. Although most models are related to the mission statements of the schools of nursing, few seem to be based on a distinct philosophy of practice. In this article, a consideration of critical theory that provides a framework for practice-based nursing education is presented. By applying the philosophical underpinnings and assumptions of practice that are guided by critical theory, educators may begin to better identify the values of academic nursing practice and incorporate this activity more fully into the educational environment.
It was noted worldwide while learning fundamental skills and facing skills assessments, nursing students seemed to experience low confidence and high anxiety levels. Could simulation-based learning help to enhance students' self-efficacy and performance? Its effectiveness is mostly unidentified. This study was conducted to provide a shared experience to give nurse educators confidence and an insight into how simulation-based teaching can fit into nursing skills learning. A pilot study was completed with 50 second-year undergraduate nursing students, and the main study included 98 students where a pretest-posttest design was adopted. Data were gathered through four questionnaires and a performance assessment under scrutinized controls such as previous experiences, lecturers' teaching skills, duration of teaching, procedure of skills performance assessment and the inter-rater reliability. The results showed that simulation-based learning significantly improved students' self-efficacy regarding skills learning and the skills performance that nurse educators wish students to acquire. However, technology anxiety, examiners' critical attitudes towards students' performance and their unpredicted verbal and non-verbal expressions, have been found as possible confounding factors. The simulation-based learning proved to have a powerful positive effect on students' achievement outcomes. Nursing skills learning is one area that can benefit greatly from this kind of teaching and learning method.
Jones, Terry L.
Topic Nursing time has relevance for those who produce it, those who receive it and those who must pay for it. Though the term nursing time may be commonly used, a common understanding of the concept within the fields of nursing and healthcare administration is lacking. Purpose The purposes of this paper are to explore the concept of nursing time and to identify implications for theory development, clinical and administrative practice, and research. Discussion Both physical and psychological forms of time are viewed as fundamental to our experience of time as social beings. Nursing time has significant intrinsic and instrumental value in nursing and healthcare. A holistic approach incorporating the physical, psychological, and sociological aspects and dimensions of nursing time is advocated. Conclusions Multiple strategies to enhance the patient experience of nursing time are warranted and should address how much time nurses spend with patients as well as how they spend that time. Patterns of overlapping and competing time structures for nurses should be identified and evaluated for their effect on physical time available for patient care and the psychological experiences of time by nurses and patients. PMID:20690994
Tanga, Hazel Y
Nurses who divert drugs pose significant threats to patient safety, but also become a liability to healthcare organizations and the nursing department where the diversion occurred. Healthcare and nursing leaders have a responsibility to ensure that security systems are in place to prevent diversion and protect patients if nursing impairment is suspected as a result of drug diversion. Nursing leaders must consider legal, regulatory, ethical, humanistic, and practical considerations in resolving this issue.
Elsom, Stephen; Happell, Brenda; Manias, Elizabeth
Significant changes to the delivery of mental health services have resulted in the expansion of the community mental health nursing role. This qualitative study was undertaken to explore the extent to which community mental health nurses are currently engaged in expanded forms of practice. Focus groups were undertaken with community mental health nurses (n = 27) from metropolitan and rural Victoria, Australia. Thematic analysis identified the following major themes: reported practice, consumers as beneficiaries of expanded practice, risk of harm and litigation, and barriers to expanded practice. The findings emphasize the need for significant changes in current legislation if expanded practice for nurses is to become a reality.
Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung
Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. PMID:27508923
Egry, E Y
This study sought to determine the beliefs of nursing students on human sexuality, their information sources, and persons influencing their opinion. A survey conducted December 1983 to January 1985 targeted female graduating students in Nursing and Obstetrics at the University of Sao Paulo (USP) School of Nursing; its findings were then compared to similar studies conducted among the general population. The findings show that the target population and general population opinions differ little, reflecting fear and prejudice about sexual practices. Also, the professional training of Brazil's nurses failed to include a fundamental understanding of human sexuality. The 42 respondents are characterized as follows: age 21 to 36 years; 95.2% single; 88% childless; 59.5% born in the city of Sao Paulo; 88% born in the state of Sao Paulo; 85.7% with long term residence in urban areas and state capitals; and 92.5% attended 4 years of nursing school at USP. Results showed: 47.6% favored premarital sex; 26.2% espoused premarital virginity for men and 19% for women; roughly 60% disapproved of extramarital relations for both sexes. 75% considered masturbation normal for both sexes; about 90% approved of contraceptive practices for men and women; 90.5% favored family planning; 26% were strictly against abortion; nearly 60% found prostitution unacceptable for both sexes; and homosexuality in both sexes was considered taboo by 42.8%, and acceptable by 14%. The vast majority favored sexual education at all levels. Regarding sources of sexual infomation: books, magazines and encyclopedias comprised 25%; male friends, 10%; girlfriends, 9.4%; boyfriends 8%; and, the University of Sao Paulo School of Nursing, a mere 6.5%. The persons who influenced their opinions were: first, boyfriend (23.7%) followed by mother, girlfriends and male friends; second, girlfriend (28.5%) followed by boyfriend and male friend; third, girlfriend, boyfriend, male friend, and teachers (7.1% each); fourth
Purkis, Mary E; Bjornsdottir, Kristin
This paper provides an analysis of nursing as a knowledgeable discipline. We examined ways in which knowledge operates in the practice of home care nursing and explored how knowledge might be fruitfully understood within the ambiguous spaces and competing temporalities characterizing contemporary healthcare services. Two popular metaphors of knowledge in nursing practice were identified and critically examined; evidence-based practice and the nurse as an intuitive worker. Pointing to faults in these conceptualizations, we suggest a different way of conceptualizing the relationship between knowledge and practice, namely practice as being activated by contextualized knowledge. This conceptualization is captured in an understanding of the intelligent creation of context by the nurse for nursing practice to be ethical and effective.
Brennan, P F; Anthony, M K
Nursing Practice Models (NPMs) represent the structural and contextual features that exist within any group practice of nursing. Currently, measurement of NPMs relies on costly and nonreproducible global judgments by experts. Quantitative measurement techniques are needed to provide a useful evaluation of nursing practice. Guided by Multi-Attribute Utility theory (MAU theory), an expert panel identified 24 factors representative of N PMs. The factors became elements in a computational index that, when summed, assigns a score to a given nursing unit reflecting the extent to which that unit's nursing practice model achieves the nursing professional ideal. Initial validation of the index and its elements consisted of comparing assessments of 40 nursing units generated by the index with a global evaluation provided by each of the expert panelists who proposed the model factors. Pearson correlations between the index-generated scores and the global assigned scores provided evidence supporting the preliminary validation of the index.
Miller, Jason E.
The distinction between doctor and nurse has been historically visible to patients, and the scope of practice for each healthcare provider has been clearly marked by a wall of separation rooted in state law. In fact, even the titles by which these providers have been addressed have remained constant, with the term “doctor” being reserved for reference to physicians. With the advent of the new doctor of nursing practice degree, however, the clear distinction between doctor and nurse is in jeopardy. Moreover, accompanying the push toward a practice doctorate for advanced nursing practice is a call for the expansion of the scope of advanced nursing practice. The urgent questions at hand are the following: First, is a practice doctorate necessary or even appropriate for advanced nursing practice? Second, should the scope of advanced nursing practice be extended at this time? In addition to the increased educational requirements placed on aspiring advanced practice nurses and the associated increase in costs of obtaining the requisite education, requiring a practice doctorate for advanced practice nursing risks blurring the line between doctor and nurse and creates a potential for patient confusion. A true need for requiring a practice doctorate for advanced practice nursing has not been demonstrated. Moreover, the states should tread carefully when considering expanded roles for advanced practice nurses to avoid creating conflict within the medical community. Considering the level of qualification of today's medical school applicants, perhaps we should be training more physicians to meet the demand head-on rather than creating a separate practice doctorate to fill the gap. PMID:19099003
Journal of Professional Nursing, 2002
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…
Peplau, H E
Peplau discusses major features of the theory of interpersonal relations. She describes her theory as among the most useful to apply during nursing practice in order to understand nurse-patient interactive phenomena. Peplau addresses how she derived constructs from clinical data and identified their congruence with nursing practice. She further addresses the specific concepts of her theory and their relations, and specific uses of the theory in practice.
Missouri Univ., Columbia. Instructional Materials Lab.
This curriculum guide provides materials for a 10-unit intravenous (IV) therapy course for licensed practical nurses. Units contain from one to nine lessons. The first unit provides an introduction and orientation to the course. Subsequent units concern documentation, anatomy and physiology as applied to IV therapy, fundamental aspects of fluid…
Degen, Greta M.
The purpose of this study was to illuminate the qualitatively different ways in which three nurses with an associate degree (ADN) and three nurses with a baccalaureate degree (BSN) experience, conceptualize, perceive, and understand their own nursing practice within the context of their educational background. Using a phenomenographic methodology…
Lusk, Marilyn; Decker, Ilene
One baccalaureate nursing program and five community college programs collaboratively developed a shared philosophy, curriculum design, and model for nursing education and practice. The model takes a holistic view of the client/patient's mind, body, and spirit engaged in life-changing transitions and depicts the role of nursing care. (SK)
National Association for Practical Nurse Education and Service, Inc., New York, NY.
The third in a series of pamphlets on practical nursing education, this document contains information on accreditation standards governing nursing programs. Included are announcements of: (1) available accreditation and consultation services, (2) policies regulating accreditation eligibility, (3) standards of ethics by which nursing programs are…
Feldbaum, Eleanor G.; Levitt, Morris J.
This report focuses on nursing educational and practice issues that government officials may have to address in the near future. The report provides statistical information on nurses, compares statistics for white and black nurses, and recommends policies for the future. Data was gathered for the report during a three-year study of 5,175…
Rice, Susan K.; Biordi, Diana L.; Zeller, Richard A.
This descriptive correlational study assessed school nurses' knowledge of and perceived relevance of the "Standards of Professional School Nursing Practice". Of the 1,162 Ohio school nurses sent questionnaires, 345 returned usable questionnaires (30%). The typical respondent was a 50-year-old Caucasian woman with 24 years of nursing…
Hsiao, Chiu-Yueh; Tsai, Yun-Fang
The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness.
Infection is spread in hospital mainly by hands, making hand decontamination the most important means of preventing dissemination. There is some evidence to suggest that when access to hand-decontaminating agents is poor or the agents available are disliked, hands are washed too seldom, increasing risks of cross-infection. However, little attention has been paid to the use of towels and factors which promote their use, although it is known that damp hands transfer bacteria more readily than dry ones and that hands which become sore through poor drying have higher bacterial counts, contributing to the risk of cross-infection. This paper reports the results of the Nursing Times Hand Drying survey designed to assess nurses' access to hand decontamination agents and towels. The results suggest that the 112 nurses who participated were aware of the need for attention to hand hygiene but that access to both hand-decontaminating agents and paper towels was variable. Forty-one per cent complained of a shortage of soap and although nearly all used paper towels, these were in many cases of poor quality. Such towels were perceived as damaging to hands, leaving them feeling damp and sore. Good-quality, soft, paper towels were much appreciated by respondents in this sample. It is concluded that the quality of paper towels contributes to good infection control practice.
Lagerwey, Mary D
This paper presents a discourse analysis of publications of the Christian Reformed Church regarding its Rehoboth Mission near Gallup, New Mexico, among the Navajo. All issues of The Banner, Acts of Synod of the Christian Reformed Church, the Rehoboth Hospital Bulletin, and the Annual Report of the Rehoboth Mission from 1880 to the present were reviewed for references to health-care at Rehoboth from 1903 to 1943. Four religiously framed discourses were identified: discourses justifying provision of health-care at the mission, discourses of the Navajos as immature and potentially dangerous, needing to be civilized, discourses of cleanliness, and discourses of calling. This paper adds to a growing body of knowledge about religious frames within which nurses have practiced in North America.
Fratzke, Jason; Tucker, Sharon; Shedenhelm, Heidi; Arnold, Jackie; Belda, Tom; Petera, Michael
Innovative strategies that preserve nursing time for direct patient care activities are needed. This study examined the utility, feasibility, and acceptability of voice recognition (VR) software to document nursing care and patient outcomes in an electronic health record in a simulated nursing care environment. A phase 1 trial included 5 iterative experiments with observations and nurse participant feedback to allow enhancements to the speech detection capabilities and refinement of the technology, software, and processes. Utility ratings improved over time; however, interference on nursing care remained a concern throughout. Nurse participants favored keyboard entry electronic health record, largely due to software and technical issues, but also relative to the culture shift the new technology brings to nursing practice. Successful adoption of VR technology by nursing will be dependent on receptiveness of the nurses and perceived benefits, timely access to education and training, and minimization of barriers to using the software.
Bungay, Vicky; Stevenson, Janine
Most research about regulatory policy change concerning expanded nursing activities has emphasized advanced practice roles and acute care settings. This study is a contribution to the small pool of research concerned with regulatory policy implementation for nurses undertaking expanded nursing practice activities in a public health context. Using the regulatory changes in certified nursing practice in one Canadian province as our starting point, we investigated the experiences of nurse leaders in implementing this change. Using a qualitative interpretive descriptive approach informed by tenets of complexity theory, we examined the experiences of 16 nurse leaders as situated within the larger public health care system in which nurses practice. Two interrelated themes, (a) preparing for certification and (b) the certification process, were identified to illustrate how competing and contrasting demands between health care and regulatory organizations created substantial barriers to policy change. Implications for health service delivery and future research are discussed.
Noel, Dianne L
Many health care and academic centers have adopted Watson's Theory of Human Caring as their guiding principle; the theory is also used in other disciplines, such as library science. Human caring theory offers occupational health nurses as structure that not only defines a focus for practice, but also provides a basis for moral and philosophical practice analyses. In particular, nurses may find this theory useful in confirming the definition of "caring" and reconsidering what nursing is all about. More importantly, consideration and application of this theory may lead to research on its applicability to the field of occupational health nursing. This article presents the science and philosophy of human caring, specifically Watson's Theory of Human Caring. Two case studies are presented that demonstrate how the theory could be used to evaluate occupational health nursing practice. To demonstrate its possible relevance as an occupational health nursing framework, an analysis of and comparison to existing occupational health nursing guidelines are detailed and discussed.
Elaine, Hardy; DeBasio, Nancy; Warmbrodt, Lynn; Gartland, Myles; Bassett, William; Tansey, Michael
Research College of Nursing and the Rockhurst University Helzberg School of Management Health Care Initiative collaborated to offer the Executive Nurse Practice: Health Care Leadership track to Research College of Nursing graduate students. This effort was not only cost effective, but also offered expert faculty in both the fields of nursing and business. The curriculum is an integration of both fields and faculties from both institutions as they communicate and collaborate each semester to successfully coordinate the track.
Yang, Tae Hoon
Isotope-based metabolic flux analysis is one of the emerging technologies applied to system level metabolic phenotype characterization in metabolic engineering. Among the developed approaches, (13)C-based metabolic flux analysis has been established as a standard tool and has been widely applied to quantitative pathway characterization of diverse biological systems. To implement (13)C-based metabolic flux analysis in practice, comprehending the underlying mathematical and computational modeling fundamentals is of importance along with carefully conducted experiments and analytical measurements. Such knowledge is also crucial when designing (13)C-labeling experiments and properly acquiring key data sets essential for in vivo flux analysis implementation. In this regard, the modeling fundamentals of (13)C-labeling systems and analytical data processing are the main topics we will deal with in this chapter. Along with this, the relevant numerical optimization techniques are addressed to help implementation of the entire computational procedures aiming at (13)C-based metabolic flux analysis in vivo.
Mundinger, Mary O.; Cook, Sarah Sheets; Lenz, Elizabeth R.; Piacentini, Karen; Auerhahn, Carolyn; Smith, Jennifer
Advanced practice nurses are assuming increasingly accountable roles in primary health care. A doctor of nursing practice degree would signify the high level of competency they achieve. Columbia University's training model is an example of the preparation needed for this level of professional practice. (SK)
Broussard, A B; Delahoussaye, C P; Poirrier, G P
The practice role of nurse educators has emerged as a mechanism to unite practice, research, and education. The long-term outcome of such a synthesis should be an improvement in the quality of nursing care delivered to clients. Clinically focused nursing research designed by nurse educators who maintain a practice role or nurse clinicians who maintain a teaching role has the potential to unify and thus advance the profession. The authors discuss the historical background from which the practice role evolved, and efforts of recent nursing leaders to facilitate the incorporation of the nursing practice role by educators. Models for faculty practice are identified, and advantages of faculty practice are reviewed. The authors also describe barriers to the establishment of faculty practice, contemporary developments impacting faculty practice, and research needed to advance faculty practice. Nurse educators in many academic communities in the 1990s are discovering that not only must they produce scholarly work in addition to their teaching and service to the university and community, but that they may also be under growing pressure to be engaged in clinical practice. This pressure may be self-imposed or may be an expectation of their colleagues in nursing education or the administrators of their nursing programs. The focus of this research brief will be to describe the historical background from which this "new" role evolved, to discuss strategies or models developed to facilitate the faculty practice role, and to identify faculty practice issues that have emerged with the adoption of this role in academia. An additional focus will be to critically review faculty practice-related research performed since Chicadonz' (1987) review.
In this this essay, the author addresses the close connection between mixed methods research and nursing practice. If the assertion that research and practice are parallel processes is accepted, then nursing practice may be considered "invisible mixed methods research," in that almost every encounter between a nurse and a patient involves collection and integration of qualitative (word) and quantitative (number) information that actually is single-case mixed methods research.
Atkin, Karl; Lunt, Neil
Interviews with 56 practice nurses, 29 general practitioners (GPs), 23 health administrators, and 1 government official revealed that nurses use a variety of education and training opportunities; GPs largely let nurses take responsibility for their continuing education. The informal nature of training opportunities and lack of funding were…
Rooted in traditional Chinese medicine, the use of acupressure to alleviate symptoms, support the healing process, promote relaxation, and improve overall health has grown considerably in the West. The effects of acupressure--like those of acupuncture, with which it shares a theoretical framework--cannot always be explained in terms of Western anatomical and physiologic concepts, but this noninvasive practice involves minimal risk, can be easily integrated into nursing practice, and has been shown to be effective in treating nausea as well as low back, neck, labor, and menstrual pain. The author discusses potential clinical indications for the use of acupressure, describes the technique, explains how to evaluate patient outcomes, and suggests how future research into this integrative intervention might be improved.
Choi, JiSun; Flynn, Linda; Aiken, Linda H.
Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. Design and Methods: The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes. Results: Controlling for individual and nursing home characteristics, staff RNs’ participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs’ job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied. Implications: A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction. PMID:21908803
Despite scientific advances in pain management, inadequate pain relief in hospitalized patients continues to be an on-going phenomenon. Although nurses do not prescribe medication for pain, the decision to administer pharmacological or other interventions for pain relief is part of nursing practice. Nurses play a critical role in the relief of…
Lee, Sheuan; Pai, Hsiang-Chu; Yen, Wen-Jiuan
The International Council of Nurses (ICN) issued the title, Positive Practice Environments: Quality Workplaces = Quality Patient Care, as the theme of International Nurses Day in 2007. An appeal is being made for all ICN National Nursing Associations to focus on improving practice environments and protecting nursing staff. The purpose of the study was to explore the perceived practice environment of nurses in Taiwan on the basis of the tool kit of positive environments designed by ICN, involving the eight dimensions of safety, supplies, resources, pay, continuing education, support, equipment, and respect. A self- administered Practice Environment Survey Scale was used. The findings indicated that participants were mostly female, the average age was 34.15 years old, and most of them worked in northern Taiwan (33.4%). The perceived practice environment score was determined as a percentage, and the average score among nurses was 65. The three lowest scores were recorded in the domains of pay, resources and equipment. There were significant differences in the perceived practice environment scores among participants' demographic characteristics (p < .05). Nurses recorded more negative practice environment scores than administrators. The results will be useful in the formulation of nursing policy and in nursing administration.
Evidence-based healthcare, the organized translation of knowledge into practice, and the implementation of evidence in practice have become vital in nursing care and health policy. Evidence translation is an essential concept that relates to the knowledge development and core competence of advanced practice nurses (APNs). The present article introduces the development and definitions of nursing evidence translation. The evidence-based nursing perspectives of Techne and Phronesis are used to illustrate the characteristics and nature of knowledge translation. The evidence translation models are introduced and the barriers that are often encountered during the three stages of evidence translation are explained. The final section discusses the future development of evidence translation.
Spurr, Shelley; Bally, Jill; Ogenchuk, Marcella; Peternelj-Taylor, Cindy
This article presents a proposed holistic Framework for Exploring Adolescent Wellness specific to the discipline of nursing. Conceptualized as a practical adolescent wellness assessment tool, the framework attends to the physical, spiritual, psychological and social dimensions of adolescent health. Through the discussion of a reconstructed case study the framework's application to nursing practice is illustrated. Nurses are distinctly positioned to promote adolescent wellness. This approach facilitates the exploration of the multiple influences on the health of adolescents, across a variety of clinical practice specialties and settings, by nurses of varying experiences.
Dyess, Susan M; Sherman, Rose O; Pratt, Beth A; Chiang-Hanisko, Lenny
With the growing complexity of healthcare practice environments and pending nurse leader retirements, the development of future nurse leaders is increasingly important. This article reports on focus group research conducted with Generation Y nurses prior to their initiating coursework in a Master’s Degree program designed to support development of future nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this qualitative study conducted to capture perspectives about nursing leaders and leadership. Conventional content analysis was used to analyze and code the data into categories. We discuss the three major categories identified, including: idealistic expectations of leaders, leading in a challenging practice environment, and cautious but optimistic outlook about their own leadership and future, and study limitations. The conclusion offers implications for future nurse leader development. The findings provide important insight into the viewpoints of nurses today about leaders and leadership.
Walker-Cillo, Gayle A; Harding, Andrew
One of the most difficult arenas in the emergency environment for the new and seasoned clinical nurse specialist is the clinical remediation of professional nursing staff. It is easy to say that each person must be treated the same, but the foundation of each practice issue and problem is unique. Identifying and utilizing a standardized process with which concerns are addressed on the basis of theoretical models, expert nursing knowledge, and standards of practice are the keys to success.
Shever, Leah L; Titler, Marita G; Mackin, Melissa Lehan; Kueny, Angela
The purpose of this article was to describe nursing practices (e.g., assessment, interventions) around fall prevention, as perceived by nurse managers in adult, medical-surgical nursing units. One hundred forty nurse managers from 51 hospitals from across the United States participated. Descriptive frequencies are used to describe nurse manager responses. The most commonly used fall risk assessment tool was the Morse Fall Risk Assessment Tool (40%). The most common fall prevention interventions included bed alarms (90%), rounds (70%), sitters (68%), and relocating the patient closer to the nurses' station (56%). Twenty-nine percent of nurse managers identified physical restraints as an intervention to prevent falls whereas only 10% mentioned ambulation. No nurse manager identified that RN hours per patient-day were adjusted to prevent falls or fall-related injuries. More work is needed to build systems that ensure evidence-based nursing interventions are consistently applied in acute care.
Campbell-Detrixhe, Dia D; Grassley, Jane S; Zeigler, Vicki L
Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants' personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs' personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.
Swanson, C S
A spirit-focused conceptual model of nursing views the person as a spiritual being whose life and purpose arise from a personal relationship with God. The individual's definition of God determines how he or she responds to stimuli, sets goals, and establishes purpose in life. Consequently, this definition influences the professional nursing relationship, and the nurse's and patient's concepts of health and perceptions of the environment. The pediatric nurse practitioner and client are the primary examples of practice examined in this study.
Calzone, Kathleen A; Jenkins, Jean; Culp, Stacey; Bonham, Vence L; Badzek, Laurie
Aim Genomics has the potential to improve personalized healthcare. Nurses are vital to the utilization of genomics in practice. This study assessed nursing attitudes, receptivity, confidence, competency, knowledge and practice in genomics to inform education efforts. Materials & methods Cross-sectional study of registered nurses who completed an online Genetic/Genomic Nursing Practice Survey posted on a national nursing organization website. Results A total of 619 registered nurses participated. The largest proportion of education level were nurses with a baccalaureate degree (39%). Most (67.5%) considered genomics very important to nursing practice. However, 57% reported their genomic knowledge base to be poor or fair. The mean total knowledge score correct response rate was 75%. Yet 60% incorrectly answered that diabetes and heart disease are caused by a single gene variant. Most (64%) had never heard of the Essential Nursing Competencies and Curricula Guidelines in Genomics. Higher academic education or post licensure genetic education increased family history collection in practice. Conclusion Most nurses are inadequately prepared to translate genomic information into personalized healthcare. Targeted genomic education is needed to assure optimal workforce preparation for genomics practice integration. PMID:24363765
Prior, Patsy; Wilkinson, Jill; Neville, Stephen
The role of practice nurses is a specific feature of the modernisation agenda of the New Zealand health service. Increasing importance is being placed on service improvement through effective decision making and enhanced clinical performance. To contribute to the development of primary health care it is crucial that nurses have the skills to appropriately implement research based and other evidence in practice. This study involved 55 West Auckland practice nurses working in the general practice setting. The aim of the study was to describe nurses' perceptions of their use of evidence-based practice, attitudes toward evidence-based practice and perceptions of their knowledge/skills associated with evidence-based practice. An additional aim was to determine the effect of educational preparation on practice, attitudes and knowledge/skills toward evidence-based practice. A descriptive survey design was selected for this study. The results demonstrated that nurses' attitudes toward evidence-based practice, knowledge and skills relevant to the implementation of evidence-based practice and the educational preparation of the nurses were important factors influencing the effective utilisation and application of research results in practice. Educational interventions are identified as an integral aspect of implementing evidence-based practice and enhancing practice nurses' knowledge and skill relevant to the use of evidence in practice. Further research is needed to assess the contextual factors which can inhibit or promote achievement of evidence-based practice by practice nurses.
The evolution of science and our society raises ethical questions in medical and nursing practice. These give rise to the requirement for individual and collective reflection in order to consider the consequences of decisions and to judge on sometimes complex choices. This reflection concerns both nursing practices and the organisation of the health system.
Georges, Jane M
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.
Nurse practitioners produce excellent patient outcomes and should be allowed to practice to the full extent of their education and training. In addition to clinical skills, nurse practitioners need to understand the business side of practice in order to ensure fair and equitable compensation.
Weiss, Josie A
Inviting advanced practice nursing students to participate in faculty research can be an innovative way to interest students in using current evidence as the basis for their practice. The author discusses strategies for effectively engaging graduate nursing students into research projects in ways that broaden the students' perspectives and strengthen their healthcare decision-making skills.
Milton, Constance L
Rules in games are fundamental to the ethics of practice. Rules provide a context or space where a game is defined and played. Throughout human life, games may be formalized with written and unwritten rules. Imaginations may be sparked in the creative structuring of new, informal games. Formal and informal rules can serve to provide direction for what may be viewed as decorum and appropriate behavior with professional groups. In this column, the author illuminates possible ethical meanings for rule-making and breaking with implications for nursing practice and education from a nursing theoretical perspective.
Talley, Linda B; Thorgrimson, Diane H; Robinson, Nellie C
Grooming nurses at all levels of the organization to master health care executive skills is critical to the organization's success and the individual's growth. Selecting and executing next steps for nursing leadership team development is critical to success. Leaders must make it their responsibility to provide nurses with increased exposure to quality, safety, and financial data, thereby allowing nurses to translate data while achieving and sustaining successful outcomes. The work of the CNO Dashboard to measure, report, trend, and translate clinical and non-clinical outcomes must be integrated throughout all levels of nursing staff so that nursing practice is positioned to continually strive for best practice. The education and evolution of nurses as business managers is critical to building a strong RN workforce.
Hessels, Amanda J.; Flynn, Linda; Cimiotti, Jeannie P.; Cadmus, Edna; Gershon, Robyn R.M.
Objectives Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals. Methods This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals. Results Nurses missed delivering a significant amount of necessary patient care (10–27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events. Conclusions This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care. PMID:27547768
Covell, Christine L; Sidani, Souraya
Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. Studies that have investigated the relationship between nursing knowledge and outcomes have been plagued with conceptual and methodological issues. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. The nursing intellectual capital theory was developed to assist with this area of inquiry. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. In this article, we review the nursing intellectual capital theory and discuss its implications for research and practice. We explain why the theory shows promise for guiding research on quality work environments and how it may assist with administrative decision-making related to nursing human resource management and continuing professional development.
Background There is a scarcity of research published on clinical scholarship. Much of the conceptualisation has been conducted in the academy. Nurse academics espouse that the practice of nursing must be built within a framework of clinical scholarship. A key concept of clinical scholarship emerging from discussions in the literature is that it is an essential component of enabling evidence–based nursing and the development of best practice standards to provide for the needs of patients/clients. However, there is no comprehensive definition of clinical scholarship from the practicing nurses. The aim of this study was to contribute to this definitional discussion on the nature of clinical scholarship in nursing. Methods Naturalistic inquiry informed the method. Using an interpretative approach 18 practicing nurses from Australia, Canada and England were interviewed using a semi-structured format. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories and the components of clinical scholarship described by the participants compared to the scholarship framework of Boyer [JHEOE 7:5-18, 2010]. Results Clinical scholarship is difficult to conceptualise. Two of the essential elements of clinical scholarship are vision and passion. The other components of clinical scholarship were building and disseminating nursing knowledge, sharing knowledge, linking academic research to practice and doing practice-based research. Conclusion Academic scholarship dominated the discourse in nursing. However, in order for nursing to develop and to impact on health care, clinical scholarship needs to be explored and theorised. Nurse educators, hospital-based researchers and health organisations need to work together with academics to achieve this goal. Frameworks of scholarship conceptualised by nurse academics are reflected in the findings of this study with their emphasis on reading and doing research and translating it
Neher, Margit; Ståhl, Christian; Ellström, Per-Erik; Nilsen, Per
As rheumatology nursing develops and extends, knowledge about current use of knowledge in rheumatology nursing practice may guide discussions about future knowledge needs. To explore what perceptions rheumatology nurses have about their knowledge sources and about what knowledge they use in their practice, 12 nurses working in specialist rheumatology were interviewed using a semi-structured interview guide. The data were analyzed using conventional qualitative content analysis. The analysis yielded four types of knowledge sources in clinical practice: interaction with others in the workplace, contacts outside the workplace, written materials, and previous knowledge and experience. Colleagues, and physicians in particular, were important for informal learning in daily rheumatology practice. Evidence from the medical arena was accessed through medical specialists, while nursing research was used less. Facilitating informal learning and continuing formal education is proposed as a way toward a more evidence-based practice in extended roles.
Palumbo, Mary Val; McIntosh, Barbara; Rambur, Betty; Naud, Shelly
The expected retirement of the largest cohort of nurses will push the RN workforce below projected need by 2020. The challenges of managing a nursing workforce with the majority of nurses over 45 years of age are now necessitating attention to polices for recruitment and retention of older nurses, particularly in rural areas. This convenience sample study employed a mailed survey to investigate perceptions of nurses in 12 institutions (four hospitals, seven home health agencies, and one nursing home serving a small rural state). The goal was to explore rural RNs' perceptions of intent to stay in their current position, with their organization, and employment as a nurse; organizational and unit-level culture regarding older nurses in the workplace; importance of specific human resource practices/policies to their own intention to stay; and extent to which these human resource practices/policies are currently done. The results indicate that although there are similarities across age cohorts, important differences exist that can be addressed to create career-span sensitive policies and practices. This study provides an indicator of progress or lack of progress in addressing older nurse recruitment and retention, and also offers guidance for differentiating policies and practices for younger and older nurses.
Allan, Helen; Barber, Debbie
This paper discusses data from a case study of fertility nursing practice. An ethnographic case study approach using participant observation and nine semi-structured interviews with staff and patients was undertaken. The data were analysed thematically and these themes are discussed in this paper. We present the meaning a small group of nurses working in a fertility unit in the UK attach to new roles and the ways in which changes in practice may be influenced. The nurses in this study believed that nature of the task demanded changes to practice and they identified personal, interpersonal and socio-cultural factors which influenced these changes. These new roles facilitated greater continuity of care for patients. This paper discusses the effects of these new roles on knowing and intimacy in nurse - patient relationships. The data suggests that new nursing roles, which are based on "traditional" nursing and "new" technical skills, are fragile and may not be shared across a professional community.
Lachat, Maryanne F; Scott, Carol A; Relf, Michael V
This article describes current nursing practice for pregnant women with HIV. In the United States, the number of new cases of HIV continues to rise in women of childbearing age. Women often learn of their HIV status when a pregnancy involves them in the healthcare delivery system. Since the manifestation of the disease in 1981, there have been significant advances in treatment, and now, among pregnant women testing positive for HIV, the risk of perinatal transmission can be decreased to 1% with pharmacologic intervention. Yet, HIV disease poses many new challenges to the woman testing positive who is considering pregnancy or who is already pregnant. The progression of the symptoms of AIDS is similar to the common symptoms of pregnancy; the HIV medications may also cause these symptoms. Adherence to the HIV medication regime is necessary for ongoing viral suppression, for missed doses can initiate drug resistance and the whole categories of antiretroviral drugs may become ineffective. Additionally, the HIV stigma continues to impact those infected and interferes with the access to healthcare. HIV poses a major challenge for the nurse caring for the childbearing woman.
Aholaakko, Teija-Kaisa; Metsälä, Eija
Aseptic practices prevent exposure of a surgical wound to microbes, operating theatre environment and personnel. The circulating nurse assists the operating theatre personnel and supervises aseptic practices preventing surgical site infections. In the absence of analytical tools, few studies exist on intraoperative nursing-related aseptic practices. This study introduces recommendations to assess the role of the circulating nurse in aseptic practices. The authors used international recommendations and research findings to construct a 20-item self-report instrument with a demonstrated reliability across the scale. The authors structured the scale based on three phases: establishment; maintenance; and disestablishment of a sterile operating field. The tool was tested among operating theatre and day surgery nurses, and compared the differences in the mean acceptance rates of aseptic practice recommendations based on background characteristics. College-level nurses and nurses with 15 or more years' work experience accepted the recommendations at higher levels than bachelor-level nurses and nurses with less work experience. Continual assessment of the evidence base and comprehensive evaluation represent important components in further developing the tool. A reasonable number of items covering clinical practice are necessary for assessing the effectiveness and cost-effectiveness of aseptic practices, and a larger response rate is needed to validate the tool in future.
Hern, Marcia J; Vaughn, Gretchen; Mason, Debby; Weitkamp, Tina
In today's global workplace, both nursing practice and education need to promote international health. Nurses from a comprehensive 373-patient-bed hospital at Cincinnati Children's Hospital Medical Center and faculty from the College of Nursing, University of Cincinnati, in southwest Ohio have successfully collaborated to develop several unique international nursing exchange programs. The goals of these programs are to increase cultural sensitivity and nursing knowledge relevant to a global community. The essential components used in creating and implementing the programs with Scotland, Honduras, and Korea will serve as an international workplace model for others, especially for those settings focused on children and family health care.
Shirey, Maria R
Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.
Jeffers, Brenda Recchia; Robinson, Sherry; Luxner, Karla; Redding, Donna
Increasing use of evidence-based practice (EBP) within complex healthcare organizations requires the identification of individuals who will support and facilitate new practice patterns. In a large Midwestern hospital, a diverse group of academic nursing faculty functioning as mentors to develop clinical nurses' skills in the use of EBP has demonstrated early success. This article highlights the context, challenges, and successes of faculty mentors for developing nursing staff's involvement in and use of EBP.
Armstrong, Alan E
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.
Peirce, Anne Griswold; Smith, Jennifer A
Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.
Morrison-Sandberg, Leslie F; Kubik, Martha Y; Johnson, Karen E
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 obesity prevention programs, and school nurses' interest in implementing obesity prevention programs. Semistructured interviews were conducted with key informants from 21 Minnesota school districts (urban = 7; suburban = 8; and rural = 6), who were licensed school nurses (LSNs). Findings indicated that LSNs provided some primary and secondary obesity prevention services. Key informants felt school nurses, administrators, and parents would be supportive of school-based, LSN-led obesity prevention efforts. Interest in increasing efforts was limited by time constraints, staffing, and resources. School nurses are well positioned to provide prevention services that will contribute to reducing childhood obesity.
Mehrdad, Neda; Joolaee, Soodabeh; Joulaee, Azadeh; Bahrani, Naser
Background: Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators’ knowledge and attitude on EBP. Materials and Methods: This was a descriptive study conducted in nursing faculties of two major universities of medical sciences affiliated to Ministry of Health and Medical Sciences in Tehran, Iran. Data were gathered using a three-section questionnaire. Content and face validity was further enhanced by submitting it to nursing research and education experts. Statistical analysis was carried out using SPSS 11 software. Results: According the results, nursing faculties’ knowledge of EBP was mainly moderate (47.1%). Significant statistical relationship was found between the level of knowledge with education and teaching experience in different nursing programs. Nurses generally held positive attitudes toward EBP (88.6%) and there was no statistical significant relationship with demographic variables. Conclusion: Nursing educators are in a position to influence nursing research in clinical practice in the future. Therefore, it is critical to achieve implementation of EBP and be a change agent for a paradigm shift toward EBP. PMID:23922597
Guy, Jacqui; Taylor, Christine; Roden, Janet; Blundell, Jennifer; Tolhurst, Gerda
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.
Stringer, Marilyn; Rajeswaran, Lakshmi; Dithole, Kefalotse; Hoke, Linda; Mampane, Patricia; Sebopelo, Sheila; Molefe, Margret; Muecke, Marjorie A; Rich, Victoria L; Polomano, Rosemary C
To forge strong relationships among nurse scholars from the University of Pennsylvania School of Nursing, Philadelphia, PA (USA); University of Botswana School of Nursing, Gaborone, Botswana; the Hospital of the University of Pennsylvania, Philadelphia; Princess Marina Hospital (PMH), Gaborone; and the Ministry of Health of Botswana, a strategic global partnership was created to bridge nursing practice and education. This partnership focused on changing practice at PMH through the translation of new knowledge and evidence-based practice. Guided by the National Institutes of Health team science field guide, the conceptual implementation of this highly successful practice change initiative is described in detail, highlighting our strategies, challenges and continued collaboration for nurses to be leaders in improving health in Botswana.
In 1995, South Korea passed the Mental Health Act, and since this time it has developed many mental health policies and facilities. The aim of this study is to understand and explore the experience of nursing students in the changed psychiatric practice environment since 1995. The present study is a qualitative thematic analysis. Interviews were conducted with 11 third and fourth grade nursing students who had experienced psychiatric practice in South Korea. A thematic analysis of 11 in-depth student interviews identified three themes: 'orientation before psychiatric practice', 'facing the mental hospital', and 'change and choice'. After practicing, nursing students developed positive attitude regarding psychiatry. Educators will have to focus more on education and support in order for the students to maintain positive attitude throughout their experience. The research herein shows that the role of the educators and psychiatric nurses is extremely important for nursing students in the elimination of a negative attitude towards psychiatry.
Willis, Odette P.
This course outline provides information to be used by students in conjunction with Nursing 89, a seminar on the legal aspects of nursing to be offered starting in Spring 1982 at Diablo University (California). General information is provided first, including a class calendar, a statement defining the purpose of the course, an outline of…
Larsson, Laura S; Butterfield, Patricia
:Nurses are increasingly the primary contact for clients concerned about health problems related to their environment. In response to the need for nursing expertise in the field of environmental health, the Institute of Medicine (IOM), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute of Nursing Research (NINR) have designed core competencies for the nursing profession. The IOM competencies focus on four areas: (1) knowledge and concepts; (2) assessment and referral; advocacy, ethics, and risk communication; and (4) legislation and regulation. The competencies establish a baseline of knowledge and awareness in order for nurses to prevent and minimize health problems associated with exposure to environmental agents. To address the known difficulties of incorporating new priorities into established practice, nurses attending an environmental health short course participated in a nominal group process focusing on the question, "What specific actions can we take to bring environmental health into the mainstream of nursing practice?" This exercise was designed to bring the concepts of the national initiatives (IOM, NINR, ATSDR) to the awareness of individual nurses involved in the direct delivery of care. Results include 38 action items nurses identified as improving awareness and utilization of environmental health principles. The top five ideas were: (1) get environmental health listed as a requirement or competency in undergraduate nursing education; (2) improve working relationships with interdepartmental persons-a team approach; (3) strategically place students in essential organizations such as NIOSH, ATSDR, or CDC; (4) educate nurse educators; and (5) create environmental health awards in nursing. The 38 original ideas were also reorganized into a five-tiered conceptual model. The concepts of this model include: (1) developing partnerships; (2) strengthening publications; (3) enhancing continuing education; (4) updating nursing
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
Griffith, Richard; Tengnah, Cassam
The numbers of district nurse clinics are continuing to grow in primary care and they provide timely and more cost effective intervention for patients. The clinics provide exciting opportunities for district nurses but also carry an increased risk of exposure to liability. This article discusses some of the key areas of accountability underpinning the duty of care of district nurses working in nurse-led clinics.
DeBrew, Jacqueline Kayler
The American Association of Colleges of Nursing (AACN), which defines the expectations of a new baccalaureate-prepared nurse, includes a liberal education as a desired outcome for bachelor of science in nursing (BSN) graduates. A liberal education is thought to provide the professional nurse with the skills needed to practice nursing, including…
The remodelling of the NHS requires a strong general practice nurse (GPN) workforce within general practice. The challenges facing general practice nursing are set within the current policy context and recent available evidence and illustrated by drawing upon the experience of a current GPN working in London. It is argued that there is a need to support the professional development of GPNs and nurture the next generation of potential GPNs if the current shortage of GPNs is to be addressed. PMID:28356920
Jiang, Lin; He, Hong-Gu; Zhou, Wen-Guang; Shi, Su-Hua; Yin, Ting-Ting; Kong, Yue
The aim of this paper is to examine the relationships among nurses' knowledge of, attitudes towards and level of competence in nursing practice, as well as factors influencing nurses' competence in nursing practice, in typhoon disaster relief work. A cross-sectional descriptive study was conducted using a self-developed questionnaire to obtain data from 607 nurses working in four tertiary hospitals and two secondary hospitals in Fujian, China, in November 2011. Our findings show that the nurses' average percentage scores on their responses to questions in the domains of knowledge, attitudes and practice were 66.33%, 68.87% and 67.60%, respectively. The findings demonstrated a significant positive relationship between nurses' attitudes and their practice. Nurses' working unit, prior training in typhoon disaster relief, current position of employment and attitudes were significant predictors of nurses' competence in practice. The results indicate that strategies need to be developed for nurses to improve their knowledge, attitudes and practice.
This paper describes how an innocent venture outside the confines of academia to update my nursing skills completely changed the focus of my research. I was deeply involved in the theoretical development of my thesis, which I thought was a feminist exploration of the meaning of health for mid-life women. I was immersed in feminist theory and was exploring the work of the French Feminists. I had written comprehensive draft chapters about nursing, women's bodies and science. While I was absorbed in my theoretical exploration I decided to venture back into practice to improve my nursing skills. I am still unsure why I chose to do this; however, in hindsight, my theoretical exploration was inexorably pushing me in that direction. While my conscious thinking was focused on my stated topic, my subconscious (my intuition) turned me towards another. Being confronted with the reality of nursing practice through working with staff nurses in a gynaecological ward caused a major disjunction in every aspect of my research: the topic, my methodology and the setting, and the experience challenged my feelings about nurses and nursing. This inevitably led to a dramatic and fundamental change in my research.
Schäfer, Ursi Barandun; Hirsbrunner, Therese; Jäger, Susanne; Näf, Ernst; Römmich, Sabine; Horlacher, Kathrin
At the Solothurn Hospitals (soH), 13 academically educated nurses are responsible for the development of nursing care with the goal to improve patient-oriented, effective, appropriate, and economic care. The strategy contains three priorities: a) expert care of single patients in demanding situations, b) sustained application of organisational methods such as primary nursing, nursing process, and skill/grade mix, and c) design and management of practice development projects related to specific patient groups. A first evaluation with qualitative and quantitative methods showed that the exemplary care of single patients by expert nurses was evaluated as positive for the patients as well as for the teams on two wards by nurses who were interviewed. After the introduction of primary nursing, the application rate was 81 to 90 % and the introduction of fall prevention methods in geriatric rehabilitation decreased the fall rate from 8.2 to 5.5 per 1000 patient days. A comparision with the literature shows that the expert nurses of soH perform both, working at the bedside and being responsible for practice development projects, as specialised Advanced Practice Nurses (APNs). APNs at the Solothurn Hospitals work also as generalists when organisational methods need to be consolidated. Their successes depend from their integration into the hierarchy and both, into the nursing as well as into the interprofessional teams. Competencies in Transformational Leadership also are essential at all management levels.
Radzvin, Linda Clerici
Registered nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence of their decisions regarding ethical challenges, nurses report experiencing moral distress. This experience is often manifested by such feelings as anger, guilt, and sadness, and has been identified as a contributing factor to burnout and turnover in nursing. The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. A random sample of 800 CRNAs from the registry of the American Association of Nurse Anesthetists was selected to participate in this study. Participating nurses were asked to complete a demographic data survey and the Ethics Stress Scale. Three hundred surveys were analyzed for this study. The data supported the assumption that CRNAs do experience moral distress in their nursing practice. Although a small number of nurse anesthetists experienced high levels of moral distress, CRNAs generally experienced moderate levels of moral distress. Moral distress was associated with situations in which anesthetists believed they were aware of the morally correct course of action but were unable to follow through with these behaviors. Also, CRNAs reported physical and psychological manifestations in relation to moral distress.
Pickwell, S M
Relatively little data has been collected documenting the scope of family nurse practitioner (FNP) clinical practice, and virtually no research definitively describes the quality of that practice. Physicians have led the way in quantitative collection of practice content information. The resulting analyses have determined not only the most common diagnoses in primary care but also the content of teaching and research in family practice. Nurse clinicians, educators, and researchers have assumed this content to be pertinent to FNP practice as well. This article describes the major studies of family physician practice and the few studies of nurse practitioner/FNP practice, and advocates intensified review of FNP clinical content as an empirical basis for practice, education, and research.
Fairchild, Roseanne Moody
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.
Dellefield, Mary Ellen
Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described.
Lee, Jane A.; And Others
The study, conducted in 1971, assessed characteristics of licensed practical nurses (LPN's) who worked in occupational health nursing. The survey instrument, a questionnaire, was returned by 591 LPN's in occupational health and provided data related to: personal characteristics, work and setting, administrative and professional functioning,…
Billingsley, Luanne; Wyld, David
Radio frequency identification (RFID) technology can save nurses time, improve quality of care, en hance patient and staff safety, and decrease costs. However, without a better understanding of these systems and their benefits to patients and hospitals, nurses may be slower to recommend, implement, or adopt RFID technology into practice.
Christian nurses are challenged by the process of incorporating faith and Christianity into their career. Nurse educators are particularly challenged to embed Christian principles into the tenure and promotion journey. Developing a God-inspired plan takes time and patience. Prayer, reflective practice, evaluation, decisions, and follow-through are areas that can be incorporated to infuse faith throughout the tenure and promotion process.
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
The document is intended to serve as a tool for self-evaluation by educational programs, evaluation for accreditation by the National League for Nursing, and appraisal of plans for the development of new practical nursing programs. The statements, which are organized into criteria and related guidelines, cover the areas of philosophy and…
Berkram, Gelene Marie
This descriptive study identified demographic, organizational, and satisfaction data of faculty in nursing education programs in rural states who do and do not engage in faculty practice. Out of a total of 509 surveys which were sent to faculty from 35 nursing schools located in twelve rural states, 366 surveys were returned for a 72% response…
Clark, Jill Macleod; And Others
A study examined how student, teacher, and practitioner/manager perceptions of the philosophy and practice of nursing changed during the Project 2000 demonstration program, which marked a dramatic revision of the curriculum taught at colleges of nursing across England and Wales. Data were collected from the following: literature review;…
Richie, Mary Fern; And Others
Psychiatric nursing faculty practice offers the academic nurse opportunity to generate salary support and integrate students into the real world of mental health care. It promotes scholarship and knowledge-building and has a direct impact on the lives of patients. (Author/JOW)
Bucknall, T; Copnell, B; Shannon, K; McKinley, D
In the emergence of the evidence based practice movement, critical care nurses have struggled to identify scientific evidence on which to base their clinical practice. While the lack of critical care nursing research is a major concern, other important issues have significantly stalled the implementation of evidence even when it is available. A descriptive study of 274 critical care nurses was undertaken to examine nursing research activity in Victorian critical care units. The study aimed to identify critical care nurses' research skills, the barriers encountered in participation and implementation and the current availability of resources. Results revealed that 42 per cent of the nurses who participated in the study believed that they were not prepared adequately to evaluate research, and less than a third believed they were sufficiently skilled to conduct valid scientific studies. An association was found between nurses' ability to confidently perform research activities and higher academic qualifications. The study found that there is a lack of organisational support and management commitment for the development of evidence based nursing. In order to facilitate the implementation of evidence based practice, clinicians must be made aware of the available resources, be educated and mentored when carrying out and using clinical research, and be supported in professional initiatives that promote evidence based practice. It is argued that this will have positive implications for patient outcomes in the critical care environment.
Livsey, Kae R
This study examines the associations between professional behaviors of baccalaureate nursing students and student perceptions of select factors within the clinical learning environment, including the role of clinical faculty leadership. Participants (n=243) were recruited from a randomly selected list of 1000 members of the National Student Nurses Association (NSNA) among sixteen states within the Southern region of the United States. Results revealed a direct relationship exists between student perceptions of structural empowerment in their clinical learning environment and professional nursing practice behaviors among students. Also found was that relationships between variables in the model are significantly strengthened by student perceptions of strong leadership behaviors of clinical faculty. Findings from this study may assist nurse educators by contributing knowledge relevant to support/facilitate the transition of individuals from student nurses to professional registered nurses and, thus enhance the impact of professional nurses' contributions in healthcare delivery.
Bartz, Claudia; Coenen, Amy; Hong, Woi-Hyun
The International Council of Nurses (ICN) is a federation of 129 national nurses associations. The International Classification for Nursing Practice (ICNP) is a programme of the ICN. The purpose of this paper is to describe the development and maintenance processes of the ICNP Programme that are used to increase participation. These include processes by which the ICNP was and continues to be developed, tested, distributed and implemented worldwide, with emphasis on the current version, ICNP Version 1.0. The ICNP is a unified nursing language that facilitates cross-mapping among local terms and existing terminologies. ICNP conforms to current terminology standards and criteria, for example, ISO standards and HL7. The ICNP Alpha and Beta Versions documented the progress of concept validation and classification of nursing phenomena and interventions. The ICNP Beta 2 Version was a combinatorial terminology organized in two multi-axial structures representing nursing phenomena and nursing actions. The ICNP Version 1.0, launched in 2005, changed the relatively straight-forward multi-axial structure into a compositional terminology through the application of description logics using Web Ontology Language (OWL) within Protégé, an ontology development environment. ICNP Version 1.0 is also represented in a multiaxial model (7-Axis) for nurses to compose nursing diagnosis, intervention and outcome statements. Language translations and clinical information systems applications are required to make the ICNP Version 1.0 available to nurses at the point of healthcare delivery. ICNP data collected in healthcare environments provide standardized terminology for nursing that allows comparison of nursing practice across health care settings, specialties and countries; facilitate data-based clinical and management decision making; and contribute to the development of guidelines and standards for best practices and optimal outcomes for patients, families and communities.
Garrett, Bernie M; MacPhee, Maura
This paper provides readers with an overview of some contemporary issues associated with nursing regulation and scope of practice in Canada. Issues with the current organizational structure of nursing regulation and its impact on nursing advocacy in Canada are explored. An argument is presented that nursing regulation needs more consistency and collaboration in Canada. Several examples are used to illustrate this. Fragmentation of regulation is explored and regulatory disciplinary processes are examined in relation to some countries with similar professional structures. The impact of changes in the regulatory status of complementary and alternative health practitioners on nursing is also critiqued. We provide recommendations for future policy and practice to better pave the way for nursing scope and regulatory clarity.
Allen, Wesley N.
As wireless devices continue to increase in utility while decreasing in dimension, design of the RF front-end becomes more complex. It is common for a single handheld device to operate on a plethora of frequency bands, utilize multiple antennae, and be subjected to a variety of environments. One complexity in particular which arises from these factors is that of impedance mismatch. Recently, tunable impedance matching networks have begun to be implemented to address this problem. This dissertation presents the first in-depth study on the frequency tuning range of tunable impedance matching networks. Both the fundamental limitations of ideal networks as well as practical considerations for design and implementation are addressed. Specifically, distributed matching networks with a single tuning element are investigated for use with parallel resistor-capacitor and series resistor-inductor loads. Analytical formulas are developed to directly calculate the frequency tuning range TR of ideal topologies. The theoretical limit of TR for these topologies is presented and discussed. Additional formulas are developed which address limitations in transmission line characteristic impedance and varactor range. Equations to predict loss due to varactor quality factor are demonstrated and the ability of parasitics to both increase and decrease TR are shown. Measured results exemplify i) the potential to develop matching networks with a small impact from parasitics, ii) the need for accurate knowledge of parasitics when designing near transition points in optimal parameters, iii) the importance of using a transmission line with the right characteristic impedance, and iv) the ability to achieve extremely low loss at the design frequency with a lossy varactor under the right conditions (measured loss of -0.07 dB). In the area of application, tunable matching networks are designed and measured for mobile handset antennas, demonstrating up to a 3 dB improvement in power delivered to a
Bonnel, W B
Knowledgeable practitioners with the skills needed to serve in a variety of clinical settings are the primary objective of the Adult-Geriatric Advanced Nursing Program and the FNP elective, Advanced Practice Nursing Care of the Frail Elderly. The continued blending of long term and acute care settings will further cloud and challenge the school responsible for educating APNs in the care of older adults, particularly the frail elderly. Education needs to provide flexibility for students through new service designs such as interactive computer courses. Nurses with an orientation to the future should consider geriatric nursing education.
Clinical decisions and clinical judgements are important elements of nursing practice because they have a direct effect on patient care. A four-stage information processing framework was used to critique a decision to carry out chest examination and auscultation during the routine assessment of a child's asthma status. The use of this process demonstrates that nurses apply a combination of analytical and intuitive strategies when making decisions. Nurses who manage the care of patients in nurse-led clinics need to acquire advanced assessment skills to support their clinical decision making.
Thompson, J L
This discussion presents a critical appraisal of recent works in Advances in Nursing Science that have dealt with metatheoretical concerns. In metatheoretical analysis, such as that presented by Silva and Rothbart, nurses are beginning to focus on the traditions that have guided research. This process should be extended by reviewing historical stages of development in empiricist and postempiricist philosophy. Recent work in postempiricist philosophy is especially important since it can help nursing transcend historicist insights. Continental philosophy goes beyond historicist critique by focusing on practical discourse within a community of investigators. This is a stage of development that can be rationally decisive for the scientific development of nursing.
Thompson, Brent W
Handheld computers have the power to transform nursing care. The roots of this power are the shift to decentralization of communication, electronic health records, and nurses' greater need for information at the point of care. This article discusses the effects of handheld resources, calculators, databases, electronic health records, and communication devices on nursing practice. The US government has articulated the necessity of implementing the use of handheld computers in healthcare. Nurse administrators need to encourage and promote the diffusion of this technology, which can reduce costs and improve care.
Montgomery, Kathryn Lothschuetz
In today's society, health care systems are characterized by change, unpredictability, increasing speed of information and knowledge exchanges, redefined organizational boundaries and hierarchy, emphasis on value, teamwork, interdisciplinary collaboration, diversity, and interconnectedness. This new reality has forced nurse educators to redefine nursing leadership and prepare the Doctorate of Nursing Practice (DNP) leader through innovative courses offering experiential learning based on complex adaptive systems and quantum leadership theory. This article describes the experiential learning approach and integrated learning experience for DNP students.
Heartfield, Marie; Morello, Andrea; Harris, Melanie; Lawn, Sharon; Pols, Vincenza; Stapleton, Carolyn; Battersby, Malcolm
Practice nurses in Australia are now funded to facilitate chronic condition management, including self-management support. Chronic disease management requires an established rapport, support and proactivity between general practitioners, patients and the practice nurses. To achieve this, training in shared decision making is needed. e-Learning supports delivery and achievement of such policy outcomes, service improvements and skill development. However, e-learning effectiveness for health care professionals' is determined by several organisational, economic, pedagogical and individual factors, with positive e-learning experience linked closely to various supports. This paper reinforces previous studies showing nurses' expanding role across general practice teams and reports on some of the challenges of e-learning. Merely providing practice nurses with necessary information via web-based learning systems does not ensure successful learning or progress toward improving health outcomes for patients.
Foglesong, Dianne H.
Describes a problem-focused audit used to measure the impact of a staff development offering on pain relief. Concludes that the audit provided concrete evidence that the class on pain did influence nursing practice and affected patients directly. (NRJ)
Dickson, Geri L; Flynn, Linda
In this article, we describe the depth of knowledge and skill nurses used in making decisions regarding the safe processes and practices of medication administration. Using grounded theory, we identified the essence of medication safety by nurses as the theme of clinical reasoning. Nurses used two medication safety processes within the clinical reasoning theme-maintaining medication safety and managing the environment-together with six categories of patient-focused medication safety practices in the first process and four categories of environmental-focused safety practices within the second process. These processes and practices present an emerging model of safe medication administration developed from the narratives of 50 medical-surgical nurses. This model provides researchers with the basis for the development of systemic policies for safer medication administration for patients. Health care professional educators might also find the results useful in developing curricula focused on patient safety as the foundation of quality care.
Matumoto, Silvia; Fortuna, Cinira Magali; Kawata, Lauren Suemi; Mishima, Silvana Martins; Pereira, Maria José Bistafa
This study aims to present the re-signification process of the meanings of nurses' clinical practice in primary care from the perspective of extended clinic and permanent education. An intervention research was carried out with the approval of an ethics committee. Nine nurses participated in reflection groups from September to December 2008 in Ribeirão Preto-SP-Brazil. The redefinition process of the meanings proposed by the institutional analysis was mapped. The results point out that the nurses perceive differences in clinical work, by acknowledging the sense of user-centered clinical practice; daily limits and tensions and the need for support from managers and the team to deal with users' problems and situations. They identify the necessity to open space in the schedule to do that. It was concluded that nurses' clinical practice is being consolidated, and that collective analysis processes permit learning and the reconstruction of practices.
Ellis, Irene; Chater, Keri
The purpose of this paper is to explore and describe the process of transition that nurses experience when moving from the acute sector to a specialist area of community nursing. Issues explored include the increased movement of nurses into the community sector, the experience of culture shock and changes in nursing roles. Transition issues including the need for effective management and infrastructure support, mentoring and preceptorship, skills acquisition and continuing education will be examined. Joint implementation of what is successful at both university and industry levels can improve the transition to community nursing.
Lee, Hyun Jung
Objectives This study is to cross-map telephone nursing consultation documentations with International Classification for Nursing Practice (ICNP; ver. 1.0 concepts). Methods The narrative telephone nursing consultation documentations of 170 ophthalmology nursing unit patients were analyzed. The nursing statements were examined and cross-mapped with the Korean version of the ICNP ver. 1.0. If all the concepts of a statement were mapped to ICNP concepts, it was classified as 'completely mapped'. If any concept of a statement wasnot mapped, it was classified as 'partially mapped'. If none of the concepts were mapped, it was classified as 'not mapped'. Results A total of 738 statements wereused for documenting telephone nursing consultations. These statements were divided into 3 groups according to their content: 1) 294 nursing phenomena-related statements (72 unique statements), 2) 440 nursing actions-related statements (76 unique statements), and 3) 4 other statements (2 unique statements). In total, 189 unique nursing concepts extracted from 150 unique statements and 108 concepts (62.44%) were mapped onto ICNP concepts. Conclusions This study demonstrated the feasibility of computerizing narrative nursing documentations for electronic telephone triagein the ophthalmology nursing unit. PMID:21818446
The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments.
Coombs, Maureen A; Moorse, Sue E
This paper proposes that the current use of physical assessment skills within critical care nursing practice is part of a on-going nursing role development process. A review of the critical care nursing role highlights how nurses in this setting have always been responsive to patient management needs. In exploring one recent nursing role development, the critical care outreach nurse, it is suggested that enhanced assessment skills enable these practitioners to safely and competently assess critically ill patients out of the intensive care environment. The use of patient case studies in this paper, demonstrate how the theory of a more intensive physical assessment knowledge base can be applied in the everyday practice of an critical care outreach nurse. Through such systematic patient review, patient management plans can be agreed and ward based practitioners can be supported in the on-going treatment of sick ward patients. The use of the cases presented also highlights the complexity of the outreach nurse's practice in addressing clinical management and team management issues.
Porr, Caroline J
This Clinical Concepts article concerns the relational tools required by public health nurses to establish relationships with single mothers living on public assistance, mothers who are vulnerable and often stigmatized. The implications of stigmatization for relationship building are highlighted based on previous research investigating how public health nurses working in Canadian jurisdictions establish professional caring relationships with this cohort of mothers. Public health nurses employed interactional strategies including engaging in a positive manner and offering verbal commendations which served as effective relational tools to break through mothers' walls of defensiveness and to resume the dynamic process of relationship building. Building Relationship is a key practice standard for public health nurses and is instrumental to their work at both individual and community levels to improve social determinants of health. The author concludes with recommendations to facilitate building relationships during everyday public health nursing practice.
Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik
Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563
Care, Wm. Dean
A study identified characteristics and motivating factors that influenced licensed practical nurses (LPNs) to participate in a registered nursing (RN) upgrading program at a hospital in western Canada. A literature review considered the concepts of motivation, participation, adult learning, and life transitions and explored a variety of models and…
Ramsbottom R.; Kinch, R. F. T.; Morris, M. G.; Dennis, A. M.
The collection of primary data in laboratory classes enhances undergraduate practical and critical thinking skills. The present article describes the use of a lecture program, running in parallel with a series of linked practical classes, that emphasizes classical or standard concepts in exercise physiology. The academic and practical program ran…
McCloskey, Joanne Comi; Donahue, William; Bulechek, Gloria M.
The identification of nursing interventions that are core to each clinical specialty will be useful in the development of nursing information systems, staff education programs and evaluations, referral networks, certification and licensing examinations, curricula, and research and theory construction. (Author/JOW)
Benoliel, Jeanne Quint
The fact that ethics has become important to nurses is a reflection of two types of developments: (1) rapid expansion and application of biomedical technology, and (2) the human rights movement. Therefore, nursing involves an increasing number of activities with both moral and technical implications. (SSH)
Williams, Marjory; Avolio, Alice E; Ott, Karen M; Miltner, Rebecca S
The Office of Nursing Services of the Department of Veterans Affairs (VA) piloted implementation of the clinical nurse leader (CNL) into the care delivery model and established a strategic goal in 2011 to implement the CNL role across the VA health care system. The VA Office of Nursing Services CNL Implementation and Evaluation (CNL I&E) Service was created as one mechanism to facilitate that goal in response to a need identified by facility nurse executives for consultative support for CNL practice integration. This article discusses strategies employed by the CNL I&E consultative team to help facility-level nursing leadership integrate CNLs into practice. Measures of success include steady growth in CNL practice capacity as well as positive feedback from nurse executives about the value of consultative engagement. Future steps to better integrate CNL practice into the VA include consolidation of lessons learned, collaboration to strengthen the evidence base for CNL practice, and further exploration of the transformational potential of CNL practice across the care continuum.
Thomas-Hawkins, Charlotte; Flynn, Linda; Lindgren, Teri G; Weaver, Susan
Little is known regarding the specific managerial activities or best practices that nurse managers in outpatient hemodialysis settings use to achieve positive safety outcomes. The purpose of this study was to identify and describe specific managerial practices used by nurse managers in outpatient hemodialysis units to enhance patient safety and quality of care. A descriptive qualitative design was used. Seventeen nurse managers in outpatient hemodialysis units comprised the study sample. Telephone interviews were conducted, and qualitative content analysis was used to encode the data. Nurse managers identified patients, staff, the dialysis unit environment, and the dialysis organization as sources of safety risks. Nurse manager safety practices illuminated from the data were complex and multifaceted, and were aimed at reducing patient, staff environmental, and organization risks. The findings from this study offer a description and a better understanding of the practices in which nurse managers in outpatient hemodialysis units engage to keep patients safe in their units, and they underscore the critical role of nurse managers in creating and maintaining patient safety within outpatient hemodialysis settings.
Ukhorskiy, Aleksandr Y.; Mauk, Barry H.; Fox, Nicola J.; Sibeck, David G.; Grebowsky, Joseph M.
The fundamental processes that energize, transport, and cause the loss of charged particles operate throughout the universe at locations as diverse as magnetized planets, the solar wind, our Sun, and other stars. The same processes operate within our immediate environment, the Earth's radiation belts. The Radiation Belt Storm Probes (RBSP) mission will provide coordinated two-spacecraft observations to obtain understanding of these fundamental processes controlling the dynamic variability of the near-Earth radiation environment. In this paper we discuss some of the profound mysteries of the radiation belt physics that will be addressed by RBSP and briefly describe the mission and its goals.
Palmer, Deborah; El Miedany, Yasser
The extensive use of biological agents in recent years for the treatment of rheumatological diseases has required a steep learning curve for the specialist nurses who manage and work in this specialty. Safe prescribing of biological therapies requires good infrastructure and specialist nursing personnel. With additional training, the specialist nurse may take responsibility for a number of tasks in the patient pathway including screening, treatment administration, patient education, prescription coordination for home drug delivery, patient support, monitoring and data collection. Biological treatment is becoming more widely used in several specialities, in particular gastroenterology, dermatology and ophthalmology. Since 2002, rheumatology specialist nurses have taken the lead in assessment and providing biologic therapy, not only for patients suffering from rheumatic diseases but also for those with immune-mediated inflammatory disorders. The unique nature and variable safety profiles of these agents led to the development of immune-mediated inflammatory disease infusion (IMID) centres and highlighted the importance of having biological specialist nurses. This article will discuss the evolution of the IMID/biologic specialist nurse role and how IMID services started with goodwill from the rheumatology nurse specialists to develop into a main component of the holistic approach to care.
Bechtel, G A; Davidhizar, R; Tiller, C M; Quinn, M E
Health care reform, innovations in technology, and the need to make health care cost-effective have affected all aspects of health care practice and education. Critical thinking skills, interpersonal and communication skills, leadership and motivation skills, computer literacy, and cultural sensitivity are all capabilities nursing graduates must now possess if they are to practice effectively in the complex and competitive contexts that today define the health care marketplace. Partnerships with community agencies are essential if faculty are to prepare a new generation of nurses who will be proficient in the skills that 21st-century nursing practice will demand. Although academic institutions have made some changes to meet marketplace demands, nursing educators, practitioners, and researchers must thoroughly reconceptualize their philosophies and retool their curricula in response to these changes.
Romero Ruiz, Adolfo; Parrado Borrego, Gema; Rodríguez González, José; Caparrós Miranda, Isabel S; Vargas Lirio, M Isabel; Ortiz Fernández, Primitiva
There is currently around one million people receiving oral anticoagulants in Spain. The drug most used is acenocoumarol, which requires coagulation monitoring to ensure that the patient is within its normal therapeutic range. Patients usually start this treatment in a hospital clinic and, when they are stabilised, they are referred to primary care, where they are followed-up by their community nurses. The usual practice is that nurses are responsible for changes in the dose when the patients are outside the range. This practice is not performed by hospital nurses, despite having sufficient experience and knowledge to adequately manage these types of patients. An Advanced Nursing Practice model has been introduced into the Haematology management unit of the Hospital Universitario Virgen de la Victoria, Málaga. This involves various aspects of attention and care of patients on anticoagulant therapy, and includes adjusting the doses of their treatment following a catalogue of therapeutic and diagnostic ranges.
Morrall, Peter; Goodman, Benny
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.
Hitchings, Kim S; Capuano, Terry Ann; Herzog, Mary Ellen
More than 25 years ago, the name "Friends of Nursing" was adopted by an academic, community Magnet(®) hospital to signify a model for community support of nursing. From inception, the intent was to recruit philanthropic dollars to promote recognition of and excellence in nursing practice, education, and research. Although philanthropy in health care settings is common, what is unique about this program is the long-standing, dedicated conceptual framework for nursing philanthropy and the very significant number of philanthropic dollars from literally thousands of donors to support a diverse range of activities to affect and advance the professional excellence of nurses and the quality of patient care. This model has been successfully replicated within a wide variety of other health care organizations and nursing services throughout the United States and abroad.
Freed, Patricia E; McLaughlin, Dorcas E
Contemporary nursing education is highly invested in the development of the academic, critical, and empirical aspects of education that represent the science of nursing, and concomitantly less attentive to the development of the creative, interpersonal aspects of education typically associated with the art of nursing. This represents a reversal of historic patterns in nursing education, but the pendulum may have swung so far that there could be costs to nursing practice unless the creative, interpersonal aspects of education can be reclaimed and balanced. Ideas and suggestions regarding how nurse educators might foster the creation of cultures of thinking, which represent whole-brain, integrated teaching approaches that are based on emerging neurocognitive evidence, are discussed.
Jamieson, Isabel; Taua, Chris
Many nurses leave nursing and never return. Others return after a period of time. Given the global shortage of nurses a better understanding of these movements is needed. The present study focused on nurses who had been out of nursing for more than five years, and explored factors that influenced their leaving and return to practice. All the nurses who had undertaken a Competency Assessment Programme at a given New Zealand tertiary institution during 2005 were invited to participate. Of the 70 questionnaires mailed out 32 (44.5%) were completed and returned. Quantitative data were analysed using Microsoft Excel, and the qualitative data were coded and analysed by means of content analysis. For each, leaving and returning, three key issues emerged. Nurses left for personal reasons, to seek a career change, or because of poor working conditions. They returned when they had the personal freedom to do so, for fiscal reasons, or because they were motivated by some sense of unfinished business. These findings indicate that it is important for educators involved with Competency Assessment Programmes to collaborate with employers in ensuring that there are opportunities for re-entry to positive work environments, with a degree of flexibility that suits the demographic characteristics of those nurses returning to practice.
Amaducci, Giovanna; Iemmi, Marina; Prandi, Marzia; Saffioti, Angelina; Carpanoni, Marika; Mecugni, Daniela
Many faculty argue that theory and theorizing are closely related to the clinical practice, that the disciplinary knowledge grows, more relevantly, from the specific care context in which it takes place and, moreover, that knowledge does not proceed only by the application of general principles of the grand theories to specific cases. Every nurse, in fact, have a mental model, of what may or may not be aware, that motivate and substantiate every action and choice of career. The study describes what the nursing theoretical model is; the mental model and the tacit knowledge underlying it. It identifies the explicit theoretical model of the professional group that rapresents nursing partecipants, aspects of continuity with the theoretical model proposed by this degree course in Nursing.. Methods Four focus groups were made which were attended by a total of 22 nurses, rapresentatives of almost every Unit of Reggio Emilia Hospital's. We argue that the theoretical nursing model of each professional group is the result of tacit knowledge, which help to define the personal mental model, and the theoretical model, which explicitly underlying theoretical content learned applied consciously and reverted to / from nursing practice. Reasoning on the use of theory in practice has allowed us to give visibility to a theoretical model explicitly nursing authentically oriented to the needs of the person, in all its complexity in specific contexts.
Buckley, Thomas; Donoghue, Judith; Heartfield, Marie; Bryce, Julianne; Cox, Darlene; Waters, Donna; Gosby, Helen; Kelly, John; Dunn, Sandra V.
This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards. Nonetheless, they invariably agreed that the standards should be clinically focussed attributes. The pillars common in many advanced practice nursing standards, such as practice, research, education, and leadership, were combined and expressed in a new and unique clinical attribute. PMID:26162455
Lima, Rogério Silva; Lourenço, Eliana Bernardes; Rosado, Sara Rodrigues; Fava, Silvana Maria Coelho Leite; Sanches, Roberta Seron; Dázio, Eliza Maria Rezende
Objective To understand the meanings that nursing staff gives to nurse's managerial practice in the inpatient unit. Methods This is an exploratory and descriptive research with qualitative approach, conducted in a general hospital in a Southern city of Minas Gerais State. We used the Theory of Social Representations as theoretical framework. The study sample were composed by 23 nursing technicians and five nursing assistants. Data collection was conducted through semi-structured interviews, from December 2011 to January 2012. For data analysis we used the discourse analysis, according to social psychology framework. Results The meanings attributed to management occurred from the closeness/distance to staff and to patients` care actions. Conclusions The managerial nurse, perceived as a process apart from care, is classified as non familiar practice, of hard understanding and valuation.
Paré, Guy; Sicotte, Claude; Moreault, Marie-Pierre; Poba-Nzaou, Placide; Nahas, Georgette; Templier, Mathieu
We investigated the effects of the introduction of mobile computing on the quality of home care nursing practice in Québec. The software, which structured and organized the nursing activities in patients' homes, was installed sequentially in nine community health centres. The completeness of the nursing notes was compared in 77 paper records (pre-implementation) and 73 electronic records (post-implementation). Overall, the introduction of the software was associated with an improvement in the completeness of the nursing notes. All 137 nurse users were asked to complete a structured questionnaire. A total of 101 completed questionnaires were returned (74% response rate). Overall, the nurses reported a very high level of satisfaction with the quality of clinical information collected. A total of 57 semi-structured interviews were conducted and most nurses believed that the new software represented a user-friendly tool with a clear and understandable structure. A postal questionnaire was sent to approximately 1240 patients. A total of 223 patients returned the questionnaire (approximately 18% response rate). Overall, patients felt that the use of mobile computing during home visits allowed nurses to manage their health condition better and, hence, provide superior care services. The use of mobile computing had positive and significant effects on the quality of care provided by home nurses.
Talbert, Tukea L
The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders.
Seed, Mary S; Torkelson, Diane J; Karshmer, Judith F
The national movement to transform the health care delivery systems must include a focus on mental health treatment. To address similar deficits across other practice domains, the Clinical Nurse Leader (CNL) role has been created. The CNL is a master's degree that prepares a nurse to use a systems perspective to improve outcomes for a cohort of patient, deliver care based on best practices, and coordinate care in a multidisciplinary team. Applying the CNL role to mental health care could help psychiatric mental health nursing be at the forefront in the transformation of mental health care delivery.
Højskov, Ida E; Glasdam, Stinne
The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired by Ricoeur was conducted and consisted of five taped admission interviews, along with the written patient documentation subsequently worked out by the nurse. The findings were presented in four constructed themes: Admission interviews are the nurse's room rather than the patient's; Information on a surgical object; The insignificant but necessary contact; and Abnormalities must be medicated. It is shown how the nurse's documentation was based on the admission interview, the medical record details on the patient (facts that are essential to know in relation to disease and treatment), as well as the nurse's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool that enables her to document what is important to the individual patient and his special circumstances and encounter with the health system.
Tennessee State Board for Vocational Education, Murfreesboro. Vocational Curriculum Lab.
THE LESSON PLANS FOR A UNIT ON MENTAL NURSING IN THE PRACTICAL NURSE EDUCATION PROGRAM WERE DEVELOPED BY A GROUP OF REGISTERED NURSES HOLDING TENNESSEE TEACHING CERTIFICATES. STUDENTS SELECTED FOR THE PROGRAM SHOULD BE HIGH SCHOOL GRADUATES OR EQUIVALENT. THE LESSONS DESIGNED FOR USE BY A REGISTERED NURSE CERTIFIED FOR TEACHING GIVE OBJECTIVES,…
How many times have we read a report or piece of research that suggests nurses could be taking on more of the work currently performed by doctors? It is invariably accompanied by figures suggesting that the NHS would save squillions of pounds every year if only consultants and GPs let nurses take on more responsibilities. Not only that, but access to services would improve and outcomes would be unaffected or might even be enhanced.
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.
Rudolfsson, Gudrun; von Post, Iréne; Eriksson, Katie
This article is a synthesis of 2 qualitative studies focusing on patients', anesthetists', and operating-room nurses' experiences of the perioperative dialogue and employing grounded theory as the method of analysis. The aim of the synthesis was to achieve a new holistic understanding of health in the perioperative dialogue. The synthesis highlights the importance of being in communion in a continuous whole due to continuity of care for the creation of health in both patients and nurses.
Callister, Lynn Clark; Matsumura, Gerry; Lookinland, Sandra; Mangum, Sandra; Loucks, Carol
With the increasing emphasis on evidence-based nursing practice, nurse educators need to more fully implement teaching strategies that help students gain critical thinking skills related to inquiry and understand the importance of evidence-based nursing practice. Research and scholarship emphases in one baccalaureate nursing program, student-identified benefits, and challenges associated with incorporating inquiry across the curriculum are described in this article. In clinical journal entries, students described the following benefits associated with curricular emphasis on inquiry: increased interest in evidence-based nursing practice and participating in the generation of research; enhanced critical thinking skills through the development of knowledge, experience, and competencies; increased motivation to continue professional growth and development by participating in lifelong learning; the desire to become better consumers of research findings; better understanding of the "real world" of clinical research; and increased desire to pursue graduate studies in nursing. The challenge to promote student growth toward competence in the application of evidence-based principles in clinical practice is ongoing.
Staggers, N; Gassert, C A; Curran, C
Valid and comprehensive nursing informatics (NI) competencies currently are lacking. Meanwhile, nursing leaders are emphasizing the need to include NI in nursing curricula, as well as within the roles of practicing nurses in all settings. This article presents the initial work of a team of NI experts toward development of a valid and reliable set of NI competencies. Previous work primarily has focused on computer-related skills, rather than examining a broad definition of informatics competencies. For this current work, NI competencies encompass all skills, not only computer-related skills, as well as knowledge and attitudes needed by nurses. The first two authors created a database of NI competencies from the existing literature. A larger panel of NI experts then affirmed, modified, added, or deleted competencies from this database. Competencies were placed into four distinct skill levels. Definitions of each skill level and an initial master list of competencies are provided.
Professional empowerment is vital to nurses' productivity and job satisfaction. A grounded theory study was conducted to describe the basic social process experienced by school nurses in relation to professional empowerment. Interviews with 10 school nurses led to the development of a situation-specific theory of school nurse empowerment, Making a Difference: The Role of the School Nurse in the Health of Children in Schools. This theory was derived from four theoretical constructs: (a) enlisting support, (b) getting through the day, (c) maintaining control over practice, and (d) adjusting to challenges. Interviews revealed that knowing at the end of each school day that they made a difference in the health of children resulted in feelings of empowerment. Participants cited various areas in which their sense of empowerment was limited, including salaries and workload. Despite these issues, they believed they had a positive impact on the health of children, leading to job satisfaction and feelings of value.
Beam, Rita J; O'Brien, Ruth A; Neal, Michelle
Reflective practice is defined as a cyclical process involving a series of phases in which an individual describes a salient event, attends to his/her positive and negative feelings about the event, and ultimately reexamines the experience in an effort to understand and to plan how he or she would act in a similar situation in the future. This paper describes how the concept of reflective practice is integrated into the evidence-based Nurse-Family Partnership (NFP) program. The pivotal role of the nursing supervisor in guiding nurses to engage in reflection on their work with families is emphasized. Exemplars drawn from the experience of 2 NFP nursing supervisors are presented to illustrate how reflection in the NFP program is operationalized. The benefits as well as the challenges to the use of reflective practice are also discussed. While anecdotal comments from NFP nurses and supervisors are cited to suggest how the regular use of reflective practice has the potential to improve implementation of the program with families, the authors further propose that research is needed to more rigorously examine the benefits that reflective practice may have on the quality of program implementation, family outcomes, and the retention of nurses working in the NFP program.
Reed, P G
Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice-based theory, as well as nursing theory-based practice.
Bell, Sue Ellen; Hulbert, James R
Translating social justice into clinical nurse specialist (CNS) practice involves not only facilitating equitable access to healthcare resources but also changing the definition of health from individual centric to population based. Clinical nurse specialists working within hospitals or healthcare systems generally have not explored the ethical conflicts between demand and available healthcare resources. Application of social justice to CNS practice requires microallocation decisions in direct patient care and macroallocation decisions in the distribution of all societal goods that alleviate health disparities. This article reviews the meaning, history, and current basis for the application of the principle of social justice to CNS practice.
Cost-effective nursing practice is essential to succeed today as resources allocated to health care are declining. Realizing that any change poses a threat to our security, it is imperative that stakeholders be permitted to participate in decision-making processes affecting their work. An honest, open exchange of ideas towards cost-effective practices should be encouraged. Cost-effective behaviours are influenced significantly by negative attitudes with regard to loss of human resources, increased workload, and potential pay cuts. This article describes innovative strategies which could promote successful cost-effective nursing practice, including working smarter, not working harder. Topics addressed are attitude, awareness and empowerment.
Hammad, Sawsam Mohammad; Al-Hussami, Mahmoud; Darawad, Muhammad Waleed
In Jordan, there is a gap in literature regarding nurses' practices of enteral nutrition. Thus, the purpose of this study was to assess nurses' practices regarding enteral nutrition of critically ill adult patients. A descriptive, cross-sectional design was used to collect data through self-reported questionnaires and descriptive analyses were used to display the results of the study. The results revealed that some aspects of enteral nutrition practices were consistent with the current best evidences such as initiation time of enteral nutrition and backrest elevation. On the contrary, some aspects showed variations and inconsistency with current best evidences such as the amount of high gastric residual volume and its management. Nurses' practices regarding enteral nutrition were not consistent with international guidelines. This inconsistency can predispose patients to underfeeding. Enhancement of research utilization is highly recommended as well as establishing evidence-based guidelines.
Allan, H T; Smith, P
This paper considers two questions: what pedagogies for teaching nursing are used in nurse education research? Are these pedagogies transferred to learning in the workplace? We argue that there are underpinning pedagogies identified in nurse education research in the area of workplace and work based learning which are broadly qualitative, action orientated and focused on knowledge generation. Such pedagogies are rooted in a philosophy of teaching and learning where learning is seen as active, reflective and socially constructed. We consider possible answers to these questions through an exploration of empirical work by Evans et al. (2009) which has focused on knowledge transfer in the workplace. Their work offers insights into how pedagogies can be applied to nurse education research which in turn may be transferred into the workplace. In particular, they argue that the concept of knowledge transfer is outdated and we should focus instead on how knowledge learnt in one context (the academy) is re-contextualised in another (the workplace). We also draw on Aranda and Law's (2007) paper on the debates concerning the use of sociology in nurse education to explore competing narratives. We conclude that the pedagogies identified in educational research are not transferred to nurse education and practice yet offer an alternative view of knowledge transfer as illustrated by Evans et al.'s work which explores how learning in the workplace may be facilitated more effectively. We conclude that the lack of transfer of nurse education research pedagogies to practice learning undermines the position of nurse teachers within the academy as nurse education becomes a practice or professional discipline without a discrete disciplinary base.
Coetzee, Siedine Knobloch; Klopper, Hester C
"Compassion fatigue" was first introduced in relation to the study of burnout among nurses, but it was never defined within this context; it has since been adopted as a synonym for secondary traumatic stress disorder, which is far removed from the original meaning of the term. The aim of the study was to define compassion fatigue within nursing practice. The method that was used in this article was concept analysis. The findings revealed several categories of compassion fatigue: risk factors, causes, process, and manifestations. The characteristics of each of these categories are specified and a connotative (theoretical) definition, model case, additional cases, empirical indicators, and a denotative (operational) definition are provided. Compassion fatigue progresses from a state of compassion discomfort to compassion stress and, finally, to compassion fatigue, which if not effaced in its early stages of compassion discomfort or compassion stress, can permanently alter the compassionate ability of the nurse. Recommendations for nursing practice, education, and research are discussed.
Sebastian, Juliann G; White Delaney, Connie
This article examines development opportunities for faculty teaching in Doctor of Nursing Practice (DNP) programs. Although faculty development for DNP programs is similar to that of other academic programs, faculty may need different strategies for teaching, scholarship, and service because DNP programs focus on translation of science into practice, systems-level changes, clinical scholarship, and the highest levels of advanced nursing practice. Faculty and student collaboration across DNP and PhD programs provide new approaches for translating research into practice and generating practice questions in need of further scientific development. Specific faculty development strategies for facilitating this collaboration are essential. Capstone projects pose special opportunities for faculty development due to the integration of these projects within diverse practice environments, with differing expectations, regulations, and pacing compared with research. Linking new care delivery models with health informatics is expected to facilitate rapid translation of research and development of improvements in practice.
Ritter, J; Fralic, M F; Tonges, M C; McCormac, M
Changes within the health care system necessitate changes in nursing practice. Given the financial environment and the need to balance the cost/quality equation, case management will become increasingly important and has the potential to become the predominant care delivery system of the 1990s. This transition represents a tremendous opportunity for nursing. The CCM role offers many potential advantages and benefits for individual nurses and the profession as a whole. Nurses practicing as case managers have the opportunity to function in a highly professional, independent manner with a great deal of interdisciplinary collaboration. In addition to the challenges and satisfactions of the work itself, the nurse case manager may also enjoy a higher salary and more scheduling control and flexibility. The broader advantages of case management include its benefits to patients and institutions and its fit with current trends in the health care environment. Nurse case managers manage hospital systems to produce optimal clinical outcomes for patients in the shortest time using as few resources as possible. This approach to care delivery places nurses in a position to demonstrate the tremendous contribution they can make to achieving the institution's goal of delivering high-quality, cost-effective care. Thus, case management fits extremely well with current trends in health care financing and outcome measurement. The model described in this article illustrates one approach to implementing these important concepts in a critical care setting.
Vought-O'Sullivan, Victoria; Meehan, Nancy K; Havice, Pamela A; Pruitt, Rosanne H
Competency-based continuing education is critical to the professional development of school nurses to ensure the application of timely, age-appropriate clinical knowledge and leadership skills in the school setting. School nurses are responsible for a large number of students with a variety of complex and diverse health care needs. Benner's theory of novice to expert provides a framework for the development of roles and competencies in the practice of school nursing. This manuscript synthesizes research reviewed in 15 articles. Common themes found in the articles include the importance of continuing education and identified barriers to attainment. In response, methods to access continuing education and financial resources are presented.
Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim
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.
Fressancourt, Yves; Quémeneur, Éric; Bertho, Kilian; Dubourg, Olivier
Intervening in the event of a major crisis in France and abroad, the national gendarmerie intervention group carries out complex and specific operations in varied conditions and environments. Due to the multiplicity and dangerousness of the missions, adapted and integrated medical support is essential. In this context, nurses provide operational medical assistance as close as possible to the intervention. This nursing practice in an exceptional environment requires specific knowledge and intensive training.
Reilly, Christine E; McDanel, Heather
1. Mental health needs exist in medically underserved areas and can be addressed in nurse-managed, community-based health centers. 2. Cognitive therapy techniques can be used in community-based health centers to intervene and alleviate patients' distress and improve their adherence to treatment. 3. A training program in cognitive therapy can help advanced practice nurses and other health care providers implement the techniques needed to address many behavioral and mental health problems.
Lyons, Stacie Salsbury; Specht, Janet Pringle; Karlman, Susan E.
Registered nurses make measurable contributions to the health and wellness of persons living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively impact resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based upon eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness of this framework for professional nursing practice. PMID:20077966
Rockett, Hannah; Thompson, Hilaire J; Blissitt, Patricia A
Current evidence shows that fever and hyperthermia are especially detrimental to patients with neurologic injury, leading to higher rates of mortality, greater disability, and longer lengths of stay. Although clinical practice guidelines exist for ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury, they lack specificity in their recommendations for fever management, making it difficult to formulate appropriate protocols for care. Using survey methods, the aims of this study were to (a) describe how nursing practices for fever management in this population have changed over the last several years, (b) assess if institutional protocols and nursing judgment follow published national guidelines for fever management in neuroscience patients, and (c) explore whether nurse or institutional characteristics influence decision making. Compared with the previous survey administered in 2007, there was a small increase (8%) in respondents reporting having an institutional fever protocol specific to neurologic patients. Temperatures to initiate treatment either based on protocols or nurse determination did not change from the previous survey. However, nurses with specialty certification and/or working in settings with institutional awards (e.g., Magnet status or Stroke Center Designation) initiated therapy at a lower temperature. Oral acetaminophen continues to be the primary choice for fever management, followed by ice packs and fans. This study encourages the development of a stepwise approach to neuro-specific protocols for fever management. Furthermore, it shows the continuing need to promote further education and specialty training among nurses and encourage collaboration with physicians to establish best practices.
Gale, J; Marshall-Lucette, S
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.
LeFlore, Judy L.; Thomas, Patricia E.
Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system. PMID:27465446
Marucci, Anna Rita; De Caro, Walter; Petrucci, Cristina; Lancia, Loreto; Sansoni, Julita
ICNP is a standardized nursing terminology included within acknowledged terminologies by WHO, it is a relevant aspect of ICN programs and strategies. This paper aims to describe structure and characteristics of ICNP terminology as well as to highlight how this tool can be useful both in practice and in terms of nursing professional development. This version looks like a pyramid with seven axes describing different areas of nursing and related interventions, enriched by two special axes related to pre-coordinated Diagnosis / Outcomes (DC) and Operations (IC) which facilitate daily use in practice. In order to clarify how this tool can be actually be used in daily nursing practice some examples are provided, clarifying how adopting the current version of ICNP terminology (2015 release) Diagnosis/Outcomes and Interventions can be built. The ICNP Italian Centre is committed to introduce it to Italian nurses as a tool for sharing and disseminating terminology in our Country, having as main final aim to achieve even in Italy, professional visibility objectives promoted in different ways by the International Council of Nurses.
Miller, Louise C; Devaney, Susan W; Kelly, Glenda L; Kuehn, Alice F
Attrition in the public health nursing work force combined with a lack of faculty to teach public health prompted development of a "long-distance" learning project. Practicing associate degree nurses enrolled in an online course in population-based practice worked with experienced public health nurse "e-mentors." Student-mentor pairs worked through course assignments, shared public health nursing experiences, and problem-solved real-time public health issues. Nursing faculty served as coordinators for student learning and mentor support. Over 3 years, 38 student-mentor pairs participated in the project. Students reported they valued the expertise and guidance of their mentors. Likewise, mentors gained confidence in their practice and abilities to mentor. Issues related to distance learning and e-mentoring centered around use of technology and adequate time to communicate with one another. E-mentoring is a viable strategy to connect nurses to a learning, sharing environment while crossing the barriers of distance, agency isolation, and busy schedules.
Shirey, Maria R
Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action.
Purposeful reflection is consistent with adult learning theory. It is known to lead to a deeper understanding of issues and to develop judgment and skill. Required by law to ensure members' competence in their professional practice, the College of Nurses of Ontario recommends and has developed a tool for evaluating reflective practice. The tool focuses on key attributes said to be demonstrated by competent practitioners, including critical thinking (CT) and job knowledge. This study aimed to determine whether nurses engage in reflective practice and whether they perceive that it enhances their CT ability. Surveys were sent to 60 gastroenterology nurses at a large teaching hospital; 34 surveys were anonymously returned. All respondents engaged in reflective practice, and 24 reported using the college's tool. Nineteen respondents strongly agreed that their nursing practice had improved as a result. Critical thinking is difficult to assess because of a lack of clear-cut performance criteria. Improvement of CT was difficult to evaluate from the responses, even though all respondents participated in reflective practice. Both CT and reflective practice need to be better defined in order to examine and explain their relationship.
As the advanced practice nursing initiative in Canada gains momentum, effort is being directed towards clarifying and defining advanced practice roles. A qualitative study was undertaken to increase understanding of the clinical nurse specialist role of advanced practice. Sixteen nurses who worked in advanced practice roles, organizing and providing healthcare for children with complex health needs and their families across the continuum of care, participated in in-depth conversations about the nature of their practice, the knowledge that informs it and the factors that influence it. Findings suggest that clinical nurse specialists have a unique role in the organization and delivery of healthcare for specialized populations with complex health needs in their dual focus on the system level of healthcare and on population health needs. Initiatives directed to children and families within the study participants' specialties included program development, consultation and educational outreach and the development of clinical guidelines and policies. Although the nurses described their practice as focusing both on individual children and families and on the population of children and families within their specialty, it is at the population level that they see their greatest potential for contributing to the delivery of high-quality, cost-effective healthcare.
Rasoul Zadeh, Nasrin; Sadeghi Gandomani, Hamidreza; Delaram, Masoumeh; Parsa Yekta, Zohre
Background: Development of practical skills in the field of nursing education has remained a serious and considerable challenge in nursing education. Moreover, newly graduated nurses may have weak practical skills, which can be a threat to patients’ safety. Objectives: The present study was conducted to compare the effect of concept mapping and conventional methods on nursing students’ practical skills. Patients and Methods: This quasi-experimental study was conducted on 70 nursing students randomly assigned into two groups of 35 people. The intervention group was taught through concept mapping method, while the control group was taught using conventional method. A two-part instrument was used including a demographic information form and a checklist for direct observation of procedural skills. Descriptive statistics, chi-square, independent samples t-tests and paired t-test were used to analyze data. Results: Before education, no significant differences were observed between the two groups in the three skills of cleaning (P = 0.251), injection (P = 0.185) and sterilizing (P = 0.568). The students mean scores were significantly increased after the education and the difference between pre and post intervention of students mean scores were significant in the both groups (P < 0.001). However, after education, in all three skills the mean scores of the intervention group were significantly higher than the control group (P < 0.001). Conclusions: Concept mapping was superior to conventional skill teaching methods. It is suggested to use concept mapping in teaching practical courses such as fundamentals of nursing. PMID:26576441
Burkitt, Ian; Husband, Charles; Mackenzie, Jennifer; Torn, Alison
The processes whereby nurses develop the skills and knowledge required to deliver individualized and holistic care were examined in a 2-year study of nurses in a range of clinical settings and a university department of nursing in England. Members of two research teams of qualified nurses joined various communities of nursing practice as…
Kjervik, Diane K.; Leonard, Dianne J.
Responses from 409 registered nurses, 105 nurse managers, 144 nurse educators, and 31 licensed practical nurses indicated that 92% were willing to retool, defined as prepare for evolving nursing roles. They were less likely to be aware of employer expectations or supports for retooling. Areas needing development included critical thinking,…
Pritchard, Toni L. Early
The nursing shortage is compounded by nursing student attrition. Schools of nursing have limited enrollment, making the admission process an important factor in resolving the ongoing nursing shortage. The purpose of this study was to identify preadmission criteria that accurately identify applicants to practical/vocational nursing (P/VN) schools…
Henry, B.; McAuliffe, M.
A survey was conducted of the anaesthesia services provided by nurses and the education available to them in this field in 107 countries. Among the procedures carried out were general anaesthesia, spinal blocks and tracheal intubation. The implications of the findings for health planning and policy-making are discussed with particular reference to workforce structure and women's involvement in it. PMID:10212519
Mindfulness is becoming more widely recognised and increasing thought is devoted to how it, along with compassion, can benefit health professionals. This article explores the concepts of mindfulness and compassion and the positive effect they may have on staff and patients. It outlines how nurses can practise these activities, and presents a case study highlighting the benefits that have been reported.
Kalischuk, Ruth Grant; Thorpe, Karran
The concept of creativity was explored in focus groups with 12 nursing students and 2 faculty. Their perceptions centered on the theme of striving for balance, which enabled them to be most creative. Strategies for fostering creativity were related to this theme and three subthemes: enhancing self-esteem, working within structure, and making time…
Landers, M G
The increasingly complex requirements of today's nursing practitioners, have been accompanied by demands on nurse educators to look at new ways to facilitate learning in the clinical area (Camiah 1996). In recent years nursing education has undergone a period of major change in many countries through integrating with universities. While nurse educators are striving to respond to changes in education the dichotomy between the theoretical input taught in the classroom and what is practised or experienced on the wards remains a problem (Ashworth & Longmate 1993, Ferguson & Jinks 1994). Dale (1994) postulates that theory provides the basis for understanding the reality of nursing, it would seem reasonable, therefore, to assume that the content studied in the classroom correlates with what the student experiences on the ward. It should also follow that if a gap exists between theory and practice, efforts should be taken for its reduction (Rafferty et al. 1996). According to MacNeil (1997) many initiatives have been introduced in an effort to bridge the theory-practice gap and these have focused around the role of the nurse teacher. These changes in education are redefining the role of the nurse teacher, therefore, the part that they currently play and will play in the future needs to be carefully considered (Phillips et al. 1996b). The aim of this paper is to provide an overview of the literature on the theory-practice divide in nursing. First, some of the reasons cited for its existence will be explored. Second, suggested ways of bridging the divide will be considered focusing on the role of the nurse teacher.
Heartfield, Marie; Gibson, Terri
This paper reports the findings of a research project designed to identify national issues impacting on the development of a mentoring framework for nurses in general practice in Australia. The project comprised the first phase of a three-phase study commissioned by the Australian Government Department of Health and Ageing to develop a contemporary, flexible and sustainable mentoring framework that enhances the capacity of nurses to contribute to general practice outcomes. Key stakeholders and influential informants from around Australia were brought together via a national teleconference to identify issues surrounding the development of such a framework. Outcomes focussed on major themes concerning choice, relationships, structures and resources. Here, we consider the issues and challenges identified in light of some contemporary case studies from outside the field of nursing in the hope of sparking new ideas and strategies. A case study from an Australian practice nurse is included. No research has been conducted on mentoring for nurses in general practice in Australia to date, highlighting an urgent need for new models and their evaluation.
Ramsbottom, R; Kinch, R F T; Morris, M G; Dennis, A M
The collection of primary data in laboratory classes enhances undergraduate practical and critical thinking skills. The present article describes the use of a lecture program, running in parallel with a series of linked practical classes, that emphasizes classical or standard concepts in exercise physiology. The academic and practical program ran under the title of a particular year II module named Sports Performance: Physiology and Assessment, and results are presented over a 3-yr period (2004-2006), based on an undergraduate population of 31 men and 34 women. The module compared laboratory-based indexes of endurance (e.g., ventilatory threshold and exercise economy) and high-intensity exercise (e.g., anaerobic power), respectively, with measures of human performance (based on 20-m shuttle run tests). The specific experimental protocols reinforced the lecture content to improve student understanding of the physiological and metabolic responses (and later adaptations) to exercise. In the present study, the strongest relationship with endurance performance was the treadmill velocity at maximal aerobic power (r = +0.88, P < 0.01, n = 51); in contrast, the strongest relationship with high-intensity exercise performance was the mean power output (in W/kg) measured during a 30-s all-out cycle ergometer sprint (r = +0.80, P < 0.01, n = 48). In class student data analysis improved undergraduate indepth or critical thinking during seminars and enhanced computer and data presentation skills. The endurance-based laboratories are particularly useful for examining the underlying scientific principles that determine aerobic performance but could equally well be adapted to investigate other topics, e.g., differences in the exercise response between men and women.
Harwood, Lori; Ridley, Jane; Lawrence-Murphy, Julie Ann; White, Sharon; Spence-Laschinger, Heather K; Bevan, Joy; O'Brien, Karen
The purpose of this study was to examine the effect of a renal nursing professional practice model (PPM) on nurses'perceptions of empowerment, characteristics of practice environments and the impact on nursing care outcomes in a university-based teaching hospital in Canada. Quantitative and qualitative methodologies were used. This paper will focus on the qualitative results. Content analysis was the data analysis method used. The following themes emerged: 1) Attunement, familiarity/knowing the patient, going the distance, 2) Patient outcomes, consistency and continuity of care, autonomy/taking the initiative, 3) Nurse rewards: satisfaction and accountability, empowerment/input, and 4) Facilitating systems: communication, support and assignment. The quantitative results had a significant (p = .005) improvement post-PPM implementation in the nursing foundations for quality of care subscale of the Practice Environment Scale of the Nursing Work Index (NWI-PES) and organizational relationships (p =.016) measured by the Conditions of Work Effectiveness II (CWEQ-II) questionnaires. This study provides evidence for PPMs and primary nursing as effective frameworks to positively impact nursing and patient outcomes in a hemodialysis unit.
Tun, Aung Myint; Thein, Kyaw Zin; Myint, Zin War; Oo, Thein Hlaing
Pernicious anemia (PA), the most common cause of cobalamin deficiency anemia worldwide, is an autoimmune disease of multifactorial etiologies involving complex environmental and immunological factors. Although it was first reported by Addison in 1849 with subsequent advances in understanding of pathogenesis and molecular biology, diagnosis of pernicious anemia is still challenging for clinicians because of its complexity and diverse clinical presentations. Herein, we provide an overview of PA, mainly focusing on its scientific and practical aspects in diagnosis. We also discuss the limitations of currently available diagnostic tools for evaluation of cobalamin deficiency and PA.
Sharpnack, Patricia A; Moon, Hope M; Waite, Pam
Today's practicing nurse faces many challenges and opportunities, and as a result, new graduate readiness for practice has increasing importance. Research completed by the Nursing Executive Center, the Advisory Board's research membership serving nursing administrators, acknowledged a considerable disparity between graduate nurse competencies and the expectation of employing healthcare systems. A pilot project designed to guide preceptors in the role of educator fostered the development of new nurse competencies that helped facilitate transition to professional practice.
Kwekkeboom, Kristine L; Bumpus, Molly; Wanta, Britt; Serlin, Ronald C
Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses.
LaRose, Patrick S., Sr.
The role of the registered nurse has evolved over the years as technology has changed and the practice of nursing has advanced. There are many factors that influence how a new nurse enters practice; however, confidence appears to play a large role in the way nursing students see themselves and how this self perception regulates transition to…
Arizona State Dept. of Education, Phoenix.
Part of a health occupations program, these instructional units consist of materials for use by those who are studying to become practical nurses. Unit 16 deals with basic concepts in the nursing of the aged, in community health, and in the legal responsibilities of the practical nurse. Covered next are nursing care procedures for adults with the…
Cech, N B; Enke, C G
In accomplishing successful electrospray ionization analyses, it is imperative to have an understanding of the effects of variables such as analyte structure, instrumental parameters, and solution composition. Here, we review some fundamental studies of the ESI process that are relevant to these issues. We discuss how analyte chargeability and surface activity are related to ESI response, and how accessible parameters such as nonpolar surface area and reversed phase HPLC retention time can be used to predict relative ESI response. Also presented is a description of how derivitizing agents can be used to maximize or enable ESI response by improving the chargeability or hydrophobicity of ESI analytes. Limiting factors in the ESI calibration curve are discussed. At high concentrations, these factors include droplet surface area and excess charge concentration, whereas at low concentrations ion transmission becomes an issue, and chemical interference can also be limiting. Stable and reproducible non-pneumatic ESI operation depends on the ability to balance a number of parameters, including applied voltage and solution surface tension, flow rate, and conductivity. We discuss how changing these parameters can shift the mode of ESI operation from stable to unstable, and how current-voltage curves can be used to characterize the mode of ESI operation. Finally, the characteristics of the ideal ESI solvent, including surface tension and conductivity requirements, are discussed. Analysis in the positive ion mode can be accomplished with acidified methanol/water solutions, but negative ion mode analysis necessitates special constituents that suppress corona discharge and facilitate the production of stable negative ions.
Hickman, Louise D; Kelly, Helen; Phillips, Jane L
EVITEACH aimed to increase undergraduate nursing student's engagement with evidence-based practice and enhance their knowledge utilisation and translation capabilities. Building students capabilities to apply evidence in professional practice is a fundamental university role. Undergraduate nursing students need to actively engage with knowledge utilisation and translational skill development to narrow the evidence practice gap in the clinical setting. A two phase mixed methods study was undertaken over a three year period (2008-2010, inclusive) utilizing a Plan-Do-Study-Act (PDSA) approach. Three undergraduate nursing cohorts (N = 188) enrolled in a compulsory knowledge translation and utilisation subject at one Australian university participated. Data collection comprised of subject evaluation data and reflective statements. Preliminary investigations identified priority areas related to subject: materials, resources, teaching and workload. These priority areas became the focus of action for two PDSA cycles. PDSA cycle 1 demonstrated significant improvement of the subject overall (p > 0.05), evaluation of the materials used (p > 0.001) and teaching sub-groups (p > 0.05). PDSA cycle 2 continued to sustain improvement of the subject overall (p > 0.05). Furthermore reflective statements collected during PDSA cycle 2 identified four themes: (1) What engages undergraduate nurses in the learning process; (2) The undergraduate nurses learning trajectory; (3) Undergraduate nurses' preconceptions of research and evidenced-based practice; and (4) Appreciating the importance of research and evidence-based practice to nursing. There is little robust evidence to guide the most effective way to build knowledge utilisation and translational skills. Effectively engaging undergraduate nursing students in knowledge translation and utilisation subjects could have immediate and long term benefits for nursing as a profession and patient outcomes. Developing evidence-based practice
Frakes, Michael A; Evans, Tracylain
The federal government spends nearly 15% of the budget on Medicare services annually, and advanced practice nurses are eligible for reimbursement from that pool. The regulations governing reimbursement are complex because of the social, political, and financial pressures involved in their development. Although economic viability and due diligence considerations make it incumbent on advanced practice nurses to understand the rules, the profession, as a whole, has knowledge deficits in this area. The essentials of regulatory development and structure are reviewed and considerations for optimizing reimbursement are described.
Balint, Katherine A; George, Nancy M
The role of the Faith Community Nurse (FCN) is a multifaceted wholistic practice focused on individuals, families, and the faith and broader communities. The FCN is skilled in professional nursing and spiritual care, supporting health through attention to spiritual, physical, mental, and social health. FCNs can help meet the growing need for healthcare, especially for the uninsured, poor, and homeless. The contribution of FCNs on, primary prevention, health maintenance, and management of chronic disease deserves attention to help broaden understanding of the scope of FCN practice.
Pye, Sherry; Green, Angela
Since its development in 1998, the Cardiology Advanced Practice Nurse team has been plagued by retention issues. The coordinator for the team developed this leadership project while participating in the 2008 to 2009 Maternal-Child Health Leadership Academy sponsored by Sigma Theta Tau International and Johnson & Johnson. The focus of this project was to develop, implement, and evaluate initiatives to empower the advanced practice nurse team, promote their professional development, and ultimately improve retention of team members. Although evaluation data show progress toward addressing work environment issues, retention remains an ongoing problem.
Grede, Alex J; Price, Jared S; Giebink, Noel C
Planar microtracking provides an alternate paradigm for solar concentration that offers the possibility of realizing high-efficiency embedded concentrating photovoltaic systems in the form factor of standard photovoltaic panels. Here, we investigate the thermodynamic limit of planar tracking optical concentrators and establish that they can, in principal, achieve the sine limit of their orientationally-tracked counterparts provided that the receiver translates a minimum distance set by the field of view half-angle. We develop a phase space methodology to optimize practical planar tracking concentrators and apply it to the design of a two surface, catadioptric system that operates with > 90% optical efficiency over a 140° field of view at geometric gains exceeding 1000×. These results provide a reference point for subsequent developments in the field and indicate that planar microtracking can achieve the high optical concentration ratio required in commercial concentrating photovoltaic systems.
McCormick, K A; Lang, N; Zielstorff, R; Milholland, D K; Saba, V; Jacox, A
The American Nurses Association (ANA) Cabinet on Nursing Practice mandated the formation of the Steering Committee on Databases to Support Clinical Nursing Practice. The Committee has established the process and the criteria by which to review and recommend nursing classification schemes based on the ANA Nursing Process Standards and elements contained in the Nursing Minimum Data Set (NMDS) for inclusion of nursing data elements in national databases. Four classification schemes have been recognized by the Committee for use in national databases. These classification schemes have been forwarded to the National Library of Medicine (NLM) for inclusion in the Unified Medical Language System (UMLS) and to the International Council of Nurses for the development of a proposed International Classification of Nursing Practice. PMID:7850567
Zimmerman, Sheryl; Shier, Victoria; Saliba, Debra
The nursing home culture change movement aims to improve resident quality of life and quality of care by emphasizing the deinstitutionalization of nursing home culture and focusing on person-centered care. This article briefly reviews the history of culture change, discusses some of the challenges related to culture change in nursing homes, and overviews the conceptualization and select models of culture change. Building from this background, it critiques current understanding, identifies critical research questions, and notes key issues arising during a workshop that addressed existing and emerging evidence in the field. This review and analysis provide a context for how 9 accompanying papers in this supplemental issue of The Gerontologist fill identified evidence gaps and provide evidence for future practice and policies that aim to transform nursing home culture.
Krautscheid, Lorretta C
Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission's 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student's ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the results of a three-year review of undergraduate student nurse performance (n = 285) related to effective clinical communication. Changes in teaching-learning strategies, implementation of a standardized communication tool, and clinical enhancements which resulted in improved student competency, will be presented.
Kennedy, Holly Powell
Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians’ individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient’s best interest can be viewed as their “agency for safety.” However, collective agency for safety and commitment to support nurses in their advocacy role is missing in many perinatal care settings. This paper draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse’s role in maintaining safety during labor and birth in acute care settings, and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care. PMID:20147827
The number of blogs and related online activities continues to grow exponentially each year. Patients increasingly are turning to the Internet for personalized, timely, and relevant health information; blogs remain a large source of that information. Nurses and other healthcare professionals can harness the informational, educational, networking, and supportive power of blogs, as well, and should understand how to access and use blogs for professional use.
Van Hulle Vincent, Catherine; Wilkie, Diana J; Wang, Edward
We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses' management of children's pain. RCP is an interactive, content-focused, and Kolb's experiential learning theory-based intervention. Using a one-group, pretest-posttest design, we evaluated feasibility of RCP and pretest-posttest difference in scores for nurses' beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnaire (PBPQ, alpha=.83) before and after they completed the RCP and an Acceptability Scale afterward. Mean total PBPQ scores significantly improved from pretest to posttest as did simulated practice scores. After RCP in actual hospital practice, nurses administered significantly more ibuprofen and ketorolac and children's pain intensity significantly decreased. Findings showed strong evidence for the feasibility of RCP and study procedures and significant improvement in nurses' beliefs and pain management practices. The 2-hr RCP program is promising and warrants replication with an attention control group and a larger sample.
Keller, Linda O; Schaffer, Marjorie A; Schoon, Patricia M; Brueshoff, Bonnie; Jost, Rose
Preparation of the public health nursing (PHN) workforce requires public health nurses from academia and practice to collaborate. However, a shortage of PHN clinical sites may lead to competition between schools of nursing for student placements. The Henry Street Consortium, a group of 5 baccalaureate schools of nursing and 13 local health departments in the state of Minnesota, developed a model for collaboration between PHN education and practice. This paper describes the development process--the forming, storming, norming, and performing stages--experienced by the Henry Street Consortium members. The consortium developed a set of entry-level core PHN competencies that are utilized by both education and practice. It developed menus of learning opportunities that were used to design population-based PHN clinical experiences. In addition, the consortium created a model for training and sustaining a preceptor network. The members of the Henry Street Consortium collaborated rather than competed, used consensus for decision making, and respected and accepted different points of view. This collaboration significantly impacted how schools of nursing and local health departments work together. The consortium's ability to retain its relevance, energy, and momentum for both academic and agency partners sustains the collaboration.
Chen, Chen-Jung; Tsai, Chuan-Hsiu; Chen, Yi-Chang
Empirical, aesthetic, ethical, and personal knowing are the four fundamental patterns of knowledge inquiry. Of these, the aesthetic knowing pattern is least discussed in nursing literature. This article discusses the definition of nursing aesthetics; its utilization in practice; and correlations between aesthetics and clinical practice. One of the advantages inherent to nursing is its ability to deliver skillful care directly to patients. Skillful performance is essential to reduce discrepancies between goals and patterns. Aesthetic nursing addresses more than the form of nursing. It further addresses the crucial elements of nursing knowledge. The science of nursing is influential in its ability to attain harmony among abundant empiric content, power of beneficence, and pleasure of aesthetic experience. In clinical practice, nurses can employ aesthetic nursing through various channels to create meaning and promote the professional image of nurses. Concepts listed in this article may be utilized in clinical supervision, practice and education.
on to treat evaluation of expanded uncertainty, joint treatment of several measurands, least-squares adjustment, curve fitting and more. Chapter 6 is devoted to Bayesian inference. Perhaps one can say that Evaluating the Measurement Uncertainty caters to a wider reader-base than the GUM; however, a mathematical or statistical background is still advantageous. Also, this is not a book with a library of worked overall uncertainty evaluations for various measurements; the feel of the book is rather theoretical. The novice will still have some work to do—but this is a good place to start. I think this book is a fitting companion to the GUM because the text complements the GUM, from fundamental principles to more sophisticated measurement situations, and moreover includes intelligent discussion regarding intent and interpretation. Evaluating the Measurement Uncertainty is detailed, and I think most metrologists will really enjoy the detail and care put into this book. Jennifer Decker
Risling, Tracie; Ferguson, Linda
Although the community of practice (CoP) concept has been heavily utilized in business literature since its inception in the 1990s, it has not been significantly featured in nursing research. With student-centered approaches increasingly infusing nursing classrooms, including opportunities for collaborative learning and the development of student learning communities, it may be time to ask: Do we practice what we teach? Nursing academia faces challenges related to recruitment and retention, scholarly productivity and engagement of new faculty, and increasing demands for collaborative research. Challenges, some would argue, that could be addressed through CoPs; a sentiment reflected in the recent expansion of nursing CoP literature. What is the current state of the application of this concept in nursing academia and what barriers present in the promotion and development of CoPs in the academy? This article addresses these questions and provides guidance for those in search of community.
Procter, Susan; Griffiths, Lauren; Fanning, Agnes; Wallman, Lizzie; Loveday, Heather P
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.
Peters, Kathleen; Halcomb, Elizabeth J; McInnes, Susan
As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and models of clinical placement. This paper uses qualitative research methods to explore the perspectives of 12 Australian general practice nurses who have experience in facilitating undergraduate clinical placements about the relationships between HEIs and nurses. Findings are presented in the following three themes: (1) Appropriate preparation for placement: They don't know what primary health really means, (2) Seeking greater consultation in the organisation of clinical placements: they've got to do it one way for everyone, and (3) Uncertainty and lack of support: I had no contact with the university. Clinical placements in general practice can be an innovative strategy providing non-traditional, yet high quality, teaching and learning experiences for undergraduate nursing students. To optimise the quality of these placements, however, it is essential that HEIs provide appropriate support to the practice nurses mentoring these students.
Finnell, Deborah S; Nowzari, Shahrzad; Reimann, Brie; Fischer, Leigh; Pace, Elizabeth; Goplerud, Eric
ABSTRACT. Substance use screening, brief intervention, and referral to treatment (SBIRT) should be an integral part of the scope of nursing practice. This commentary is an appeal for nurses to advance their knowledge and competencies related to SBIRT. The question of how to move SBIRT into the mainstream of nursing practice was posed to several leaders of federal agencies, health care and nursing organizations, nurse educators, and nurse leaders. The authors provide recommendations for moving this set of clinical strategies (i.e., SBIRT) into day-to-day nursing practice.
The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting within the scope of their VA employment. Certified Registered Nurse Anesthetists (CRNA) will not be included in VA's full practice authority under this final rule, but comment is requested on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking. The final rulemaking establishes the professional qualifications an individual must possess to be appointed as an APRN within VA, establishes the criteria under which VA may grant full practice authority to an APRN, and defines the scope of full practice authority for each of the three roles of APRN. The services provided by an APRN under full practice authority in VA are consistent with the nursing profession's standards of practice for such roles. This rulemaking increases veterans' access to VA health care by expanding the pool of qualified health care professionals who are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision of physicians, and it permits VA to use its health care resources more effectively and in a manner that is consistent with the role of APRNs in the non-VA health care sector, while maintaining the patient-centered, safe, high-quality health care that veterans receive from VA.
Felton, Anne; Royal, Jan
Rapid changes during the past two decades have seen a growing challenge to prepare newly qualified nurses who are clinically competent and confident to meet the demands of contemporary healthcare. Recent publications emphasise the need to prioritise clinical skills in nurse education (DH 2012a, Francis, 2012). This discussion reports on a project scoping the clinical skills required within pre-registration nursing curricula and considers how this has influenced curriculum development at one Higher Education Institution in the UK. This paper reports on the project analysis of nursing and healthcare policy, identifying six core themes of skills relevant for nursing practice. Furthermore it explores the findings of a series of focus groups with nursing practitioners and managers identifying priorities for clinical skills in the pre-registration curriculum. These highlighted a broad range of skills required of newly qualified practitioners, which pose a challenge for integration within nurse education. How this challenge has been addressed through the incorporation of these skills themes throughout a new pre-registration curriculum is also examined.
Treloar, Anna; McMillan, Margaret; Stone, Teresa
Storytelling is a valuable adjunctive method of preparing undergraduate mental health nursing students for practice. To explore the possibilities of this method of teaching, 100 stories were collected from experienced nurses working in mental health and analysed using a case study methodology. The aim was to explore the purpose of clinical anecdotes told by experienced nurses working in mental health settings to undergraduates and new recruits, with an ancillary purpose of looking at the implications of these anecdotes for the exploration of contemporary mental health practice and education. A framework for student discussion of stories is provided. The insights gained illuminate not only the history of mental health nursing and the daily activities of nurses working in mental health, but also some of the deep-level skills developed and used by these nurses as they work in the complexity and ambiguity of an imperfect world where the job requires managing the unexpected every shift, and where there might not always be a textbook-perfect solution to clinical situations.
The nursing profession prides itself on its ability to reflect on practice to improve patient care. Yet we have seen a number of high-profile cases in recent years where care has not been provided at the level you would expect.
Ethics, by its definition, is a philosophical discipline which enables human beings to behave, to act and to be, in the best way possible, between themselves and towards their environment. In private nursing practice, the ethical dimension is based on personal reflection which enables each individual to adapt their attitude in order to act for the best.
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
Papers on "Current Issues and Their Implications for Practical Nurse Programs" included in the document were authored by Margaret McLaughlin, Ruth B. Edelson, and Kenneth G. Skaggs. Summaries of presentations by Robert M. Morgan and Helen K. Powers are also included. (JK)
Springer, Pam; Carey, Jean
This Idaho instructor's guide lists tasks and enabling objectives, outlines instruction, and provides handout masters, overhead masters, and tests for intravenous therapy (IV) instruction for licensed practical nurses. Following an introduction and a list of criteria for successful completion of IV therapy courses, the document lists tasks and…
Rogers, Helen V.; Reid-Sloan, Jamee
This curriculum guide, revised from a 1975 edition, provides teachers with up-to-date information and skill-related applications needed by practical nurses. It includes 4 sections and 24 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities, information sheets, assignment…
Hahn, Joan Earle; Aronow, Harriet Udin
Background: Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community-based health care systems. As they age into middle years, they are at increased risk for functional decline. This paper presents a description of an advanced practice nurse (APN) intervention used in a pilot…
Davis, Marcella Z., Ed.; And Others
A major portion of the collection of 20 readings authored by practicing professionals consists of field observations presented both as raw data (field notes) and as analyzed and organized data. About the work of nurses in a variety of settings, a recurrent theme is that work behavior is greatly influenced by organizational and structural elements…
Kenny, Richard F.; Van Neste-Kenny, Jocelyne M. C.; Park, Caroline L.; Burton, Pamela A.; Meiers, Jan
We report here on an exploratory formative evaluation of a project to integrate mobile learning into a Western Canadian college nursing program. Third-year students used Hewlett Packard iPAQ mobile devices for five weeks in a practice education course in April-May, 2007. Koole's (2009) "Framework for the Rational Analysis of Mobile…
Fitzgerald, Sheila T.; Hill, Martha N.; Santamaria, Barbara; Howard, Cheryl; Jadack, Rose
Responses from 1,107 nurses working with asthma patients showed positive to neutral views of consensus reports with practice recommendations from professional associations, government, and health agencies. Most felt the reports were a better source of information than colleagues, textbooks, or journals. However, 75% were unaware of one major set…
Ravanipour, Maryam; Bahreini, Masoud; Ravanipour, Masoumeh
Background: Peer learning is an educational process wherein someone of the same age or level of experience level interacts with other students interested in the same topic. There is limited evidence specifically focusing on the practical use of peer learning in Iran. The aim of this study was to explore nursing students’ experiences of peer learning in clinical practice. Materials and Methods: A qualitative content analysis was conducted. Focus groups were used to find the students’ experiences about peerlearning. Twenty-eight baccalaureate nursing students at Bushehr University of Medical Sciences were selected purposively, and were arranged in four groups of seven students each. The focus group interviews were conducted using a semi-structured interview schedule. All interviews were tape-recorded, transcribed verbatim, and analyzed using conventional content analysis method. Results: The analysis identified four themes: Paradoxical dualism, peer exploitation, first learning efficacy, and socialization practice. Gained advantages and perceived disadvantages created paradoxical dualism, and peer exploitation resulted from peer selection and peer training. Conclusion: Nursing students reported general satisfaction concerning peer learning due to much more in-depth learning with little stress than conventional learning methods. Peer learning is a useful method for nursing students for practicing educational leadership and learning the clinical skills before they get a job. PMID:26097860
This paper explores the implications of Michel Foucault's philosophical analyses for understanding nursing practice. Foucault describes power within a given society as unfolding not through large-scale events but rather through a complex 'micro-physics'. Power operates upon the human body. With the increasing use of observation, in understanding both the natural and social world, the body has become the subject of the 'gaze'. The body as object, however, is neither a universal belief nor truth but a product of ways of perceiving and examining it. In relation to nursing, the subjection of the body to the 'gaze' and the practices of the institutional environment of the hospital are important for understanding the knowledge formulated. The power of practice is in the generation of knowledge. The nature and form of knowledge is instrumental in establishing the quality of nurse-patient relationships. This paper explores, through the particular exemplar of the patient in intensive care, the power of present practices to shape knowledge, and thereby dictate and limit the quality of the nurse-patient relationship.
Nagle, Lynn M; Crosby, Kristine; Frisch, Noreen; Borycki, Elizabeth; Donelle, Lorie; Hannah, Kathryn; Harris, Alexandra; Jetté, Sylvie; Shaben, Tracy
Information and communication technologies (ICT) have brought about significant changes to the processes of health care delivery and changed how nurses perform in clinical, administrative, academic, and research settings. Because the potential benefits of ICT are significant, it is critical that new nurses have the knowledge and skills in informatics to provide safe and effective care. Despite the prevalence of technology in our day to day lives, and the potential significant benefits to patients, new nurses may not be prepared to work in this evolving reality. An important step in addressing this need for ICT preparation is to ensure that new graduates are entering the work force ready for technology-enabled care environments. In this paper, we describe the process and outcomes of developing informatics entry-to-practice competencies for adoption by Canadian Schools of Nursing.
The development of the Victorian mental health nurse practitioner youth early psychosis, is a pioneer advance in clinical psychiatric/mental health nursing. This paper will explore and describe the scope of practice for the youth early psychosis mental health nurse practitioner candidate, and how the model is informed by relevant literature. The role description and context of the nurse practitioner candidate, which is synonymous with the role of the endorsed nurse practitioner, is described. Advanced practice nursing is discussed in terms of what the nurse practitioner literature says and contrasted with perceptions of a clinical nurse's everyday practice. Inherent challenges and issues are highlighted that need to sit in the background of any picture being painted of the mental health nurse practitioner role in Victoria into the future. An alternative perspective in the mental health care of the young person is proposed for the nurse practitioner scope of practice.
Siaki, Leilani A; Lentino, Cynthia V; Mark, Debra D; Hopkins-Chadwick, Denise L
Despite the Institute of Medicine's goal of 90% of all practice being evidence-based by 2020, educational and practice institutions are not on target to achieve this goal. Evidence-based practice is one of 5 core elements of the Army Nurse Corps' patient care delivery system and a key focus of the Hawaii State Center for Nursing. In order to increase evidence-based practice (EBP), a civilian-military partnership was formed to include healthcare organizations in the state, optimize resources, and share strategies for successful practice changes statewide. The partnership has been successful in meeting each of these goals using national EBP competencies and Bloom's taxonomy as a guide. The article presents a discussion regarding the history, processes, and outcomes of this partnership.
Acuña-Reyes, Raquel; Cigarroa-Martínez, Didier; Ureña-Bogarín, Enrique; Orgaz-Fernández, Jose David
Objectives: Determine the domain of preventive dentistry in nursing personnel assigned to a primary care unit. Methods: Prospective descriptive study, questionnaire validation, and prevalence study. In the first stage, the questionnaire for the practice of preventive dentistry (CPEP, for the term in Spanish) was validated; consistency and reliability were measured by Cronbach's alpha, Pearson's correlation, factor analysis with intra-class correlation coefficient (ICC). In the second stage, the domain in preventive dental nurses was explored. Results: The overall internal consistency of CPEP is α= 0.66, ICC= 0.64, CI95%: 0.29-0.87 (p >0.01). Twenty-one subjects in the study, average age 43, 81.0% female, average seniority of 12.5 were included. A total of 71.5% showed weak domain, 28.5% regular domain, and there was no questionnaire with good domain result. The older the subjects were, the smaller the domain; female nurses showed greater mastery of preventive dentistry (29%, CI95%: 0.1-15.1) than male nurses. Public health nurses showed greater mastery with respect to other categories (50%, CI95%: 0.56-2.8). Conclusions: The CDEP has enough consistency to explore the domain of preventive dentistry in health-care staff. The domain of preventive dentistry in primary care nursing is poor, required to strengthen to provide education in preventive dentistry to the insured population. PMID:25386037
This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries.
Rondeau, K V; Wagar, T H
Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain
Primary and acute care settings are the focus of a concerted effort to implement evidence-based practice (EBP) in health care; yet, little attention has been given to use of EBP among school nurses. The aims of this study were to (a) describe current use of EBP among school nurses attending a national school nurse conference, (b) describe…
Cunningham, Donna D
We frequently hear the word simulation in nursing educatioh. Research has been done on the use of high fidelity simulation in registered nursing programs. High fidelity simulators are expensive and require more than one faculty to facilitate. The question remains: Does every nursing program require a high fidelity simulation laboratory? This article will define the three levels of fidelity and describe the incorporation of a medium fidelity simulation into a practical nursing program and will describe the benefits of simulation use. The article will assist the faculty and students new to simulation, and allow them to choose the equipment and scenarios that will be most advantageous for their individual programs. The choice of equipment, scenarios, and fidelity often depends upon the space, time, funds, and faculty available. Simulation adds an important component to nursing education. Using simulation wisely helps students practice in a controlled environment without danger to living patients. The lessons learned will someday play into a "life or death" scenario, and the patient will not be a simulation mannequin.
Gaumer, Gary L; Koeniger-Donohue, Rebecca; Friel, Christina; Sudbay, Mary Beth
The purpose of this study is to describe the use of information technology by advance practice nurses. A survey of 519 graduates of the Simmons College nurse practitioner program was conducted. Areas of investigation included the nurse practitioner's use of informatics technology, perception of information technology competence, adequacy of information technology training and support in the workplace, specific information technology health functions used in the workplace, and perceived benefits of using information technology. The data on the 249 usable responses were analyzed using descriptive statistics. These analyses compare the use of information technology by type of job, specialty, years of practice, and setting of work. Results indicate that more than 90% of nurse practitioners utilize computers at work, yet a large fraction of them still have low self-perception of information technology competence, believe initial training at the work site was inadequate, and believe that academic preparation for information technology was also inadequate. There is considerable variation in these measures across nurse practitioner specialties, settings of care, job characteristics, and experience.
Sánchez-Martín, C Inmaculada
The increase in chronic diseases and the progressive ageing of the population is a source of concern for the different agencies with responsibility for health care. This has led to the creation of many documents focused on the analysis of the current situation and care of chronic diseases, including the WHO recommendations intended to assist countries and health services design and implement strategies that will address the existing demand, control and prevention of chronic diseases. In addition, there is a need to respond to the demand generated by chronic diseases in every sense, and from the different systems it is becoming more difficult to get enough support from multidisciplinary teams where the nurse has a central importance. While chronic diseases are becoming a threat due to the costs they generate, it is also an opportunity for nursing to be at the forefront for advanced care requirements, performed by professionals with recognized advanced clinical skills and ability for case management while monitoring and controlling complex chronic patients. The different services of the National Health System have introduced nurses that play different roles (cases managers, liaison nurses, advanced practice nurses and so on). However, it could be argued that they are not being trained to a desirable development level. It is therefore time for health care authorities to determine the role of the advanced practice nurse in relation to functional positions, and allow them to make an advance in the development of unified skills for the whole National Health System. From our experience we have learned that the advanced practice nurse is a resource that helps in the sustainability of services, thanks to the efficiency shown in the results obtained from the care given to both chronic and complex chronic patients.
J. Thielen, J. Norris, “ Nursing education application of a computerized nursing expert system”, J. Nurs. Educ., vol. 29(6), pp. 244-248, 1990. [10...Syst., vol. 9(1-2), pp. 57-68, 1985.  N. Saleem, B. Moses, “Expert systems as computer assisted instruction systems for nursing education and
Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen; Gallagher-Ford, Lynn; Kaplan, Louise
This descriptive survey assessed the perception of evidence-based practice (EBP) among nurses in the United States. Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence-based best practices. A descriptive survey was conducted with a random sample of 1015 RNs who are members of the American Nurses Association. Although nurses believe in evidence-based care, barriers remain prevalent, including resistance from colleagues, nurse leaders, and managers. Differences existed in responses of nurses from Magnet® versus non-Magnet institutions as well as nurses with master's versus nonmaster's degrees. Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine's 2020 goal that 90% of clinical decisions be evidence-based.
Moorer, Oyweda W; Meterko, Mark; Alt-White, Anna C; Sullivan, Jennifer L
In the past decade, the use of information technology (IT) to support healthcare delivery has greatly expanded. Introducing new clinical information systems and updating existing systems require continued learning and training among registered nurses (RNs) and other clinicians. Consequently, a 5-item measure was designed as a subscale to the Practice Environment Scale of the Nursing Work Index. This new subscale, the Nursing Information Technology Subscale (NITS) measures RNs' perception of the extent to which IT in their practice environment supports patient care delivery. A psychometric evaluation of the NITS was conducted at 8 Veterans Affairs hospitals. The findings demonstrated that this brief subscale has acceptable reliability as well as convergent and discriminant validity.
Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.
This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the practical nursing program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies, and section II…
A community practice framework is presented as the synthesis of research findings from the analysis of a critical ethnonursing study of women in recovery from chemical dependence. Critical Social Theory is used to examine the paradoxical experiences of women from their lifeworld and system within the community. The framework focuses on the mutual moral caring actions of the community nurse and the women in the recovery. It is supported by the concepts of transcultural nursing ethics. The utility of the framework is to promote clarity of speech and parity of community membership for women in recovery from chemical dependence and their return to the community.
Krishnasamy, M; Corner, J; Bredin, M; Plant, H; Bailey, C
This paper considers methodological and philosophical issues that arose during a multi-centre, randomized controlled trial of a new nursing intervention to manage breathlessness with patients with primary lung cancer. Despite including a diverse range of instruments to measure the effects of the intervention, the uniqueness of individuals' experiences of breathlessness were often hidden by a requirement to frame the study within a reductionist research approach. Evidence from the study suggests that breathlessness is only partly defined when understood and explored within a bio-medical framework, and that effective therapy can only be achieved once the nature and impact of breathlessness have been understood from the perspective of the individual experiencing it. We conclude that to work therapeutically we need to know how patients interpret their illness and its resultant problems and that this demands methodological creativity.
Anderson, Jacqueline J; Mokracek, Marilyn; Lindy, Cheryl N
St. Luke's Episcopal Hospital in Houston established a best-practice council as a strategy to link nursing quality to evidence-based practice. Replacing a system based on reporting quality control and compliance, this Best Practice Council formed interdisciplinary teams, charged them each with a quality issue, and directed them to change practice as needed under the guidance of the St. Luke's Episcopal Hospital Evidence Based Practice Model. This article reviews the activities of the Best Practice Council and the projects of teams assigned to study best practice in (1) preventing bloodstream infection (related to central lines), (2) preventing patient falls, (3) assessing and preventing pressure ulcers, and (4) ensuring good hand-off communication.
This paper explores Jacques Derrida's strategy of deconstruction as a way of understanding and critiquing nursing theory and practice. Deconstruction has its origins in philosophy, but I argue that it is useful and relevant as a way of challenging the dominant paradigm of any discipline, including nursing. Because deconstruction is notoriously difficult to define, I offer a number of examples of deconstruction in action. In particular, I focus on three critiques of reflective practice by the meta-narrative of evidence-based practice (EBP) and attempt to show how those critiques can be directed back at EBP itself. I conclude with the observation that EBP is open to many of the criticisms that it directs at other discourses, including problems of a lack of empirical evidence, of distortions due to memory, and of falsification of the 'facts'.
Henderson, Amanda; Cooke, Marie; Creedy, Debra K; Walker, Rachel
Effective clinical learning requires integration of nursing students into ward activities, staff engagement to address individual student learning needs, and innovative teaching approaches. Assessing characteristics of practice environments can provide useful insights for development. This study identified predominant features of clinical learning environments from nursing students' perspectives across studies using the same measure in different countries over the last decade. Six studies, from three different countries, using the Clinical Leaning Environment Inventory (CLEI) were reviewed. Studies explored consistent trends about learning environment. Students rated sense of task accomplishment high. Affiliation also rated highly though was influenced by models of care. Feedback measuring whether students' individual needs and views were accommodated consistently rated lower. Across different countries students report similar perceptions about learning environments. Clinical learning environments are most effective in promoting safe practice and are inclusive of student learners, but not readily open to innovation and challenges to routine practices.
This is the first of two articles exploring the concept of concordance in practice. This first paper draws on psychology, research in clinical practice and social participation theory to argue for a concordant approach to nursing care. Where most writers have confined discussions on concordance to medicines management, the author seeks to widen the debate to explore the value of the principle across the whole spectrum of nursing practice. Studies describing patient involvement are mapped against Arnstein's model of citizen participation to determine true levels of patient-practitioner working. The outcomes of care delivered in a paternalistic way are compared with those arising from patient-practitioner partnership working across a range of healthcare settings. The values underpinning concordance and the relationships and skills necessary to achieve and sustain it are considered. A recommendation for practice is that concordance needs to be taught as a central part of the healthcare process rather than merely an ethical principle in healthcare education. The power of the nurse-patient relationship on which concordance is built needs to be recognised and valued. The principle of concordance will be more feasible in practice when accompanied by other initiatives that promote public participation in education review commissioning and standard setting.
Denny, Margaret; Weber, Ellen F; Wells, John; Stokes, Olga Redmond; Lane, Paula; Denieffe, Suzanne
Multiple intelligences have only recently entered the teaching dialogue in nurse education and research. It is argued that despite the rhetoric of a student centred approach nurse education remains wedded to conventional teaching approaches that fail to engage with the individual and unwittingly silence the student's voice. This paper will examine the concept of multiple intelligences (MI) and outline Gardner's contention that the brain functions using eight intelligences which can be employed to improve learning at an individual level. It will then outline the use of MI using a five phase model, developed by Weber, known as a multiple intelligence teaching approach (MITA). It is contended that MITA has great potential in nurse education, particularly in terms of reinforcing learning beyond the educational domain and into the individual's professional development and clinical practice.
Yakimo, Richard; Kurlowicz, Lenore H; Murray, Ruth Beckmann
This report describes and evaluates the current status of outcome analysis in Psychiatric Consultation-Liaison Nursing (PCLN) and offers suggestions for future development. The status of outcome evaluation generally in psychiatric nursing is described with attention given to the scope of practice of PCLN and outcomes used by psychiatric consultation-liaison nurses (PCLNs) to evaluate their interventions. An evaluation framework based on Donabedian's paradigm of structure, process, and outcome is presented and its applicability shown to PCLN. This framework is further explicated with regard to a review of published studies of PCLN within the outcome domains of cost reduction, satisfaction with services, changes in clinical status, and perceptions of work environment. Finally, recommendations for further development of outcomes in PCLN are offered, based on the strengths and limitations of the extant literature.
Foley, Vicki; Myrick, Florence; Yonge, Olive
Research has shown that while preceptorship offers a reality-oriented learning environment and facilitates competence of students, there are inherent rewards and stressors associated with the experience. Students and preceptors can be from different generations, and as such, they may often come to the learning space with differing values and expectations. The nature of the preceptorship experience in this intergenerational context was explored in a recent phenomenological study with seven preceptors and seven nursing students in an undergraduate nursing program in Eastern Canada. Overall the experience was found to be inclusive of three main themes: being affirmed, being challenged, and being on a pedagogical journey. In this paper we explore the first of these themes, being affirmed. Highlighting the positive aspects of the preceptorship experience in the intergenerational context is necessary to promote a culture of openness and respect for generational differences within clinical nursing practice settings and to improving the overall quality of the educational experience. PMID:22778943
Huynh, Truc; Alderson, Marie
Human ecology is an umbrella concept encompassing several social, physical, and cultural elements existing in the individual's external environment. The pragmatic utility method was used to analyze the "human ecology" concept in order to ascertain the conceptual fit with nursing epistemology and to promote its use by nurses in clinical practice. Relevant articles for the review were retrieved from the MEDLINE, CINAHL, PsycINFO, and CSA databases using the terms "human ecology," "environment," "nursing," and "ecology." Data analysis revealed that human ecology is perceived as a theoretical perspective designating a complex, multilayered, and multidimensional system, one that comprises individuals and their reciprocal interactions with their global environments and the subsequent impact of these interactions upon their health. Human ecology preconditions include the individuals, their environments, and their transactions. Attributes of this concept encompass the characteristics of an open system (e.g., interdependence, reciprocal).
Thinking like a nurse (TLN) has been identified as a core competency of professional nursing practice. The term embraces the full context of the daily metacognitive process nurses use to provide competent nursing care and was theorized in this study to have four attributes: critical thinking, clinical judgment, moral reasoning, and professional…
How Do Dyslexic Nursing Students Cope with Clinical Practice Placements? The Impact of the Dyslexic Profile on the Clinical Practice of Dyslexic Nursing Students: Pedagogical Issues and Considerations
Price, Geraldine A.; Gale, Anne
The safety of dyslexic nurses, and whether they are a danger to their patients, has been widely discussed. This empirical study sought to discover the impact of the dyslexic profile on clinical practice for nursing students. Two focus groups of third-year nursing students in higher education were set up: a control group and a dyslexic group. The…
Macleod, Catriona; Nhamo-Murire, Mercy
Nurses play a key role in the provision of services in relation to sexuality in both primary and sexual and reproductive health-care. Given the intersection of sexualities with a range of social injustices, this study reviews research on nursing practice concerning sexuality from an emancipatory/social justice perspective. A systematic review of English articles published in nursing journals appearing on the Web of Science database from 2009 to 2014 was conducted. Thirty-eight articles met the inclusion criteria. Analysis consisted of a descriptive phase (types and location of studies, aspects of sexualities focused on, target health users and aspects of nursing practice focused on) and a critical/emancipatory phase. In terms of practice, our analysis revealed that: barriers exist to the integration of issues relating to sexuality in nursing practice; the social location of nurses and their personal feelings regarding sexuality influence their practice; content that addresses gendered norms and media that assist in communication underpin some emancipatory practices. Few studies locate analyses of nursing practice within gendered, cultural and social norms; consider advocacy as part of the practice of nurses; or analyse the promotion of health user participation in health services and structures. The implications for emancipatory practice are drawn out.
Krautscheid, Lorretta C; Britton, Justin; Craig, Carol
Novice post-licensure nurses are frequently exposed to microethical nursing practice problems during their first 24 months of formative practice. Often, novice nurses trust the advice of experienced nurse coworkers, deferring to such advice even when they know the advice contradicts evidence-based practice. This study revealed the prevalence of deference behaviors and associated rationale. Study findings emphasize the importance of incorporating conflict management, effective communication techniques, ethical frameworks, and EBP standards within pre- and post-licensure education.
Sroczynski, Maureen; Gravlin, Gayle; Route, Paulette Seymour; Hoffart, Nancy; Creelman, Patricia
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.
Williams, Lynne; Rycroft-Malone, Jo; Burton, Christopher R
In the context of modern nursing practice that is embedded within complex social situations, critical discussions about the contribution of major philosophers are relevant and important. Whilst nurse theorists have advanced and shaped nursing as a discipline, other major philosophers can offer much to advance nursing enquiry. In this paper, we focus on philosopher Roy Bhaskar who, amongst others, developed critical realism, a philosophy for social science which connects with how many of us think about the world. Bhaskar's work focuses our attention on the interplay between structure and agency and on the search for the causative or generative mechanisms that explain the social world. Bhaskar was interested in human emancipation, and we suggest his work is of great importance to advance understanding of complex social situations. Critical realism has already been endorsed by a range of disciplines, especially in research which focuses on real problems and acknowledges the complexities of the social world. In recent evidence from healthcare literature, there has been a surge in research using realist methodology (realist evaluation and realist synthesis), which is underpinned by the philosophy of critical realism and which offers a different perspective to understanding nursing and healthcare problems through the realist lens. However, we suggest that sufficient attention is not always paid to the philosophical roots of this methodology. In this paper, we provide insight into Bhaskar's work and demonstrate how research positioned within critical realism and realist methodology can advance nursing and healthcare-related knowledge. Through shining a light on Bhaskar, we illustrate how critical realism philosophy is a natural fit with human and health science enquiry, including nursing.
Schachner, María B; Recondo, Francisco J; González, Zulma A; Sommer, Janine A; Stanziola, Enrique; Gassino, Fernando D; Simón, Mariana; López, Gastón E; Benítez, Sonia E
Regarding the user-centered design (UCD) practices carried out at Hospital Italiano of Buenos Aires, nursing e-chart user interface was redesigned in order to improve records' quality of nursing process based on an adapted Virginia Henderson theoretical model and patient safety standards to fulfil Joint Commission accreditation requirements. UCD practices were applied as standardized and recommended for electronic medical records usability evaluation. Implementation of these practices yielded a series of prototypes in 5 iterative cycles of incremental improvements to achieve goals of usability which were used and perceived as satisfactory by general care nurses. Nurses' involvement allowed balance between their needs and institution requirements.
Matthews, Elizabeth; Malcolm, Colette
Nursing a patient in pain is a challenging task requiring up-to-date knowledge, skilled interventions and attitudes that convey trust, care and an honest belief in what the patient says (Carr, 1997). This study examined the knowledge and attitudes of nurses who have completed a knowledge and competency training programme within an orthopaedic centre (Group one) against a group of nurses who were attending a pain conference who had not completed this programme (Group two). The questionnaire used was the Nurse's Knowledge and Attitudes Survey Regarding Pain (Ferrell and McCaffery, 2002). Findings from the survey revealed that there was no significant difference in the total correct responses between the two groups and there was a severe deficit in knowledge relating to questions about non-pharmacological methods of treating pain and opioid use in chronic pain conditions. However Group one had a higher correct response rate (p=0.001) in the vignettes that are based on daily nursing practice.
Handwerker, Sarah M
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.
Cornwell, C; Chiverton, P
Within the rapidly changing health care system, there is an increased need for professionals who can provide cost-effective primary health care for mentally ill patients. This article discusses the role of the Psychiatric Advanced Practice Nurse (APN) with Prescriptive Authority as a cost-effective, high-quality component of comprehensive mental health care delivery. Historical aspects of the development of the Nurse Practitioner (NP) role are discussed, as well as issues specific to the role in psychiatric nursing. The implementation of this role at Rochester is described, followed by recommendations for studying the impact of the psychiatric NP on care delivery, including process and outcome variables.
Andison, Margot; Moss, Jacqueline
This study utilized the ISO RTM for Nursing Action as a model to decompose nursing actions and as a framework for analyzing the practice patterns of nurses working in a medical intensive care unit (MICU). Observations were made in a 25-bed MICU and nursing actions recorded in terms of model attributes. 1013 actions were observed; decomposed into the ISO RTM categories, they represented 68 distinct actions, 166 targets, 6 recipients of care, 81 means, 16 routes and 115 sites. The most frequent actions were 'assessing' (19.1%) and 'documenting' (10.5%). The most frequent target was 'medication' (8.5%) and the most frequent recipient of care was 'patient' (94.1%). Data revealed nurses perform, yet do not document all actions. Thus in this setting, the existing documentation system does not adequately represent all aspects of nursing practice. The ISO RTM permits evaluation of the depth and breadth of nursing care by identifying all nursing actions.
Nagington, Maurice G
Judith Butler is one of the most influential late 20th and early 21st century philosophers in regard to left wing politics, as well as an active campaigner for social justice within the United States and worldwide. Her academic work has been foundational to the academic discipline of queer theory and has been extensively critiqued and applied across a hugely wide range of disciplines. In addition, Butler's work itself is extensive covering topics such as gender, sexuality, race, literary theory, and warfare. This article can only serve as a taster for the potential application of her work in relation to nursing, which is in its infancy. This introduction covers three of the potentially most productive themes in Butler's work, namely power, performativity, and ethics. Each of these themes are critically explored in turn, sometimes in relation to their actual application in nursing literature, but also in relation to their potential for producing novel critiques of nursing practice. Suggestions are made about how Butler's work can develop nursing research and practice. The article concludes with a short summary of Butler's key works as well as suggested reading for people interested in examining how her theories have been applied across different academic settings.
In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision.
Brooke, Joanne Mary; Mallion, Jaimee
The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses.
Thomas, Cynthia M
Direct and indirect violent behaviors toward nursing students and newly registered nurses must be eliminated. Nursing students and newly registered nurses are particularly vulnerable to acts of violence. The article discusses the effect of violence on students and newly registered nurses, the role of the continuing education nurse in eliminating violence, examples of aggressive situations, and strategies to educate and support students and new nurses and empower them to eliminate violence directed toward them. Strategies include confrontation tips, implementation of violence-free contracts, participation in role-play activities, adoption of a professional communication technique, reflection journaling and cognitive recognition, promotion of carefronting, introduction of dialogue through the World Café, and use of nurse preceptors, practice partnerships, residency programs.
Hoare, Karen J; Mills, Jane; Francis, Karen
Practice nursing in New Zealand is not well described in the literature. One survey illustrated that most of the New Zealand practice nurses sampled did not know of the country's two premier evidence-based health websites. A recent review compared general practice in the UK, New Zealand and Australia and found that whereas there had been significant developments in empowering the practice nurse workforce to run nurse-led clinics in the UK, New Zealand and Australia lagged behind. The aim of this reported constructivist grounded theory study was to investigate practice nurses' use of information. Conducted in Auckland, New Zealand, data were collected through ethnographic techniques in one general practice between September 2009 and January 2010 to enhance theoretical sensitivity to the area of information use. Subsequently, six experienced practice nurses (one twice after moving jobs) and five new graduate nurses from five different general practices were interviewed, using open-ended questions, between January 2010 and August 2011. Concurrent data collection and analysis occurred throughout the study period. The use of memos, the constant comparative method, data categorisation and finally, data abstraction resulted in the final theory of reciprocal role modelling. Experienced practice nurses role modelled clinical skills to new graduate nurses. Unexpectedly, new graduate nurses were unconscious experts at sourcing information and role modelled this skill to experienced practice nurses. Once this attribute was acknowledged by the experienced practice nurse, mutual learning occurred that enabled both groups of nurses to become better practitioners. Graduate nurses of the millennial generation were identified as a resource for experienced practice nurses who belong to the baby boomer generation and generation X.
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Council on Nurse Education and Practice (NACNEP). Dates and Times: November 7, 2013, 9:00 a.m.-5:00 p.m... Jeanne Brown, Staff Assistant, National Advisory Council on Nurse Education and Practice,...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Council on Nurse Education and Practice (NACNEP) Dates and Times: April 24 and 25, 2013, 9:00 a.m.-5:00 p... contact Jeanne Brown, Staff Assistant, National Advisory Council on Nurse Education and Practice,...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... on Nurse Education and Practice (NACNEP). Dates and Times: January 31, 2013, 9:30 a.m.-12:30 p.m... Nurse Education and Practice, Parklawn Building, Room 9-61, 5600 Fishers Lane, Rockville, Maryland...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Council on Nurse Education and Practice (NACNEP). Dates and Times: November 7, 2011, 8:30 a.m.-4 p.m..., National Advisory Council on Nurse Education and Practice, Parklawn Building, Room 9-61, 5600 Fishers...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Council on Nurse Education and Practice (NACNEP). Dates and Times: April 11, 2011, 8:30 a.m.-4 p.m. April.... Purpose: The purpose of this meeting is to address diversity in nurse education and practice....
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Council on Nurse Education and Practice (NACNEP). Dates and Times: November 17, 2010, 1 p.m.-5 p.m...: The purpose of this meeting is to address diversity in nurse education and practice. The objectives...
Story, Donna Ketchum
Designing a career ladder curriculum is not simply taking an existing practical nurse curriculum and an associate degree nursing curriculum and placing one after the other. The curriculum is designed to produce students who are competent practitioners as practical nurses at the end of the first level and then allow them to continue for an…
Killingsworth, Erin Elizabeth
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…
This article presents an analysis of the reflective practice of mentors and student nurses who were interviewed as part of a personal skill improvement project. Colleagues and students were asked to provide feedback on their perceptions of how the author demonstrated the skill of identifying and managing underperformance in nursing students. Their narratives were examined with the intention of identifying areas for improving underperformance and how it could be managed in future. Key findings were the requirement for mentors to increase engagement with students, especially in terms of protected time, participatory learning, honest and open dialogue and the need for a commitment to building a supportive and effective mentor-student relationship. This article offers insight into how current mentors and students perceive the management of underperformance and raises awareness of related issues in an attempt to improve mentoring practice.
The translation of research to clinical practice and health decision making is challenging. Under military operational conditions (e.g., the provision of care in the field), translation may be even more challenging. Two barriers that limit the use of evidence to guide practice, which are particularly germane under operational conditions, are conflicting or absent research results specific to the population of interest and relevant studies not being compiled in one place (Titler, 2007; Titler & Everett, 2001). The Agency for Healthcare Research and Quality Knowledge Transfer Framework (Nieva et al.,2005) provides a structure to facilitate evidence translation and to overcome these barriers. This article summarizes one aspect of a program of operational nursing research supported by the TriService Nursing Research Program, which exemplifies the three stages of the Agency for Healthcare Research and Quality framework.
Hunter, Lyndal H.; Aqtash, Salah; Day, Gary E.
In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care—particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. PMID:25944674
Villegas, Whitney J; Allen, Patricia E
Advanced practice registered nurses (APRNs) have the unique potential to affect the changing needs of health care in the United States, but are restricted in care provision by varying state regulations and reimbursement policies. Although research shows APRN care to be safe, cost-effective, and of high quality, most medical professional organizations continue to oppose the removal of scope-of-practice barriers, citing patient safety concerns. Nursing organizations at the state and national levels have already begun to invest the time and resources needed for policy change. However, empirical evidence of APRN quality of care must be shared with policymakers, funding entities, and the public. Additionally, support must be garnered from the public and other health care disciplines. Scope-of-practice policy change will occur through the emergence of strong individuals within nursing professional organizations and the joining together of organizations to form one voice.
This paper describes how a critical care nurse consultant's clinical role has evolved within a surgical high dependency unit (SHDU) in a large teaching hospitals trust. In order to provide some background to role development, an overview of the research exploring the nature of advanced nursing practice in the context of critical care will be presented. From the outset, advanced nursing practice was not perceived as the acquisition and application of technical procedures usually undertaken by doctors, but possibly an integration of medicine and nursing where holistic nursing assessment is combined with symptom-focused physical examination. A reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation will be presented. A model of working that can be applied to high dependency units, integrating the role of the advanced nurse practitioner within the clinical team, will be described.
Wood, Pamela J
Storytelling and narrative are widely used in nurse education and the value of narrative-based curricula, such as those governed by narrative pedagogy, is well recognised. Storytelling stimulates students' imagination, a central feature of narrative learning. One form of story and imagination yet to be fully considered by educators is the historical story and historical imagination. The use of historical storytelling creates a temporal dissonance between the story and reader that stimulates readers' imagination and response, and enables them to gain rich insights which can be applied to the present. Reader-response theory can support educators when using narrative and storytelling. This article presents an analysis of graduate nursing students' reader-responses to a nurse's story from the past. This narrative learning group used their historical imagination in responding to the story and prompted and challenged each other in their interpretation and in translating their responses to their current nursing practice. The article discusses this analysis within the context of reader-response theory and its potential application to narrative-based learning in nurse education. Historical stories stimulate historical imagination and offer a different frame of reference for students' development of textual competence and for applying insights to the present.
Vessey, Judith A
When school nurses embrace evidence-based practice (EBP), higher-quality care is provided to students, their families, and the larger community. Despite this, school nursing has been slow to embrace EBP. Practice-Based Research Networks (PBRNs), which capitalize on the combined strengths of clinicians and researchers to study clinical questions, are one approach to overcoming barriers towards advancing evidence-based practice (EBP) in school nursing. This article will briefly review EBP and PBRNs. The development of Massachusetts School Nurse Research Network (MASNRN), a PBRN designed to investigate health issues common across schools and to validate school nursing practice, will then be described. Details regarding MASNRN's mission, governance, communications systems, staffing, and network maintenance and funding will be explicated. MASNRN can serve as a model for PBRN development within the broader school nursing community.
Ziebert, Carolyn; Klingbeil, Carol; Schmitt, Catherine A; Stonek, Alice V; Totka, Joan P; Stelter, Ashley; Schiffman, Rachel F
This descriptive qualitative study explored data from debriefs of all newly hired nurses at 3, 6, and 12 months posthire during a newly designed transition-to-practice program at a pediatric hospital. Four major themes emerged: preceptors, education process, adaptation to the organization, and role transition. Supportive factors included staged orientation, limited preceptors, mentors, regular communication with leaders, and a culture of teamwork. Stressors included too many preceptors, mentorship needs, floating, communication challenges, and organizational changes.
Although in geriatrics we are better than many other clinical disciplines in terms of providing interdisciplinary care to older adults, I hope that we will continue to recognize how much more could actually be done. Before addressing the relationship between advanced practice nurses (APNs) and consultant pharmacists in real world settings, I want to review teamwork in geriatrics in general. It is critical to define what we mean by team, what type of team, and what the goals are of this teamwork.
DuHamel, Martha B; Hirnle, Constance; Karvonen, Colleen; Sayre, Cindy; Wyant, Sheryl; Colobong Smith, Nancy; Keener, Sheila; Barrett, Shannon; Whitney, Joanne D
In a 14-week medical-surgical nursing review course, two teaching strategies are used to promote active learning and assess the transfer of knowledge to nursing practice. Practice tests and clinical examples provide opportunities for participants to engage in self-assessment and reflective learning and enhance their nursing knowledge, skills, and practice. These strategies also contribute to program evaluation and are adaptable to a variety of course formats, including traditional classroom, web conference, and online self-study.
Banister, Gaurdia; Bowen-Brady, Helene M; Winfrey, Marion E
The Clinical Leadership Collaborative for Diversity in Nursing was developed through an academe-service partnership focused on supporting minority nursing students and facilitating transition to practice. A key program element is mentoring. Students are paired with an experienced, minority clinical nurse or nurse leader from one of the partnering agencies, who helps guide the student throughout the junior and senior year of school and first year of employment. The mentoring component was evaluated through surveys in which mentors and mentees rated one another and offered open-ended comments on the program's impact. Aspects of mentees rated highest by mentors include manner (courteous and professional), ability to communicate and get along with others, preparation for meetings, and fully utilizing their time with mentors. Aspects of mentors rated highest by mentees include warmth, encouragement, and willingness to listen; enthusiasm for nursing and how they sparked the mentee's interest; and clarity regarding expectations for mentees and how they pushed mentees to achieve high standards. In the open-ended comments, mentees consistently identified mentoring as the program's strongest component. Sixty-four minority students have participated to date with a zero rate of attrition and very low job turnover among graduates.
Alzghoul, Bashar I; Abdullah, Nor Azimah Chew
Pain is one of the most common reasons that drive people to go to hospitals. It has been found that several factors affect the practices of pain management. In this regard, this study aimed at investigating the underlying determinants in terms of pain management practices. Based on reviewing the previous studies and the suggestions of the KAP model, it was hypothesized that the main elements of the KAP model (attitudes and knowledge) significantly predict the variation in the practices of nurses regarding pain management. A questionnaire comprising the KAP model' s constructs, i.e. knowledge and attitude towards pain management, as well as pain management practices, was used to collect data from 266 registered nurses (n=266) who are deemed competent in the management of patients' pain in the Jordanian public hospitals. The two constructs, attitude and knowledge, which are the main determinants of the KAP model were found to independently predict nurses' practices of managing patients' pain. Knowledge of pain management was found to be the strongest predictor. Additionally, it was found that about 69% of the variance in pain management could be explained by the constructs of the KAP model. Therefore, it is recommended that the Jordanian hospitals and universities focus on nurses' knowledge and attitude towards pain management in order to enhance their practices in the field of pain management.
Forchuk, C; Dorsay, J P
Nursing theories which have evolved from mental health--psychiatric nursing have focused on the individual nurse-client relationship. Other nursing theories generally focus on the individual as client. Therefore, nurses working with families may have difficulty in applying these frameworks to their practice. Nursing theories need to be expanded to include families, groups and communities more explicitly. The well established theory of Hildegard Peplau, which previous studies have found to be the theory most frequently used by psychiatric nurses, and the family systems nursing theory of Wright and Leahey share a complementary focus. Both theories form part of the interpersonal paradigm of nursing; both view nursing from an interactional perspective, rather than focusing on individuals. Use of a combined theoretical approach offers several advantages. The approach explicitly considers both the individual and the family. The combination provides grounding for family work in an articulated nursing theory.
Vallejo-Torres, Laura; Morris, Stephen
Rising demand for and costs of health care have led to an increasing role of practice nurses in primary care in many countries, including the United Kingdom. Previous research has explored how practice nurse care differs from that provided by general practitioners (GPs) in terms of costs and health outcomes, and has highlighted the importance of matching skills and experience with roles and responsibilities. However, there has been little research to compare the characteristics of patients seen by GPs and practice nurses in primary care. We aim to investigate the factors associated with the use of practice nurse visits, and to compare these with the factors associated with GP use. We jointly model the use of practice nurse and GP visits using a bivariate probit regression model with a large set of covariates taken from two rounds of the Health Survey for England (2001, 2002). We find that practice nurse use is associated with age and gender, health, socioeconomic and supply variables. There are differences in the factors associated with practice nurse and GP use. Chronically ill patients are more likely to see a practice nurse, while acute ill health has a stronger association with the probability of seeing the GP. Practice nurse use is also correlated with a narrower range of health conditions compared with GP use. We also found differences between practice nurse and GP visits with respect to the association with economic activity, ethnic group, number of children, degree of urbanisation, and distance to practice.
Background Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice. Methods A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data. Results The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task. Conclusions If health practitioners are to be effective at communicating research evidence, we suggest that more research
Weslin, Anna T; Silva-Smith, Amy
Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care.
Vessey, Judith A.
When school nurses embrace evidence-based practice (EBP), higher-quality care is provided to students, their families, and the larger community. Despite this, school nursing has been slow to embrace EBP. Practice-Based Research Networks (PBRNs), which capitalize on the combined strengths of clinicians and researchers to study clinical questions,…
Freeman, B A; Coronado, J R
In a large VA teaching hospital, the primary nursing care delivery model is established with an all-RN staff. Several new initiatives and incentives have been implemented to maintain nurse satisfaction during this period of nurse shortage, but the primary nurse's relationship with her or his patient is the most satisfying and rewarding opportunity in this setting. The professional profile of the nurse staff reflects high academic preparation, certification in clinical area of practice, and involvement in nursing organizations. Primary nursing is successful because of the availability of support services, which enable the nurse to remain with the patient on the nursing unit. The primary nursing care delivery model and staffing were evaluated and revised to include licensed vocational (practical) nurses as associate nurses. Nurses on staff affirm their authority and autonomy to make and carry out clinical decisions about the nursing care of their primary patients. Physicians recognize nurses as the co-primary care provider in a clinical practice atmosphere of mutual respect and collaboration. New opportunities for professional growth and self-actualization enrich the work environment.
Ruth-Sahd, Lisa A
Reflective practice has become part of the discourse of nursing education classrooms, conferences, and journals, and are popular features of nursing continuing education programs. Yet, the idea of reflective practice has become increasingly more disparate. This critical analysis examines data-based studies and provides an overview of reflective practice, discusses common themes that emerged from the studies, and identifies implications for reflective practice in the field of nursing education.
Kear, Tamara; Ulrich, Beth
In order to assure patient safety, it is necessary to create positive patient safety cultures. This article presents the initial qualitative results from a national study, "Patient Safety Culture in Nephrology Nurse Practice Settings." Based on the responses of participants, themes were identified for both issues and potential solutions and best practices. Issue themes included underreporting of events and near misses, poor staffing ratios, long work hours, communication lapses, and training, infection control, and compliance. Potential solutions and best practice themes included non-punitive and transparent event reporting, fall reduction strategies, improved medication administration practices, and scheduled safety huddles and safety meetings. The results of this landmark study can be used to start conversations and spark education programs to improve patient safety culture in nephrology nurse practice settings.
DuChateau, Teresa A.; Beversdorf, Sarah; Wolff, Marie
School nurses are responsible for providing and supervising school nursing services for children with complex health concerns. Given school nurses frequently practice in isolation and may have limited access to clinical practice changes, they can benefit from up-to-date, evidence-based resources. Additionally, the resources must account for the fact that the nursing procedures will be performed in the unique setting of a school building and in many cases, will be performed by school personnel who have limited formal education in health care. This article provides an overview of a newly developed, easy to use, online school nursing procedures website for school nurses and other school personnel. PMID:25816427
Beardwood, Barbara A; Kainer, Jan M
This article explores risk in professional nursing practice. Professional risk refers to the threat of professional discipline if it is found that a registered nurse has violated professional nursing practice standards. We argue professional risk is socially constructed and understood differently by nurse regulatory bodies, unions, professional associations and frontline nurses. Regulatory bodies emphasize professional accountability of nurses; professional associations focus on system problems in health-care; unions undertake protecting nurses' right to health and safety; and frontline nurses experience fear and uncertainty in their attempt to interpret practice standards to avoid professional discipline. Perspectives of professional risk are investigated by analyzing three professional nursing bodies' views of professional codes governing the right of nurses to refuse unsafe work assignments. The workplace dynamics surrounding work refusal experienced by frontline nurses are illustrated primarily through the lens of the 2003 SARS influenza outbreak in Ontario, Canada. We conclude that frontline nurses in Ontario are required to manage risk by following professional protocols prioritizing patient care and professional accountability which disregard the systemic, unpredictable and hazardous circumstances in their everyday practice. Moreover, we argue professional protocols cannot anticipate every eventuality in clinical practice creating the fear of professional discipline for nurses.
Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R
This study examined certified nursing assistants' (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities' practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience.
Barooah, Adrita; Boerner, Kathrin; van Riesenbeck, Isabelle; Burack, Orah R.
This study examined certified nursing assistants’ (CNAs) experiences of nursing home practices following resident death. Participants were 140 CNAs who had experienced recent resident death. In semi-structured, in-person interviews, CNAs were asked about their experiences with the removal of the resident's body, filling the bed with a new resident, and how they were notified about the death. The facilities’ practice of filling the bed quickly was most often experienced as negative. Responses to body removal and staff notification varied, but negative experiences were reported by a substantial minority. Being notified prior to returning to work was associated with a more positive experience. Learning about the death by walking into a room to find the bed empty or already filled was the most negative experience. Study findings suggest that more mindful approaches to the transitions related to resident deaths would be valued by CNAs and could improve their work experience. PMID:25554351
Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R
Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.
Joyce-McCoach, Joanne T; Parrish, Dominique R; Andersen, Patrea R; Wall, Natalie
Being reflective is well established as an important conduit of practice development, a desirable tertiary graduate quality and a core competency of health professional membership. By assisting students to be more effective in their ability to reflect, they are better able to formulate strategies to manage issues experienced within a professional context, which ultimately assists them to be better service providers. However, some students are challenged by the practice of reflection and these challenges are even more notable for international students. This paper presents a teaching initiative that focused specifically on enhancing the capacity of an international cohort of nursing students, to engage in reflective practice. The initiative centered on an evaluation of a reflective practice core subject, which was taught in a Master of Nursing programme delivered in Hong Kong. A learning-centered framework was used to evaluate the subject and identify innovative strategies that would better assist international students to develop reflective practices. The outcomes of curriculum and teaching analysis and proposed changes and innovations in teaching practice to support international students are presented and discussed.
Pierce, Carol J
Reducing nursing practice variance by standardization of practice guidelines based on supportive literature has demonstrated improvements in the quality of patient care and positive patient outcomes. The challenge is to link the bedside nurse providing nursing care to subject matter experts well-versed in the critical analysis of clinical practice recommendations. This article discusses the restructuring of nursing research departments within Army healthcare facilities to facilitate nursing practice based on supportive evidence and the development of a senior nursing leadership practice council to support dissemination of approved nursing practice guidelines across all Army inpatient medical facilities.
Resck, Zélia Marilda Rodrigues; Gomes, Elizabeth Laus Ribas
Qualitative research using a dialectics view; the objective is to analyze the demands and the expectations from the setting of managerial practices in view of the Pedagogical Project and the strategies which may or may not favor the transforming praxis. It involves 11 students, 12 professors, and 12 service nurses who are the participants in the teaching-learning process of managerial knowledge, in the interceding space, in the fields of practice and in the curricular training programs, both in the hospital environment and in the basic health services and of the Nursing graduation course from a Federal University, from the city of Alfenas-MG. It uses the collecting technique by focal group and the analysis of the contents is subsided by two great discussions: background and work. The results point that the nurse's background and praxis must go through the work processes in the caring, managerial and educative dimensions as well as in the scientific investigation, building paths for the development of competences, in the teaching and service interaction, following the current National Curriculum Guidelines.
Sastre-Fullana, Pedro; Morales-Asencio, Jose Miguel; Sesé-Abad, Albert; Fernández-Domínguez, Juan Carlos; De Pedro-Gómez, Joan
Objective To describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context. Design and setting APNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing –APN– experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting. Methods An initial step for tool's content development process based on Delphi method approach of expert consensus was implemented. A subsequent phase of tool validation started from the analysis of APN core competencies latent measurement model, including exploratory and confirmatory techniques. Reliability evidence for each latent factor was also obtained. Items' scores were submitted to descriptive analysis, plus univariate and multivariate normality tests. Results An eight-factor competency assessment latent model obtained adequate fit, and it was composed by ‘Research and Evidence-Based Practice’, ‘Clinical and Professional Leadership’, ‘Interprofessional Relationship and Mentoring’, ‘Professional Autonomy’, ‘Quality Management’, ‘Care Management’, ‘Professional Teaching and Education’ and ‘Health Promotion’. Conclusions Adequate empirical evidence of reliability and validity for APNCAI makes it useful for application in healthcare policy programmes for APN competency assessment in Spain. PMID:28235968
Lacovara, Jane E
When nurse researcher Marlene Kramer published Reality Shock: Why Nurses Leave Nursing in 1974, her seminal work launched a national discussion related to the distress felt by many baccalaureate-prepared novice nurses about leaving the academic setting and transitioning to the clinical setting. In particular, Kramer (1974) highlighted conflict between the values these new nurses had been taught in school and the reality of practicing as a professional nurse in a clinical setting. For example, in an educational setting, nursing students may focus on one or two patients at a time, whereas in the clinical setting, nurses must practice simultaneously with multiple patients with varied and numerous health deficits. This conflict is felt acutely by novice and experienced oncology nurses who are tasked with providing quality physical care, as well as emotional care and support to patients with cancer and their families .
MacDonnell, Judith A
This article describes findings from a qualitative policy study focused on female nurses' activism in relation to lesbian health. Critical feminist analysis and comparative life history methodology were applied to career histories obtained from 10 diversely situated female nurses across Ontario, Canada. The findings show that nursing activist practices are informed by advocacy experiences that foster inclusive professional and community education plus formal education processes that shape their political socialization. Implications for nursing theory include the development of political knowledges and practices that support caring science, sociopolitical knowing, and primary healthcare nursing practice in a community context.
Déry, Johanne; DʼAmour, Danielle; Blais, Régis; Clarke, Sean P
Enacted scope of practice is a major issue for nursing administrators, given the potentially negative effect on accessibility, continuity, safety and quality of care, job satisfaction, and organizational costs of nurses working at reduced scope. Optimal deployment of nurses to a fuller enacted scope of nursing practice holds much promise for addressing all of these larger challenges. In this sense, new model of the Enacted Scope of Nursing Practice presented in this article provides a number of directions for interventions that could improve health system functioning.
Carlson, Cathy L
Over the past 30 years, postoperative pain relief has been shown to be inadequate. To provide optimal postoperative pain relief, it is imperative for nurses to use evidence-based postoperative pain assessment practices. This correlational descriptive study was conducted to identify factors, termed prior conditions, that influenced nurses' decisions to adopt three evidence-based postoperative pain assessment practices. A convenience sample of nurses who cared for adult postoperative patients in two Midwestern hospitals were surveyed, and 443 (46.9%) nurses responded. The previous practice and innovativeness of nurses were supportive of adoption of the three practices. Nurses felt that patients received adequate pain relief, which is unsupportive of adoption of the three practices because there is no impetus to change. Nurses who perceived the prior conditions as being supportive of adoption of pain management practices used multiple sources to identify solutions to clinical practice problems, and those who read professional nursing journals were more likely to have adopted the three practices and were more innovative. The number of sources used to identify solutions to clinical practice problems, previous practices, and innovativeness were predictive of nurses' adoption of the three evidence-based postoperative pain assessment practices. Nurses need to be encouraged to use multiple sources, including professional nursing journals, to identify solutions to clinical practice problems. Innovative nurses may be considered to be opinion leaders and need to be identified to promote the adoption of evidence-based postoperative pain assessment practices. Further exploration of the large unexplained variance in adoption of evidence-based postoperative pain assessment practices is needed.
Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John
Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.
Mohamed, Zainah; Newton, Jennifer Margaret; Lau, Rosalind
This study sought to explore the impact of Malaysian nurses' perceptions, knowledge and experiences in preterm infant skin care practices using a descriptive approach. Questionnaires were distributed to Neonatal Intensive Care Unit (NICU) nurses in one teaching hospital in Malaysia. A knowledge gap was revealed among nurses in both theoretical and practical knowledge of preterm infant skin. Nurses working for more than 5 years in NICU or having a Neonatal Nursing Certificate (NNC) were not predictors of having adequate knowledge of preterm infants' skin care. The results highlight the complex issue of providing effective skin care to preterm infants. However, a specific finding related to nurses' confidence provides some direction for future practice and research initiatives. Clear clinical evidence-based guidelines and Continuing Nursing Education on relevant topics of preterm infants' care may provide the required knowledge for the nurses.
Narayanasamy, Aru; Penney, Vivian
This article presents coaching, which facilitates the highest form of learning, as a potential strategy for promoting professional development in nursing. In doing so, it sets out what coaching is and highlights its benefits in terms of team building, adaptation to changes, career planning and professional development. Having established the rudiments of coaching and identifying its qualities, the article then sets out strategies of coaching using three models: the 3-D Technique Model, The Practice Spiral Model and The Grow Model. Three case histories are presented to explain how these models could be used to implement coaching and personal learning plans (PLP). Directions are provided where training for coaching is available. It is concluded that coaching can be a powerful tool in enhancing nurses' and other health professionals' ability to contribute to the success of healthcare organisations.
de Lima, C B; Baptista, S de S
This study was run in a community committee of Nossa Senhora da Aparecida, a surrounding city of Joao Pessoa, Paraiba. It aimed at characterizing nursing practice there and discussing its occurrence. The analysis was run based on eight inhabitants and four nurses speeches through semistructured interviews whose data were collected qualitatively. It focused on the discussion which evolved from questions regarding to education and health from the perspective of exercising citizenship. In the participants of the study representations, education seemed dynamic and implied awareness ... a question of life. Health is comprehended under 3 points of view: the one of welfare, the one of suffering and the one of biological balance. The perspective of citizenship exercise reveals itself sometimes as conformism, through silence or resignation and sometimes as resistance, through the ideal manifestation and courage for fighting for better life condition.
Hanrahan, Nancy P; Delaney, Kathleen R; Stuart, Gail W
The mental health system is inefficient and ineffective in providing behavioral health care services to the 1 in 4 Americans who have a mental illness or a substance abuse problem. Current health care reform initiatives present a significant opportunity for advanced practice psychiatric nurses-psychiatric mental health (APRN-PMH) to develop action-oriented recommendations for developing their workforce and thereby increasing access to high-quality and full-spectrum behavioral health care services. If endorsed by the professional nursing associations and the APRN-PMH workforce, the strategies presented in this paper provide a blueprint for developing the APRN-PMH workforce. Achieving these goals will significantly reform the APRN-PMH workforce, thereby contributing to the overall goal of supporting an integrated model of behavioral health care. No change has as much potential to influence the APRN-PMH workforce as the uniting of all APRN-PMHs in a "Blueprint for APRN-PMH Workforce Development."
Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula
The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. PMID:25673578
Hain, Debra; Haras, Mary S
A rapidly evolving healthcare environment demands sound research evidence to inform clinical practice and improve patient outcomes. Over the past several decades, nurses have generated new knowledge by conducting research studies, but it takes time for this evidence to be implemented in practice. As nurses strive to be leaders and active participants in healthcare redesign, it is essential that they possess the requisite knowledge and skills to engage in evidence-based practice (EBP). Professional nursing organizations can make substantial contributions to the move healthcare quality forward by providing EBP workshops similar to those conducted by the American Nephrology Nurses'Association.
Yokota, Mitsuhiro; Hirano, Kimitaka; Honda, Chikahisa
An educational practice for small size class in fundamental education of our faculty has been carried out using a special fund from the Ministry of Education, Culture, Sports, Science and Technology since fiscal year 2005. The fundamental subjects such as Mathematics and Physics are very important for the students of Faculty of Engineering. In order to achieve the aim of each subject for students with insufficient understanding, we wrestle with the project of the education for small size class. Some projects are described in this paper.
Missal, Bernita; Schafer, Beth Kaiser; Halm, Margo A; Schaffer, Marjorie A
This article describes a partnership model between a university and health care organizations for teaching graduate nursing research from a framework of evidence-based practice. Nurses from health care organizations identified topics for graduate students to search the literature and synthesize evidence for guiding nursing practice. Nurse educators mentored graduate students in conducting critical appraisals of the literature. Students learned how to search for the evidence, summarize the existing research findings, and translate the findings into practice recommendations. Through presenting and discussing their findings with key stakeholders, students learned how nurses planned to integrate the evidence into practice. Nurses used the evidence-based results to improve their practice in the two partner hospitals. The partnership stimulated action for further inquiry into best practices.
Kimpson, Sally; Purkis, Mary E
The concept of professional autonomy has figured prominently in literature that addresses nursing's project of professionalization. Nursing's capacity to determine the nature and scope of its practice is related in important ways to the location of practice. Within highly structured environments such as acute-care hospitals, nurses' professional autonomy has frequently been contested yet is often implicated by nursing's elite as a necessary condition in the construction of quality work environments. Professional concerns and management practices related to retaining experienced nurses to support sustainability in healthcare delivery systems' impact on the ability of nurses to practice autonomously. Our paper focuses on the emerging field of practice of chronic disease management. We describe the complex relationships negotiated by a nurse in a theoretically autonomous practice setting as she seeks to fulfil both the requirements of a research protocol designed by physician experts representing the specialty of renal medicine, and her professional obligations to respond to the expressed needs of patients with early-stage renal disease. We utilize a case study approach to explore particular contemporary concerns that nurses in practice confront as they attempt to accomplish professional relationships with patients central to achieving prescribed medical outcomes where nursing practice, as an element of the achievement of those outcomes, is constituted as absent or unacknowledged by the medical researchers leading the project. Implications for nursing's discourses on the professional project of autonomy will be discussed.
Fairweather, C; Gardner, G
Over the past decade the discipline of nursing has been reviewing its practice, especially in relation to specialty areas. There has been an appreciation by nursing leaders that specialisation brings with it concerns related to a disuniting effect on the discipline and a fragmentation of nursing's traditional generalist practice. Accompanying these concerns is a debate over what is a specialty and how to define a specialist. This qualitative study drew upon a constructivist methodology, to explore how nurses, working in specialty areas, define and give meaning to their practice. Three groups of nurses (n=20) from the specialty of critical care were interviewed using a focus group technique. The data were analysed to build constructions of specialty practice. A distinct and qualitative difference was recognised in the practice behaviours of nurses working in the specialty area. The qualitatively different practice behaviours have been identified as 'nursing-in-a-specialty' and 'specialist nurse'. Two constructions emerged to differentiate the skill behaviours, these were 'practice' and 'knowledge'. The specialist nurse practices were based on two distinct types of practice, that of 'discretion' and 'incorporation'. 'Knowledge' was constructed as a synthesis of propositional and practice knowledge. By Carrie Fairweather and Glenn Gardner.
This article presents the results of a qualitative empirical study of interaction between teachers and students during lessons in nursing training, focussing in particular on the perspectives of nursing didactics. It examines whether the classes warrant appropriate preparation for beginners with regard to the complex demands of professional practice. The presentation focuses on a widespread educational concept named "rule-orientation". This category summarises those communication patterns of teachers which create rules for operating in typical nursing situations and which are presented as benchmarks for professional practice. Limitations associated with this concept are (1) lacking science-based justification of those operation rules, (2) the communication of standards and recipes instead of clinical judgement, and (3) the partial resolution of intrinsically contradictious demands in nursing practice. Three nursing didactical target dimensions for nursing education are being concretised as a referential framework for class-related decisions that can contribute to better qualify nursing students for professional practice.
Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem.
Taylor, Sherry T.
This case study attempted to discover and comprehend the relationship of students and contributing factors of success, of one Licensed Practical Nurse (LPN) to Associate Degree in Nursing (ADN) program, to formulate an understanding of which contributing factors are most beneficial to enable students to persist to graduation and/or successfully…
Oyira, Emilia James; Ella, R. E.; Chukwudi, Usochukwu Easter; Paulina, Akpan Idiok
Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research…
Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla
Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…
McDonald, Stuart; Willis, Gail; Fourie, Willem; Hedgecock, Bronwyn
The first year of practice is usually a challenging time for nursing graduates. In New Zealand most undertake a Nursing Entry to Practice (NETP) programme aimed at socialising them into their new role and work environment. Some of these programmes now have embedded postgraduate courses. This means that graduates undertake higher education while at the same time adjusting to a new role and work environment. Using a cross-sectional survey design the purpose of this study was to explore graduate nurses' experiences of postgraduate education within a NETP programme. Overall, participants felt well prepared for postgraduate studies at academic, personal and professional levels, although most suggested that NETP programmes could allow for a stand-down period of three to four months before postgraduate education is introduced. This would give the graduate an opportunity to adjust to the clinical environment. They also highlighted the importance of making expectations clear from the outset. This study revealed that the number and nature of postgraduate courses offered in a NETP programme requires further investigation.
Willard, Suzanne; Nelson, John; Reyes, Darcel; Linn, Annē
The move to integrate HIV treatment and care into primary care is a major obstacle for the current U.S. health care workforce. Many HIV specialty providers will soon retire, while few primary care clinicians have been adequately trained in the diagnosis, care, and treatment of people living with HIV. The Health Resources and Services Administration (HRSA) has supported the development of a Doctor of Nursing Practice (DNP) program with an HIV specialty at Rutgers, the State University of New Jersey, to assure successful transition to an HIV primary care workforce. The Rutgers School of Nursing has been at the forefront of the DNP education movement and is among the first to develop an HIV-focused DNP program. Thirty-seven students have enrolled in the 3-year program, and two have graduated from the first cohort. Here we discuss the planning, implementation, successes, and recommendations of the new program.
Woods, Michelle; Murfet, Giuliana
The role of the Australian Nurse Practitioner (NP) is in its infancy and at a crossroads where extensive research demonstrates effective quality care and yet the role remains underrecognised and underutilised. The translation of practice into “value” is critical for the sustainability of NP roles and requires the practitioner to adopt a systematic method of inquiry. Kim's (1999) “Critical Reflective Inquiry” (CRI) method was adapted by two Australian NPs who specialise in diabetes and chronic disease management. Kim highlights the intent of CRI as understanding the meaning of practice, delivering improvements to practice through self-reflection, and the critique of practice that can lead to practice changes and development of new models of care translated to “products” of value. Based on the thematically analysis of 3 years of CRI application, the authors formed 5 headings that represented the NP's practice as Specialised Care Access, Complications and Diagnostics Interventions, Pharmaceutical Treatment, Vulnerable Populations, and Leadership. The utility of CRI demonstrates how NP practice is integral to a continuous cycle of addressing health care services gaps, and the conversion of “products” into “value” and positions the NP to assimilate the role of the practitioner-researcher. PMID:25705517
Forrester, David Anthony; O'Keefe, Trish; Torres, Sara
The Interdisciplinary Health Research Consultant-Professor in Residence Program is a partnership between the University of Medicine and Dentistry of New Jersey (UMDNJ) School of Nursing (SN), the New Jersey Joanna Briggs Institute (JBI) Center for Evidence Based Practice, and Morristown Memorial Hospital/Atlantic Health (MMH/AH). It provides MMH with the expert research and evidence-based practice (EBP) consultation and affiliation of a UMDNJ-SN faculty member and the resources of the New Jersey JBI Center for Evidence Based Practice. For the participating SN faculty member, it provides a clinical laboratory to pursue an individualized program of scientific research and scholarly publication. This research scholar works closely with the MMH/AH to (a) identify and evaluate existing mechanisms to support interdisciplinary health research and EBP at MMH; (b) develop and implement new mechanisms to support interdisciplinary health research and EBP; (c) implement the findings of published research using EBP strategies; (d) replicate interdisciplinary research studies; (e) conduct original interdisciplinary research studies; (f) seek intra- or extramural funding to support interdisciplinary research studies; and (g) support requirements for American Nurses' Credentialing Center accreditation for Magnet designation. The program has been successful in its first year of implementation.
Lin, Shou-Ju; Huang, Lain-Hua
The practice environment for nurses has seen tremendous change over the past century due to the dedication and trailblazing work of nursing pioneers. This article describes how the nursing practice environment in Taiwan has evolved over this period. References used include nursing narratives, hospital accreditation standards, standard operating procedures, workplace safety standards, and worksite-related values and expectations. The efforts of the professional nursing community to realize a positive practice environment are further discussed. Over this century of change, the only thing that has remained unchanged is the commitment of nurses to "treat patients as one's own family". In the current as well as the previous periods of manpower shortages in nursing, the nursing community has managed to turn crisis into opportunity by using the situation to enhance pay and benefits. Nursing professionalism is widely respected and recognized throughout Taiwan society. The rapidly changing needs of the 21st century in aspects such as the advancement of high technology, the rapid growth of the elderly population, and the fast rate of social change seriously impact the development of the nursing profession. How to effectively apply high technology, simplify workflows, provide high quality and humanistic nursing care, build safe and quality workplaces, attract bright nursing students, and provide healthcare for the entire population will remain the responsibilities of nursing for generations to come.
The ability to reflect is becoming a core competency in many nursing educational programs. A clinical journal assignment was developed for first-semester (novice) nursing students. The aim was to see if the process of reflection-on-action through the medium of journal writing promoted fundamental clinical decision-making abilities of the first semester nursing student. This author discusses components of the clinical decision-making process used to structure six clinical journal questions for use by the first semester nursing students during their clinical rotation. Exemplars of students' self-reported reflections are included.
Moreira, Roberta F. C.; Sato, Tatiana O.; Foltran, Fabiana A.; Silva, Luciana C. C. B.; Coury, Helenice J. C. G.
Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals. PMID:25054385
Effective use of simulation is dependent on a complete understanding of simulation's central conceptual elements. Deliberate practice, a constituent of Ericsson's theory of expertise, has been identified as a central concept in effective simulation learning. Deliberate practice is compatible with simulation frameworks already being suggested for use in nursing education. This paper uses Wilson's Method of concept analysis for the purpose of exploring the concept of deliberate practice in the context of clinical simulation in nursing education. Nursing education should move forward in a manner that reflects best practice in nursing education.
Fashafsheh, Imad; Ayed, Ahmad; Eqtait, Faeda; Harazneh, Lubna
Health care professionals are constantly exposed to microorganisms. Many of which can cause serious or even lethal infections. Nurses in particular are often exposed to various infections during the course of carrying out their nursing activities. Therefore nurses should have sound knowledge and strict adherence to infection control practice. Aim…
Khubchandani, Jagdish; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Hendershot, Candace
Background: This study assessed the perceptions and practices of school nurses regarding adolescent dating violence (ADV). Methods: The membership list of the National Association of School Nurses was used to identify a national random cross-sectional sample of high school nurses in the United States (N?=?750). A valid and reliable survey…
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Council on Nurse Education and Practice (NACNEP). Dates and Times: April 22, 2010, 8:30 a.m.-4:30 p.m... meeting are to: (1) Delineate the variety of roles nurses play in primary care including health...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on Nurse Education... Administration (HRSA) is requesting nominations to fill eight vacancies on the National Advisory Council on Nurse... contact, Lakisha Smith, Executive Secretary, National Advisory Council on Nurse Education and Practice,...
Cline, April P.
It is important that practical nurse (PN) educators be able to identify which students are likely to be successful in their programs. However, the majority of literature related to predicting success of nursing students has been done on baccalaureate nursing students in the university setting. This study sought to determine whether the same…
Nokes, Kathleen M.; Stein, Gary L.
A survey of 23 advanced practice nursing programs showed only 3 had HIV-specific graduate-level nursing courses. Recommendations were made for HIV-specific courses, integration of HIV content into other courses, use of Centers for Disease Control and Occupational Safety and Health Administration guidelines, and subspecialties in HIV nursing. (SK)
Goldstein, Perry C
The impact of disease management progrmms on the role of the nursing profession in the evolving U.S. health care system is reviewed. Needed changes in educational and training programs are discussed in relation to demands for changing clinical and administrative skills in nursing with an emphasis on increasing demand for advanced practice nurses.
Barry, Charlotte D; Gordon, Shirley C; Lange, Bernadette
A community nursing practice (CNP) model is presented as the synthesis of a decade of experience of caring for persons and communities. Values form the basis of the model and provide the grounding for practice. Transcendent values of respect, caring, and wholeness are explicated in the actualizing values of primary health care: access, essentiality, empowerment, intersectoral collaboration, and community participation. Usefulness of the CNPM in providing a framework for community nursing practice at school-based community wellness centers in both the United States and Africa is described. Narratives of practice and research presented in the unique voice of three faculty members illuminate the model's values and paradigmatic view of person, nursing, community, and environment. These narratives provide insight into how the CNPM has served as a heuristic in the design of creative responses to calls for nursing in community nursing practice, education, and research.
Vance, David; Larsen, Kirsten I; Eagerton, Gregory; Wright, Mary A
Optimal cognitive functioning is necessary to successfully negotiate one's environment, yet medical conditions can interfere with brain health, thus negatively impacting cognitive functioning. Such comorbidities include hypertension, heart disease, diabetes, depression, and HIV, as well as others. The physiological properties of these comorbidities can reduce one's cognitive reserve and limit one's cognitive efficiency. This article provides an overview of a few common comorbidities known to affect cognitive functioning and addresses ways in which cognitive functioning may be ameliorated and protected or mitigated in lieu of cognitive declines in such clinical populations. Implications for nursing practice and research are posited.
Whiteley, Annette D; Kurtz, Donna L M; Cash, Penelope A
Individuals with developmental disabilities (DD) experience stigma, discrimination, and barriers, including access to appropriate health care, that restrict their ability to be equal participants in society. In this study, underlying contexts, assumptions, and ways of acting are investigated that perpetuate inequalities and pejorative treatment toward those with disabilities. Several nurse researchers and educators suggest specific content for, or approaches to, education about DD. Critical pedagogy that employs cultural competency and a disability studies' framework to guide curriculum and course development will allow assumptions underlying common health care practices that oppress and "other" people with disabilities to be exposed and changed.
This article proposes a new holistic conceptualization of empathy for nursing practice that allows different aspects of the literature to be understood. This study is based on the data of a doctoral study exploring the nature of empathy on an oncology ward. The findings revealed that empathy is not a single phenomenon. Four different forms of empathy were identified, namely, empathy as an incident, empathy as a way of knowing, empathy as a process, and empathy as a way of being. These different forms of empathy can be understood in terms of a continuum of empathy development and suggest a new way of conceptualizing empathy that can be depicted diagrammatically.
Chiang-Hanisko, Lenny; Newman, David; Dyess, Susan; Piyakong, Duangporn; Liehr, Patricia
The mixed methods approach purposefully combines both quantitative and qualitative techniques, enabling a multi-faceted understanding of nursing phenomena. The purpose of this article is to introduce three mixed methods designs (parallel; sequential; conversion) and highlight interpretive processes that occur with the synthesis of qualitative and quantitative findings. Real world examples of research studies conducted by the authors will demonstrate the processes leading to the merger of data. The examples include: research questions; data collection procedures and analysis with a focus on synthesizing findings. Based on experience with mixed methods studied, the authors introduce two synthesis patterns (complementary; contrasting), considering application for practice and implications for research.
Roch, Geneviève; Dubois, Carl-Ardy; Clarke, Sean P
Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices.
Chafetz, Linda; Collins-Bride, Geraldine M; White, Mary
This Faculty Practice developed in response to increasing medical complexity among severely mentally ill adults in community programs. It represents collaboration between an academic nursing program and Progress Foundation, a residential care provider in San Francisco for the severely mentally ill (SMI). Over ten years, the practice and research agenda have evolved together, through a commitment to mutual collaboration by clinicians and researchers from the University of California San Francisco (UCSF) School of Nursing, and the mental health community. Initial efforts at research focused on description of clients and practice. Research efforts have broadened and evolve to include an on-going clinical trial that tests the value of adding active health promotion to primary care. Factors contributing to success included trust among research and clinical faculty and community partners, use of clinical data in the service of practice and education, and relative freedom from fiscal administration. The merging of practice and research increases visibility of nursing contributions and will allow testing of models for care.
Ng, San; Kessler, Linda; Srivastava, Rani; Dusek, Janice; Duncan, Deborah; Tansey, Margaret; Jeffs, Lianne
Despite the growing prevalence and healthcare needs of people living with mental illness, the stigma associated with mental health nursing continues to present challenges to recruiting new nurses to this sector. As a key recruitment strategy, five mental health hospitals and three educational institutions collaborated to develop and pilot an innovative nursing residency program. The purpose of the Mental Health Nursing Residency Program was to dispel myths associated with practising in the sector by promoting mental health as a vibrant specialty and offering a unique opportunity to gain specialized competencies. The program curriculum combines protected clinical time, collaborative learning and mentored clinical practice. Evaluation results show significant benefits to clinical practice and an improved ability to recruit and retain nurses. Nursing leadership was crucial at multiple levels for success. In this paper, we describe our journey in designing and implementing a nursing residency program for other nurse leaders interested in providing a similar program to build on our experience.
The initial development of the Nursing Minimum Data Set (NMDS) was analyzed based on archival material from Harriet Werley and Norma Lang, two nurses involved with the project, and American Nurses Association materials. The process of identifying information to be included in the NMDS was contentious. Individual nurses argued on behalf of particular data because of a strong belief in how nursing practice (through information collection) should be structured. Little attention was paid to existing practice conditions that would ultimately determine whether the NMDS would be used.
Huynh, Truc; Alderson, Marie; Nadon, Michelle; Kershaw-Rousseau, Sylvia
Recognizing the emotional labour underlying interprofessional collaborations (IPCs) could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs) and licensed practical nurses (LPNs) have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1) the professional identity of LPNs has evolved into a that of a unique social group; (2) LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patient's status with RNs and, together, establishing a course of nursing actions; (3) the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4) the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5) an LPN's emotional labour (i.e., internal emotional regulation) is most tangible during uncollaborative interactions with RNs. PMID:22135732
Few would argue with the idea that nursing research should be conducted ethically yet obtaining ethical approval is considered by many to have become unnecessarily burdensome. This brief article investigates the idea that there might be a relationship between the level of perceived burdensomeness of the research ethics application process on the one hand and the character of the nurse-researcher on the other. Given that nurses are required to be other-regarding, a nurse who undertakes research primarily for self-regarding reasons would seem to be acting in ways inconsistent with the aims of nursing as set out in nursing codes. It is suggested that the self-regarding nurse-researcher may find the ethics application process more burdensome than the other-regarding nurse-researcher who, it is further suggested, is engaged with nursing research as a practice in the technical sense in which that term has been developed by the philosopher Alasdair MacIntyre.
Xu, Yan; Jang, Kihoon; Yamashita, Tadahiro; Tanaka, Yo; Mawatari, Kazuma; Kitamori, Takehiko
By combining cell technology and microchip technology, innovative cellular biochemical tools can be created from the microscale to the nanoscale for both practical applications and fundamental research. On the microscale level, novel practical applications taking advantage of the unique capabilities of microfluidics have been accelerated in clinical diagnosis, food safety, environmental monitoring, and drug discovery. On the other hand, one important trend of this field is further downscaling of feature size to the 10(1)-10(3) nm scale, which we call extended-nano space. Extended-nano space technology is leading to the creation of innovative nanofluidic cellular and biochemical tools for analysis of single cells at the single-molecule level. As a pioneering group in this field, we focus not only on the development of practical applications of cellular microchip devices but also on fundamental research to initiate new possibilities in the field. In this paper, we review our recent progress on tissue reconstruction, routine cell-based assays on microchip systems, and preliminary fundamental method for single-cell analysis at the single-molecule level with integration of the burgeoning technologies of extended-nano space.
Rose, Jayln; Glass, Nel
The article reports on selected findings of a research study concerning emotional wellbeing and professional nursing practice (Rose 2002). It highlights the relationship between community mental health nurses' and emotional wellbeing, and their capacity to provide satisfying professional nursing practice (Rose 2002). The notion of emotional wellbeing, factors that impacted upon the participants' emotional wellbeing, and the relationship of emotional wellbeing to professional practice were revealed in the study. These findings were based on a qualitative critical feminist research inquiry and specifically, interviews with five women community mental health nurses in Australia. Whilst complex, emotional wellbeing was found to be both implicitly and explicitly linked to the participants intertwined personal and professional experiences. Four key components were identified: the nebulous notion; the stress relationship; the mind, body, spirit connection; and, inner sense of balance. In terms of emotional wellbeing and professional practice, three themes were revealed. These were: being able to speak out (or not); being autonomous (or not) and being satisfied (or not). The authors argue that the emotional wellbeing of nurses working in community mental health settings is critical to satisfying professional practice. Furthermore nursing work involves emotional work which impacts on one's emotional wellbeing and emotional wellbeing is integrally linked to professional practice. It is recommended that health organisations must be pro-active in addressing the emotional needs of nurses to ensure the delivery of health care that is aligned to professional practice. This approach will ensure nurses will feel more recognised and validated in terms of their nursing practice.
McCarthy, Cindy T; Aquino-Russell, Catherine
This column illuminates nursing practice through two unique theoretical perspectives: Peplau's theory of interpersonal relations and Parse's theory of humanbecoming. Processes of each practice method will be explicated as each is related to a practice scenario. The key differences between Peplau's and Parse's practice methodologies are identified. Nursing is a unique, evolving, everchanging profession for which theory can be used as a guide for practice. This column demonstrates two of these unique theories. Whether through health promotion or quality of life from the person's perspective, theory provides meaning in nursing practice and in everyday life.
Sherman, Rose; Dyess, Susan; Hannah, Ed; Prestia, Angela
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.
Oberlies, Amanda Stefancyk
The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.
Norfolk Public Schools, VA.
This instructional guide includes the curriculum for two complete and separate courses to be taught at the associate degree level. The first six units of the guide are the course content for a 2-3 semester hour course, "Transition from Licensed Practical Nurse (LPN) to Associate Degree Nursing (ADN)." The entire content of the guide, 19…
dos Santos, José Luís Guedes; Erdmann, Alacoque Lorenzini
Objective: to elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. Method: a mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index - Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Results: based on the results obtained with the Brazilian Nursing Work Index - Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. Conclusion: it is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses. PMID:26625992
Merrick, Eamon; Duffield, Christine; Baldwin, Richard; Fry, Margaret; Stasa, Helen
Like other countries, Australia is looking to reforms in the primary health care sector to meet the growing demand for care. Expansion of the role of practice nurses (PNs) is one way in which this demand may be met. To date the Federal Australian government has played a significant role in encouraging growth in the PN workforce. If PNs tend to be GP directed, with little autonomy, care must be taken to consider whether to expand existing scopes of practice. In contrast, if PNs rely on their own independent clinical judgment and skill, this would support potential expansions to the scope of the PN role. Understanding these issues is important to inform the development of future workforce policy. This paper examines the structural policy dimensions within which these changes are occurring, and makes recommendations for future research on PNs.
The decision to open a nurse practitioner practice is often difficult to make. Success depends on the possession of specific resources, such as adequate skills, finances, emotional support and the desire to be one's own boss. These skills will be critical as the NP develops a business plan and a budget, and makes important decisions, such as the form the business will take: sole proprietorship, partnership or corporation. Using external resources such as attorneys and accountants is also useful, especially when tackling issues of licenses, taxes and insurance. Start-up costs can be kept to a minimum with creativity and used equipment. In-house laboratories and reference laboratories must conform to strict regulations. A practice without established patients will need to market services aggressively through a successful mix of product, price, place and promotion. Patients' acceptance of the NP office will be enhanced by smooth patient flow, adequate space and cleanliness.
Cuthbert, Colleen Ann; Moules, Nancy
The Oncology Nursing Society (ONS) has established an ambitious research agenda and professional priorities based on a survey by LoBiondo-Wood et al. (2014). With the overall goal to "improve cancer care and the lives of individuals with cancer" (Moore & Badger, 2014, p. 93) through research activities, translating those research findings to direct clinical practice can be overwhelming. As clinicians, understanding how to critique research for quality prior to incorporating research findings into practice is important. The ultimate goal in this critique is to ensure that decisions made about patient care are based on strong evidence. However, the process for appraisal of qualitative research can be ambiguous and often contradictory as a result of the elusive aspect of quality in qualitative research methods (Seale, 1999). In addition, with more than 100 tools available to evaluate qualitative research studies (Higgins & Green, 2011), a lack of consensus exists on how to critically appraise research findings.
Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant
Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce.Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territoriesResults Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies.Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices.What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally
Popovich, D M
This exploratory study assessed pediatric nurses' attitudes, knowledge, and patient care practices related to the sexuality of hospitalized preschool and early school-age children. Sexuality was defined as the sum of the physical, emotional, and psychologic attributes that are expressed in gender identity and behavior. For this study, a questionnaire containing 24 attitude, 20 knowledge, and 29 nursing practice Likert-scale items was used to survey 45 pediatric nurses in a southeastern tertiary care teaching hospital. Results indicated that, in general, the nurses surveyed had positive attitudes, sound knowledge, and appropriate practice with regard to the sexuality-related needs of their patients. However, there appeared to be some attitudinal biases and knowledge gaps that could adversely affect nursing practice. These findings were used to alter the content in pediatric nursing education at the study institution.
Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice. PMID:27417590
Hahn, E J; Bryant, R; Peden, A; Robinson, K L; Williams, C A
To better prepare new graduates for entry-level positions in community settings, faculty of one college of nursing gathered information using focus groups of prospective employers. The groups were to identify the skills and qualities nurses need to practice in the community and ways to redesign nursing curricula to better prepare undergraduates for community-based practice. Data for this qualitative study were collected in five separate focus groups conducted with prospective employers (N = 18) from four major areas of Kentucky. By collaborating with prospective employers in the community, a partnership was established between nurse educators and community health leaders to improve the marketability of baccalaureate graduates. Assessment was the most frequently named skill essential to nursing practice in the community. Independence, critical thinking, collaboration, and confidence consistently emerged as important skills and qualities. Prospective employers were positive about developing partnerships to improve under-graduate nursing curricula. Recommendations for curricula to better prepare undergraduates for community-based practice are suggested.
Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice.
Wako, Fumiko; Tsuru, Satoko; Omori, Miho; Watanabe, Chitose; Uchiyama, Makiko; Asada, Miwa; Inoue, Kikumi
A common language in nursing facilitates better communication among nurses and healthcare team, assuring better nursing care, hence better patient outcomes. As we developed and disseminated the standardized terminology of nursing which provided nurses with a set of terms to describe nursing observations and nursing actions, we developed a certain number of nursing care plans using the terms in it. The nursing care plans included those for the patients requiring medical (pharmaceutical)/surgical procedures or the patients showing some signs and symptoms. Generally, nurses found that the nursing care plans were useful and flexible enough to allow for the modification according to the needs of each individual patient. In conclusion, the nursing care plans based on the standardized terminology showed its relevance to the clinical settings.
Jeffs, Lianne; Sidani, Souraya; Rose, Donald; Espin, Sherry; Smith, Orla; Martin, Kirsten; Byer, Charlie; Fu, Kaiyan; Ferris, Ella
An evolving body of literature suggests that the implementation of evidence based clinical and professional guidelines and strategies can improve patient care. However, gaps exist in our understanding of the effect of implementation of guidelines on outcomes, particularly patient outcomes. To address this gap, a measurement framework was developed to assess the impact of an organization-wide implementation of two nursing-centric best-practice guidelines on patient, nurse and organizational level outcomes. From an implementation standpoint, we anticipate that our data will show improvements in the following: (i) patient satisfaction scores and safety outcomes; (ii) nurses ability to value and engage in evidence based practice; and (iii) organizational support for evidence-informed nursing care that results in quality patient outcomes. Our measurement framework and multifaceted methodological approach outlined in this paper might serve as a blueprint for other organizations in their efforts to evaluate the impacts associated with implementation of clinical and professional guidelines and best practices.
Drawing on the evidence base on the core clinical skills and competencies required by newly qualified nurses, this comprehensive text provides useful learning outcomes, activities to encourage reflection, and top tips to expand readers' knowledge and practice.
In order to obtain the state nursing diploma nurses must acquire a specific number of skills. Where does trust fit in? Although it is not implicit it forms the core of the nursing relationship with the patient and his or her family. This article presents the personal account of a private nurse practitioner.
Marks, Rachel; Hodgen, Jeremy; Coben, Diana; Bretscher, Nicola
This paper examines nursing students' experiences of the teaching and assessment of numeracy for nursing. Data from interviews with eight student nurses at a large school of nursing in the United Kingdom are analysed using a constructivist grounded theory approach to explore their perceptions of any disjunctures between the ways in which numeracy…
Professional empowerment is vital to nurses' productivity and job satisfaction. A grounded theory study was conducted to describe the basic social process experienced by school nurses in relation to professional empowerment. Interviews with 10 school nurses led to the development of a situation-specific theory of school nurse empowerment,…
Fries, Kathleen; Stewart, Julie G
The concept of community is multidimensional and may include geographical boundaries and/or the shared interests of its members. Community nursing practice involves nurses, patients, and families who collaborate to address health issues and to promote positive health initiatives. Informed by community health theorists, experiential learning activities provide the structure to promote partnering in community nursing practice to achieve outcomes that benefit those who serve and those who are served.
Laabs, Carolyn A
The purpose of this study was to begin to develop a consensus as to the essential content and methods of ethics education for advanced practice nurses. An online Delphi technique was used to survey ethics experts to determine whether items were essential, desirable, or unnecessary to ethics education for students in doctor of nursing practice programs. Only the American Nurses Association Code of Ethics and ethics terminology were deemed essential foundational knowledge.
Munroe, Theresa; Loerzel, Victoria
Nurses are expected to apply genomic concepts in clinical practice. This study evaluated undergraduate nursing students' genomic knowledge and attitudes about using this knowledge in practice. Using a pretest-posttest design, findings indicated that students' knowledge was poor, but improved over a semester with genomics content. Most students did not feel ready to use this knowledge in the clinical setting. These findings suggest the need for more genomic education in nursing curriculum.
Rudner Lugo, Nancy
In the United States, Advanced Practice Registered Nurse (APRN) regulations are determined at the state level, through legislation and rule making. The lack of an evidence base to APRN regulation has resulted in a patchwork of varied regulations and requirements for nurse practitioners. The author begins this article by reviewing the history of the Equal Rights Amendment (ERA) in the United States and describing her study that assessed APRN fullpractice authority in states that ratified the ERA versus states that opposed it. She presents the study findings, limitations of the comparison, and discussion of the findings and implications. In conclusion, the findings demonstrated that progress toward full APRN practice will require building strategies for political support and framing the need to update APRN regulations in a manner that aligns with each state’s social and political values.
Oelke, Nelly; Wilhelm, Amanda; Jackson, Karen
The role of nurses in primary care is poorly understood and many are not working to their full scope of practice. Building on previous research, this knowledge translation (KT) project's aim was to facilitate nurses' capacity to optimise their practice in these settings. A Summit engaging Alberta stakeholders in a deliberative discussion was the…
Tomlinson, Robert M.; And Others
Last in a series of three reports prepared to present the results of a project with the proposal title, An Integrated, Longitudinal Study of Practical Nursing, this report is based on data obtained through 45 cooperating practical nursing programs in Illinois and Iowa. Information was obtained from school records, through interviews with students…
Abston-Coleman, Sharon L.; Levy, Dessie R.
Students in practical nursing programs require 32 weeks of coursework (1 academic year) and completion of a national licensing exam (NCLEX-PN) to secure employment. The purpose of this study was to identify selected academic variables that were related to NCLEX-PN performance for first-time test takers of two types of practical nursing programs at…
Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767
Kottner, Jan; Surber, Christian
Skin (self-)care is part of human life from birth until death. Today many different skin care practices, preferences, traditions and routines exist in parallel. In addition, preventive and therapeutic skin care is delivered in nursing and healthcare by formal and informal caregivers. The aim of this contribution is a critical discussion about skin care in the context of professional nursing practice. An explicit skin assessment using accurate diagnostic statements is needed for clinical decision making. Special attention should be paid on high risk skin areas, which may be either too dry or too moist. From a safety perspective the protection and maintenance of skin integrity should have the highest priority. Skin cleansing is the removal of unwanted substances from the skin surface. Despite cleansing efficacy soap, other surfactants and water will inevitably always result in the destruction of the skin barrier. Thousands of products are available to hydrate, moisturize, protect and restore skin properties dependent upon their formulation and the concentration of ingredients. These products intended to left in contact with skin exhibit several actions on and in the skin interfering with skin biology. Unwanted side effects include hyper-hydration and disorganization of lipid bilayers in the stratum corneum, a dysfunctional barrier, increased susceptibility to irritants and allergies, and increases of skin surface pH. Where the skin barrier is impaired appropriate interventions, e.g. apply lipophilic products in sufficient quantity to treat dry skin or protect the skin from exposure to irritants should be provided. A key statement of this contribution is: every skin care activity matters. Every time something is placed on the skin, a functional and structural response is provoked. This response can be either desired or undesired, beneficial or harmful. The choice of all skin care interventions in nursing and healthcare practice must be based on an accurate assessment
Stratton, T D; Dunkin, J W; Juhl, N; Geller, J M
Researchers have demonstrated repeatedly the importance of the relationship linking job satisfaction to employee retention. In rural areas of the country, where a persistent maldistribution of nurses continues to hamper health care delivery, the potential benefits of bolstering retention via enhancements in job satisfaction are of utmost utility to administrators and providers alike. Data were gathered from a multistate survey of registered nurses (RNs) practicing in rural hospitals, skilled nursing facilities, and community/public health settings (N = 1,647; response rate = 40.3%). The investigators found that the use of tuition reimbursement corresponded significantly with increased levels of job satisfaction among nurses in all three practice environments, as did day care services for nurses in acute care settings. Also, among hospital-based RNs, level of nursing education was found to be a significant factor in the relationship between tuition reimbursement and job satisfaction, with the highest level occurring among diploma-prepared nurses.
Lewinson, Lesline P; McSherry, Wilfred; Kevern, Peter
Spirituality is known to be an integral part of holistic care, yet research shows that it is not well valued or represented in nurse education and practice. However, the nursing profession continues to make efforts to redress the balance by issuing statements and guidance for the inclusion of spirituality by nurses in their practice. A systematic literature review was undertaken and confirms that nurses are aware of their lack of knowledge, understanding and skills in the area of spirituality and spiritual care, and desire to be better informed and skilled in this area. Consequently, in order for nurses to support the spiritual dimension of their role, nurse education has a vital part to play in raising spiritual awareness and facilitating competence and confidence in this domain. The literature review also reveals that studies involving pre-registration are few, but those available do provide examples of innovation and various teaching methods to deliver this topic in nursing curricular.
Parenting and family life are fundamental social constructs in human society and in law and public policy. Family structures and support systems provide important economic and psychological advantages for parents as well as for their children. Stigma toward lesbian and gay parents often marginalize individuals in these families and restrict family members' full expression of social citizenship, humanity, and personhood. Stigma directly contributes to increased risk for substance abuse, anxiety, and depressive illness among both parents and children. This article reviews the relevant policy literature to deconstruct the impacts of stigma on the psychological health and well-being of sexual minority parents so that psychiatric/mental health nurses and other health care providers can identify and counter these effects in their practices and advocate for policy improvements.
Jiang, Hong; Ives Erickson, Jeanette; Ditomassi, Marianne; Adams, Jeffrey M
This article illustrates the impact of a twinning relationship between the nursing services of Huashan Hospital, Fudan University (HH), in Shanghai, China, and of Massachusetts General Hospital (MGH) in Boston, Massachusetts. Through twinning, the healthcare leaders and nursing staff at HH learned key concepts, skills, and methods from their MGH colleagues, enhancing the role, presence, and overall impact of nursing in their organization. Strategies to advance a nursing leadership development agenda included establishing twinning relationships and immersing nurse leaders into each other's practice arena via nurse visitation exchanges. This collaborative effort, although only 3 years old, begins the process of modeling twinning for replication among nurses and across organizations internationally. Improvements in nursing care delivery and patient care at both organizations are attributed to this project.
Mitchell, Gail J
The author of this paper examines emerging implications of holding ideas about evidence and evidence-based practice. Evidence has a very specific role in the delivery of safe clinical care, but it is creating a serious problematic for the practice of nursing. It is proposed that: evidence-based practice be re-situated or reconstructed as a collective and organizational responsibility and not the responsibility of individual nurses in practice; nurses re-focus on articulating a more ethical foundation for praxis, one that emerges from nursing philosophy and one that is co-constituted with persons/families/groups; and nurse leaders and educators establish teaching-learning and practice environments that enable a peer-to-peer process of critical review and curious inquiry of available evidence in the contexts of shared work.
Carlson, Cathy L
To provide optimal postoperative pain relief, nursing practice should be based on the best evidence available. For over 20 years, results of studies regarding nurses' use of evidence-based practices, including postoperative pain assessment practices, have shown that nurses use the practices inconsistently. The present cross-sectional survey study was conducted to: 1) determine the extent to which registered nurses caring for postoperative patients experiencing pain used three evidence-based postoperative pain assessment practices; and 2) identify relationships among the level of adoption of evidence-based postoperative pain assessment practices and selected characteristics of registered nurses. Data were collected from a convenience sample of all nurses caring for adult postoperative patients in two Midwestern hospitals where 443 surveys (46.9%) were returned. Respondents were aware of, but not using, three evidence-based postoperative pain assessment practices consistently. Registered nurses who used multiple sources to identify solutions to clinical practice problems or read one or two professional journals regularly were more likely to have adopted the three evidence-based postoperative pain assessment practices. Registered nurses need to be encouraged to use multiple sources to identify solutions to clinical practice problems, including professional nursing journals. Innovative approaches to promote the application of research to education and practice settings are needed. It is important to identify opinion leaders, because opinion leaders are an important resource in overcoming the barriers so that adoption of pain of evidence-based postoperative pain assessment practices can proceed. Additional research is needed to identify what variables effect the adoption of evidence-based practices and identify interventions to improve the level of adoption.
Evans, Alicia M; Glass, Nel; Traynor, Michael
It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of 'surplus'. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients.
Fisher, Jacklin E; Happell, Brenda
The introduction of evidence-based practice (EBP) and the hierarchical approach to evidence it engenders within research and evaluation has aroused controversy in the mental health professions. The aim of this paper is to present a critique of EBP with a specific relationship to mental health nursing. It will be argued that in its current form, EBP presents a potential impediment to the facilitation of consumer participation in mental health services and to the recovery model. The need for the consumer voice and the importance of the lived experience of mental illness are not readily reconciled with a strong scientific paradigm that promotes detachment and objectivity. The importance of evidence in contemporary mental health care will also be acknowledged and discussed in light of the current climate of increased consumer knowledge, fiscal constraint, and extensive social criticism of mental health-care services. The current approach to EBP requires reconstruction to support the consumer-focused nature of mental health nursing, and to facilitate the implementation of a recovery model for mental health care.
Bernhart-Just, Alexandra; Hillewerth, Kathrin; Holzer-Pruss, Christina; Paprotny, Monika; Zimmermann Heinrich, Heidi
The data model developed on behalf of the Nursing Service Commission of the Canton of Zurich (Pflegedienstkommission des Kantons Zürich) is based on the NANDA nursing diagnoses, the Nursing Outcome Classification, and the Nursing Intervention Classification (NNN Classifications). It also includes integrated functions for cost-centered accounting, service recording, and the Swiss Nursing Minimum Data Set. The data model uses the NNN classifications to map a possible form of the nursing process in the electronic patient health record, where the nurse can choose nursing diagnoses, outcomes, and interventions relevant to the patient situation. The nurses' choice is guided both by the different classifications and their linkages, and the use of specific text components pre-defined for each classification and accessible through the respective linkages. This article describes the developed data model and illustrates its clinical application in a specific patient's situation. Preparatory work required for the implementation of NNN classifications in practical nursing such as content filtering and the creation of linkages between the NNN classifications are described. Against the background of documentation of the nursing process based on the DAPEP(1) data model, possible changes and requirements are deduced. The article provides a contribution to the discussion of a change in documentation of the nursing process by implementing nursing classifications in electronic patient records.
This article examines field studies of nursing work published in the English language between 1993 and 2003 as the first step towards an empirically based reformulation of the nursing mandate. A decade of ethnographic research reveals that, contrary to contemporary theories which promote an image of nursing work centred on individualised unmediated caring relationships, in real-life practice the core nursing contribution is that of the healthcare mediator. Eight bundles of activity that comprise this intermediary role are described utilising evidence from the literature. The mismatch between nursing's culture and ideals and the structure and constraints of the work setting is a chronic source of practitioner dissatisfaction. It is argued that the profession has little to gain by pursuing an agenda of holistic patient care centred on emotional intimacy and that an alternative occupational mandate focused on the healthcare mediator function might make for more humane health services and a more viable professional future.
Allan, Helen T
This paper illustrates the role of psychodynamic small group work in integrating theory and practice for nursing students. Psychodynamic work with individual patients and small staff groups is established in some areas of medical and nursing practice although not widely used in general nursing. Clinical material which was brought to two group supervision sessions by student nurses on clinical placement is presented in this paper and discussed using a psychodynamic perspective. A critical review of psychodynamic small group work and a position paper is presented in this paper to argue that using a psychodynamic approach in nurse education may address the theory-practice gap for student nurses by allowing them to reflect on the emotional issues arising in clinical placements. The paper illustrates how supervision can assist students to integrate theory and practice. It is suggested that reflecting on feelings in small group work with student nurses with a tutor or supervisor who works psychodynamically may help students integrate their theoretical and practical learning. Understanding the theory-practice gap from a psychodynamic perspective may help nurse tutors in their personal tutor work to integrate theoretical and practical learning for students and thereby support students in providing good quality care for their patients.
Falk, Nancy L; Garrison, Kenneth F; Brown, Mary-Michael; Pintz, Christine; Bocchino, Joseph
Strategic planning and thinking skills are essential for today's nurse leaders. Doctor of nursing practice (DNP) programs provide an opportunity for developing effective nurse strategists. A well-designed strategy course can stimulate intellectual growth at all levels of Bloom's Taxonomy. Discussion forums in online education provide new opportunities for rich interaction among peers en route to development of well-informed strategic plans. An interprofessional perspective adds a rich and vital aspect to doctoral nursing education and it serves to inform strategic plan development. A roadmap for teaching strategic planning to current and future nursing leaders will guide the integration of essential content into DNP programs.