[Effect of leader-member exchange on nurses'sense of calling in workplace].

PubMed

Zhang, L G; Ma, H L; Wang, Z J; Zhou, Y Y; Jin, T T

2017-12-20

Objective: To investigate the effect of leader-member exchange on nurses'sense of calling in workplace based on self-determination theory. Methods: A total of 381 nurses were randomly selected from five tertiary general hospitals in Zhejiang province, China from October to December, 2016. They were subjected to a survey using the Leader-Member Exchange Scale, Job Autonomy Scale, Core Self-Evaluation Scale, and Calling Scale. The mediating effect was used to test the procedures and the data were subjected to hierarchical regression analysis. Results: The leader-member exchange was positively correlated with job autonomy, core self-evaluation, and sense of calling ( r =0.471, P <0.001; r =0.373, P <0.001; r =0.475, P <0.001) ; the leader-member exchange had a positive predictive effect on job autonomy and sense of calling ( β = 0.47, P <0.001; β =0.48, P <0.001) ; the job autonomy had a partial mediating effect on the relationship between leader-member exchange and sense of calling ( F =66.50, P <0.001) ; the core self-evaluation negatively adjusted the positive relationship between leader-member exchange and job autonomy ( F =27.81, P <0.001) . Conclusion: High-quality leader-member exchange enhances the sense of calling by improving staffs' job autonomy and the core self-evaluation reduces the positive relationship between leader-member exchange and job autonomy.

Improving communication among nurses and patients.

PubMed

Unluturk, Mehmet S; Ozcanhan, Mehmet H; Dalkilic, Gokhan

2015-07-01

Patients use nurse call systems to signal nurses for medical help. Traditional push button-flashing lamp call systems are not integrated with other hospital automation systems. Therefore, nurse response time becomes a matter of personal discretion. The improvement obtained by integrating a pager system into the nurse call systems does not increase care efficiency, because unnecessary visits are still not eliminated. To obtain an immediate response and a purposeful visit by a nurse; regardless of the location of nurse in hospital, traditional systems have to be improved by intelligent telephone system integration. The results of the developed Nurse Call System Software (NCSS), the Wireless Phone System Software (WPSS), the Location System Software (LSS) and the communication protocol are provided, together with detailed XML message structures. The benefits of the proposed system are also discussed and the direction of future work is presented. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Longitudinal relationship of work hours, mandatory overtime, and on-call to musculoskeletal problems in nurses.

PubMed

Trinkoff, Alison M; Le, Rong; Geiger-Brown, Jeanne; Lipscomb, Jane; Lang, Gary

2006-11-01

Nurses are at very high risk for work-related musculoskeletal injury/disorders (MSD) with low back pain/injury being the most frequently occurring MSD. Nurses are also likely to work extended schedules (long hours, on-call, mandatory overtime, working on days off). The purpose of this study was to examine the relationship of extended work schedules in nurses to MSD. Using a longitudinal, three wave survey of 2,617 registered nurses, Wave 1 work schedule data were related to neck, shoulder, and back (MSD) cases occurring in Waves 2 or 3. Schedule characteristics increasing MSD risk included 13+ hour/days, off-shifts, weekend work, work during time off (while sick, on days off, without breaks), and overtime/on-call. These increases in risk were not explained by psychological demands, but were largely explained by physical demands. Adverse schedules are significantly related to nurse MSD. Healthier schedules, less overtime, and reducing work on days off would minimize risk and recovery time. Copyright (c) 2006 Wiley-Liss, Inc.

Emphasizing the Value of Nephrology Nursing Through Nursing-Sensitive Indicators: A Call for Action.

PubMed

Thomas-Hawkins, Charlotte; Latham, Carolyn E; Hain, Debra J

2017-01-01

Nursing is the largest healthcare profession in the United States (U.S.). As principal frontline caregivers in the U.S. healthcare system, nurses have tremendous influence over a patient's healthcare experience. A growing body of evidence states that the nursing workforce has a direct impact on healthcare quality. A standardized approach to measuring nursing's contribution to patient care and safety using nursing-sensitive quality indicators assists in examining the extent to which nurses and nursing affect the quality and safety of health care. This article focuses on nursing-sensitive quality indicators and discusses healthcare quality indicators and nursing-sensitive indicators used in the U.S. A summary of the work of the American Nephrology Nurses' Association Task Force on Nephrology Nursing-Sensitive Quality Indicators (NNSQI) and an NNSQI exemplar are provided. Copyright© by the American Nephrology Nurses Association.

Effects of night-time on-call work on heart rate variability before bed and sleep quality in visiting nurses.

PubMed

Kikuchi, Yukiko; Ishii, Noriko; Kodama, Hideya

2018-05-28

In Japan, many visiting nurses work carrying cell phones to respond to calls from users even at night (on-call work). The purpose of this study was to investigate whether on-call work affected heart rate variability (HRV) before bed and decreased sleep quality in visiting nurses even if their sleep was not interrupted due to actual calls. Thirty-one visiting nurses (mean age, 49.8 years; standard deviation, 6.3 years) were asked to record their 2.5-min resting HRV before bed, and to undergo one-channel sleep electroencephalography (EEG) and subjective sleep evaluations upon waking (Oguri, Shirakawa, and Azumi Sleep Inventory) at home for 4-5 consecutive days, including both on-call and non-on-call days. Paired data sets of outcome measures, including HRV parameters, sleep macrostructure variables, and subjective sleep quality scores between on-call and non-on-call days were compared; the most recent measurements for each category were used for each subject. There were no differences in HRV measures and objective sleep EEG variables. A significant increase in "sleepiness on rising" and a decrease in "feeling refreshed" were observed on on-call days (P = 0.019 and 0.021, respectively), and younger subjects (≤ 51 years old) demonstrated a significant reduction in "sleepiness on rising" (significant interaction effect, P = 0.029). Adverse effects of on-call work on sleep quality in most visiting nurses are thought to be subjective, and relatively young nurses tend to notice a decrease in sleep quality. On-call work itself does not appear to be a substantial stressor that could affect HRV and sleep structure.

Call for neonatal nursing specialization in developing countries.

PubMed

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

2013-01-01

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

Interprofessional trust in emergency department - as experienced by nurses in charge and doctors on call.

PubMed

Friberg, Klara; Husebø, Sissel Eikeland; Olsen, Øystein Evjen; Saetre Hansen, Britt

2016-11-01

The aim of this study was to describe that which characterises interprofessional trust in a Norwegian emergency department, as expressed by nurses in charge and doctors on call. Interprofessional trust requires knowledge of and skills in interprofessional collaboration. It also requires established trust in fellow collaborators, as well as in the work environment and in the more comprehensive system in which the work is conducted. Nurses in charge and doctors on call who collaborate in the context of an emergency department do so under changing conditions in terms of staff composition and work load. The study was designed in a qualitative, inductive and sequential manner. Data were collected from September-November 2013 through four focus group interviews and was analysed by means of qualitative content analysis. The data revealed two themes that were characteristic of interprofessional trust: 'having relational knowledge' and 'being part of a context'. Together, the themes can be understood as equally important to contextual collaboration. A model of interprofessional trust between an individual level and system level was developed from the results. The study indicates that interprofessional trust is a changeable phenomenon that has great impact on the possibility for development at an individual level and at a more abstract system level. Interprofessional trust can be improved by focusing on trust-building activities between staff at the individual level and between staff and organisation at the system level. Supportive activities such as continuous interprofessional education are suggested as valuable to the development and maintenance of trust. © 2016 John Wiley & Sons Ltd.

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

PubMed

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

1996-03-01

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

Association between Precipitation Upstream of a Drinking Water Utility and Nurse Advice Calls Relating to Acute Gastrointestinal Illnesses

PubMed Central

Tornevi, Andreas; Axelsson, Gösta; Forsberg, Bertil

2013-01-01

Background The River Göta Älv is a source of fresh-water for the City of Gothenburg (Sweden). We recently identified a clear association between upstream precipitation and indicator bacteria concentrations in the river water outside the intake to the drinking water utility. This study aimed to determine if variation in the incidence of acute gastrointestinal illnesses is associated with upstream precipitation. Methods We acquired data, covering 1494 days, on the daily number of telephone calls to the nurse advice line from citizens in Gothenburg living in areas with Göta Älv as a fresh-water supply. We separated calls relating to gastrointestinal illnesses from other medical concerns, and analyzed their association with precipitation using a distributed lag non-linear Poisson regression model, adjusting for seasonal patterns and covariates. We used a 0–21-day lag period for precipitation to account for drinking water delivery times and incubation periods of waterborne pathogens. Results The study period contained 25,659 nurse advice calls relating to gastrointestinal illnesses. Heavy rainfall was associated with increased calls the same day and around 5–6 days later. Consecutive days of wet weather were also found to be associated with an increase in the daily number of gastrointestinal concerns. No associations were identified between precipitation and nurse advice calls relating to other medical concerns. Conclusion An increase in nurse advice calls relating to gastrointestinal illnesses around 5–6 days after heavy rainfall is consistent with a hypothesis that the cause could be related to drinking water due to insufficient barriers in the drinking water production, suggesting the need for improved drinking water treatment. PMID:23875009

Association between precipitation upstream of a drinking water utility and nurse advice calls relating to acute gastrointestinal illnesses.

PubMed

Tornevi, Andreas; Axelsson, Gösta; Forsberg, Bertil

2013-01-01

The River Göta Älv is a source of fresh-water for the City of Gothenburg (Sweden). We recently identified a clear association between upstream precipitation and indicator bacteria concentrations in the river water outside the intake to the drinking water utility. This study aimed to determine if variation in the incidence of acute gastrointestinal illnesses is associated with upstream precipitation. We acquired data, covering 1494 days, on the daily number of telephone calls to the nurse advice line from citizens in Gothenburg living in areas with Göta Älv as a fresh-water supply. We separated calls relating to gastrointestinal illnesses from other medical concerns, and analyzed their association with precipitation using a distributed lag non-linear Poisson regression model, adjusting for seasonal patterns and covariates. We used a 0-21-day lag period for precipitation to account for drinking water delivery times and incubation periods of waterborne pathogens. The study period contained 25,659 nurse advice calls relating to gastrointestinal illnesses. Heavy rainfall was associated with increased calls the same day and around 5-6 days later. Consecutive days of wet weather were also found to be associated with an increase in the daily number of gastrointestinal concerns. No associations were identified between precipitation and nurse advice calls relating to other medical concerns. An increase in nurse advice calls relating to gastrointestinal illnesses around 5-6 days after heavy rainfall is consistent with a hypothesis that the cause could be related to drinking water due to insufficient barriers in the drinking water production, suggesting the need for improved drinking water treatment.

[Difficulties/suffering experienced by nurses : strategies for maintaining their mental health, the calling of the profession and their job performance].

PubMed

Boivin-Desrochers, Camille; Alderson, Marie

2014-10-01

The nursing profession is faced with an issue of growing concern, that of the mental health of its practitioners. The many difficulties that nurses experience in the workplace may prove to be detrimental to the maintenance of an optimal mental state. With respect to these difficulties, several strategies can be implemented and used by nurses and managers. The present literature review aims to identify the difficulties and suffering experienced by nurses and the strategies employed to ensure the preservation of mental health, as well as maintaining the calling of the profession and job performance. It also aims to provide nurses and managers of the health care system with ideas to promote optimal mental health for nurses. In this context, « psychodynamique du travail » was chosen as the framework to structure the analysis of the literature dealing with elements surrounding the suffering and difficulties experienced by nurses. The use of this theoretical framework deepens and supports the relationship between the suffering experienced at work and the mental health of nurses.

Taking aim at nurse stress: a call to action.

PubMed

Kashani, Mariam; Eliasson, Arn; Chrosniak, Linda; Vernalis, Marina

2010-02-01

The study investigates stress levels and related behaviors of nurses in a military medical center during wartime. In 2007, nurses completed a questionnaire survey with objective validation of data in a subsample using actigraphy over 12 weeks. Of 270 nurses, 255 (94%) returned surveys. A total of 81% reported moderately high or high stress with sources listed as work (66%) and fatigue (39%). Many reported coming to work despite feeling ill and/or stressed (13.6 days/3 months). In contrast, morale was high or moderately high in 71%. Nurses reported an average of 5.5 hours of sleep/night, 8.8 h/wk taken for self, and 3.8 h/wk for exercise. Actigraphy data showed an average of 6.0 hours of sleep/night. These findings highlight a mismatch between stress levels and coping perceptions indicating an inability to properly care for self. To manage the effects of chronic stress, nurse leaders should implement systems targeting healthy life balance.

Urgent Call for Nursing Big Data.

PubMed

Delaney, Connie W

2016-01-01

The purpose of this panel is to expand internationally a National Action Plan for sharable and comparable nursing data for quality improvement and big data science. There is an urgent need to assure that nursing has sharable and comparable data for quality improvement and big data science. A national collaborative - Nursing Knowledge and Big Data Science includes multi-stakeholder groups focused on a National Action Plan toward implementing and using sharable and comparable nursing big data. Panelists will share accomplishments and future plans with an eye toward international collaboration. This presentation is suitable for any audience attending the NI2016 conference.

The Role of Nurse Leaders in Advancing Carer Communication Needs across Transitions of Care: A Call to Action.

PubMed

Udod, Sonia A; Lobchuk, Michelle

2017-01-01

This paper focuses on the central role of senior nurse leaders in advancing organizational resources and support for communication between healthcare providers and carers that influences patient and carer outcomes during the transition from hospital to the community. A Think Tank (Lobchuk 2012) funded by the Canadian Institutes of Health Research (CIHR) gathered interdisciplinary and intersectoral stakeholders from local, national and international levels to develop a Family Carer Communication Research Collaboration. Workshop stakeholders addressed critical challenges in meeting communication needs of carers as partners with clinicians in promoting safe care for the elderly, chronically or seriously ill or disabled individuals in the community. Key priority areas identified the need to uncover nurse leader perspectives at the system, nurse leader, healthcare provider and patient levels where communication with carers occurs. The overarching outcome from the workshop focuses on the need for nurse leaders to advocate for patients and their families in meeting carer communication needs. The authors' "call to action" requires commitment and investment from nurse leaders in the critical juncture of healthcare delivery to strengthen communication between healthcare providers and carers that influence patient and carer outcomes in seamless transitions of care.

Call to Action: The Case for Advancing Disaster Nursing Education in the United States.

PubMed

Veenema, Tener Goodwin; Lavin, Roberta Proffitt; Griffin, Anne; Gable, Alicia R; Couig, Mary Pat; Dobalian, Aram

2017-11-01

Climate change, human conflict, and emerging infectious diseases are inexorable actors in our rapidly evolving healthcare landscape that are triggering an ever-increasing number of disaster events. A global nursing workforce is needed that possesses the knowledge, skills, and abilities to respond to any disaster or large-scale public health emergency in a timely and appropriate manner. The purpose of this article is to articulate a compelling mandate for the advancement of disaster nursing education within the United States with clear action steps in order to contribute to the achievement of this vision. A national panel of invited disaster nursing experts was convened through a series of monthly semistructured conference calls to work collectively towards the achievement of a national agenda for the future of disaster nursing education. National nursing education experts have developed consensus recommendations for the advancement of disaster nursing education in the United States. This article proposes next steps and action items to achieve the desired vision of national nurse readiness. Novel action steps for expanding disaster educational opportunities across the continuum of nursing are proposed in response to the current compelling need to prepare for, respond to, and mitigate the impact of disasters on human health. U.S. educational institutions and health and human service organizations that employ nurses must commit to increasing access to a variety of quality disaster-related educational programs for nurses and nurse leaders. Opportunities exist to strengthen disaster readiness and enhance national health security by expanding educational programming and training for nurses. © 2017 Sigma Theta Tau International.

After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

PubMed

Kelly, Michelle M; Blunt, Elizabeth; Nestor, Kelly

2017-12-01

Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum. ©2017 American Association of Nurse Practitioners.

Nursing Classification Systems

PubMed Central

Henry, Suzanne Bakken; Mead, Charles N.

1997-01-01

Abstract Our premise is that from the perspective of maximum flexibility of data usage by computer-based record (CPR) systems, existing nursing classification systems are necessary, but not sufficient, for representing important aspects of “what nurses do.” In particular, we have focused our attention on those classification systems that represent nurses' clinical activities through the abstraction of activities into categories of nursing interventions. In this theoretical paper, we argue that taxonomic, combinatorial vocabularies capable of coding atomic-level nursing activities are required to effectively capture in a reproducible and reversible manner the clinical decisions and actions of nurses, and that, without such vocabularies and associated grammars, potentially important clinical process data is lost during the encoding process. Existing nursing intervention classification systems do not fulfill these criteria. As background to our argument, we first present an overview of the content, methods, and evaluation criteria used in previous studies whose focus has been to evaluate the effectiveness of existing coding and classification systems. Next, using the Ingenerf typology of taxonomic vocabularies, we categorize the formal type and structure of three existing nursing intervention classification systems—Nursing Interventions Classification, Omaha System, and Home Health Care Classification. Third, we use records from home care patients to show examples of lossy data transformation, the loss of potentially significant atomic data, resulting from encoding using each of the three systems. Last, we provide an example of the application of a formal representation methodology (conceptual graphs) which we believe could be used as a model to build the required combinatorial, taxonomic vocabulary for representing nursing interventions. PMID:9147341

Conscientious objection: a call to nursing leadership.

PubMed

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

2010-09-01

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

[The nurse coordinator in the French health system].

PubMed

Le Bœuf, Dominique

2016-06-01

Participating in the coordination of care in order to provide global patient management is an integral part of nursing activities. The term nurse coordinator, however, encompasses diverse realities. Legally defined within in-home nursing care services, it remains vague in all other care organisations which call upon these nursing competencies. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The effect of nurses’ preparedness and nurse practitioner status on triage call management in primary care: A secondary analysis of cross-sectional data from the ESTEEM trial

PubMed Central

Varley, Anna; Warren, Fiona C.; Richards, Suzanne H.; Calitri, Raff; Chaplin, Katherine; Fletcher, Emily; Holt, Tim A.; Lattimer, Valerie; Murdoch, Jamie; Richards, David A.; Campbell, John

2016-01-01

Background Nurse-led telephone triage is increasingly used to manage demand for general practitioner consultations in UK general practice. Previous studies are equivocal about the relationship between clinical experience and the call outcomes of nurse triage. Most research is limited to investigating nurse telephone triage in out-of-hours settings. Objective To investigate whether the professional characteristics of primary care nurses undertaking computer decision supported software telephone triage are related to call disposition. Design Questionnaire survey of nurses delivering the nurse intervention arm of the ESTEEM trial, to capture role type (practice nurse or nurse practitioner), prescriber status, number of years’ nursing experience, graduate status, previous experience of triage, and perceived preparedness for triage. Our main outcome was the proportion of triaged patients recommended for follow-up within the practice (call disposition), including all contact types (face-to-face, telephone or home visit), by a general practitioner or nurse. Settings 15 general practices and 7012 patients receiving the nurse triage intervention in four regions of the UK. Participants 45 nurse practitioners and practice nurse trained in the use of clinical decision support software. Methods We investigated the associations between nursing characteristics and triage call disposition for patient ‘same-day’ appointment requests in general practice using multivariable logistic regression modelling. Results Valid responses from 35 nurses (78%) from 14 practices: 31/35 (89%) had ≥10 years’ experience with 24/35 (69%) having ≥20 years. Most patient contacts (3842/4605; 86%) were recommended for follow-up within the practice. Nurse practitioners were less likely to recommend patients for follow-up odds ratio 0.19, 95% confidence interval 0.07; 0.49 than practice nurses. Nurses who reported that their previous experience had prepared them less well for triage were more

Retooling the nurse executive for 21st century practice: decision support systems.

PubMed

Fralic, M F; Denby, C B

2000-01-01

Health care financing and care delivery systems are changing at almost warp speed. This requires new responses and new capabilities from contemporary nurse executives and calls for new approaches to the preparation of the next generation of nursing leaders. The premise of this article is that, in these highly unstable environments, the nurse executive faces the need to make high-impact decisions in relatively short time frames. A standardized process for objective decision making becomes essential. This article describes that process.

A call to action for nurses: declining enrollment and the nursing shortage.

PubMed

Albaugh, J A

2001-10-01

Once again, nursing and health care face a crisis related to the continued decline in nursing school enrollment and the nursing shortage. This particular shortage seems to be especially problematic because of the increased number of aging baby boomers and the dwindling professional nurse pool. Nurses must work together to increase understanding and awareness of the opportunities in the profession and to resolve this crisis. There are specific actions nurses can take to improve the perception of nursing and renew interest in a dynamic field that is so crucial to society.

Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking.

PubMed

Dolansky, Mary A; Moore, Shirley M

2013-09-30

Over a decade has passed since the Institute of Medicine's reports on the need to improve the American healthcare system, and yet only slight improvement in quality and safety has been reported. The Quality and Safety Education for Nurses (QSEN) initiative was developed to integrate quality and safety competencies into nursing education. The current challenge is for nurses to move beyond the application of QSEN competencies to individual patients and families and incorporate systems thinking in quality and safety education and healthcare delivery. This article provides a history of QSEN and proposes a framework in which systems thinking is a critical aspect in the application of the QSEN competencies. We provide examples of how using this framework expands nursing focus from individual care to care of the system and propose ways to teach and measure systems thinking. The conclusion calls for movement from personal effort and individual care to a focus on care of the system that will accelerate improvement of healthcare quality and safety.

Learning from the nurses and the paramedics: the experience of a Kenyan medical officer intern-a call for research

PubMed Central

Mwenda, Aruyaru Stanley

2012-01-01

In the Kenyan medical educations system, one has to go through one year of internship after graduating from medical school in order to be licensed to practise medicine. This internship period is laden with work to the extent of overwhelming and stressing the medical officer interns. Irrespective of what competence interns come with into the field there is still a lot they have to learn from the nurses and the paramedics. Most of the learning takes place during the acute care settings when the intern is on call and is from the nurses. The paramedics most helpful to the intern are the theater assistants who teach interns how to use the various surgical instruments and sometimes direct during minor operations. PMID:22891094

Conference calls.

PubMed

2002-07-01

Last minute places were still available as Emergency Nurse went to press at an RCN A&E Nursing Association symposium on July 2 to examine the impact of the Department of Health's Reforming Emergency Care strategy. For details of the event, to be held at Cheadle, Cheshire, call Grant Williams on 07771 740243.

The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

PubMed

Bern-Klug, Mercedes

2008-01-01

Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

Evaluating Nurses' Satisfaction With Two Nursing Information Systems.

PubMed

Khajouei, Reza; Abbasi, Reza

2017-06-01

Evaluating user satisfaction is one of the methods to ensure the usability of information systems. Considering the importance of nursing information systems in patient health, the objective of this study is to evaluate nurses' satisfaction with two widely used nursing information systems (Peyvand Dadeh and Tirazhe) in Iran. This descriptive-analytical study was done on 230 nurses in all teaching hospitals of Kerman University of Medical Sciences in 2015. Data were collected using an augmented version of a questionnaire developed by IBM. Data were analyzed by SPSS.16 using descriptive and analytical statistical methods including t test, analysis of variance, and Pearson correlation coefficient. The mean of overall satisfaction with the two systems was 61 ± 2.2 and 74 ± 2.4, respectively. The mean of satisfaction with different systems dimensions, that is, ease of use, information quality, and interface quality, was, respectively, 24 ± 1.9, 26 ± 9.7, and 12 ± 4.7 for Tirazhe and 29 ± 1.1, 39 ± 1.04 and 13 ± 5.3 for Peyvand Dadeh system. Nurses' satisfaction with both systems was at a medium level. The majority of nurses were relatively satisfied with the information quality and user interface quality of these systems. The results suggest that designing nursing information systems in accordance with their users' need improves usability. Hence, policy and decision makers of healthcare institutions should invest on usability when purchasing such systems.

Power in telephone-advice nursing.

PubMed

Leppänen, Vesa

2010-03-01

Power is a central aspect of nursing, especially in telephone-advice nursing, where nurses assess callers' medical problems and decide what measures that need to be taken. This article presents a framework for understanding how power operates in social interaction between nurses and callers in telephone-advice nursing in primary care in Sweden. Power is analysed as the result of nurses and callers being oriented to five social structures that are relevant to their actions in this context, namely the organization of telephone-advice nursing, the social stock of medical knowledge, the professional division of labour between nurses and doctors, structures of social interaction and structures of emotions. While structural constraints govern some actions to a high degree, calls take place in an organizational free room that give nurses more leeway for acting more creatively. The discussion focuses on the introduction of new technologies of control, for instance computerized decision support systems and audio recording of calls, and on how they reduce the free room. Empirical data consist of 276 audio-recorded telephone calls to 13 nurses at six primary-care centres and of qualitative interviews with 18 nurses.

Chemical Dependency and Nursing Students: A Complicated Process Calling for Nurse Educator Involvement.

PubMed

Dittman, Patricia W

2015-01-01

Chemical use and dependency is a prevalent problem in society and among the members of the nursing profession. Nursing students, as the novice representatives of the profession, may be particularly vulnerable to chemical use. Nursing leaders in both educational institutions and practice settings must recognize highly vulnerable individuals, which nursing activities are most vulnerable, and interventions to assist and support the vulnerable individual while assuring a safe practice environment. As nurses, it is our responsibility, both ethically and legally, to provide a safe working environment not only for our patients but also for ourselves by reporting the behaviors of nurses who may be impaired through the proper channels according to your state's Nurse Practice Act. Through a united approach, nurse leaders from both the academic and practice environments should provide a safe and effective rehabilitation approach.

The resource utilization group system: its effect on nursing home case mix and costs.

PubMed

Thorpe, K E; Gertler, P J; Goldman, P

1991-01-01

Using data from 1985 and 1986, we examine how New York state's prospective payment system affected nursing homes. The system, called Resource Utilization Group (RUG-II), aimed to limit nursing home cost growth and improve access to nursing homes by "heavy-care" patients. As in Medicare's prospective hospital reimbursement system, payments to nursing homes were based on a "price," rather than facility-specific rates. With respect to cost growth, we observed considerable diversity among homes. Specifically, those nursing homes most financially constrained by the RUG-II methodology exhibited the slowest rates of cost growth; we observed higher cost growth among the homes least constrained. This higher rate of cost growth raises a question about the desirability of using a pricing methodology to determine nursing home payment rates. In addition to moderating cost growth, we also observed a significant change in the mix of patients admitted to nursing homes. During the first year of the RUG-II program, nursing homes admitted more heavy-care patients and reduced days of care to lighter-care patients. Thus, through 1986, the RUG-II program appeared to satisfy at least one of its major policy objectives.

Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems: a literature review.

PubMed

Vorwerk, Jane; King, Lindy

2016-01-01

This review investigated the impact of consumer participation in recognition of patient deterioration and response through call activation in rapid response systems. Nurses and doctors have taken the main role in recognition and response to patient deterioration through hospital rapid response systems. Yet patients and visitors (consumers) have appeared well placed to notice early signs of deterioration. In response, many hospitals have sought to partner health professionals with consumers in detection and response to early deterioration. However, to date, there have been no published research-based reviews to establish the impact of introducing consumer involvement into rapid response systems. A critical research-based review was undertaken. A comprehensive search of databases from 2006-2014 identified 11 studies. Critical appraisal of these studies was undertaken and thematic analysis of the findings revealed four major themes. Following implementation of the consumer activation programmes, the number of calls made by the consumers following detection of deterioration increased. Interestingly, the number of staff calls also increased. Importantly, mortality numbers were found to decrease in one major study following the introduction of consumer call activation. Consumer and staff knowledge and satisfaction with the new programmes indicated mixed results. Initial concerns of the staff over consumer involvement overwhelming the rapid response systems did not eventuate. Evaluation of successful consumer-activated programmes indicated the importance of: effective staff education and training; ongoing consumer education by nurses and clear educational materials. Findings indicated positive patient outcomes following introduction of consumer call activation programmes within rapid response systems. Effective consumer programmes included information that was readily accessible, easy-to-understand and available in a range of multimedia materials accompanied by the

WITHDRAWN: Nursing record systems: effects on nursing practice and healthcare outcomes.

PubMed

Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R

2018-05-15

A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning

Responding to the call for globalization in nursing education: the implementation of the transatlantic double-degree program.

PubMed

Hornberger, Cynthia A; Erämaa, Sirkka; Helembai, Kornélia; McCartan, Patrick J; Turtiainen, Tarja

2014-01-01

Increased demand for nurses worldwide has highlighted the need for a flexible nursing workforce eligible for licensure in multiple countries. Nursing's curricular innovation mirrors the call for reform within higher education including globalization of curricula (E. J. S. Hovenga, 2004; D. Nayyar, 2008; B. J. G. Wood, S. M. Tapsall, & G. N. Soutar, 2005), increased opportunities for student mobility exchanges, dialogue between different academic traditions, and mutual understanding and transparency between universities (J. González & R. Wagenaar, 2005). The European Union (EU) and United States have combined efforts to achieve these objectives by creating the Atlantis program in 2007 (U.S. Department of Education, 2011). This article describes experiences of four nursing programs participating in an Atlantis project to develop a double-degree baccalaureate program for undergraduate nursing students. Early learnings include increasing awareness and appreciation of essential curricular and performance competencies of the baccalaureate-prepared professional nurse. Challenges include language competency; variations in curriculum, cultural norms, student expectations, and learning assessment; and philosophical differences regarding first-level professional nurse preparation as specialist versus generalist. The Transatlantic Double Degree program has successfully implemented the double-degree program. Members have gained valuable insights into key issues surrounding the creation of a more uniform, yet flexible, educational standard between our countries. © 2014.

Nursing record systems: effects on nursing practice and health care outcomes.

PubMed

Currell, R; Wainwright, P; Urquhart, C

2000-01-01

A nursing record system is the record of care planned and/or given to individual patients/clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. We searched The Cochrane Library, MEDLINE, Cinahl, Sigle, and databases of the Royal College of Nursing, King's Fund, the NHS Centre for Reviews and Dissemination, and the Institute of Electrical Engineers up to August 1999; and OCLC First Search, Department of Health database, NHS Register of Computer Applications and the Health Visitors' Association database up to the end of 1995. We hand searched the Journal of Nursing Administration (1971-1999), Computers in Nursing (1984-1999), Information Technology in Nursing (1989-1999) and reference lists of articles. We also hand searched the major health informatics conference proceedings. We contacted experts in the field of nursing informatics, suppliers of nursing computer systems, and relevant Internet groups. Randomised trials, controlled before and after studies and interrupted time series comparing one kind of nursing record system with another, in hospital, community or primary care settings. The participants were qualified nurses, students or health care assistants working under the direction of a qualified nurse and patients receiving care recorded and/or planned using nursing record systems. Two reviewers independently assessed trial quality and extracted data. Six trials involving 1407 people were included. In three studies of client held records, there were no overall positive or negative effects, although some administrative benefits through fewer missing notes were suggested. A paediatric pain management sheet study showed a positive effect on the children's pain intensity. A computerised nursing care planning study showed a negative effect on documented nursing

Reducing nurses'. Workload using a computerized nursing support system linked to the hospital information system.

PubMed

Ito, C; Satoh, I; Michiya, H; Kitayama, Y; Miyazaki, K; Ota, S; Satoh, H; Sakurai, T; Shirato, H; Miyasaka, K

1997-01-01

A computerised nursing support system (CNSS) linked to the hospital information system (HIS) was developed and has been in use for one year, in order to reduce the workload of nurses. CNSS consists of (1) a hand held computer for each nurse (2) desk-top computers in the nurses' station and doctors' rooms (3) a data server (4) an interface with the main hospital information system. Nurses enter vital signs, food intake and other information about the patients into the hand held computer at the bed-side. The information is then sent automatically to the CNSS data server, which also receives patients' details (prescribed medicines etc.) from the HIS. Nurses and doctors can see all the information on the desk-top and hand held computers. This system was introduced in May 1995 into a university hospital ward with 40 beds. A questionnaire was completed by 23 nurses before and after the introduction of CNSS. The mean time required to post vital data was significantly reduced from 121 seconds to 54 seconds (p < 0.01). After three months 30% of nurses felt CNSS had reduced their workload, while 30% felt it had complicated their work; after five months 70% noted a reduction and 0% reported that CNSS had made their work more complex. The study therefore concludes that the interface between a computerised nursing support system and the hospital information system reduced the workload of nurses.

Conduits to care: call lights and patients' perceptions of communication.

PubMed

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

Conduits to care: call lights and patients’ perceptions of communication

PubMed Central

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Background Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. PMID:29075125

Nursing record systems: effects on nursing practice and health care outcomes.

PubMed

Currell, R; Urquhart, C

2003-01-01

A nursing record system is the record of care planned and/or given to individual patients/clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. We searched The Cochrane Library, the EPOC trial register (October 2002), MEDLINE, Cinahl, Sigle, and databases of the Royal College of Nursing, King's Fund, the NHS Centre for Reviews and Dissemination, and the Institute of Electrical Engineers up to August 1999; and OCLC First Search, Department of Health database, NHS Register of Computer Applications and the Health Visitors' Association database up to the end of 1995. We hand searched the Journal of Nursing Administration (1971-1999), Computers in Nursing (1984-1999), Information Technology in Nursing (1989-1999) and reference lists of articles. We also hand searched the major health informatics conference proceedings. We contacted experts in the field of nursing informatics, suppliers of nursing computer systems, and relevant Internet groups. To update the review the Medline, Cinahl, British Nursing Index, Aslib Index to Theses databases were all searched from 1998 to 2002. The Journal of Nursing Administration, Computers in Nursing, Information Technology in Nursing were all hand searched up to 2002. The searches of the other databases and grey literature included in the original review, were not updated (except for Health Care Computing Conference and Med Info) as the original searches produced little relevant material. Randomised trials, controlled before and after studies and interrupted time series comparing one kind of nursing record system with another, in hospital, community or primary care settings. The participants were qualified nurses, students or health care assistants working under the direction of a qualified nurse and patients receiving care recorded

"You're being paged!" outcomes of a nursing home on-call role-playing and longitudinal curriculum.

PubMed

Yuasa, Misuzu; Bell, Christina L; Inaba, Michiko; Tamura, Bruce K; Ahsan, Samina; Saunders, Valisa; Masaki, Kamal

2013-11-01

Effectively handling telephone calls about nursing home (NH) residents is an important skill for healthcare professionals, but little formal training is typically provided. The objective of the current study was to describe and evaluate the effectiveness of a novel structured role-playing didactic session followed by an on-call NH longitudinal clinical experience. The effectiveness of the structured role-playing didactic session was compared in different learners, including geriatric medicine fellows (n = 10), family medicine residents and faculty (n = 14), nurse practitioner students (n = 31), and other learners (n = 7). The curriculum focused on common problems encountered while caring for NH residents during on-call periods. Learners rated themselves using an 18-item pre/post questionnaire including five attitude and 13 skills questions, using a 1-to-5 Likert scale. T-tests were used to compare means before and after sessions. Significant improvements were found in overall mean attitudes and skills scores. For all learners, the greatest improvements were seen in "comfort in managing residents at the NH," "managing feeding or gastrostomy tube dislodgement," "identifying different availability of medications, laboratory studies, and procedures in NH," and "describing steps to send NH residents to the emergency department." Geriatric medicine fellows' attitudes and skills improved significantly after the longitudinal clinical experience. The faculty survey demonstrated improved documentation, communication, and fellows' management of on-call problems after curriculum implementation. This novel curriculum used role-playing to provide training for on-call management of NH residents. This curriculum has been successfully disseminated on a national geriatrics educational resource website (POGOe) and is applicable to geriatric medicine fellowships, internal medicine and family medicine residency programs, and other training programs. © 2013, Copyright the Authors

Developing a charging system for a nursing specialty: ET nursing.

PubMed

Lowery, G E; Gage, J; Lowenstein, A

1994-05-01

Because of limited resources and economic constraints, justifying the existence of ET nurses has become an economic challenge for hospitals and nurses. To justify the role of the ET nurse, a charging system for enterostomal therapy was developed at a corporate, for-profit hospital. Three months after implementation, an evaluation of the system demonstrated that revenue was generated in excess of the ET nurse's salary.

Succession planning: a call to action for nurse executives.

PubMed

Trepanier, Sylvain; Crenshaw, Jeannette T

2013-10-01

To discuss the organisational benefits of strategic succession planning in acute care hospital settings as a responsibility of chief nurse executives. A formal succession planning process is crucial to the financial and operational viability and sustainability of acute care hospitals. A succession plan is an essential business strategy that promotes effective leadership transition and continuity while maintaining productivity. Nursing and business literature were reviewed; reports contrasting institutions with and without succession plans were examined; and, operational implications were considered. It is imperative that chief nurse executives respond to the business benefits of an effective succession planning programme, identify common barriers and solutions, and implement best practices for a successful strategic succession planning programme. A strategic succession planning programme may offer many benefits to an acute care hospital, including improved retention rates, increased staff engagement and enhanced financial performance. Considering the ageing nursing workforce and the potential increase in demand for nursing services in the near future, nurse executives and other nurse leaders must actively engage in a formal succession planning process. A formal succession planning programme will help to provide strategic leadership continuity, operational effectiveness and improved quality of care. © 2013 John Wiley & Sons Ltd.

A Nursing Intelligence System to Support Secondary Use of Nursing Routine Data

PubMed Central

Rauchegger, F.; Ammenwerth, E.

2015-01-01

Summary Background Nursing care is facing exponential growth of information from nursing documentation. This amount of electronically available data collected routinely opens up new opportunities for secondary use. Objectives To present a case study of a nursing intelligence system for reusing routinely collected nursing documentation data for multiple purposes, including quality management of nursing care. Methods The SPIRIT framework for systematically planning the reuse of clinical routine data was leveraged to design a nursing intelligence system which then was implemented using open source tools in a large university hospital group following the spiral model of software engineering. Results The nursing intelligence system is in routine use now and updated regularly, and includes over 40 million data sets. It allows the outcome and quality analysis of data related to the nursing process. Conclusions Following a systematic approach for planning and designing a solution for reusing routine care data appeared to be successful. The resulting nursing intelligence system is useful in practice now, but remains malleable for future changes. PMID:26171085

System restricts nurses' overtime.

PubMed

2010-10-01

Noting concern over patient safety and staff well-being, Emory Healthcare in Atlanta has instituted a new policy that restricts overtime hours for nurses, including those in the ED. Here are some of the ways in which the system ensures their nurses get adequate rest: Nurses who want to work overtime cannot be on duty more than 60 hours a week. A central staffing center has been established to cover shifts. A number of the nurses have ED experience. Steps have been taken to ensure that nurses can take their 30-minute lunches and 15-minute breaks.

Radiation dose of nurses during IR procedures: a controlled trial evaluating operator alerts before nursing tasks.

PubMed

Komemushi, Atsushi; Suzuki, Satoshi; Sano, Akira; Kanno, Shohei; Kariya, Shuji; Nakatani, Miyuki; Yoshida, Rie; Kono, Yumiko; Ikeda, Koshi; Utsunomiya, Keita; Harima, Yoko; Komemushi, Sadao; Tanigawa, Noboru

2014-08-01

To compare radiation exposure of nurses when performing nursing tasks associated with interventional procedures depending on whether or not the nurses called out to the operator before approaching the patient. In a prospective study, 93 interventional radiology procedures were randomly divided into a call group and a no-call group; there were 50 procedures in the call group and 43 procedures in the no-call group. Two monitoring badges were used to calculate effective dose of nurses. In the call group, the nurse first told the operator she was going to approach the patient each time she was about to do so. In the no-call group, the nurse did not say anything to the operator when she was about to approach the patient. In all the nursing tasks, the equivalent dose at the umbilical level inside the lead apron was below the detectable limit. The equivalent dose at the sternal level outside the lead apron was 0.16 μSv ± 0.41 per procedure in the call group and 0.51 μSv ± 1.17 per procedure in the no-call group. The effective dose was 0.018 μSv ± 0.04 per procedure in the call group and 0.056 μSv ± 0.129 per procedure in the no-call group. The call group had a significantly lower radiation dose (P = .034). Radiation doses of nurses were lower in the group in which the nurse called to the operator before she approached the patient. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

Alarm Fatigue vs User Expectations Regarding Context-Aware Alarm Handling in Hospital Environments Using CallMeSmart.

PubMed

Solvoll, Terje; Arntsen, Harald; Hartvigsen, Gunnar

2017-01-01

Surveys and research show that mobile communication systems in hospital settings are old and cause frequent interruptions. In the quest to remedy this, an Android based communication system called CallMeSmart tries to encapsulate most of the frequent communication into one hand held device focusing on reducing interruptions and at the same time make the workday easier for healthcare workers. The objective of CallMeSmart is to use context-awareness techniques to automatically monitor the availability of physicians' and nurses', and use this information to prevent or route phone calls, text messages, pages and alarms that would otherwise compromise patient care. In this paper, we present the results from interviewing nurses on alarm fatigue and their expectations regarding context-aware alarm handling using CallMeSmart.

Systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a service representative

DOEpatents

Harris, Scott H.; Johnson, Joel A.; Neiswanger, Jeffery R.; Twitchell, Kevin E.

2004-03-09

The present invention includes systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a customer service representative. In one embodiment of the invention, a system configured to distribute a telephone call within a network includes a distributor adapted to connect with a telephone system, the distributor being configured to connect a telephone call using the telephone system and output the telephone call and associated data of the telephone call; and a plurality of customer service representative terminals connected with the distributor and a selected customer service representative terminal being configured to receive the telephone call and the associated data, the distributor and the selected customer service representative terminal being configured to synchronize, application of the telephone call and associated data from the distributor to the selected customer service representative terminal.

Review: evaluating information systems in nursing.

PubMed

Oroviogoicoechea, Cristina; Elliott, Barbara; Watson, Roger

2008-03-01

To review existing nursing research on inpatient hospitals' information technology (IT) systems in order to explore new approaches for evaluation research on nursing informatics to guide further design and implementation of effective IT systems. There has been an increase in the use of IT and information systems in nursing in recent years. However, there has been little evaluation of these systems and little guidance on how they might be evaluated. A literature review was conducted between 1995 and 2005 inclusive using CINAHL and Medline and the search terms 'nursing information systems', 'clinical information systems', 'hospital information systems', 'documentation', 'nursing records', 'charting'. Research in nursing information systems was analysed and some deficiencies and contradictory results were identified which impede a comprehensive understanding of effective implementation. There is a need for IT systems to be understood from a wider perspective that includes aspects related to the context where they are implemented. Social and organizational aspects need to be considered in evaluation studies and realistic evaluation can provide a framework for the evaluation of information systems in nursing. The rapid introduction of IT systems for clinical practice urges evaluation of already implemented systems examining how and in what circumstances they work to guide effective further development and implementation of IT systems to enhance clinical practice. Evaluation involves more factors than just involving technologies such as changing attitudes, cultures and healthcare practices. Realistic evaluation could provide configurations of context-mechanism-outcomes that explain the underlying relationships to understand why and how a programme or intervention works.

A framework for the transition from nursing records to a nursing information system.

PubMed

Turley, J P

1992-01-01

The future of patient record keeping is being developed now. Critical aspects are in place with the development of computer communication standards for health care. The Institute of Medicine's report on the computerized patient record has galvanized many in the health care field to rethink their methods of record keeping. Nurses need to examine the history of the nursing record and look toward the development of a comprehensive nursing information system. Nurses, along with the other disciplines, must examine what they want the system of the future to encompass. A suggested framework for the information system has four major nursing components: (1) data storage component, (2) transaction log, (3) nursing decision support systems, and (4) an engine to link and combine the first three components and to present a consistent easy-to-use interface to the nurse. Done properly, this approach will reduce the amount of time nurses spend charting, add dimension to their notation, and increase the efficiency of data usage for clinical practice. The nursing information system must allow information availability in a manner that accentuates quality practice while releasing the nurse from time-consuming record keeping. These goals are possible to meet, but only if nurses plan for the design now, before it becomes a fait accompli.

An investigation on task-technology fit of mobile nursing information systems for nursing performance.

PubMed

Hsiao, Ju-Ling; Chen, Rai-Fu

2012-05-01

This study investigates factors affecting the fit between nursing tasks and mobile nursing information systems and the relationships between the task-technology fit of mobile nursing information systems and nurse performance from the perspective of task-technology fit. Survey research recruited nursing staffs as subjects from selected case hospital. A total of 310 questionnaires were sent out, and 219 copies were obtained, indicating a valid response rate of 70.6%. Collected data were analyzed using the structural equation modeling technique. Our study found that dependence tasks have positive effects on information acquisition (γ=0.234, P<.05) and information identification (γ=0.478, P<.001), and independent tasks have significant effects on information acquisition (γ=0.213, P<.05). Therefore, the introduction of mobile nursing information systems in assisting nursing practices can help facilitate both independent and dependent nursing tasks. Our study discovered that the supporting functions of mobile nursing information systems have positive effects on information integration and interpretation (γ=0.365, P<.001), as well as information acquisition (γ=0.253, P<.05). The service supports of mobile nursing information systems have positive effects on information acquisition (γ=0.318, P<.001) and information integration and interpretation (γ=0.143, P<.01). Furthermore, information identification (β=.055, P<.05), information acquisition (β=.176, P<.001), and information integration and interpretation (β=.706, P<.001) provided using mobile nursing information systems have positive effects on nursing performance, indicating 83.2% of totally explained variance. As shown, the use of mobile nursing information systems could provide nursing staffs with real-time and accurate information to increase efficiency and effectiveness in patient-care duties, further improving nursing performance.

Technical Standards for Nursing Education Programs in the 21st Century.

PubMed

Ailey, Sarah H; Marks, Beth

The Institute of Medicine (2000, 2002) exposed serious safety problems in the health system and called for total qualitative system change. The Institute of Medicine (2011, 2015) also calls for improving the education of nurses to provide leadership for a redesigned health system. Intertwined with improving education is the need to recruit and retain diverse highly qualified students. Disability is part of diversity inclusion, but current technical standards (nonacademic requirements) for admission to many nursing programs are a barrier to the entry of persons with disabilities. Rehabilitation nurse leaders are in a unique position to improve disability diversity in nursing. The purpose of this paper is to discuss the importance of disability diversity in nursing. The history of existing technical standards used in many nursing programs is reviewed along with examples. On the basis of the concept that disability inclusion is a part of diversity inclusion, we propose a new model of technical standards for nursing education. Rehabilitation nurse leaders can lead in eliminating barriers to persons with disabilities entering nursing.

Strategies to improve nurse knowledge of delirium: a call to the adult-gerontology clinical nurse specialist.

PubMed

Middle, Beverly; Miklancie, Margaret

2015-01-01

The purpose of this article is to discuss the role of the adult-gerontology clinical nurse specialist in addressing the problem of delirium in hospitalized older adults through strategies to improve nurse knowledge. Delirium is a significant issue in hospitalized older adults. This acute confusional state can adversely impact older adults in various ways. Delirium has been implicated in (1) poor physical, cognitive, and psychological outcomes, (2) prolonged hospitalizations, (3) increased costs of care, (4) need for continued postacute care, and (5) patient and provider stress. To prevent delirium, nurses must possess the knowledge to identify risk factors and institute preventive strategies. Once a change in mental status occurs, it is critical that nurses recognize delirium and the steps necessary to provide safe, effective care. Nurses are the major providers of bedside care; however, multiple studies have identified a lack of nurse knowledge regarding delirium. The adult-gerontology clinical nurse specialist can be instrumental in fostering knowledge on this important issue. Multiple interventions can be conducted by the adult-gerontology clinical nurse specialist with acute care nurses to increase delirium knowledge. A review of the literature revealed strategies that might be used in the hospital setting. Before educational endeavors, it is crucial to assess baseline nurse knowledge of delirium. Educational strategies can then include use of standardized delirium assessment tools, implementation of the Geriatric Resource Nurse model, fostering geriatric case studies and simulations, conducting geriatric grand rounds, and development of structured delirium educational programs. Exploring the patient experience, post delirium, can provide an invaluable, first-hand account of the acute confusional state. This information can impact nurse knowledge as well as patient safety and well-being. Geriatric certification and professional organizational involvement can be

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

PubMed

Hyun, S; Park, H A

2002-06-01

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

Data systems can boost nursing care. Nurse management information systems in resource management.

PubMed

Wilson, J

1992-02-01

Resource management aims to improve patient care by matching resources with patient needs. Nurse management information systems provide data on skill mix, rostering requirements, ward costs and patient dependency levels, enabling a nursing strategy to be planned for the ward.

Primary Nursing: A Call for Clarity, Empowerment, and Accountability.

PubMed

Ruch, Shirley

2018-04-01

Registered nurses' (RNs') unique educational preparation, skills, scope of practice, and relationship with those we serve must be articulated and honored. The Primary Nursing care delivery model gives practical, functional life to the relationship of professional trust between RNs and their patients.

[Concept for Planning the Nurse-Patient Ratio and Nursing Fee Payment Linkage System].

PubMed

Lu, Meei-Shiow; Tseng, Hsiu-Yi; Liang, Shu-Yuan; Lin, Chiou-Fen

2017-02-01

This article describes the current situation in Taiwan with regard to the nurse-patient ratio and nursing fee payments, reviews the related policies and results in developed countries, and then proposes a plan for improving the domestic situation. Direct relationships exist between patient nursing quality and patient safety and the nurse-patient ratio as well as between nursing fee payments and the nurse-patient ratio. Therefore, in order to enhance the quality and safety of nursing care, it will be necessary to develop and institute a payment linkage system that links nursing fee payments to the nurse-patient ratio. This process requires public consensus and planning in order to institute an equitable and effective payment linkage system in the future.

Integrating Systems Thinking Into Nursing Education.

PubMed

Phillips, Janet M; Stalter, Ann M

2016-09-01

A critical need exists for nursing leadership in current complex health care settings. Systems thinking can be incorporated into nursing education at all levels by using evidence-based principles in education. Teaching tips are provided using a systems awareness model to guide nurse educators in the assessment and integration of systems thinking and engaging learners in interprofessional education and practice. J Contin Educ Nurs. 2016;47(9):395-397. Copyright 2016, SLACK Incorporated.

Nurses' Satisfaction With Using Nursing Information Systems From Technology Acceptance Model and Information Systems Success Model Perspectives: A Reductionist Approach.

PubMed

Lin, Hsien-Cheng

2017-02-01

Nursing information systems can enhance nursing practice and the efficiency and quality of administrative affairs within the nursing department and thus have been widely considered for implementation. Close alignment of human-computer interaction can advance optimal clinical performance with the use of information systems. However, a lack of introduction of the concept of alignment between users' perceptions and technological functionality has caused dissatisfaction, as shown in the existing literature. This study provides insight into the alignment between nurses' perceptions and how technological functionality affects their satisfaction with Nursing Information System use through a reductionist perspective of alignment. This cross-sectional study collected data from 531 registered nurses in Taiwan. The results indicated that "perceived usefulness in system quality alignment," "perceived usefulness in information quality alignment," "perceived ease of use in system quality alignment," "perceived ease of use in information quality alignment," and "perceived ease of use in service quality alignment" have significantly affected nurses' satisfaction with Nursing Information System use. However, "perceived usefulness in service quality alignment" had no significant effect on nurses' satisfaction. This study also provides some meaningful implications for theoretical and practical aspects of design.

Social challenges when implementing information systems in everyday work in a nursing context.

PubMed

Nilsson, Lina; Eriksén, Sara; Borg, Christel

2014-09-01

Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses' solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.

Exploring nursing e-learning systems success based on information system success model.

PubMed

Chang, Hui-Chuan; Liu, Chung-Feng; Hwang, Hsin-Ginn

2011-12-01

E-learning is thought of as an innovative approach to enhance nurses' care service knowledge. Extensive research has provided rich information toward system development, courses design, and nurses' satisfaction with an e-learning system. However, a comprehensive view in understanding nursing e-learning system success is an important but less focused-on topic. The purpose of this research was to explore net benefits of nursing e-learning systems based on the updated DeLone and McLean's Information System Success Model. The study used a self-administered questionnaire to collected 208 valid nurses' responses from 21 of Taiwan's medium- and large-scale hospitals that have implemented nursing e-learning systems. The result confirms that the model is sufficient to explore the nurses' use of e-learning systems in terms of intention to use, user satisfaction, and net benefits. However, while the three exogenous quality factors (system quality, information quality, and service quality) were all found to be critical factors affecting user satisfaction, only information quality showed a direct effect on the intention to use. This study provides useful insights for evaluating nursing e-learning system qualities as well as an understanding of nurses' intentions and satisfaction related to performance benefits.

Nursing 2000: Collaboration to Promote Careers in Registered Nursing.

ERIC Educational Resources Information Center

Wilson, Connie S.; Mitchell, Barbara S.

1999-01-01

The effectiveness of the collaborative Nursing 2000 model in promoting nursing careers was evaluated through a survey of 1,598 nursing students (637 responses). Most effective techniques were the "shadow a nurse" program, publications, classroom and community presentations, and career-counseling telephone calls. (SK)

Influence of patient and provider factors on the workload of on-call physicians

PubMed Central

Hsu, Nin-Chieh; Huang, Chun-Che; Jerng, Jih-Shuin; Hsu, Chia-Hao; Yang, Ming-Chin; Chang, Ray-E; Ko, Wen-Je; Yu, Chong-Jen

2016-01-01

Abstract Factors associated with the physician workload are scarcely reported. The study aims to investigate the associated factors of on-call physician workload based on a published conceptual framework. The study was conducted in a general internal medicine unit of National Taiwan University Hospital. On-call physician workloads were recorded on a shift basis from 1198 hospitalized patients between May 2010 and April 2011. The proxy of on-call workloads included night calls, bedside evaluation/management (E/M), and performing clinical procedures in a shift. Multivariable logistic and negative binomial regression models were used to determine the factors associated with the workloads of on-call physicians. During the study period, 378 (31.6%) of patients had night calls with related workloads. Multivariate analysis showed that the number of patients with unstable conditions in a shift (odds ratio [OR] 1.89 and 1.66, respectively) and the intensive care unit (ICU) training of the nurse leader (OR 2.87 and 3.08, respectively) resulted in higher likelihood of night calls to and bedside E/M visits by the on-call physician. However, ICU training of nurses (OR = 0.37, 95% confidence interval: 0.16–0.86) decreased the demand of performing clinical procedures by the on-call physician. Moreover, number of patients with unstable conditions (risk ratio [RR] 1.52 and 1.55, respectively) had significantly increased the number of night calls and bedside E/M by on-call physicians by around 50%. Nurses with N1 level (RR 2.16 and 2.71, respectively) were more likely to place night calls and facilitate bedside E/M by the on-call physician compared to nurses with N0 level. In addition, the nurse leaders with ICU training (RR 1.72 and 3.07, respectively) had significant increases in night calls and bedside E/M by the on-call physician compared to those without ICU training. On-call physician workload is associated with patient factors and the training of nurses. Number of

Critical care nursing: Embedded complex systems.

PubMed

Trinier, Ruth; Liske, Lori; Nenadovic, Vera

2016-01-01

Variability in parameters such as heart rate, respiratory rate and blood pressure defines healthy physiology and the ability of the person to adequately respond to stressors. Critically ill patients have lost this variability and require highly specialized nursing care to support life and monitor changes in condition. The critical care environment is a dynamic system through which information flows. The critical care unit is typically designed as a tree structure with generally one attending physician and multiple nurses and allied health care professionals. Information flow through the system allows for identification of deteriorating patient status and timely interventionfor rescue from further deleterious effects. Nurses provide the majority of direct patient care in the critical care setting in 2:1, 1:1 or 1:2 nurse-to-patient ratios. The bedside nurse-critically ill patient relationship represents the primary, real-time feedback loop of information exchange, monitoring and treatment. Variables that enhance information flow through this loop and support timely nursing intervention can improve patient outcomes, while barriers can lead to errors and adverse events. Examining patient information flow in the critical care environment from a dynamic systems perspective provides insights into how nurses deliver effective patient care and prevent adverse events.

An introductory orientation to clinical pathology core and on-call responsibilities.

PubMed

Pappas, A A; Drew, M J; Flick, J; Fink, L; Fuller, G L; Hough, A J

1994-05-01

An introductory 4-week orientation for clinical pathology is described. There were 76 hours of lectures, 74 hours of conferences, and 68 hours of laboratories for a total of 221 hours. During the orientation, all calls handled by the residents were evaluated as to resolution, patient outcome, and interaction required. Eighty calls were received during the orientation from 57 technologists (71%), 16 physicians (20%), and seven nurses (9%). The calls originated concerning the following: blood banking, 37 (46%); hematology, 21 (27%); chemistry, 14 (18%); microbiology, five (6%); and administration, three (4%). Sixty percent of the calls were consultative and 40% were supervisory. Ninety-nine percent were handled appropriately by the residents. Patient outcome was moderately or significantly affected in 44% of all calls, divided between 67% of all consultative calls and 9% of all supervisory calls. Significant pathologist interaction was required in 49% of all calls, divided between 71% of the consultative calls and 16% of the supervisory calls. Using this integrated, dynamic system of resident instruction, on-call experience, and evaluation, residents quickly gain confidence in handling call, didactic clinical consultation, and patient management. The orientation and on-call system described provides for a relevant and dynamic system for resident education.

Nurses' experiences using a nursing information system: early stage of technology implementation.

PubMed

Lee, Ting-Ting

2007-01-01

Adoption of information technology in nursing practice has become a trend in healthcare. The impact of this technology on users has been widely studied, but little attention has been given to its influence at the beginning stage of implementation. Knowing the barriers to adopting technology could shorten this transition stage and minimize its negative influences. The purpose of this study was to explore nurses' experiences in the early stage of implementing a nursing information system. Focus groups were used to collect data at a medical center in Taiwan. The results showed that nurses had problems with the system's content design, had insufficient training, were concerned about data security, were stressed by added work, and experienced poor interdisciplinary cooperation. To smooth this beginning stage, the author recommends involving nurses early in the system design, providing sufficient training in keyboard entry skills, redesigning workflow, and improving interdisciplinary communication.

Use of electronic information systems in nursing management.

PubMed

Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula

2010-05-01

The purpose of this study is to describe nurse managers' perceptions of the use of electronic information systems in their daily work. Several kinds of software are used for administrative and information management purposes in health care organizations, but the issue has been studied less from nurse managers' perspective. The material for this qualitative study was acquired according to the principles of focus group interview. Altogether eight focus groups were held with 48 nurse managers from both primary and specialized health care organizations. The nurse managers were asked in focus groups to describe the use of information systems in their daily work in addition to some other themes. The material was analyzed by inductive content analysis using ATLAS.ti computer program. The main category "pros and cons of using information systems in nursing management" summarized the nurse managers' perceptions of using electronic information systems. The main category consisted of three sub-categories: (1) nurse managers' perceptions of the use of information technology; (2) usability of management information systems; (3) development of personnel competencies and work processes. The nurse managers made several comments on the implementation of immature electronic information systems which caused inefficiencies in working processes. However, they considered electronic information systems to be essential elements of their daily work. Furthermore, the nurse managers' descriptions of the pros and cons of using information systems reflected partly the shortcomings of strategic management and lack of coordination in health care organizations. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Developing an information systems strategy for nursing.

PubMed

Callanan, K M; Hughes, S J

1995-01-01

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

Automatic generation of nursing narratives from entity-attribute-value triplet for electronic nursing records system.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Lee, Joo Yun; Jo, Soo Jung; Jeon, Eunjoo; Byeon, Namsoo; Choi, Seung Yong; Chung, Eunja

2014-01-01

The aim of this study is to develop and evaluate a natural language generation system to populate nursing narratives using detailed clinical models. Semantic, contextual, and syntactical knowledges were extracted. A natural language generation system linking these knowledges was developed. The quality of generated nursing narratives was evaluated by the three nurse experts using a five-point rating scale. With 82 detailed clinical models, in total 66,888 nursing narratives in four different types of statement were generated. The mean scores for overall quality was 4.66, for content 4.60, for grammaticality 4.40, for writing style 4.13, and for correctness 4.60. The system developed in this study generated nursing narratives with different levels of granularity. The generated nursing narratives can improve semantic interoperability of nursing data documented in nursing records.

Relationships among work stress, job satisfaction, mental health, and healthy lifestyle behaviors in new graduate nurses attending the nurse athlete program: a call to action for nursing leaders.

PubMed

Melnyk, Bernadette Mazurek; Hrabe, David P; Szalacha, Laura A

2013-01-01

Although nurses are educated to take outstanding care of others, they themselves often have poor health outcomes, including high rates of depression and obesity, which are associated with stressful work environments. Furthermore, a high percentage of new graduate nurses leave their positions in the first year of employment, resulting in exorbitant costs to health care systems. The aim of this study was to determine the relationships among key variables that influence job satisfaction and healthy lifestyle behaviors of new graduate nurses, including workplace stress, work environment, lifestyle beliefs, and mental health. A descriptive correlational design was used with baseline data from 61 new graduate nurses attending the 2-day Nurse Athlete program, a workshop that focuses on nutrition, energy management, and physical activity. Higher levels of workplace stress were associated with higher levels of depression and anxiety as well as lower levels of resiliency, job satisfaction, and healthy lifestyle beliefs. Nurse leaders and managers must invest in creating healthy work environments for new and experienced nurses as well as provide mental health screening, resources, and intervention programs that focus on education and skills-building in health promoting behaviors, including emotional regulation of stress, anxiety, and depression.

Hydration amongst nurses and doctors on-call (the HANDS on prospective cohort study).

PubMed

El-Sharkawy, Ahmed M; Bragg, Damian; Watson, Phillip; Neal, Keith; Sahota, Opinder; Maughan, Ronald J; Lobo, Dileep N

2016-08-01

Dehydration of as little 2% of total body weight may impair physical and cognitive performance. The aim of this study was to investigate the prevalence of dehydration at the start and end of shifts in nurses and doctors on-call. The secondary aims were to assess the relation between hydration status and cognitive function. This prospective cohort study was conducted on nurses and doctors working on medical and surgical admissions wards at a university teaching hospital. Participants arrived on the ward approximately 20 min before their shift and were asked to provide a urine sample. Height and weight were then measured. A 10 mL blood sample was analysed for full blood count, serum urea and electrolytes, and blood glucose. Cognitive function was assessed using a series of computer-based tests including the Stroop Colour Naming Interference Test and Sternberg Memory Paradigm. Participants then worked normally but were asked to keep a fluid diary for the duration of their shift and fluid balance was estimated. Tests were repeated at the end of the shift. Dehydration was defined as urine osmolality >800 mOsmol/kg and oliguria was defined as urine output <0.5 ml/kg/hour. We recruited 92 nurses and doctors, of whom 88 completed the study, amounting to 130 shifts. 52% participated for one shift, and 48% for two shifts. Thirty-six percent of participants were dehydrated at the start of the shift and 45% were dehydrated at the end of their shift. Mean (SD) urinary osmolality was significantly greater at the end of the shift when compared with the start [720 (282) vs. 622 (297) mOsm/kg, P = 0.031). Moreover, 41% were oliguric at the end of the shift. Single number and five-letter Sternberg short-term memory tests were significantly impaired in dehydrated participants (P < 0.05). This study highlights that a significant proportion of nurses and doctors were dehydrated at the start and end of medical and surgical shifts. Dehydration was associated with some

Enhancement on infectious diseases nursing plan information system.

PubMed

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

2009-01-01

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

ParticleCall: A particle filter for base calling in next-generation sequencing systems

PubMed Central

2012-01-01

Background Next-generation sequencing systems are capable of rapid and cost-effective DNA sequencing, thus enabling routine sequencing tasks and taking us one step closer to personalized medicine. Accuracy and lengths of their reads, however, are yet to surpass those provided by the conventional Sanger sequencing method. This motivates the search for computationally efficient algorithms capable of reliable and accurate detection of the order of nucleotides in short DNA fragments from the acquired data. Results In this paper, we consider Illumina’s sequencing-by-synthesis platform which relies on reversible terminator chemistry and describe the acquired signal by reformulating its mathematical model as a Hidden Markov Model. Relying on this model and sequential Monte Carlo methods, we develop a parameter estimation and base calling scheme called ParticleCall. ParticleCall is tested on a data set obtained by sequencing phiX174 bacteriophage using Illumina’s Genome Analyzer II. The results show that the developed base calling scheme is significantly more computationally efficient than the best performing unsupervised method currently available, while achieving the same accuracy. Conclusions The proposed ParticleCall provides more accurate calls than the Illumina’s base calling algorithm, Bustard. At the same time, ParticleCall is significantly more computationally efficient than other recent schemes with similar performance, rendering it more feasible for high-throughput sequencing data analysis. Improvement of base calling accuracy will have immediate beneficial effects on the performance of downstream applications such as SNP and genotype calling. ParticleCall is freely available at https://sourceforge.net/projects/particlecall. PMID:22776067

Advancing the education of nurses: a call for action.

PubMed

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

2010-12-01

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

A comparison of calls subjected to a malpractice claim versus 'normal calls' within the Swedish healthcare direct: a case-control study.

PubMed

Ernesäter, Annica; Engström, Maria; Winblad, Ulrika; Holmström, Inger K

2014-10-03

The purpose of this study is to compare communication patterns in calls subjected to a malpractice claim with matched controls. In many countries, telephone advice nursing is patients' first contact with healthcare. Telenurses' assessment of callers' symptoms and needs are based on verbal communication only, and problems with over-triage and under-triage have been reported. A total sample of all reported medical errors (n=33) during the period 2003-2010 within Swedish Healthcare Direct was retrieved. Corresponding calls were thereafter identified and collected as sound files from the manager in charge at the respective call centres. For technical reasons, calls from four of the cases were not possible to retrieve. For the present study, matched control calls (n=26) based on the patient's age, gender and main symptom presented by the caller were collected. Male patients were in majority (n=16), and the most common reasons for calling were abdominal pain (n=10) and chest pain (n=5). There were statistically significant differences between the communication in the cases and controls: telenurses used fewer open-ended medical questions (p<0.001) in the cases compared to the control calls; callers provided telenurses with more medical information in the control calls compared to the cases (p=0.001); and telenurses used more facilitation and patient activation activities in the control calls (p=0.034), such as back-channel response (p=0.001), compared to the cases. The present study shows that telenurses in malpractice claimed calls used more closed-ended questioning compared to those in control calls, who used more open-ended questioning and back-channel response, which provided them with richer medical descriptions and more information from the caller. Hence, these communicative techniques are important in addition to solid medical and nursing competence and sound decision aid systems. Published by the BMJ Publishing Group Limited. For permission to use (where not

Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

PubMed

Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

2018-04-09

Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

Integrated Comprehensive Care - A Case Study in Nursing Leadership and System Transformation.

PubMed

Wheatley, Laura; Doyle, Winnie; Evans, Cheryl; Gosse, Carolyn; Smith, Kevin

2017-01-01

Calls for transformational change of our healthcare system are increasingly clear, persuasive and insistent. They resonate at all levels, with those who fund, deliver, provide and receive care, and they are rooted in a deep understanding that the system, as currently rigidly structured, most often lacks the necessary flexibility to comprehensively meet the needs of patients across the continuum of care. The St. Joseph's Health System (SJHS) Integrated Comprehensive Care (ICC) Program, which bundles care and funding across the hospital to home continuum, has reduced fragmentation of care, and it has delivered improved outcomes for patients, providers and the system. This case study explores the essential contribution of nursing leadership to this successful transformation of healthcare service delivery.

Design of an Intelligent Nursing Clinical Pathway and Nursing Order Support System for Traditional Chinese Medicine.

PubMed

Ding, Bao-Fen; Chang, Polun; Wang, Ping; Li, Hai-Ting; Kuo, Ming-Chuan

2017-01-01

With an in-depth analysis of nursing work in 14 hospitals over a period of two years, one unique total nursing information system framework was established where the nursing clinical pathways are used as the main frame and the nursing orders as the nodes on the frame. We used the nursing order concept with the principles of nursing process. A closed-loop management model composed of the nursing orders was set up to solve nursing problems. Based on the principles of traditional Chinese medicine, we further designed an intelligent support module to automatically deduct clinical nursing pathways to promote standardized management and improve the quality of nursing care. The system has successfully been implemented in some facilities since 2015.

What happens when the board of nursing comes calling: investigation and disciplinary actions.

PubMed

Smalls, Harriett Twiggs

2014-01-01

Each state has a Board of Nursing that governs the nurses that practice in that state. Each Board of Nursing has a process by which it investigates and hears cases against nurses accused of wrongdoing. This article gives a general overview of what steps are usually taken when the Board of Nursing suspects that a nurse's actions may be in violation of the laws that govern nursing practice.

Creating a Learner-Centered Environment in Nursing Education: An Immersion Experience

ERIC Educational Resources Information Center

Steiner, Susan H.; Floyd, Evelyn; Hewett, Beverly J.; Lewis, Nicole C.; Walker, Eldon H.

2010-01-01

A call for change in nursing education has been issued in order to prepare the nurse of the future in a changing health care delivery system with increasing complexity. The learning environment is changing, including the faculty role. Innovative research-based pedagogies are suggested as a way to challenge traditional nursing education. The…

[Information system for supporting the Nursing Care Systematization].

PubMed

Malucelli, Andreia; Otemaier, Kelly Rafaela; Bonnet, Marcel; Cubas, Marcia Regina; Garcia, Telma Ribeiro

2010-01-01

It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional practice documentation. This paper describes the methodological steps and results of the information system development - requirements elicitation, modeling, object-relational mapping, implementation and system validation.

Preparing the nursing workforce of the future.

PubMed

Ellenbecker, Carol H

2010-05-01

Nurse shortages coupled with the need for national healthcare reform present a challenge. We are not preparing enough nurses nor are we preparing nurses with the right skills to fully participate in a reformed healthcare system. Historical forces in nursing education have resulted in multiple levels of entry into nursing practice and an inadequate nursing workforce. Today's environment of expanding knowledge, the call for interdisciplinary healthcare delivery teams, and evidence of the relationship between nurse education and improved patient outcomes strongly indicate the need for nurses prepared at the baccalaureate level. Requiring a baccalaureate degree for entry into nursing practice, and as the initial degree of nursing education would prepare nurses earlier for graduate education and the much needed roles of educator, researcher and advanced practice nurse. The nursing profession should take the lead in advocating for educational policies that would adequately prepare the nurse workforce of the future.

Effects of communication media choice on the quality and efficacy of emergency calls assisted by a mobile nursing protocol tool.

PubMed

Castro, Luis A; Favela, Jesus; Garcia-Peña, Carmen

2014-11-01

The transition from paper to electronic-based records in the healthcare industry has posed several challenges to conventional medical practices. The introduction of technology in day-to-day medical and nursing practices deserves careful consideration. In this work, we report the results of a controlled experiment to compare nurses' consultation in emergency calls in six different conditions. We studied the effect that the type of communication media (face-to-face, telephone, videoconference) and type of nursing protocol media (paper-based, electronic-based) can have on consultation time, mistakes made, pauses during consultation, eye contact, and efficacy of the consultation. We found that the type of communication media has an effect on consultation time; on average, fewer mistakes were made during telephone-based consultations; for eye contact, there were significantly fewer eye contacts during face-to-face than during videoconference consultations; finally, the type of communication media or protocol media did not have any effect in the efficacy of the consultation.

Capturing Accurate and Useful Information on Medication-Related Telenursing Triage Calls.

PubMed

Lake, R; Li, L; Baysari, M; Byrne, M; Robinson, M; Westbrook, J I

2016-01-01

Registered nurses providing telenursing triage and advice services record information on the medication related calls they handle. However the quality and consistency of these data were rarely examined. Our aim was to examine medication related calls made to the healthdirect advice service in November 2014, to assess their basic characteristics and how the data entry format influenced information collected and data consistency. Registered nurses selected the patient question type from a range of categories, and entered the medications involved in a free text field. Medication names were manually extracted from the free text fields. We also compared the selected patient question type with the free text description of the call, in order to gauge data consistency. Results showed that nurses provided patients with advice on medication-related queries in a timely matter (the median call duration of 9 minutes). From 1835 calls, we were able to identify and classify 2156 medications into 384 generic names. However, in 204 cases (11.2% of calls) no medication name was entered. A further 308 (15.0%) of the medication names entered were not identifiable. When we compared the selected patient question with the free text description of calls, we found that these were consistent in 63.27% of cases. Telenursing and triage advice services provide a valuable resource to the public with quick and easily accessible advice. To support nurses provide quality services and record accurate information about the queries, appropriate data entry format and design would be beneficial.

47 CFR 64.1320 - Payphone call tracking system audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Payphone call tracking system audits. 64.1320... call tracking system audits. (a) Unless it has entered into an alternative compensation arrangement... Completing Carrier must undergo an audit of its § 64.1310(a)(1) tracking system by an independent third party...

Nursing Services Delivery Theory: an open system approach

PubMed Central

Meyer, Raquel M; O’Brien-Pallas, Linda L

2010-01-01

meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573

Consumer satisfaction with telehealth advice-nursing.

PubMed

Chang, B L; Mayo, A; Omery, A

2001-01-01

An increase in interest in the establishment of telephone advice services has resulted in the proliferation of call centers. Despite their wide usage, research for the most part has not addressed the quality of care in relation to consumer satisfaction. This paper examines consumer outcomes of satisfaction, and follow-up with recommendations, within a framework of the nursing process and its associated components of assessment (including problem identification), care planning, intervention, and evaluation. The data for the study were obtained from seven after-hours call centers operating under the auspices of health maintenance organizations, preferred provider organizations, and private insurance companies. A sample of 157 non-redundant telephone calls from adults with medical-surgical problems were audiotaped with providers' and callers' consent. Sociodemographic information of the advice nurses, and chief complaints of the callers were obtained. The quality of nursing of the audiotaped calls was rated through an implicit review method by registered nurse raters using an advice nurse structured implicit review (AN-SIR) form developed for the study. Follow-up information was obtained through telephone calls to ascertain the consumers' perceptions of satisfaction, helpfulness, and follow-through with recommendations. Results indicated that consumers calling with a variety of general complaints contacted 32 nurses in advice nurse call centers. The quality of nursing process was found to be the best in the area of intervention. Evaluation was also well above the midpoint on a transformed scale of zero to 100. Assessment, although slightly above midpoint, was the lowest of the three components of the nursing process examined. Consumer satisfaction was high with 95.4 percent of the consumers rating the calls as completely or at least somewhat satisfied, and 93.2 percent, stating the advice was very or somewhat helpful. Exploratory regression analysis showed that the

Examination of wireless technology to improve nurse communication, response time to bed alarms, and patient safety.

PubMed

Guarascio-Howard, Linda

2011-01-01

A medical-surgical unit in a southwestern United States hospital examined the results of adding wireless communication technology to assist nurses in identifying patient bed status changes and enhancing team communication. Following the addition of wireless communication, response time to patient calls and the number of nurse-initiated communications were compared to pre-wireless calls and response time sampling period. In the baseline study, nurse-initiated communications and response time to patient calls were investigated for a team nursing model (Guarascio-Howard & Malloch, 2007). At this time, technology consisted of a nurse call system and telephones located at each decentralized nurse station and health unit coordinator (HUC) station. For this follow-up study, a wireless device was given to nurses and their team members following training on device use and privacy issues. Four registered nurses (RNs) were shadowed for 8 hours (32 hours total) before and after the introduction of the wireless devices. Data were collected regarding patient room visits, number of patient calls, bed status calls, response time to calls, and the initiator of the communication episodes. Follow-up study response time to calls significantly decreased (t-test p = .03). RNs and licensed practical nurses responded to bed status calls in less than 1 minute-62% of the 37 calls. Communication results indicated a significant shift (One Proportion Z Test) in RN-initiated communications, suggesting an enhanced ability to communicate with team members and to assist in monitoring patient status. Patient falls trended downward, although not significantly (p > .05), for a 6-month period of wireless technology use compared to the same period the previous year. The addition of a wireless device has advantages in team nursing, namely increasing communication with staff members and decreasing response time to patient and bed status calls. Limitations of the study included a change in caregiver team

Problem Solving for Volatilizing Situation in Nursing: Developing Thinking Process Supporting System using NursingNAVI® Contents.

PubMed

Tsuru, Satoko; Wako, Fumiko; Omori, Miho; Sudo, Kumiko

2015-01-01

We have identified three foci of the nursing observation and nursing action respectively. Using these frameworks, we have developed the structured knowledge model for a number of diseases and medical interventions. We developed this structure based NursingNAVI® contents collaborated with some quality centered hospitals. Authors analysed the nursing care documentations of post-gastrectomy patients in light of the standardized nursing care plan in the "NursingNAVI®" developed by ourselves and revealed the "failure to observe" and "failure to document", which leaded to the volatility of the patients' data, conditions and some situation. This phenomenon should have been avoided if nurses had employed a standardized nursing care plan. So, we developed thinking process support system for planning, delivering, recording and evaluating in daily nursing using NursingNAVI® contents. A hospital decided to use NursingNAVI® contents in HIS. It was suggested that the system has availability for nursing OJT and time reduction of planning and recording without volatilizing situation.

Important considerations about nursing intelligence and information systems.

PubMed

Ballard, E C

1997-01-01

This discussion focuses on the importance of nursing intelligence to the organisation, and the nurses' role in gathering and utilising such intelligence. Deliberations with professional colleagues suggest that intelligence can only be utilised fully when the information systems are developed in such a way as to meet the needs of the people who manage and provide nursing care at the consumer level; that is, the activity of nursing itself. If accommodation is made for the recycling of nursing intelligence, there would be a support and furtherance of 'professional' intelligence. Two main issues emerge: how can nurses support the needs of management to optimise intelligence input? how can organisations optimise the contribution of nurses to its information processes and interpretation of intelligence? The expansion of this 'professional' intelligence would promote a generation of constantly reviewed data, offering a quality approach to nursing activities and an organisation's intelligence system.

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

PubMed

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

2016-01-01

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

47 CFR 64.1320 - Payphone call tracking system audits.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Certified Public Accountants, to determine whether the call tracking system accurately tracks payphone calls... Certified Public Accountants for attestation engagements, the System Audit Report shall consist of: (1) The... the payphone service provider for inspection any documents, including working papers, underlying the...

47 CFR 64.1320 - Payphone call tracking system audits.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Certified Public Accountants, to determine whether the call tracking system accurately tracks payphone calls... Certified Public Accountants for attestation engagements, the System Audit Report shall consist of: (1) The... the payphone service provider for inspection any documents, including working papers, underlying the...

47 CFR 64.1320 - Payphone call tracking system audits.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Certified Public Accountants, to determine whether the call tracking system accurately tracks payphone calls... Certified Public Accountants for attestation engagements, the System Audit Report shall consist of: (1) The... the payphone service provider for inspection any documents, including working papers, underlying the...

47 CFR 64.1320 - Payphone call tracking system audits.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Certified Public Accountants, to determine whether the call tracking system accurately tracks payphone calls... Certified Public Accountants for attestation engagements, the System Audit Report shall consist of: (1) The... the payphone service provider for inspection any documents, including working papers, underlying the...

A Call for More Diploma Nurses to Attain a Baccalaureate Degree

PubMed Central

Kamanyire, Joy K.; Achora, Susan

2015-01-01

The healthcare needs of the Omani population are evolving, particularly with regards to changes in disease complexity, advances in technology and the enhanced delivery of healthcare services. Nurses now need to adapt to a fundamental shift in the provision of patient-centred care. In line with lifelong learning goals, registered nurses in Oman at the diploma level should seek to obtain a more advanced qualification, for instance a Bachelor of Science in Nursing, to ensure they possess the requisite skills and knowledge to keep abreast of new developments in healthcare management. Challenges involved in this transition and suggestions to overcome these potential obstacles are discussed in this article in order to inform nursing education stakeholders. Recommendations to ensure the success of bridging programmes are also suggested. PMID:26357551

Nursing process decision support system for urology ward.

PubMed

Hao, Angelica Te-Hui; Wu, Lee-Pin; Kumar, Ajit; Jian, Wen-Shan; Huang, Li-Fang; Kao, Ching-Chiu; Hsu, Chien-Yeh

2013-07-01

We developed a nursing process decision support system (NPDSS) based on three clinical pathways, including benign prostatic hypertrophy, inguinal hernia, and urinary tract stone. NPDSS included six major nursing diagnoses - acute pain, impaired urinary elimination, impaired skin integrity, anxiety, infection risk, and risk of falling. This paper aims to describe the design, development and validation process of the NPDSS. We deployed the Delphi method to reach consensus for decision support rules of NPDSS. A team of nine-member expert nurses from a medical center in Taiwan was involved in Delphi method. The Cronbach's α method was used for examining the reliability of the questionnaire used in the Delphi method. The Visual Basic 6.0 as front-end and Microsoft Access 2003 as back-end was used to develop the system. A team of six nursing experts was asked to evaluate the usability of the developed systems. A 5-point Likert scale questionnaire was used for the evaluation. The sensitivity and specificity of NPDSS were validated using 150 nursing chart. The study showed a consistency between the diagnoses of the developed system (NPDSS) and the nursing charts. The sensitivities of the nursing diagnoses including acute pain, impaired urinary elimination, risk of infection, and risk of falling were 96.9%, 98.1%, 94.9%, and 89.9% respectively; and the specificities were 88%, 49.5%, 62%, and 88% respectively. We did not calculate the sensitivity and specificity of impaired skin integrity and anxiety due to non-availability of enough sample size. NPDSS can help nurses in decision making of nursing diagnoses. Besides, it can help them to generate nursing diagnoses based on patient-specific data, individualized care plans, and implementation within their usual nursing workflow. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Transforming nursing education: a review of current curricular practices in relation to Benner's latest work.

PubMed

Handwerker, Sarah M

2012-09-12

Current societal and healthcare system trends highlight the need to transform nursing education to prepare nurses capable of outstanding practice in the 21st century. Patricia Benner and colleagues urged nurse educators to transform their practice in the 2010 publication Educating Nurses, A Call to Radical Transformation. Frequently utilized pedagogical frameworks in nursing education include behaviorism and constructivism. Much of the structure and basis for instruction and evaluation can be found rooted in these philosophies. By first exploring both behaviorism and constructivism and then relating their use in nursing education to the call to transform, educators can be encourage to examine current practice and possibly modify aspects to include more rich experiential learning.

The need for academic electronic health record systems in nurse education.

PubMed

Chung, Joohyun; Cho, Insook

2017-07-01

The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems. Copyright © 2017. Published by Elsevier Ltd.

The Certified Clinical Nurse Leader in Critical Care.

PubMed

L'Ecuyer, Kristine M; Shatto, Bobbi J; Hoffmann, Rosemary L; Crecelius, Matthew L

2016-01-01

Challenges of the current health system in the United States call for collaboration of health care professionals, careful utilization of resources, and greater efficiency of system processes. Innovations to the delivery of care include the introduction of the clinical nurse leader role to provide leadership at the point of care, where it is needed most. Clinical nurse leaders have demonstrated their ability to address needed changes and implement improvements in processes that impact the efficiency and quality of patient care across the continuum and in a variety of settings, including critical care. This article describes the role of the certified clinical nurse leader, their education and skill set, and outlines outcomes that have been realized by their efforts. Specific examples of how clinical nurse leaders impact critical care nursing are discussed.

A Trial of Nursing Cost Accounting using Nursing Practice Data on a Hospital Information System.

PubMed

Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa

2015-01-01

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.

Nursing Leadership in Home and Community Care: An Introduction.

PubMed

Donner, Gail

2017-01-01

There is agreement across all provinces that there is transformation needed in the area of home and community care. Yet, where is the collective voice of nurse leaders in this transformation? The guest editor calls on nurses to respond to this unique opportunity to shape the transformation of our health system, and improve care for patients and their caregivers.

Nursing Quality Assurance: The Wisconsin System

ERIC Educational Resources Information Center

Hover, Julie; Zimmer, Marie J.

1978-01-01

Evaluation model guidelines for hospital departments of nursing to use in their nursing quality assurance programs are presented as developed in Wisconsin. Four essential components of the Wisconsin outcome evaluation system are criteria, assessment, standards, and improvement of care. Sample tests and charts are included in the article. (MF)

Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

PubMed

Beaulieu, Richard; Humphreys, Janice

2008-01-01

Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P < .05), and the importance of being involved in decision making (P < .05). A telephone advice nurse may increase both parent/caregiver and provider satisfaction and access to care.

Evaluation of a patient centered e-nursing and caring system.

PubMed

Tsai, Lai-Yin; Shan, Huang; Mei-Bei, Lin

2006-01-01

This study aims to develop an electronic nursing and caring system to manage patients' information and provide patients with safe and efficient services. By transmitting data among wireless cards, optical network, and mainframe computer, nursing care will be delivered more systematically and patients' safety centered caring will be delivered more efficiently and effectively. With this system, manual record keeping time was cut down, and relevant nursing and caring information was linked up. With the development of an electronic nursing system, nurses were able to make the best use of the Internet resources, integrate information management systematically and improve quality of nursing and caring service.

[Italian male nurses called to arms in World War II: the letters of the years of imprisonment].

PubMed

Gaetano, Rosa Maria; Milos, Roberto; Rossi, Ivana Maria; Rancati, Stefania

2016-01-01

During the Second World War the male staff of assistance in the Italia hospitals was called to arms.This work concerns the letters sent by the male nurses who were captured by the Germans and put in prison. The aim is to know whether their profession had somehow affected their living condition in jail and had favoured their release or not. 88 personal files of nurses on duty in Ospedale Maggiore and sent to the front during the period between 1940 and 1945 have been studied. The documents are kept in the historical archive of the Ospedale Maggiore of Milan and the research covered the period from December to January 2013. The sources have been analyzed according to Chabod's method of historical research (2012). 4 prisoners have been found among the 88 files of soldiers and handwritten letter has been selected for each one. These letters the attempt of the prisoners to reassure their loved ones emerges. Moreover, in the files of the prisoners' formal request for their release sent by hospital board were found. As a result one of the prisoners was released. This paper suggests that the fact of being a nurse in a hospital influenced the conditions during tha period of captivity. Much is still to be found to shed light on a dramatic period of our country and to restore the memory of the contribution given by the profession.

President's Inaugural Address: We Call It School Nursing

ERIC Educational Resources Information Center

Mattey, Beth

2015-01-01

The incoming President of the National Association of School Nurses (NASN) traditionally outlines the theme for their presidency during their inaugural address. This address is given by incoming President of the NASN, Beth Mattey, who discusses previous themes that supported the mission of NASN, but changed every two years with each new president.…

Telephone calls by individuals with cancer.

PubMed

Flannery, Marie; McAndrews, Leanne; Stein, Karen F

2013-09-01

To describe symptom type and reporting patterns found in spontaneously initiated telephone calls placed to an ambulatory cancer center practice. Retrospective, descriptive. Adult hematology oncology cancer center. 563 individuals with a wide range of oncology diagnoses who initiated 1,229 telephone calls to report symptoms. Raw data were extracted from telephone forms using a data collection sheet with 23 variables obtained for each phone call, using pre-established coding criteria. A literature-based, investigator-developed instrument was used for the coding criteria and selection of which variables to extract. Symptom reporting, telephone calls, pain, and symptoms. A total of 2,378 symptoms were reported by telephone during the four months. At least 10% of the sample reported pain (38%), fatigue (16%), nausea (16%), swelling (12%), diarrhea (12%), dyspnea (10%), and anorexia (10%). The modal response was to call only one time and to report only one symptom (55%). Pain emerged as the symptom that most often prompted an individual to pick up the telephone and call. Although variation was seen in symptom reporting, an interesting pattern emerged with an individual reporting on a solitary symptom in a single telephone call. The emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone. Report of symptoms by telephone can provide nurses unique insight into patient-centered needs. Although pain has been an important focus of education and research for decades, it remains a priority for individuals with cancer. A wide range in symptom reporting by telephone was evident.

Feasibility of using a pediatric call center as part of a quality improvement effort to prevent hospital readmission.

PubMed

Kirsch, Sallie Davis; Wilson, Lauren S; Harkins, Michelle; Albin, Dawn; Del Beccaro, Mark A

2015-01-01

The primary aim of this intervention was to assess the feasibility of using call center nurses who are experts in telephone triage to conduct post discharge telephone calls, as part of a quality improvement effort to prevent hospital readmission. Families of patients with bronchiolitis were called between 24 and 48 hours after discharge. The calls conducted by the nurses were efficient (average time was 12 minutes), and their assessments helped to identify gaps in inpatient family education. Overall, the project demonstrated the efficacy in readmission prevention by using nurses who staff a call center to conduct post-hospitalization telephone calls. Copyright © 2015 Elsevier Inc. All rights reserved.

Nursing: not the problem, but leading solutions.

PubMed

Smadu, Marlene; Shamian, Judith

2012-01-01

One of the major themes uncovered by Graham and Sibbald in their analysis of the 50-year-old issues of Hospital Administration in Canada (HAC) is the evolution of nursing. However, the HAC approach 50 years ago was that nursing was a problem to be solved, not a resource for health, the health system and the public, and that image would stay with nursing in Canada for many years to come. The recent commissioning by the Canadian Nurses Association of a National Expert Commission to examine sustainability of health and the healthcare system, and the resultant report, The Health of Our Nation, the Future of Our Health System: A Nursing Call to Action, released in June 2012, reflect a significantly different expectation about nurses and the nursing profession - they are not problems to be addressed, but are leading the solutions to better health, better care and better value. And patients are not passive recipients of care decided on by professionals alone, but central team members - "CEOs of their own healthcare" - in an inter-professional patient-/family-focused team that collectively supports people in their health journey. A number of examples of potential articles about and from nursing, based on the findings of the National Expert Commission, are included to illustrate how nursing should be reflected in an issue of HAC in 2012.

Nursing Services Delivery Theory: an open system approach.

PubMed

Meyer, Raquel M; O'Brien-Pallas, Linda L

2010-12-01

This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a 'black box' that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. A search of CINAHL and Business Source Premier for the years 1980-2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. THE Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. © 2010 Blackwell Publishing Ltd.

Disaster-Related Community Resilience: A Concept Analysis and a Call to Action for Nurses.

PubMed

Heagele, Tara

2017-05-01

A paucity of nursing literature is available on disaster-related community resilience. Using a nursing method for analyzing concepts, this article attempts to clarify the meaning of this novel concept to encourage nursing research and practice. This concept analysis provides an introduction to the phenomenon of disaster-related community resilience for nurses and consumers of nursing research. The article proposes the definition, antecedents, attributes, consequences, and empirical referents of disaster-related community resilience and provides suggestions for nursing research and practice. It also provides nurses a foundation for participating in resilience-building activities that may save lives and allow communities to recover more rapidly postdisaster. © 2016 Wiley Periodicals, Inc.

Measuring Nursing Value from the Electronic Health Record.

PubMed

Welton, John M; Harper, Ellen M

2016-01-01

We report the findings of a big data nursing value expert group made up of 14 members of the nursing informatics, leadership, academic and research communities within the United States tasked with 1. Defining nursing value, 2. Developing a common data model and metrics for nursing care value, and 3. Developing nursing business intelligence tools using the nursing value data set. This work is a component of the Big Data and Nursing Knowledge Development conference series sponsored by the University Of Minnesota School Of Nursing. The panel met by conference calls for fourteen 1.5 hour sessions for a total of 21 total hours of interaction from August 2014 through May 2015. Primary deliverables from the bit data expert group were: development and publication of definitions and metrics for nursing value; construction of a common data model to extract key data from electronic health records; and measures of nursing costs and finance to provide a basis for developing nursing business intelligence and analysis systems.

Developing a Framework to Help Bedside Nurses Bring About Change.

PubMed

Porter, Jordan S; Strout, Kelley A

2016-12-01

: Nurses across all care settings and experience levels are being called upon to lead. In a 2011 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine examined the ways nurses could more fully apply their knowledge of direct patient care to address the increasing demands placed on the health care system since the passage of the Affordable Care Act. The report asked: "What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?"Multiple variables influence a nurse's ability to assume a leadership role, and multiple barriers to these roles continue to exist. This article uses the first-person voice to share the experience of a new graduate nurse in a formal nurse residency program who found himself in a position to identify the need for, advocate for, and ultimately influence a policy change in the staffing practice of floating as it was applied to new RNs on his unit. In a retrospective analysis of the process, the new graduate RN and his former professor acting as a writing mentor developed a leadership framework for nurses called RN LEADER, which they hope will empower and guide other nurses to lead evidence-based change in their workplaces.

Zebra finch mates use their forebrain song system in unlearned call communication.

PubMed

Ter Maat, Andries; Trost, Lisa; Sagunsky, Hannes; Seltmann, Susanne; Gahr, Manfred

2014-01-01

Unlearned calls are produced by all birds whereas learned songs are only found in three avian taxa, most notably in songbirds. The neural basis for song learning and production is formed by interconnected song nuclei: the song control system. In addition to song, zebra finches produce large numbers of soft, unlearned calls, among which "stack" calls are uttered frequently. To determine unequivocally the calls produced by each member of a group, we mounted miniature wireless microphones on each zebra finch. We find that group living paired males and females communicate using bilateral stack calling. To investigate the role of the song control system in call-based male female communication, we recorded the electrical activity in a premotor nucleus of the song control system in freely behaving male birds. The unique combination of acoustic monitoring together with wireless brain recording of individual zebra finches in groups shows that the neuronal activity of the song system correlates with the production of unlearned stack calls. The results suggest that the song system evolved from a brain circuit controlling simple unlearned calls to a system capable of producing acoustically rich, learned vocalizations.

Zebra Finch Mates Use Their Forebrain Song System in Unlearned Call Communication

PubMed Central

Ter Maat, Andries; Trost, Lisa; Sagunsky, Hannes; Seltmann, Susanne; Gahr, Manfred

2014-01-01

Unlearned calls are produced by all birds whereas learned songs are only found in three avian taxa, most notably in songbirds. The neural basis for song learning and production is formed by interconnected song nuclei: the song control system. In addition to song, zebra finches produce large numbers of soft, unlearned calls, among which “stack” calls are uttered frequently. To determine unequivocally the calls produced by each member of a group, we mounted miniature wireless microphones on each zebra finch. We find that group living paired males and females communicate using bilateral stack calling. To investigate the role of the song control system in call-based male female communication, we recorded the electrical activity in a premotor nucleus of the song control system in freely behaving male birds. The unique combination of acoustic monitoring together with wireless brain recording of individual zebra finches in groups shows that the neuronal activity of the song system correlates with the production of unlearned stack calls. The results suggest that the song system evolved from a brain circuit controlling simple unlearned calls to a system capable of producing acoustically rich, learned vocalizations. PMID:25313846

Prototyping context-aware nursing support mobile system.

PubMed

Esashi, Misa; Nakano, Tomohiro; Onose, Nao; Sato, Kikue; Hikita, Tomoko; Hoya, Reiko; Okamoto, Kazuya; Ohboshi, Naoki; Kuroda, Tomohiro

2016-08-01

A context aware nursing support system to push right information to the right person at the right moment is the key to increase clinical safety under a computerized hospital. We prototyped a system which obtains context from positions of nurses and list of expected clinical procedures. A WoZ test showed that the proposed approach has potential to decrease incidents caused by information delivery error.

Enhanced early warning system impact on nursing practice: A phenomenological study.

PubMed

Burns, Kathleen A; Reber, Tracey; Theodore, Karen; Welch, Brenda; Roy, Debra; Siedlecki, Sandra L

2018-05-01

To determine how an enhanced early warning system has an impact on nursing practice. Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied. Phenomenological design. Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed. Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition. Rather than hinder critical thinking, as many early warning systems' critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration. © 2017 John Wiley & Sons Ltd.

Selected Aspects of the eCall Emergency Notification System

NASA Astrophysics Data System (ADS)

Kaminski, Tomasz; Nowacki, Gabriel; Mitraszewska, Izabella; Niezgoda, Michał; Kruszewski, Mikołaj; Kaminska, Ewa; Filipek, Przemysław

2012-02-01

The article describes problems associated with the road collision detection for the purpose of the automatic emergency call. At the moment collision is detected, the eCall device installed in the vehicle will automatically make contact with Emergency Notification Centre and send the set of essential information on the vehicle and the place of the accident. To activate the alarm, the information about the deployment of the airbags will not be used, because connection of the eCall device might interfere with the vehicle’s safety systems. It is necessary to develop a method enabling detection of the road collision, similar to the one used in airbag systems, and based on the signals available from the acceleration sensors.

Implementation of a successful on-call system in clinical chemistry.

PubMed

Hobbs, G A; Jortani, S A; Valdes, R

1997-11-01

Successful practice of clinical pathology depends on a wide variety of laboratory, clinical, and managerial decisions. The skills needed to make these decisions can most effectively be learned by residents and fellows in pathology using a service-oriented on-call approach. We report our experience implementing an on-call system in the clinical chemistry laboratory at the University of Louisville Hospital (Ky). We detail the guidelines used to establish this system and the elements required for its successful implementation. The system emphasizes a laboratory-initiated approach to linking laboratory results to patient care. From inception of the program during late 1990 through 1995, the number of beeper calls (including clinician contacts) steadily increased and is currently 8 to 20 per week. The on-call system is active 24 hours per day, 7 days per week, thus representing activity on all three laboratory shifts. Types of responses were separated into administrative (12%), analytical (42%), clinical (63%), quality control or quality assurance (12%), and consultation (13%) categories. We also present 6 case reports as examples demonstrating multiple elements in these categories. In 23% of the calls, clinician contact was required and achieved by the fellow or resident on call for the laboratory. The on-call reports are documented and presented informally at weekly on-call report sessions. Emphasis is placed on learning and refinement of investigative skills needed to function as an effective laboratory director. Educational emphasis for the medical staff is in establishing awareness of the presence of the laboratory as an important interactive component of patient care. In addition, we found this program to be beneficial to the hospital and to the department of pathology in fulfilling its clinical service and teaching missions. Our experience may be helpful to other institutions establishing such a program.

Registered Nurse Staffing in Pennsylvania Nursing Homes: Comparison before and after Implementation of Medicare's Prospective Payment System.

ERIC Educational Resources Information Center

Kanda, Katsuya; Mezey, Mathy

1991-01-01

Examined changes in resident acuity and registered nurse staffing in all nursing homes in Pennsylvania before and after introduction of Medicare Prospective Payment System (PPS) in 1983. Found that acuity of nursing home residents increased significantly since introduction of PPS, full-time registered nurse staffing remained unchanged, and…

Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

PubMed

Strudwick, Gillian; Hardiker, Nicholas R

2016-10-01

In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing

Developing a Nursing Database System in Kenya

PubMed Central

Riley, Patricia L; Vindigni, Stephen M; Arudo, John; Waudo, Agnes N; Kamenju, Andrew; Ngoya, Japheth; Oywer, Elizabeth O; Rakuom, Chris P; Salmon, Marla E; Kelley, Maureen; Rogers, Martha; St Louis, Michael E; Marum, Lawrence H

2007-01-01

Objective To describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. Principal Findings Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified. Conclusions The Kenya nursing database is a first step toward facilitating evidence-based decision making in HRH. This database is unique to developing countries in sub-Saharan Africa. Establishing an electronic workforce database requires long-term investment and sustained support by national and global stakeholders. PMID:17489921

Nurses across borders: foregrounding international migration in nursing history.

PubMed

Choy, Catherine Ceniza

2010-01-01

Although the international migration of nurses has played a formative role in increasing the racial and ethnic diversity of the health care labor force, nursing historians have paid very little attention to the theme of international migration and the experiences of foreign-trained nurses, A focus on international migration complements two new approaches in nursing history: the agenda to internationalize its frameworks, and the call to move away from "great women, great events" and toward the experiences of "ordinary" nurses. This article undertakes a close reading of the life and work of Filipino American nurse Ines Cayaban to reconceptualize nursing biography in an international framework that is attentive to issues of migration, race, gender, and colonialism. It was a Hannah keynote lecture delivered by the author on June 5, 2008, as part of the CAHN/ACHN (Canadian Association for the History of Nursing/Association Canadienne pour l'Histoire du Nursing) International Nursing History Conference.

Capturing early signs of deterioration: the dutch-early-nurse-worry-indicator-score and its value in the Rapid Response System.

PubMed

Douw, Gooske; Huisman-de Waal, Getty; van Zanten, Arthur R H; van der Hoeven, Johannes G; Schoonhoven, Lisette

2017-09-01

To determine the predictive value of individual and combined dutch-early-nurse-worry-indicator-score indicators at various Early Warning Score levels, differentiating between Early Warning Scores reaching the trigger threshold to call a rapid response team and Early Warning Score levels not reaching this point. Dutch-early-nurse-worry-indicator-score comprises nine indicators underlying nurses' 'worry' about a patient's condition. All indicators independently show significant association with unplanned intensive care/high dependency unit admission or unexpected mortality. Prediction of this outcome improved by adding the dutch-early-nurse-worry-indicator-score indicators to an Early Warning Score based on vital signs. An observational cohort study was conducted on three surgical wards in a tertiary university-affiliated teaching hospital. Included were surgical, native-speaking, adult patients. Nurses scored presence of 'worry' and/or dutch-early-nurse-worry-indicator-score indicators every shift or when worried. Vital signs were measured according to the prevailing protocol. Unplanned intensive care/high dependency unit admission or unexpected mortality was the composite endpoint. Percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators were calculated at various Early Warning Score levels in control and event groups. Entering all dutch-early-nurse-worry-indicator-score indicators in a multiple logistic regression analysis, we calculated a weighted score and calculated sensitivity, specificity, positive predicted value and negative predicted value for each possible total score. In 3522 patients, 102 (2·9%) had an unplanned intensive care/high dependency unit admissions (n = 97) or unexpected mortality (n = 5). Patients with such events and only slightly changed vital signs had significantly higher percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators expressed than patients in the control group. Increasing number

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

When the business of nursing was the nursing business: the private duty registry system, 1900-1940.

PubMed

Whelan, Jean C

2012-05-31

In the initial decades of the 20th century, most nurses worked in the private sector as private duty nurses dependent on their own resources for securing and obtaining employment with individual patients. To organize and systematize the ways in which nurses sought jobs, a structure of private duty registries, agencies which connected nurses with patients, was established via professional nurse associations. This article describes the origins of the private duty nurse labor market as the main employment field for early nurses and ways in which the private duty registry system connected nurses and patients. The impact of professional nurses associations and two registries, (New York and Chicago) illustrates how the business of nursing was carried out, including registry formation, operation, and administration. Private duty nurses are compelling examples of a previous generation of nurse entrepreneurs. The discussion identifies problems and challenges of private nursing practice via registries, including the decline and legacy of this innovative nurse role. The story of early 20th century nurse owned and operated registries provides an early and critical historical illustration of the realization of nurse power, entrepreneurship, and control over professional practice that we still learn from today.

Nursing Education Transformation: Promising Practices in Academic Progression.

PubMed

Gorski, Mary Sue; Farmer, Patricia D; Sroczynski, Maureen; Close, Liz; Wortock, Jean M

2015-09-01

Health care has changed over the past decade; yet, nursing education has not kept pace with social and scientific advances. The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, called for a more highly educated nursing work-force and an improved nursing education system. Since the release of that report, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, has worked with nursing education leaders to better understand existing and evolving nursing education structures. Through a consensus-building process, four overarching promising practice models, with an emphasis on seamless academic progression, emerged to advance the goals of education transformation. Key nurse educators and other stakeholders refined those models through a series of meetings, collaborative partnerships, and focused projects that were held across the United States. This article summarizes that process and provides a description of the models, challenges, common themes, recommendations, and progress to date. Copyright 2015, SLACK Incorporated.

Job evaluation for clinical nursing jobs by implementing the NHS JE system.

PubMed

Kahya, Emin; Oral, Nurten

2007-10-01

The purpose of this paper was to evaluate locally all the clinical nursing jobs implementing the NHS JE system in four hospitals. The NHS JE was developed by the Department of Health in the UK in 2003-2004. A job analysis questionnaire was designed to gather current job descriptions. It was distributed to each of 158 clinical nurses and supervisor nurses in 31 variety clinics at four hospitals in one city. The questionnaires were analysed to evaluate locally all the identified 94 nursing jobs. Fourteen of 19 nursing jobs in the medical and surgical clinics can be matched to the nurse national job in the NHS JE system. The results indicated that two new nursing jobs titled nurse B and nurse advanced B should be added to the list of national nursing jobs in the NHS JE system.

A mobile Nursing Information System based on human-computer interaction design for improving quality of nursing.

PubMed

Su, Kuo-Wei; Liu, Cheng-Li

2012-06-01

A conventional Nursing Information System (NIS), which supports the role of nurse in some areas, is typically deployed as an immobile system. However, the traditional information system can't response to patients' conditions in real-time, causing delays on the availability of this information. With the advances of information technology, mobile devices are increasingly being used to extend the human mind's limited capacity to recall and process large numbers of relevant variables and to support information management, general administration, and clinical practice. Unfortunately, there have been few studies about the combination of a well-designed small-screen interface with a personal digital assistant (PDA) in clinical nursing. Some researchers found that user interface design is an important factor in determining the usability and potential use of a mobile system. Therefore, this study proposed a systematic approach to the development of a mobile nursing information system (MNIS) based on Mobile Human-Computer Interaction (M-HCI) for use in clinical nursing. The system combines principles of small-screen interface design with user-specified requirements. In addition, the iconic functions were designed with metaphor concept that will help users learn the system more quickly with less working-memory. An experiment involving learnability testing, thinking aloud and a questionnaire investigation was conducted for evaluating the effect of MNIS on PDA. The results show that the proposed MNIS is good on learning and higher satisfaction on symbol investigation, terminology and system information.

Influence of patient and provider factors on the workload of on-call physicians: A general internal medicine cohort observational study.

PubMed

Hsu, Nin-Chieh; Huang, Chun-Che; Jerng, Jih-Shuin; Hsu, Chia-Hao; Yang, Ming-Chin; Chang, Ray-E; Ko, Wen-Je; Yu, Chong-Jen

2016-08-01

Factors associated with the physician workload are scarcely reported. The study aims to investigate the associated factors of on-call physician workload based on a published conceptual framework.The study was conducted in a general internal medicine unit of National Taiwan University Hospital. On-call physician workloads were recorded on a shift basis from 1198 hospitalized patients between May 2010 and April 2011. The proxy of on-call workloads included night calls, bedside evaluation/management (E/M), and performing clinical procedures in a shift. Multivariable logistic and negative binomial regression models were used to determine the factors associated with the workloads of on-call physicians.During the study period, 378 (31.6%) of patients had night calls with related workloads. Multivariate analysis showed that the number of patients with unstable conditions in a shift (odds ratio [OR] 1.89 and 1.66, respectively) and the intensive care unit (ICU) training of the nurse leader (OR 2.87 and 3.08, respectively) resulted in higher likelihood of night calls to and bedside E/M visits by the on-call physician. However, ICU training of nurses (OR = 0.37, 95% confidence interval: 0.16-0.86) decreased the demand of performing clinical procedures by the on-call physician. Moreover, number of patients with unstable conditions (risk ratio [RR] 1.52 and 1.55, respectively) had significantly increased the number of night calls and bedside E/M by on-call physicians by around 50%. Nurses with N1 level (RR 2.16 and 2.71, respectively) were more likely to place night calls and facilitate bedside E/M by the on-call physician compared to nurses with N0 level. In addition, the nurse leaders with ICU training (RR 1.72 and 3.07, respectively) had significant increases in night calls and bedside E/M by the on-call physician compared to those without ICU training.On-call physician workload is associated with patient factors and the training of nurses. Number of unstable patients

Novel nursing terminologies for the rapid response system.

PubMed

Wong, Elizabeth

2009-01-01

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

A Full-Time Nurse for Every School: A Call to Action to Make It Happen.

PubMed

Nikpour, Jacqueline; Hassmiller, Susan

2017-09-01

In June 2016, the American Academy of Pediatrics released its new policy statement recommending a full-time registered nurse in every school building. Indeed, increasing attention is being focused on school nursing, in part due to recent legislation, including the Affordable Care Act, the Healthy Hunger-Free Kids Act, and the Every Student Succeeds Act. Advocating for nursing practice within an education setting presents unique challenges in terms of changing the common perception of school nurses, variances in funding streams for school nursing, and the ability to link health outcomes with educational outcomes. The purpose of this article is to discuss the rationale for a school nurse in every building along with presenting action steps that individual and groups of school nurses can utilize to advocate for a full-time registered nurse in every school.

From scientific discovery to health outcomes: A synergistic model of doctoral nursing education.

PubMed

Michael, Melanie J; Clochesy, John M

2016-05-01

Across the globe, health system leaders and stakeholder are calling for system-level reforms in education, research, and practice to accelerate the uptake and application of new knowledge in practice and to improve health care delivery and health outcomes. An evolving bi-dimensional research-practice focused model of doctoral nursing education in the U.S. is creating unprecedented opportunities for collaborative translational and investigative efforts for nurse researchers and practitioners. The nursing academy must commit to a shared goal of preparing future generations of nurse scientists and practitioners with the capacity and motivation to work together to accelerate the translation of evidence into practice in order to place nursing at the forefront of health system improvement efforts and advance the profession. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2014-02-01

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

Remote nursing certified practice: viewing nursing and nurse practitioner practice through a social justice lens.

PubMed

Tarlier, Denise S; Browne, Annette J

2011-06-01

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.

Collaborations in leadership: the nurse case management and nursing administration connection.

PubMed

Carr, Dana Deravin

2009-01-01

With a multiple decade's long surge in managed care and the growth of case management as a profession, there is increasing recognition of the leadership role that case managers employ daily as they coordinate and facilitate patient-centered initiatives. Now, more than ever, case managers are being called upon to further expand their leadership capabilities and take a more active role in professional partnering to ensure the continued attainment of clinical, fiscal, and quality outcomes. All settings, particularly acute care hospitals and integrated delivery systems. The collaboration between nurse case managers and nursing administration provides a framework for the establishment of a collegial and supportive working relationship: one that is built on the strength of mutual goals, shared leadership abilities, respect, and professional loyalty.

Leadership for Nursing Work-Based Mobile Learning

ERIC Educational Resources Information Center

Fahlman, Dorothy

2016-01-01

This paper reflects on work-based mobile learning in the Canadian healthcare system for registered nurses' ongoing skills development and continuing professional development. It calls on distributed leadership to address the organizational contextual factors for making this mode of learning sustainable. [For the full proceedings, see ED571335.

Nursing involvement in euthanasia: a 'nursing-as-healing-praxis' approach.

PubMed

McCabe, Helen

2007-07-01

In an earlier article, it was found that the terms of preference utilitarianism are insufficiently sound for guiding nursing activity in general, including in relation to nursing involvement in euthanasia. In this article, I shall examine the terms of a more traditional philosophical approach in order to determine the moral legitimacy, or otherwise, of nursing engagement in measures intended to end the lives of patients. In attempting this task, nursing practice is considered in light of what I shall call a 'nursing-as-healing-praxis' approach which includes an account of the moral purpose of nursing and the virtues necessary for realizing that purpose. Ultimately, it is concluded that the terms of this approach rule out the involvement of nurses in euthanasia such that if euthanasia can be justified at all, those outside the nursing profession must provide for its administration.

Computer-aided auscultation learning system for nursing technique instruction.

PubMed

Hou, Chun-Ju; Chen, Yen-Ting; Hu, Ling-Chen; Chuang, Chih-Chieh; Chiu, Yu-Hsien; Tsai, Ming-Shih

2008-01-01

Pulmonary auscultation is a physical assessment skill learned by nursing students for examining the respiratory system. Generally, a sound simulator equipped mannequin is used to group teach auscultation techniques via classroom demonstration. However, nursing students cannot readily duplicate this learning environment for self-study. The advancement of electronic and digital signal processing technologies facilitates simulating this learning environment. This study aims to develop a computer-aided auscultation learning system for assisting teachers and nursing students in auscultation teaching and learning. This system provides teachers with signal recording and processing of lung sounds and immediate playback of lung sounds for students. A graphical user interface allows teachers to control the measuring device, draw lung sound waveforms, highlight lung sound segments of interest, and include descriptive text. Effects on learning lung sound auscultation were evaluated for verifying the feasibility of the system. Fifteen nursing students voluntarily participated in the repeated experiment. The results of a paired t test showed that auscultative abilities of the students were significantly improved by using the computer-aided auscultation learning system.

Strategic management of health care information systems: nurse managers' perceptions.

PubMed

Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha

2009-01-01

The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

Crisis management systems: staff nurses demand more support from their supervisors.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2008-08-01

This study illustrates the contributions of the necessity, comprehensiveness, and difference (between necessity and comprehensiveness) levels of crisis management systems to participants' general satisfaction with their working institutions' nursing-related crisis management activities. Crisis management systems include strategic, technical/structural, assessment, public communication, and psychological/cultural aspects. An effective institutional crisis management system might help to decrease the number of incidents related to medical disputes or to prevent a crisis from worsening and becoming disastrous. A cross-sectional survey was administered during a nursing conference held in Taipei, Taiwan, on June 27, 2005. Two hundred ninety questionnaires were distributed, and 121 were retrieved (response rate, 41.7%; nursing administrators and staff). Univariate and multivariate analyses were performed. Ordinal logistic regression analyses show that being a public hospital managed by the government and having more difference on the strategic aspect between the necessity and comprehensiveness levels contribute to lower satisfaction with nursing-related crisis management activities (Nagelkerke R(2) = .441). In addition, staff nurses perceive higher necessity levels on all five aspects compared to nursing administrators. This study provides important insights into how the policies and activities of a medical institution's crisis management system can be prioritized and implemented. It is also important for students in nursing programs and for currently employed nurses to learn how to manage disputes related to nursing practice, so that early resolution can be achieved and crises can be avoided. These results suggest that staff nurses demand more support from their supervisors.

Strategic positioning for nursing excellence in health systems: insights from chief nursing executives.

PubMed

Arnold, Lauren; Drenkard, Karen; Ela, Sue; Goedken, Jolene; Hamilton, Connie; Harris, Carla; Holecek, Nancy; White, Maureen

2006-01-01

The emergence of health systems as a dominant structure for organizing healthcare has stimulated the development of health system chief nursing executive (CNE) positions. These positions have large spans of control, requiring CNEs to balance a wide range of responsibilities, making them accountable for fiscal management, quality of care, compliance, and contributing to organizational growth. As such the CNE is required to use principles of distributive justice to guide priority setting and decision making. This review addresses important questions about CNE system integration strategies, strategic priorities, and organizational positioning as they attempt to fulfill their ethical responsibilities to patients and the nurses they serve.

A qualitative content analysis of knowledge storage in nursing education system.

PubMed

Karimi Moonaghi, Hossein; Ahanchian, Mohammad Reza; Hassanian, Zahra Marzieh

2014-10-01

The need for effective management of intellectual and academic assets is constantly growing. The nursing educational system should be considered as a storage of knowledge since it is deposited in the nursing educational system in the form of intellectual investment. The purpose of the present study was to explore nursing knowledge storage in the nursing educational system. The participants of this study consisted of eight nursing educators and five students. The inductive content analysis method was used in this research. Participants were interviewed through the semi-structured method. Data analysis was done by five stage framework approaches. The trustworthiness of the study was ensured through validity and acceptability criteria. Data analysis showed that nursing educators and students were involve in teaching and learning activities by storing knowledge in subjective and objective forms. Knowledge was gained through the different educational activities of the nursing educators and through contact with their peers. Moreover, the nursing students gained knowledge for better learning and a more knowledgeable and advanced performance with the help of the educators. This study revealed the main components of knowledge storage. An enhanced preservation of explicit knowledge is recommended in the nursing educational system so that in the future, students and educators can easily access the same knowledge from storage sources and not from individuals who might be carrying only a single experience of the subject.

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

ERIC Educational Resources Information Center

Pobocik, Tamara J.

2013-01-01

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

Participatory design of an integrated information system design to support public health nurses and nurse managers.

PubMed

Reeder, Blaine; Hills, Rebecca A; Turner, Anne M; Demiris, George

2014-01-01

The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. © 2013 Wiley Periodicals, Inc.

Participatory Design of an Integrated Information System Design to Support Public Health Nurses and Nurse Managers

PubMed Central

Reeder, Blaine; Hills, Rebecca A.; Turner, Anne M.; Demiris, George

2014-01-01

Objectives The objectives of the study were to use persona-driven and scenario-based design methods to create a conceptual information system design to support public health nursing. Design and Sample We enrolled 19 participants from two local health departments to conduct an information needs assessment, create a conceptual design, and conduct a preliminary design validation. Measures Interviews and thematic analysis were used to characterize information needs and solicit design recommendations from participants. Personas were constructed from participant background information, and scenario-based design was used to create a conceptual information system design. Two focus groups were conducted as a first iteration validation of information needs, personas, and scenarios. Results Eighty-nine information needs were identified. Two personas and 89 scenarios were created. Public health nurses and nurse managers confirmed the accuracy of information needs, personas, scenarios, and the perceived usefulness of proposed features of the conceptual design. Design artifacts were modified based on focus group results. Conclusion Persona-driven design and scenario-based design are feasible methods to design for common work activities in different local health departments. Public health nurses and nurse managers should be engaged in the design of systems that support their work. PMID:24117760

Confirmation of Expectations and Satisfaction with Hospital Information Systems: A Nursing Perspective.

PubMed

Ayatollahi, Haleh; Langarizadeh, Mostafa; Chenani, Habib

2016-10-01

This study aimed to compare nurses' satisfaction with, and expectations of, hospital information systems in two teaching hospitals. This was a survey study, which was completed in 2014. The potential participants were 267 nurses who worked in two teaching hospitals and used the same hospital information system. Data were collected using two questionnaires. Both questionnaires were examined in terms of content validity and reliability. The results showed that, for a majority of nurses, their expectations of the system were not met in either hospital. Moreover, there was a significant association between the nurses' expectations and the perceived usefulness of the systems ( p < 0.001), between the nurses' expectations and their satisfaction with the systems ( p < 0.001), and between the perceived usefulness and nurses' satisfaction with the systems ( p < 0.001). The results suggested that, apart from the technical issues of implementing clinical information systems, non-technical factors should be taken into account. Among them, the nature of clinical tasks and the organizational culture require more attention to allow a successful system to be designed and implemented.

An Internationally Consented Standard for Nursing Process-Clinical Decision Support Systems in Electronic Health Records.

PubMed

Müller-Staub, Maria; de Graaf-Waar, Helen; Paans, Wolter

2016-11-01

Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.

Spoken Grammar Practice and Feedback in an ASR-Based CALL System

ERIC Educational Resources Information Center

de Vries, Bart Penning; Cucchiarini, Catia; Bodnar, Stephen; Strik, Helmer; van Hout, Roeland

2015-01-01

Speaking practice is important for learners of a second language. Computer assisted language learning (CALL) systems can provide attractive opportunities for speaking practice when combined with automatic speech recognition (ASR) technology. In this paper, we present a CALL system that offers spoken practice of word order, an important aspect of…

[Work schedules in the Hungarian health care system and the sleep quality of nurses].

PubMed

Fusz, Katalin; Pakai, Annamária; Kívés, Zsuzsanna; Szunomár, Szilvia; Regős, Annamária; Oláh, András

2016-03-06

One way of ensuring the continuity of health care is the shift work, which is burdensome and it can lead to sleep disturbances. The aim of the study was to measure the typical Hungarian nursing shift systems in hospitals, to analyse the causes of irregular work schedules, and to compare the sleep quality of nurses in different work schedules. 236 head nurses filled out the national online survey, and 217 nurses in clinics of the University of Pécs filled the Hungarian version of Bergen Shift Work Sleep Questionnaire. The head nurses provided data of 8697 nurses's schedules. 51.89% of nurses work in flexible shift system. 1944 employees work in regular shift system, most of them in the following order: 12-hour day shift and 12-hour night shift, followed by a one- or two-day rest. Where there is no system of shifts, the most frequent causes are the needs of nurses and the nurse shortage. Nurses who are working in irregular shift system had worse sleep quality than nurses who are working in flexible and regular shift system (p = 0.044). It would be helpful if the least burdensome shift system could be established.

Optimal service using Matlab - simulink controlled Queuing system at call centers

NASA Astrophysics Data System (ADS)

Balaji, N.; Siva, E. P.; Chandrasekaran, A. D.; Tamilazhagan, V.

2018-04-01

This paper presents graphical integrated model based academic research on telephone call centres. This paper introduces an important feature of impatient customers and abandonments in the queue system. However the modern call centre is a complex socio-technical system. Queuing theory has now become a suitable application in the telecom industry to provide better online services. Through this Matlab-simulink multi queuing structured models provide better solutions in complex situations at call centres. Service performance measures analyzed at optimal level through Simulink queuing model.

Systems thinking and incivility in nursing practice: An integrative review.

PubMed

Phillips, Janet M; Stalter, Ann M; Winegardner, Sherri; Wiggs, Carol; Jauch, Amy

2018-01-23

There is a critical need for nurses and interprofessional healthcare providers to implement systems thinking (ST) across international borders, addressing incivility and its perilous effects on patient quality and safety. An estimated one million patients die in hospitals worldwide due to avoidable patient-related errors. Establishing safe and civil workplaces using ST is paramount to promoting clear, level-headed thinking from which patient-centered nursing actions can impact health systems. The purpose of the paper is to answer the research question, What ST evidence fosters the effect of workplace civility in practice settings? Whittemore and Knafl's integrative review method guided this study. The quality of articles was determined using Chu et al.'s Mixed Methods Assessment Tool. Thirty-eight studies were reviewed. Themes emerged describing antecedents and consequences of incivility as embedded within complex systems, suggesting improvements for civility and systems/ST in nursing practice. This integrative review provides information about worldwide incivility in nursing practice from a systems perspective. Several models are offered as a means of promoting civility in nursing practice to improve patient quality and safety. Further study is needed regarding incivility and resultant effects on patient quality and safety. © 2018 Wiley Periodicals, Inc.

A Qualitative Content Analysis of Knowledge Storage in Nursing Education System

PubMed Central

Karimi Moonaghi, Hossein; Ahanchian, Mohammad Reza; Hassanian, Zahra Marzieh

2014-01-01

Background: The need for effective management of intellectual and academic assets is constantly growing. The nursing educational system should be considered as a storage of knowledge since it is deposited in the nursing educational system in the form of intellectual investment. Objectives: The purpose of the present study was to explore nursing knowledge storage in the nursing educational system. Materials and Methods: The participants of this study consisted of eight nursing educators and five students. The inductive content analysis method was used in this research. Participants were interviewed through the semi-structured method. Data analysis was done by five stage framework approaches. The trustworthiness of the study was ensured through validity and acceptability criteria. Results: Data analysis showed that nursing educators and students were involve in teaching and learning activities by storing knowledge in subjective and objective forms. Knowledge was gained through the different educational activities of the nursing educators and through contact with their peers. Moreover, the nursing students gained knowledge for better learning and a more knowledgeable and advanced performance with the help of the educators. Conclusions: This study revealed the main components of knowledge storage. An enhanced preservation of explicit knowledge is recommended in the nursing educational system so that in the future, students and educators can easily access the same knowledge from storage sources and not from individuals who might be carrying only a single experience of the subject. PMID:25558388

Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

PubMed

Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

2016-04-01

Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

CoVaCS: a consensus variant calling system.

PubMed

Chiara, Matteo; Gioiosa, Silvia; Chillemi, Giovanni; D'Antonio, Mattia; Flati, Tiziano; Picardi, Ernesto; Zambelli, Federico; Horner, David Stephen; Pesole, Graziano; Castrignanò, Tiziana

2018-02-05

The advent and ongoing development of next generation sequencing technologies (NGS) has led to a rapid increase in the rate of human genome re-sequencing data, paving the way for personalized genomics and precision medicine. The body of genome resequencing data is progressively increasing underlining the need for accurate and time-effective bioinformatics systems for genotyping - a crucial prerequisite for identification of candidate causal mutations in diagnostic screens. Here we present CoVaCS, a fully automated, highly accurate system with a web based graphical interface for genotyping and variant annotation. Extensive tests on a gold standard benchmark data-set -the NA12878 Illumina platinum genome- confirm that call-sets based on our consensus strategy are completely in line with those attained by similar command line based approaches, and far more accurate than call-sets from any individual tool. Importantly our system exhibits better sensitivity and higher specificity than equivalent commercial software. CoVaCS offers optimized pipelines integrating state of the art tools for variant calling and annotation for whole genome sequencing (WGS), whole-exome sequencing (WES) and target-gene sequencing (TGS) data. The system is currently hosted at Cineca, and offers the speed of a HPC computing facility, a crucial consideration when large numbers of samples must be analysed. Importantly, all the analyses are performed automatically allowing high reproducibility of the results. As such, we believe that CoVaCS can be a valuable tool for the analysis of human genome resequencing studies. CoVaCS is available at: https://bioinformatics.cineca.it/covacs .

The chief nurse executive role in large healthcare systems.

PubMed

Englebright, Jane; Perlin, Jonathan

2008-01-01

Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a council of facility CNEs. The increasingly competitive healthcare environment in which value-based purchasing of healthcare and pay-for-performance programs demand improved clinical performance for financial success has led to reconsideration of whether a council model can provide either the leadership or adequate attention to clinical (and operational) improvement. In turn, community hospitals and health systems look to CNE or chief nursing officer roles at the highest level of the organization as resources that are able to segue between the clinical and operational domains, translating clinical performance demands into operating strategies and tactics. This article explores CNE characteristics required for success in these increasingly responsible and visible roles.

49 CFR 198.39 - Qualifications for operation of one-call notification system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Qualifications for operation of one-call...) PIPELINE SAFETY REGULATIONS FOR GRANTS TO AID STATE PIPELINE SAFETY PROGRAMS Adoption of One-Call Damage Prevention Program § 198.39 Qualifications for operation of one-call notification system. A one-call...

Documentation of Nursing Practice Using a Computerized Medical Information System

PubMed Central

Romano, Carol

1981-01-01

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.

The experience of an information system for nursing practice: the importance of nursing records in the management of a care plan.

PubMed

Nunes, Sofia R T; Rego, Guilhermina; Nunes, Rui

2014-07-01

Health information systems are becoming common because they are important tools to support decision making and assist nurses in their daily interventions. The Information System for Nursing Practice promotes consistent nursing records, as it is directed to the nursing practice and process. The aims of this study were to identify and describe the most frequent type of nursing actions in the care plan for a patient after acute myocardial infarction, considering the seven-axis model of the International Classification of Nursing Practice and the rate of health education given to patients during hospitalization. A cross-sectional analysis was performed retrospectively by searching the computerized database of the Information System for Nursing Practice. We verified some gaps in information with regard to unidentified records of diagnoses and interventions. During hospitalization, the most used interventions were in the fields of observing (40%) and managing (23%). Interventions associated with management of signs and symptoms were more frequent and were performed in 84.9% of the patients. In the field of informing, health education in relation to diet was performed in 21.7% of the patients; exercise, in 16%; and tobacco, in 11.3%. The use of nursing records and information systems can improve nursing care coordination and care plan management.

Psychiatric nurses' beliefs, attitudes, and perceived barriers about medical emergency teams.

PubMed

Herisko, Camellia; Puskar, Kathryn; Mitchell, Ann M

2013-10-01

A literature review of nurses' attitudes, beliefs, and barriers regarding the medical emergency team (MET) process is limited to medical hospitals. How psychiatric nurses view the MET process and their prior experiences with METs are important because they are often the ones assessing the need for, and then calling, the MET. This article examines psychiatric nurses' attitudes, beliefs, and barriers toward the MET process in a 310-bed psychiatric hospital that is part of an urban academic medical center. Through the use of key informant interviews, nurses were asked for their feedback and input regarding the current MET practices. The results may be useful in improving the current operating system.

The Usage Behavior and Intention Stability of Nurses: An Empirical Study of a Nursing Information System.

PubMed

Lin, I-Chun; Lin, Chihung; Hsu, Chien-Lung; Roan, Jinsheng; Yeh, Jehn-Shan; Cheng, Yu-Han

2016-03-01

Many prior studies of technology adoption treat user intention as the single predictor of actual usage behavior. However, as many researchers of behavioral science have pointed out, multiple factors mediate the relationship between user intention and usage behavior. The present article explores the factors that mediate the relationship between intention and actual behavior. We develop a conceptual framework that is based on the Technology Acceptance Model III and behavior theory to further elicit system usage behavior and to confirm "intention stability" and "past experience" as two significant mediating factors in this relationship. The target system was a nursing information system that had been recently adopted by a medical center in central Taiwan. Data were collected using a questionnaire survey conducted in two rounds. Two hundred forty-five valid questionnaires were returned (response rate: 49%). Mediated moderation was analyzed to explore the presence of mediators or moderators between intention and behavior. The results support that intention stability is a mediated moderator and that prior experience is a moderator of the relationship between intention and behavior. These two factors increased by over 13.6% the explanatory power of intention on actual behavior. Furthermore, this study expanded the scope of prior research by confirming intention stability as a moderating variable between intention and behavior. Finally, this study identified the moderating effect of past experience on the intention-behavior relationship, indicating that past experience enhances the predictive power of intention on behavior. The findings of this study may assist hospital managers to better understand the nursing information system usage behaviors of nursing staff and to develop ways to enhance the intention stability of these staff. Managers may improve the familiarity of nursing staff with the system by increasing their system-related practice time. More experience should

[Developing a home care nursing information system by utilizing wire-wireless network and mobile computing system].

PubMed

Park, Jung-Ho; Park, Sung-Ae; Yoon, Soon-Nyoung; Kang, Sung-Rye

2004-04-01

The purpose of this study was to develop a home care nursing network system for operating home care effectively and efficiently by utilizing a wire-wireless network and mobile computing in order to record and send patients' data in real time, and by combining the headquarter office and the local offices with home care nurses over the Internet. It complements the preceding research from 1999 by adding home care nursing standard guidelines and upgrading the PDA program. Method/1 and Prototyping were adopted to develop the main network system. The detailed research process is as follows : 1)home care nursing standard guidelines for Diabetes, cancer and peritoneal-dialysis were added in 12 domains of nursing problem fields with nursing assessment/intervention algorithms. 2) complementing the PDA program was done by omitting and integrating the home care nursing algorithm path which is unnecessary and duplicated. Also, upgrading the PDA system was done by utilizing the machinery and tools where the PDA and the data transmission modem are integrated, CDMX-1X base construction, in order to reduce a transmission error or transmission failure.

Confidential close call reporting system : preliminary evaluation findings.

DOT National Transportation Integrated Search

2008-12-01

The Federal Railroad Administration (FRA) is implementing a collaborative problem-solving approach to improving safety. The Confidential Close Call Reporting System (C3RS) is a human factors-based approach that is designed to reduce the accident rate...

[Development of a computerized system using standard nursing language for creation of a nursing minimum data set].

PubMed

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

2012-01-01

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

Demand for nursing competencies: an exploratory study in Taiwan's hospital system.

PubMed

Tzeng, Huey-Ming; Ketefian, Shaké

2003-07-01

Along with increasing complexity of nursing services, hospital employers are demanding qualified and competent staff nurses for high quality clinical care. In Taiwan, disparities in the demand for competent nurses by employers and the supply produced by nursing educators still exist and require attention. A comprehensive understanding of the specific needs of Taiwan's medical care system for nursing services would help bridge the current gap between demand for and supply of competently trained nurses. This exploratory study investigated hospital employers' perceptions of the extent to which the nursing skills identified by Cleary et al. [Image: Journal of Nursing Scholarship (1998)20(4):39-42] were needed for staff nurses in Taiwan's medical care system. There were a total of 21 nursing competencies and classification on these items was also implemented. A cross-sectional, quantitative, survey design was conducted. Subjects' participation was voluntary, an information leaflet and an informed consent form was included in the questionnaire. A total of 89 nursing employers (nursing directors, associate directors, supervisor, or head nurse) participated, resulting in a 42.6% response rate. Factor analysis grouped these skills into three factors: basic-level patient care, intermediate-level patient care and basic management, and advanced-level patient care and supervision. This study confirmed that levels of nursing competencies needed differed by type of hospital accreditation. These levels also varied depending on types of services provided, employers' professional titles and tenure of currently employed nurses. The questionnaire developed for this study could be used as one of the tools to communicate demand and supply of nursing competencies between nurse educators and employers. These competencies could be used to develop a checklist for evaluating adequacy of nursing programmes in order to meet nurses' new roles and responsibilities and improve nursing care

Chemotherapy-related neuropathic symptom management: a randomized trial of an automated symptom-monitoring system paired with nurse practitioner follow-up.

PubMed

Kolb, Noah Allan; Smith, Albert Gordon; Singleton, John Robinson; Beck, Susan L; Howard, Diantha; Dittus, Kim; Karafiath, Summer; Mooney, Kathi

2018-05-01

The purpose of this study was to evaluate a new care model to reduce chemotherapy-induced neuropathic symptoms. Neuropathic symptom usual care was prospectively compared to an automated symptom-monitoring and coaching system, SymptomCare@Home (SCH), which included nurse practitioner follow-up triggered by moderate to severe symptoms. Patients beginning chemotherapy were randomized to usual care (UC) or to the SCH intervention. This sub-analysis included only taxane/platin therapies. Participants called the automated telephone symptom-monitoring system daily to report numbness and tingling. The monitoring system recorded patient-reported neuropathic symptom severity, distress, and activity interference on a 0-10 scale. UC participants were instructed to call their oncologist for symptom management. SCH participants with symptom severity of ≥ 4 received automated self-care strategies, and a nurse practitioner (NP) provided guideline-based care. There were 252 participants, 78.6% of which were female. Mean age was 55.1 years. Mean follow-up was 90.2 ± 39.9 days (81.1 ± 40.3 calls). SCH participants had fewer days of moderate (1.8 ± 4.0 vs. 8.6 ± 17.3, p < 0.001) and severe chemotherapy-induced peripheral neuropathy symptoms (0.3 ± 1.0 vs. 1.1 ± 5.2, p = 0.006). SCH participants had fewer days with moderate and severe symptom-related distress (1.4 ± 3.7 vs. 6.9 ± 15.0, p < 0.001; 0.2 ± 0.9 vs. 1.5 ± 6.1, p = 0.001) and trended towards less activity interference (3.3 ± 1.9 vs. 3.8 ± 2.1, p = 0.08). Other neuropathic symptoms were addressed in 5.8-15.4% of SCH follow-up calls. The SCH system effectively identified neuropathic symptoms and their severity and, paired with NP follow-up, reduced symptom prevalence, severity, and distress compared to usual care.

Nurses' attitudes toward the use of the bar-coding medication administration system.

PubMed

Marini, Sana Daya; Hasman, Arie; Huijer, Huda Abu-Saad; Dimassi, Hani

2010-01-01

This study determines nurses' attitudes toward bar-coding medication administration system use. Some of the factors underlying the successful use of bar-coding medication administration systems that are viewed as a connotative indicator of users' attitudes were used to gather data that describe the attitudinal basis for system adoption and use decisions in terms of subjective satisfaction. Only 67 nurses in the United States had the chance to respond to the e-questionnaire posted on the CARING list server for the months of June and July 2007. Participants rated their satisfaction with bar-coding medication administration system use based on system functionality, usability, and its positive/negative impact on the nursing practice. Results showed, to some extent, positive attitude, but the image profile draws attention to nurses' concerns for improving certain system characteristics. The high bar-coding medication administration system skills revealed a more negative perception of the system by the nursing staff. The reasons underlying dissatisfaction with bar-coding medication administration use by skillful users are an important source of knowledge that can be helpful for system development as well as system deployment. As a result, strengthening bar-coding medication administration system usability by magnifying its ability to eliminate medication errors and the contributing factors, maximizing system functionality by ascertaining its power as an extra eye in the medication administration process, and impacting the clinical nursing practice positively by being helpful to nurses, speeding up the medication administration process, and being user-friendly can offer a congenial settings for establishing positive attitude toward system use, which in turn leads to successful bar-coding medication administration system use.

Electronic Nursing Documentation: Patient Care Continuity Using the Clinical Care Classification System (CCC).

PubMed

Whittenburg, Luann; Meetim, Aunchisa

2016-01-01

An innovative nursing documentation project conducted at Bumrungrad International Hospital in Bangkok, Thailand demonstrated patient care continuity between nursing patient assessments and nursing Plans of Care using the Clinical Care Classification System (CCC). The project developed a new generation of interactive nursing Plans of Care using the six steps of the American Nurses Association (ANA) Nursing process and the MEDCIN^® clinical knowledgebase to present CCC coded concepts as a natural by-product of a nurse's documentation process. The MEDCIN^® clinical knowledgebase is a standardized point-of-care terminology intended for use in electronic health record systems. The CCC is an ANA recognized nursing terminology.

The nursing profession in Sri Lanka: time for policy changes.

PubMed

Aluwihare-Samaranayake, D; Ogilvie, L; Cummings, G G; Gellatly, Ian R

2017-09-01

We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made. Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems. We draw on first-hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession. Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence-based practice, research, leadership, and information systems. There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders. Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers. © 2017 International Council of Nurses.

[Surgeons' hope: expanding the professional role of co-medical staff and introducing the nurse practitioner/physician assistant and team approach to the healthcare system].

PubMed

Maehara, Tadaaki; Nishida, Hiroshi; Watanabe, Takashi; Tominaga, Ryuji; Tabayashi, Koichi

2010-07-01

The healthcare system surrounding surgeons is collapsing due to Japan's policy of limiting health expenditure, market fundamentalism, shortage of healthcare providers, unfavorable working environment for surgeons, increasing risk of malpractice suits, and decreasing number of those who desire to pursue the surgery specialty. In the USA, nonphysician and mid-level clinicians such as nurse practitioners (NPs) and physician assistants (PAs) have been working since the 1960s, and the team approach to medicine which benefits patients is functioning well. One strategy to avoid the collapse of the Japanese surgical healthcare system is introducing the NP/PA system. The division of labor in medicine can provide high-quality, safe healthcare and increase the confidence of the public by contributing to: reduced postoperative complications; increased patient satisfaction; decreased length of postoperative hospital stay: and economic benefits. We have requested that the Ministry of Health, Labor and Welfare establish a Japanese NP/PA system to care for patients more efficiently perioperatively. The ministry has decided to launch a trial profession called "tokutei (specifically qualified) nurse" in February 2010. These nurses will be trained and educated at the Master's degree level and allowed to practice several predetermined skill sets under physician supervision. We hope that all healthcare providers will assist in transforming the tokutei nurse system into a Japanese NP/PA system.

Effectiveness of Nursing Management Information Systems: A Systematic Review

PubMed Central

Choi, Mona; Yang, You Lee

2014-01-01

Objectives The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. Methods For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag* and admin*, and nurs* were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Results Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. Conclusions The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs. PMID:25405060

Effectiveness of nursing management information systems: a systematic review.

PubMed

Choi, Mona; Yang, You Lee; Lee, Sun-Mi

2014-10-01

The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag(*) and admin(*), and nurs(*) were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs.

Comparison of office visit and nurse advice hotline data for syndromic surveillance--Baltimore-Washington, D.C., metropolitan area, 2002.

PubMed

Henry, Jade Vu; Magruder, S; Snyder, M

2004-09-24

Kaiser Permanente of the Mid-Atlantic States (KPMAS) is collaborating with the Electronic Surveillance System for Early Notification of Community-Based Epidemics II (ESSENCE II) program to understand how managed-care data can be effectively used for syndromic surveillance. This study examined whether KPMAS nurse advice hotline data would be able to predict the syndrome diagnoses made during subsequent KPMAS office visits. All nurse advice hotline calls during 2002 that were linked to an outpatient office visit were identified. By using International Classification of Diseases, Ninth Revision (ICD-9) codes, outpatient visits were categorized into seven ESSENCE II syndrome groups (coma, gastrointestinal, respiratory, neurologic, hemorrhagic, infectious dermatologic, and fever). Nurse advice hotline calls were categorized into ESSENCE II syndrome groups on the basis of the advice guidelines assigned. For each syndrome group, the sensitivity, specificity, and positive predictive value of hotline calls were calculated by using office visits as a diagnostic standard. For matching syndrome call-visit pairs, the lag (i.e., the number of hours that elapsed between the date and time the patient spoke to an advice nurse and the date and time the patient made an office visit) was calculated. Of all syndrome groups, the sensitivity of hotline calls for respiratory syndrome was highest (74.7%), followed by hotline calls for gastrointestinal syndrome (72.0%). The specificity of all nurse advice syndrome groups ranged from 88.9% to 99.9%. The mean lag between hotline calls and office visits ranged from 8.3 to 50 hours, depending on the syndrome group. The timeliness of hotline data capture compared with office visit data capture, as well as the sensitivity and specificity of hotline calls for detecting respiratory and gastrointestinal syndromes, indicate that KPMAS nurse advice hotline data can be used to predict KPMAS syndromic outpatient office visits.

Developing nursing capacity for health systems and services research in Cuba, 2008-2011.

PubMed

Martínez, Nelcy

2012-07-01

Health systems and services research by nursing personnel could inform decision-making and nursing care, providing evidence concerning quality of and patient satisfaction. Such studies are rather uncommon in Cuban research institutes, where clinical research predominates. Assess the results of a strategy implemented between 2008 and 2011 to develop nursing capacity for health systems and services research in 14 national research institutes based in Havana. The study comprised four stages: description of approaches to health systems and services research by nurses worldwide and in Cuba; analysis of current capacities for such research in Cuba; intervention design and implementation; and evaluation. Various techniques were used including: literature review, bibliometric analysis, questionnaire survey, consultation with experts, focus groups, and workshops for participant orientation and design and followup of research projects. Qualitative information reduction and quantitative information summary methods were used. Initially, 32 nursing managers participated; a further 105 nurses from the institutes were involved in research teams formed during intervention implementation. Of all published nursing research articles retrieved, 8.9% (185 of 2081) concerned health systems and services research, of which 26.5% (49 of 185) dealt with quality assessment. At baseline, 75% of Cuban nurses surveyed had poor knowledge of health systems and services research. Orientation, design and followup workshops for all institute teams developed individual and institutional capacity for health systems and services research. Post-intervention, 84.7% (27) of nurses reached good knowledge and 14.3% (5) fair; institutional research teams were formed and maintained in 9 institutes, and 13 projects designed and implemented (11 institutional, 2 addressing ministerial-level priorities) to research nursing issues at selected centers. A systematic strategy to build nursing capacity for health

[Personal emergency call system based on human vital and system technical parameters in a Smart Home environment].

PubMed

Hampicke, M; Schadow, B; Rossdeutscher, W; Fellbaum, K; Boenick, U

2002-11-01

Progress in microtechnology and radio transmission technology has enabled the development of highly reliable emergency-call systems. The present article describes systems that have been specially designed to improve the safety and independence of handicapped and elderly persons living at home. For such persons immediate help in an emergency situation is of crucial importance. The technical state of the art of emergency-call systems specially developed for use by the elderly, is briefly discussed, in particular the well-known radio emergency-call button, with the aid of which an alarm can be activated manually. This system, however, does not offer adequate safety in all emergency situations. Alternative or complementary systems designed to automatically trigger an alarm on the basis of the recording and evaluation of so-called vital parameters, are therefore proposed. In addition, in a smart-home environment with networked devices, further parameters--so-called environment parameters can be used. It is found that the identification of an emergency situation becomes more reliable as the number of parameters employed increases.

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

PubMed

Wall, Sarah

2013-06-01

In Canada, as well as internationally, efficiency-focused organizational restructuring in healthcare has resulted in stressful job change for nurses, although nurses continue to work in a system that values technology-based, physician-provided services. Employed nurses have had to participate in organizational activities that undermine their professional values and goals. Nursing entrepreneurship presents an opportunity to explore nursing's professional potential in nursing practice that is uniquely independent. In this study, a focused ethnographic approach was used to explore the experiences of self-employed nurses, who see themselves as leaders in advancing the profession of nursing and its contribution to healthcare. Key themes in the findings include the responses of self-employed nurses to health system change, expanded roles for nurses, the consequences of this non-traditional approach to nursing work and the possibilities for change that arise from nursing entrepreneurship. This research has implications for healthcare policy, professional advocacy and nursing education. Copyright © 2013 Longwoods Publishing.

Comparing usability testing outcomes and functions of six electronic nursing record systems.

PubMed

Cho, Insook; Kim, Eunman; Choi, Woan Heui; Staggers, Nancy

2016-04-01

This study examined the usability of six differing electronic nursing record (ENR) systems on the efficiency, proficiency and available functions for documenting nursing care and subsequently compared the results to nurses' perceived satisfaction from a previous study. The six hospitals had different ENR systems, all with narrative nursing notes in use for more than three years. Stratified by type of nursing unit, 54 staff nurses were digitally recorded during on-site usability testing by employing validated patient care scenarios and think-aloud protocols. The time to complete specific tasks was also measured. Qualitative performance data were converted into scores on efficiency (relevancy), proficiency (accuracy), and a competency index using scoring schemes described by McGuire and Babbott. Six nurse managers and the researchers completed assessments of available ENR functions and examined computerized nursing process components including the linkages among them. For the usability test, participants' mean efficiency score was 94.2% (95% CI, 91.4-96.9%). The mean proficiency was 60.6% (95% CI, 54.3-66.8%), and the mean competency index was 59.5% (95% CI, 52.9-66.0). Efficiency scores were significantly different across ENRs as was the time to complete tasks, ranging from 226.3 to 457.2s (χ(2)=12.3, P=0.031; χ(2)=11.2, P=0.048). No significant differences were seen for proficiency scores. The coverage of the various ENRs' nursing process ranged from 67% to 100%, but only two systems had complete integration of nursing components. Two systems with high efficiency and proficiency scores had much lower usability test scores and perceived user satisfaction along with more complex navigation patterns. In terms of system usability and functions, different levels of sophistication of and interaction performance with ENR systems exist in practice. This suggests that ENRs may have variable impacts on clinical outcomes and care quality. Future studies are needed to

[Evaluation of Educational Effect of Problem-Posing System in Nursing Processing Study].

PubMed

Tsuji, Keiko; Takano, Yasuomi; Yamakawa, Hiroto; Kaneko, Daisuke; Takai, Kiyako; Kodama, Hiromi; Hagiwara, Tomoko; Komatsugawa, Hiroshi

2015-09-01

The nursing processing study is generally difficult, because it is important for nursing college students to understand knowledge and utilize it. We have developed an integrated system to understand, utilize, and share knowledge. We added a problem-posing function to this system, and expected that students would deeply understand the nursing processing study through the new system. This system consisted of four steps: create a problem, create an answer input section, create a hint, and verification. Nursing students created problems related to nursing processing by this system. When we gave a lecture on the nursing processing for second year students of A university, we tried to use the creating problem function of this system. We evaluated the effect by the number of problems and the contents of the created problem, that is, whether the contents consisted of a lecture stage or not. We also evaluated the correlation between those and regular examination and report scores. We derived the following: 1. weak correlation between the number of created problems and report score (r=0.27), 2. significant differences between regular examination and report scores of students who created problems corresponding to the learning stage, and those of students who created problems not corresponding to it (P<0.05). From these results, problem-posing is suggested to be effective to fix and utilize knowledge in the lecture of nursing processing theory.

ESIF Call for High-Impact Integrated Projects | Energy Systems Integration

Science.gov Websites

Integrated Projects As a U.S. Department of Energy user facility, the Energy Systems Integration Facility concepts, tools, and technologies needed to measure, analyze, predict, protect, and control the grid of the Facility | NREL ESIF Call for High-Impact Integrated Projects ESIF Call for High-Impact

Methodological challenges collecting parent phone-call healthcare utilization data.

PubMed

Moreau, Paula; Crawford, Sybil; Sullivan-Bolyai, Susan

2016-02-01

Recommendations by the National Institute of Nursing Research and other groups have strongly encouraged nurses to pay greater attention to cost-effectiveness analysis when conducting research. Given the increasing prominence of translational science and comparative effective research, cost-effective analysis has become a basic tool in determining intervention value in research. Tracking phone-call communication (number of calls and context) with cross-checks between parents and healthcare providers is an example of this type of healthcare utilization data collection. This article identifies some methodological challenges that have emerged in the process of collecting this type of data in a randomized controlled trial: Parent education Through Simulation-Diabetes (PETS-D). We also describe ways in which those challenges have been addressed with comparison data results, and make recommendations for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

Making Patient Risk Visible: Implementation of a Nursing Document Information System to Improve Patient Safety.

PubMed

Wang, Panfeng; Zhang, Hongjun; Li, Baohua; Lin, Keke

2016-01-01

The aims of this study were to develop a nursing information system (NIS), enhance the visibility of patient risk, and identify challenges and facilitators to adoption of the NIS risk assessment system for nurse leaders. This article describes the function of a nursing risk assessment information system, and the results of a survey on the risk assessment system. The results suggested that quality of information processing in nursing significantly improved patient safety. Nurses surveyed demonstrated a high degree of satisfaction, with saving time and improving safety. The nursing document information system described was introduced to improve patient safety and decrease risk. The application of the system has greatly enhanced the efficiency of nursing work, and guides the nurses to make an accurate, comprehensive and objective assessment of patient information, contributing significantly to further improvement in care standards and care decisions.

Pod Nursing on a Medical/Surgical Unit: Implementation and Outcomes Evaluation

PubMed Central

Friese, Christopher R.; Grunawalt, Julie C.; Bhullar, Sara; Bihlmeyer, Karen; Chang, Robert; Wood, Winnie

2014-01-01

A medical/surgical unit at the University of Michigan Health System implemented a pod nursing model of care to improve efficiency and patient and staff satisfaction. One centralized station was replaced with 4 satellites and supplies were relocated next to patient rooms. Patients were assigned to 2 nurses who worked as partners. Three patient (satisfaction, call lights, and falls) and nurse (satisfaction and overtime) outcomes improved after implementation. Efforts should be focused on addressing patient acuity imbalances across assignments and strengthening communication among the health care team. Studies are needed to test the model in larger and more diverse settings. PMID:24662689

Pod nursing on a medical/surgical unit: implementation and outcomes evaluation.

PubMed

Friese, Christopher R; Grunawalt, Julie C; Bhullar, Sara; Bihlmeyer, Karen; Chang, Robert; Wood, Winnie

2014-04-01

A medical/surgical unit at the University of Michigan Health System implemented a pod nursing model of care to improve efficiency and patient and staff satisfaction. One centralized station was replaced with 4 satellites and supplies were relocated next to patient rooms. Patients were assigned to 2 nurses who worked as partners. Three patient (satisfaction, call lights, and falls) and nurse (satisfaction and overtime) outcomes improved after implementation. Efforts should be focused on addressing patient acuity imbalances across assignments and strengthening communication among the healthcare team. Studies are needed to test the model in larger and more diverse settings.

Nurse practitioner-based sign-out system to facilitate patient communication on a neurosurgical service: a pilot study with recommendations.

PubMed

Rabinovitch, Deborah L; Hamill, Melinda; Zanchetta, Clauda; Bernstein, Mark

2009-12-01

Failure to communicate important patient information between physicians causes medical errors and adverse patient events. On-call neurosurgery physicians at the Toronto Western Hospital do not know the medical details of all the patients that they are covering at night because they do not care for the entire service of patients during the day. Because there is no formal handover system to transfer patient information to the on-call physician, a nurse practitioner-based sign-out system was recently introduced. Its effectiveness for communication was evaluated with preintervention-postintervention questionnaires and by recording daily logins. There was a statistically significant decrease in number of logins after 8 weeks of use (p = .05, Fisher's exact test), and the tool was abandoned after 16 weeks. Modifications identified to improve the system include the ability to sort by attending physician and to automatically populate the list with new patients. Effective communication is important for reducing medical errors, and perhaps these modifications will facilitate this important endeavor.

The ecology and evolution of avian alarm call signaling systems

NASA Astrophysics Data System (ADS)

Billings, Alexis Chandon

Communication is often set up as a simple dyadic exchange between one sender and one receiver. However, in reality, signaling systems have evolved and are used with many forms and types of information bombarding multiple senders, who in turn send multiple signals of different modalities, through various environmental spaces, finally reaching multiple receivers. In order to understand both the ecology and evolution of a signaling system, we must examine all the facets of the signaling system. My dissertation focused on the alarm call signaling system in birds. Alarm calls are acoustic signals given in response to danger or predators. My first two chapters examine how information about predators alters alarm calls. In chapter one I found that chickadees make distinctions between predators of different hunting strategies and appear to encode information about predators differently if they are heard instead of seen. In my second chapter, I test these findings more robustly in a non-model bird, the Steller's jay. I again found that predator species matters, but that how Steller's jays respond if they saw or heard the predator depends on the predator species. In my third chapter, I tested how habitat has influenced the evolution of mobbing call acoustic structure. I found that habitat is not a major contributor to the variation in acoustic structure seen across species and that other selective pressures such as body size may be more important. In my fourth chapter I present a new framework to understand the evolution of multimodal communication across species. I identify a unique constraint, the need for overlapping sensory systems, thresholds and cognitive abilities between sender and receiver in order for different forms of interspecific communication to evolve. Taken together, these chapters attempt to understand a signaling system from both an ecological and evolutionary perspective by examining each piece of the communication scheme.

Development and validation of a nursing professionalism evaluation model in a career ladder system.

PubMed

Kim, Yeon Hee; Jung, Young Sun; Min, Ja; Song, Eun Young; Ok, Jung Hui; Lim, Changwon; Kim, Kyunghee; Kim, Ji-Su

2017-01-01

The clinical ladder system categorizes the degree of nursing professionalism and rewards and is an important human resource tool for managing nursing. We developed a model to evaluate nursing professionalism, which determines the clinical ladder system levels, and verified its validity. Data were collected using a clinical competence tool developed in this study, and existing methods such as the nursing professionalism evaluation tool, peer reviews, and face-to-face interviews to evaluate promotions and verify the presented content in a medical institution. Reliability and convergent and discriminant validity of the clinical competence evaluation tool were verified using SmartPLS software. The validity of the model for evaluating overall nursing professionalism was also analyzed. Clinical competence was determined by five dimensions of nursing practice: scientific, technical, ethical, aesthetic, and existential. The structural model explained 66% of the variance. Clinical competence scales, peer reviews, and face-to-face interviews directly determined nursing professionalism levels. The evaluation system can be used for evaluating nurses' professionalism in actual medical institutions from a nursing practice perspective. A conceptual framework for establishing a human resources management system for nurses and a tool for evaluating nursing professionalism at medical institutions is provided.

Paths to nursing leadership.

PubMed

Bondas, Terese

2006-07-01

The aim was to explore why nurses enter nursing leadership and apply for a management position in health care. The study is part of a research programme in nursing leadership and evidence-based care. Nursing has not invested enough in the development of nursing leadership for the development of patient care. There is scarce research on nurses' motives and reasons for committing themselves to a career in nursing leadership. A strategic sample of 68 Finnish nurse leaders completed a semistructured questionnaire. Analytic induction was applied in an attempt to generate a theory. A theory, Paths to Nursing Leadership, is proposed for further research. Four different paths were found according to variations between the nurse leaders' education, primary commitment and situational factors. They are called the Path of Ideals, the Path of Chance, the Career Path and the Temporary Path. Situational factors and role models of good but also bad nursing leadership besides motivational and educational factors have played a significant role when Finnish nurses have entered nursing leadership. The educational requirements for nurse leaders and recruitment to nursing management positions need serious attention in order to develop a competent nursing leadership.

A generalized baleen whale call detection and classification system.

PubMed

Baumgartner, Mark F; Mussoline, Sarah E

2011-05-01

Passive acoustic monitoring allows the assessment of marine mammal occurrence and distribution at greater temporal and spatial scales than is now possible with traditional visual surveys. However, the large volume of acoustic data and the lengthy and laborious task of manually analyzing these data have hindered broad application of this technique. To overcome these limitations, a generalized automated detection and classification system (DCS) was developed to efficiently and accurately identify low-frequency baleen whale calls. The DCS (1) accounts for persistent narrowband and transient broadband noise, (2) characterizes temporal variation of dominant call frequencies via pitch-tracking, and (3) classifies calls based on attributes of the resulting pitch tracks using quadratic discriminant function analysis (QDFA). Automated detections of sei whale (Balaenoptera borealis) downsweep calls and North Atlantic right whale (Eubalaena glacialis) upcalls were evaluated using recordings collected in the southwestern Gulf of Maine during the spring seasons of 2006 and 2007. The accuracy of the DCS was similar to that of a human analyst: variability in differences between the DCS and an analyst was similar to that between independent analysts, and temporal variability in call rates was similar among the DCS and several analysts.

The application of Aronson's taxonomy to medication errors in nursing.

PubMed

Johnson, Maree; Young, Helen

2011-01-01

Medication administration is a frequent nursing activity that is prone to error. In this study of 318 self-reported medication incidents (including near misses), very few resulted in patient harm-7% required intervention or prolonged hospitalization or caused temporary harm. Aronson's classification system provided an excellent framework for analysis of the incidents with a close connection between the type of error and the change strategy to minimize medication incidents. Taking a behavioral approach to medication error classification has provided helpful strategies for nurses such as nurse-call cards on patient lockers when patients are absent and checking of medication sign-off by outgoing and incoming staff at handover.

Evaluation of Nursing Information Systems: Application of Usability Aspects in the Development of Systems.

PubMed

Moghaddasi, Hamid; Rabiei, Reza; Asadi, Farkhondeh; Ostvan, Negin

2017-04-01

As the largest group providing healthcare services, nurses require well-designed information systems in their practice. This study aims to evaluate the usability of nursing information systems (NIS). This cross-sectional survey was conducted in 2015. The settings of the study consisted of four hospitals affiliated with three medical universities in Tehran (Iran). The subjects of the study included nurses who had access to and used a NIS developed by four major software companies. The data were collected using a modified version of a usability questionnaire known as IsoMetrics, based on the International Standard ISO 9241, Part 11. The questionnaire is composed of 35 questions divided into seven general criteria. The validity of the questionnaire was determined by experts in the field, and the reliability was checked using Cronbach's alpha (α = 0.91). The questionnaire was then distributed to 184 nurses. The response rate was 64.6%. Among the seven ISO usability criteria, suitability for the task (3.10 ± 1.24) and suitability for learning (3.10 ± 1.27) had the highest mean value. The lowest mean value (2.37 ± 1.29) was related to the suitability for individualization. Addressing issues related to individualization and self-descriptiveness could improve the usability of nursing systems. Considering usability requirements in the design of a NIS will lead to the efficient and effective use of these systems.

The health system consequences of agency nursing and moonlighting in South Africa

PubMed Central

Rispel, Laetitia C.; Blaauw, Duane

2015-01-01

Background Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA® 13. Results In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other socio-demographic variables. Conclusion Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front

Nurse-Initiated Telephone Follow Up after Ureteroscopic Stone Surgery.

PubMed

Tackitt, Helen M; Eaton, Samuel H; Lentz, Aaron C

2016-01-01

This article presents findings of a quality improvement (QI) project using the DMAIC (define, measure, analyze, improve, and control) model designed to decrease the rate of emergency department (ED) visits and nurse advice line calls after ureteroscopic stone surgery. Results indicated that nurse-initiated follow- up phone calls can decrease ED visits.

Components of US Associate Degree Nursing Programs and Their Relationship to the National Council Licensure Examination for Registered Nurses Graduate Pass Rates

ERIC Educational Resources Information Center

Popescu, Caroline A.

2011-01-01

The nursing shortage has accelerated the need for nursing programs to discover program components related to success on the NCLEX-RN. As the demand for nurses is growing, nursing programs have been called upon to help find solutions to the problem. This study attempted to contribute to the resolution of the shortage and provide nursing educators…

Introducing Advanced Practice Nurses / Nurse Practitioners in health care systems: a framework for reflection and analysis.

PubMed

De Geest, Sabina; Moons, Philip; Callens, Betty; Gut, Chris; Lindpaintner, Lyn; Spirig, Rebecca

2008-11-01

An increasing number of countries are exploring the option of introducing Advanced Practice Nurses (APN), such as Nurse Practitioners (NP), as part of the health care workforce. This is particular relevant in light of the increase of the elderly and chronically ill. It is crucial that this introduction is preceded by an in depth understanding of the concept of advanced practice nursing as well as an analysis of the context. Firstly, a conceptual clarification of Advanced Practice Nurses and Nurse Practitioners is provided. Secondly, a framework is introduced that assists in the analysis of the introduction and development of Advanced Practice Nurse roles in a particular health care system. Thirdly, outcomes research on Advanced Practice Nursing is presented. Argumentation developed using data based papers and policy reports on Advanced Practice Nursing. The proposed framework consists of five drivers: (1) the health care needs of the population, (2) education, (3) workforce, (4) practice patterns and (5) legal and health policy framework. These drivers act synergistically and are dynamic in time and space. Outcomes research shows that nurse practitioners show clinical outcomes similar to or better than those of physicians. Further examples demonstrate favourable outcomes in view of the six Ds of outcome research; death, disease, disability, discomfort, dissatisfaction and dollars, for models of care in which Advanced Practice Nurses play a prominent role. Advanced Practice Nurses such as Nurse Practitioners show potential to contribute favourably to guaranteeing optimal health care. Advanced Practice Nurses will wield the greatest influence on health care by focusing on the most pressing health problems in society, especially the care of the chronically ill.

Nursing teamwork in a health system: A multisite study.

PubMed

Kaiser, Jennifer A; Westers, Judith B

2018-01-16

The aim of this study was to examine how the facets of teamwork exist among nurse-only teams in acute and continuing care settings. The health care 'team' conventionally describes the interdisciplinary team in both literature and practice. Nursing-specific teams are rarely considered in the literature. An examination of this specific professional cohort is important to understand how teamwork exists among those who provide the majority of patient care. This was a descriptive, comparative, cross-sectional study using the Nursing Teamwork Survey to measure teamwork of nursing-based teams among 1414 participants in multiple acute care environments across a large Midwestern health system. The characteristics of nursing teams were analysed. The results from the subscales within the teamwork model showed that nursing teams had a good understanding of the various roles and responsibilities. However, nurse team members held a more individualistic rather than collective team-oriented mindset. Increased teamwork has a positive effect on job satisfaction, staffing efficiencies, retention and care delivery. Nurse leaders can use the information provided in this study to target the aspects of highly functioning teams by improving team orientation, trust and backup behaviours. © 2018 John Wiley & Sons Ltd.

Nurses' Clinical Decision Making on Adopting a Wound Clinical Decision Support System.

PubMed

Khong, Peck Chui Betty; Hoi, Shu Yin; Holroyd, Eleanor; Wang, Wenru

2015-07-01

Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting.

Pediatric Endocrinology Nurses Society

MedlinePlus

... Scholarship applications are DUE no later than April 1, 2018. Click here for scholarship information. ​ ​ ​​​​​​​​​​​ Recent PENS Announcements Text2 ​ 2018 PENS Call for Presentations & Advanced Case Studies PENS Recognition Program Journal of Pediatric Nursing - ​Call ...

Feasibility of using the Omaha System to represent public health nurse manager interventions.

PubMed

Monsen, Karen A; Newsom, Eric T

2011-01-01

To test the feasibility of representing public health nurse (PHN) manager interventions using a recognized standardized nursing terminology. A nurse manager in a Midwest local public health agency documented nurse manager interventions using the Omaha System for 5 months. ANALYTIC STRATEGY: The data were analyzed and the results were compared with the results from a parallel analysis of existing PHN intervention data. Interventions for 79 "clients" (projects, teams, or individuals) captured 76% of recorded work hours, and addressed 43% of Omaha System problems. Most problems were addressed at the "community" level (87.1%) versus the "individual" level (12.9%). Nursing practice differed between the 2 knowledge domains of public health family home visiting nursing and public health nursing management. Standardized nursing terminologies have the potential to represent, describe, and quantify nurse manager interventions for future evaluation and research. © 2011 Wiley Periodicals, Inc.

Nurse employment contracts in Chinese hospitals: impact of inequitable benefit structures on nurse and patient satisfaction.

PubMed

Shang, Jingjing; You, Liming; Ma, Chenjuan; Altares, Danielle; Sloane, Douglas M; Aiken, Linda H

2014-01-13

Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of 'bianzhi' nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals. This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics. Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than 'bianzhi' nurses who have more job security (P <0.01). Contract-based nurses who were dissatisfied with their salary and benefits were more likely to intend to leave their current positions (P <0.01). Hospitals with high levels of dissatisfaction with salary and benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P < 0.05). Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and 'bianzhi' nurses may adversely affect both nurse and patient satisfaction in hospitals. Our study provides

A family systems nursing intervention model for paediatric health crisis.

PubMed

Tomlinson, Patricia Short; Peden-McAlpine, Cynthia; Sherman, Suzan

2012-03-01

This article discusses the development of a family systems nursing intervention for clinical use in health crisis. Although studies in paediatric critical care provide evidence that family stress is an important clinical phenomenon, studies have demonstrated that few nurses have the requisite family intervention skills to provide family members with adequate support during crisis. In addition, few intervention studies that focus on provider-family relationships with the goal of reducing stress have been reported. This article contributes to the literature by redressing this lack. Data sources.  The literature search supporting this project spanned from 1980 to 2009 and included searches from classic nursing theory, family theory and relevant nursing research specific to the design of the intervention reported. The goal of the intervention is to provide a theoretical and practical foundation for explicit action that enhances relationships with caregivers thereby supporting the integrity of the family and enhancing their coping abilities. The intervention, based on the Family Systems Model and the family's understandings of the situation, defines specific goals and desired outcomes to guide strategic actions. Discussion of the conceptual foundation, procedural development and an example of the protocol is provided. Implications for nursing.  The intervention is designed for nurses with limited knowledge in family theory to aid them to better help families dealing with stress. The proposed intervention can be used to increase nurses' skills in family centred nursing care. Although designed for use in paediatric critical care, it can, with modifications, be used in other nursing specialty areas. © 2011 Blackwell Publishing Ltd.

75 FR 55801 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

... 0938-AP87 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing... Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2011.'' DATES: Effective... illustrate the skilled nursing facility (SNF) prospective payment system (PPS) payment rate computations for...

RN jurisdiction over nursing care systems in nursing homes: application of latent class analysis

PubMed Central

Corazzini, Kirsten N.; Anderson, Ruth A.; Mueller, Christine; Thorpe, Joshua M.; McConnell, Eleanor S.

2015-01-01

Background In the context of declining registered nurse (RN) staffing levels in nursing homes, professional nursing jurisdiction over nursing care systems may erode. Objectives The purpose of this study is to develop a typology of professional nursing jurisdiction in nursing homes in relation to characteristics of RN staffing, drawing upon Abbott's (1988) tasks and jurisdictions framework. Method The study was a cross-sectional, observational study using the 2004 National Nursing Home Survey (N=1,120 nursing homes). Latent class analysis tested whether RN staffing indicators differentiated facilities in a typology of RN jurisdiction, and compared classes on key organizational environment characteristics. Multiple logistic regression analysis related the emergent classes to presence or absence of specialty care programs in 8 clinical areas. Results Three classes of capacity for jurisdiction were identified, including ‘low capacity’ (41% of homes) with low probabilities of having any indicators of RN jurisdiction, ‘mixed capacity’ (26% of homes) with moderate to high probabilities of having higher RN education and staffing levels, and ‘high capacity’ (32% of homes) with moderate to high probabilities of having almost all indicators of RN jurisdiction. ‘High capacity’ homes were more likely to have specialty care programs relative to ‘low capacity’ homes; such homes were less likely to be chain-owned, and more likely to be larger, provide higher technical levels of patient care, have unionized nursing assistants, have a lower ratio of LPNs to RNs, and a higher education level of the administrator. Discussion Findings provide preliminary support for the theoretical framework as a starting point to move beyond extensive reliance on staffing levels and mix as indicators of quality. Further, findings indicate the importance of RN specialty certification. PMID:22166907

Design of an Electronic Reminder System for Supporting the Integerity of Nursing Records.

PubMed

Chen, Chien-Min; Hou, I-Ching; Chen, Hsiao-Ping; Weng, Yung-Ching

2016-01-01

The integrity of electronic nursing records (ENRs) stands for the quality of medical records. But patients' conditions are varied (e.g. not every patient had wound or need fall prevention), to achieve the integrity of ENRs depends much on clinical nurses' attention. Our study site, an one 2,300-bed hospital in northern Taiwan, there are a total of 20 ENRs including nursing assessments, nursing care plan, discharge planning etc. implemented in the whole hospital before 2014. It become important to help clinical nurses to decrease their human recall burden to complete these records. Thus, the purpose of this study was to design an ENRs reminder system (NRS) to facilitate nursing recording process. The research team consisted of an ENR engineer, a clinical head nurse and a nursing informatics specialist began to investigate NRS through three phases (e.g. information requirements; design and implementation). In early 2014, a qualitative research method was used to identify NRS information requirements through both groups (e.g. clinical nurses and their head nurses) focus interviews. According to the their requirements, one prototype was created by the nursing informatics specialist. Then the engineer used Microsoft Visual Studio 2012, C#, and Oracle to designed a web-based NRS (Figure 1). Then the integrity reminder system which including a total of twelve electronic nursing records was designed and the preliminary accuracy validation of the system was 100%. NRS could be used to support nursing recording process and prepared for implementing in the following phase.

Information technology: changing nursing processes at the point-of-care.

PubMed

Courtney, Karen L; Demiris, George; Alexander, Greg L

2005-01-01

Changing societal demographics, increasing complexity in healthcare knowledge, and increasing nursing shortages have led healthcare strategists to call for a redesign of the healthcare system. Embedded within most redesign recommendations is the increased use of technology to make nursing practice more efficient. However, information technology (IT) has the potential to go beyond simple efficiency increases. If IT is perceived truly as a part of the redesign of healthcare delivery rather than simply the automation of existing processes, then it can change nursing processes within institutions and furthermore change the point-of-care between nurses and patients. Nursing adoption of technology within the workplace is a result of the interactions between technical skills, social acceptance, and workplace culture. Nursing needs for information not only influence their adoption of particular technologies but also shape their design. The objective of this article is to illustrate how IT can change not only nursing practice and processes but also the point-of-care. A case study of the use of IT by nurses in telehomecare is presented and administrative implications are discussed.

A Freely-Available Authoring System for Browser-Based CALL with Speech Recognition

ERIC Educational Resources Information Center

O'Brien, Myles

2017-01-01

A system for authoring browser-based CALL material incorporating Google speech recognition has been developed and made freely available for download. The system provides a teacher with a simple way to set up CALL material, including an optional image, sound or video, which will elicit spoken (and/or typed) answers from the user and check them…

Bundling the value of discharge telephone calls and leader rounding.

PubMed

Setia, Nina; Meade, Christine

2009-03-01

Discharge telephone calls made by hospital staff provide invaluable opportunities to prevent adverse events, improve quality of care, and increase patient satisfaction. Similarly, the effect of rounding on patients can improve clinical quality and improve both patient and staff satisfaction. The author discusses how the combination of implementing both nurse leader rounding and discharge telephone calls simultaneously produced powerful positive outcomes in satisfaction and patient quality of care.

Predictors of attitude and intention to use knowledge management system among Korean nurses.

PubMed

Yun, Eun Kyoung

2013-12-01

Knowledge sharing using Knowledge Management (KM) systems helps nurses to understand and acquire appropriate knowledge that influences the quality of healthcare service. The purpose of this study was to identify organizational and individual factors influencing attitude and intention to use KM systems among Korean nurses. A cross-sectional survey design was used to study a sample of 245 nurses employed at five hospitals in Seoul. A multiple hierarchical regression was used to examine predictors of nurses' attitude and intention to use. From an individual perspective, nurse's informatics competency was identified as a significant factor influencing attitudes toward knowledge management usage within adhocracy and clan cultures. However, from an organizational perspective, level of hospital information system was identified as a significant factor influencing KM system usage within adhocracy cultures. The findings of this study will be helpful in better understanding and assessing the impact of the factors affecting the implementation of nursing knowledge management systems and in further developing successful managerial strategies using knowledge resources in healthcare settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Applications of complex systems theory in nursing education, research, and practice.

PubMed

Clancy, Thomas R; Effken, Judith A; Pesut, Daniel

2008-01-01

The clinical and administrative processes in today's healthcare environment are becoming increasingly complex. Multiple providers, new technology, competition, and the growing ubiquity of information all contribute to the notion of health care as a complex system. A complex system (CS) is characterized by a highly connected network of entities (e.g., physical objects, people or groups of people) from which higher order behavior emerges. Research in the transdisciplinary field of CS has focused on the use of computational modeling and simulation as a methodology for analyzing CS behavior. The creation of virtual worlds through computer simulation allows researchers to analyze multiple variables simultaneously and begin to understand behaviors that are common regardless of the discipline. The application of CS principles, mediated through computer simulation, informs nursing practice of the benefits and drawbacks of new procedures, protocols and practices before having to actually implement them. The inclusion of new computational tools and their applications in nursing education is also gaining attention. For example, education in CSs and applied computational applications has been endorsed by The Institute of Medicine, the American Organization of Nurse Executives and the American Association of Colleges of Nursing as essential training of nurse leaders. The purpose of this article is to review current research literature regarding CS science within the context of expert practice and implications for the education of nurse leadership roles. The article focuses on 3 broad areas: CS defined, literature review and exemplars from CS research and applications of CS theory in nursing leadership education. The article also highlights the key role nursing informaticists play in integrating emerging computational tools in the analysis of complex nursing systems.

What is nursing in the 21st century and what does the 21st century health system require of nursing?

PubMed

Scott, P Anne; Matthews, Anne; Kirwan, Marcia

2014-01-01

It is frequently claimed that nursing is vital to the safe, humane provision of health care and health service to our populations. It is also recognized however, that nursing is a costly health care resource that must be used effectively and efficiently. There is a growing recognition, from within the nursing profession, health care policy makers and society, of the need to analyse the contribution of nursing to health care and its costs. This becomes increasingly pertinent and urgent in a situation, such as that existing in Ireland, where the current financial crisis has lead to public sector employment moratoria, staff cuts and staffing deficits, combined with increased patient expectation, escalating health care costs, and a health care system restructuring and reform agenda. Such factors, increasingly common internationally, make the identification and effective use of the nursing contribution to health care an issue of international importance. This paper seeks to explore the nature of nursing and the function of the nurse within a 21st century health care system, with a focus on the Irish context. However, this analysis fits into and is relevant to the international context and discussion regarding the nursing workforce. This paper uses recent empirical studies exploring the domains of activity and focus of nursing, together with nurses perceptions of their role and work environment, in order to connect those findings with core conceptual questions about the nature and function of nursing. © 2013 John Wiley & Sons Ltd.

The Nurse Project: an analysis for nurses to take back our work.

PubMed

Rankin, Janet M

2009-12-01

This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can 'talk back' and 'act back' to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches to understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work.

The Bellevue Classification System: nursing's voice upon the library shelves*†

PubMed Central

Mages, Keith C

2011-01-01

This article examines the inspiration, construction, and meaning of the Bellevue Classification System (BCS), created during the 1930s for use in the Bellevue School of Nursing Library. Nursing instructor Ann Doyle, with assistance from librarian Mary Casamajor, designed the BCS after consulting with library leaders and examining leading contemporary classification systems, including the Dewey Decimal Classification and Library of Congress, Ballard, and National Health Library classification systems. A close textual reading of the classes, subclasses, and subdivisions of these classification systems against those of the resulting BCS, reveals Doyle's belief that the BCS was created not only to organize the literature, but also to promote the burgeoning intellectualism and professionalism of early twentieth-century American nursing. PMID:21243054

Evaluating the impact of a new pay system on nurses in the UK.

PubMed

Buchan, James; Ball, Jane

2011-01-01

This study examines the impact of implementing a new pay system (Agenda for Change) on nursing staff in the National Health Service (NHS) in the UK. This new pay system covered approximately 400,000 nursing staff. Its objectives were to improve the delivery of patient care as well as staff recruitment, retention and motivation. The new system aimed to provide a simplified approach to pay determination, with a more systematic use of agreed job descriptions and job evaluation to 'price' individual jobs, linked to a new career development framework. Secondary analysis of survey data. Analysis of results of large-scale surveys of members of the Royal College of Nursing of the United Kingdom (RCN) to assess the response of nurses to questions about the implementation process itself and their attitude to pay levels. The results demonstrated that there was some positive change after implementation of Agenda for Change in 2006, mainly some time after implementation, and that the process of implementation itself raised expectations that were not fully met for all nurses. There were clear indications of differential impact and reported experiences, with some categories of nurse being less satisfied with the process of implementation. The overall message is that a national pay system has strengths and weaknesses compared to the local systems used in other countries and that these benefits can only be maximised by effective communication, adequate funding and consistent management of the system. How nurses' pay is determined and delivered can be a major satisfier and incentive to nurses if the process is well managed and can be a factor in supporting clinical practice, performance and innovation. This study highlights that a large-scale national exercise to reform the pay system for nurses is a major undertaking, carries risk and will take significant time to implement effectively. © 2010 Blackwell Publishing Ltd.

Nurses' perceptions of research utilization in a corporate health care system.

PubMed

McCloskey, Donna Jo

2008-01-01

To explore selected characteristics of nurses based upon educational level (masters, baccalaureate, associate degree/diploma), years of experience, and hospital position (management, advanced practice, staff nurse) that might affect perceived availability of research resources, attitude towards research, support, and research use in practice. A descriptive nonexperimental mailed survey design was used for this study. Nurses in five hospitals within a corporate hospital system were surveyed using the Research Utilization Questionnaire (RUQ). The RUQ was used to measure nurses' perceptions of research utilization in the four dimensions of perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities. ANOVA was used to analyze the data. Statistically significant differences (p<.001) were found in the perceived use of research, attitude toward research, availability of research resources, and perceived support for research activities based on educational level and organizational position. No significant differences were found in the perception of nurses based on years of experience. The results of this study have implications for staff nurses, administrators, advanced practice nurses, and educators working in hospital systems. The different perceptions based upon educational level and hospital position can be integrated and used at all levels of nursing practice to promote research utilization and evidence-based practice initiatives within the organizational structure. The results of this study have nursing implications within administration and for nursing practice. The different perceptions that were found based upon educational level and hospital position can be positively integrated and used by administrators and by nurses all levels of nursing practice to promote research utilization and evidence based practice initiatives within the organizational structure.

[An Exploration of Working Conditions and Flexible System for Hospital Nurses].

PubMed

Huang, Chung-I; Yu, Chien; Yu, Chin-Cheh

2016-04-01

The lack of sufficient numbers of professional nurses in the healthcare system in Taiwan is an issue that affects the sustainability of this system and that relates closely to working conditions. The present study explores the expectations that nurses hold with regard to working conditions and the operation of a flexible system in hospitals. A literature review and focus-group interviews were used to develop the questionnaire Working Conditions and Flexible System. A total of 1,150 copies of this questionnaire were distributed to practicing nurses using stratified random sampling, with 1,146 valid copies returned for a valid recovery rate of 99.65%. The results show that the expectations of participants concerning working conditions and a flexible system focus on the 6 factors of task, numerical, divisional, temporal, wages, and leading flexibility. The total mean was 4.35 (SD=0.42). The means for the 6 types of flexibility were all greater than 4.0. Participants deemed flexibility to be of high importance. The demographic variables hospital, work location, age, education level, work position, work unit, and total work years all affected the 6 types of flexibility significantly. The present study supports that the retention of nurses is significantly associated with working conditions and the operation of a flexible system. Administrators and mangers must create positive working conditions and a flexible system in order to enhance the retention and career development of nurses.

A management information system for nurse/midwives.

PubMed Central

Ogunbekun, I.

1999-01-01

The experiences of nurse/midwives with a simple management information system in the private sector are reported from four facilities in Nigeria. When such a system is being introduced, special attention should be given to strengthening the ability of health workers to record and collate data satisfactorily. PMID:10083721

Perceptions of stress, burnout, and support systems in pediatric bone marrow transplantation nursing.

PubMed

Gallagher, Regan; Gormley, Denise K

2009-12-01

Bone marrow transplantation (BMT) is used to treat various conditions, ranging from immune disorders to many types of cancer. The critical complexity of patients and the environment in which BMT nurses work can lead to stress, burnout, and, ultimately, poor retention. This study aimed to investigate nurses' perceptions of work-related stress and burnout as well as current support systems for nurses. The study included 30 BMT staff nurses from a large pediatric medical center in the midwestern United States. Critical illness or acuity of patients was reported as the most stressful factor; long work hours was the least stressful factor. Most nurses perceived moderate to high levels of emotional exhaustion, and 33% reported moderate levels of depersonalization. Fifty percent perceived high levels of personal accomplishment, despite the critical illness or acuity of their patients, demanding patient families, rotating shifts, short staffing, and caring for dying patients. Most nurses felt that support systems were in place and that staff was accessible, but most respondents were undecided about the helpfulness of the support systems. Results suggest that support systems may significantly affect work satisfaction and feelings of accomplishment for BMT nurses.

Evaluating an accelerated nursing program: a dashboard for diversity.

PubMed

Schmidt, Bonnie J; MacWilliams, Brent R

2015-01-01

Diversity is a topic of increasing attention in higher education and the nursing workforce. Experts have called for a nursing workforce that mirrors the population it serves. Students in nursing programs in the United States do not reflect our country's diverse population; therefore, much work is needed before that goal can be reached. Diversity cannot be successfully achieved in nursing education without inclusion and attention to quality. The Inclusive Excellence framework can be used by nurse educators to promote inclusion, diversity, and excellence. In this framework, excellence and diversity are linked in an intentional metric-driven process. Accelerated programs offer a possible venue to promote diversity, and one accelerated program is examined using a set of metrics and a dashboard approach commonly used in business settings. Several recommendations were made for future assessment, interventions, and monitoring. Nurse educators are called to examine and adopt a diversity dashboard in all nursing programs. Copyright © 2015 Elsevier Inc. All rights reserved.

Linkit: A CALL System for Learning Chinese Characters, Words, and Phrases

ERIC Educational Resources Information Center

Shei, Chris; Hsieh, Hsun-Ping

2012-01-01

Teaching Chinese as a foreign language (TCFL) is increasingly becoming a mainstream profession and an independent academic discipline. However, there is little research in CALL targeting the Chinese language to date. This research attempts to show how a CALL system can be constructed following the unique properties of the Chinese language so it…

Nursing documentation with NANDA and NIC in a comprehensive HIS/EPR system.

PubMed

Flø, Kåre

2006-01-01

DIPS nursing documentation system facilitates that nurses can write several types of notes into the EPR. Within these notes the nurses can register NANDA diagnoses and NIC interventions with nursing activities. To choose NANDA and NIC the nurse can use a search engine, or she can choose a relevant Care plan guideline and pick the suggested diagnoses and interventions from there. Diagnoses and interventions with nursing activities registered are presented in a Care plan. When a nurse writes a note for a patient she will always be presented the Care plan and she can easy evaluate and update the Care plan.

An Integrated Nursing Management Information System: From Concept to Reality

PubMed Central

Pinkley, Connie L.; Sommer, Patricia K.

1988-01-01

This paper addresses the transition from the conceptualization of a Nursing Management Information System (NMIS) integrated and interdependent with the Hospital Information System (HIS) to its realization. Concepts of input, throughout, and output are presented to illustrate developmental strategies used to achieve nursing information products. Essential processing capabilities include: 1) ability to interact with multiple data sources; 2) database management, statistical, and graphics software packages; 3) online, batch and reporting; and 4) interactive data analysis. Challenges encountered in system construction are examined.

Nursing Information Systems Requirements: A Milestone for Patient Outcome and Patient Safety Improvement.

PubMed

Farzandipour, Mehrdad; Meidani, Zahra; Riazi, Hossein; Sadeqi Jabali, Monireh

2016-12-01

Considering the integral role of understanding users' requirements in information system success, this research aimed to determine functional requirements of nursing information systems through a national survey. Delphi technique method was applied to conduct this study through three phases: focus group method modified Delphi technique and classic Delphi technique. A cross-sectional study was conducted to evaluate the proposed requirements within 15 general hospitals in Iran. Forty-three of 76 approved requirements were clinical, and 33 were administrative ones. Nurses' mean agreements for clinical requirements were higher than those of administrative requirements; minimum and maximum means of clinical requirements were 3.3 and 3.88, respectively. Minimum and maximum means of administrative requirements were 3.1 and 3.47, respectively. Research findings indicated that those information system requirements that support nurses in doing tasks including direct care, medicine prescription, patient treatment management, and patient safety have been the target of special attention. As nurses' requirements deal directly with patient outcome and patient safety, nursing information systems requirements should not only address automation but also nurses' tasks and work processes based on work analysis.

Intensive care alarm system

NASA Technical Reports Server (NTRS)

Christensen, J. L.; Herbert, A. L.

1973-01-01

Inductive loop has been added to commercially available call system fitted with earphone receiver. System transmits high frequency signals to nurse's receiver to announce patient's need for help without disturbing others.

A continuous operating protection system called COPS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chaperon, G.

1987-01-01

The continuous operating protection system called COPS is a diverless solution to achieve the stabilization and protection of subsea pipelines and cables: the system is based on the use of a continuous fabric form work mattress which is spread on the sea bed over the pipeline or cable to be protected by a remotely controlled underwater crawler and simultaneously filled with cement grout. The method has been successfully used in the GULLFAKS field where about 3.6 km of grout mattresses having a cross section of 2 meters by 0.2 meters have been laid. The performances of the system are presentedmore » as well as a trade off comparison with the other stabilization and protection methods currently used: burying, rock dumping or placement of covers.« less

The culture contributing to interruptions in the nursing work environment: An ethnography.

PubMed

Hopkinson, Susan G; Wiegand, Debra L

2017-12-01

To understand the occurrence of interruptions within the culture of the medical nursing unit work environment. Interruptions may lead to errors in nursing work. Little is known about how the culture of the nursing work environment contributes to interruptions. A micro-focused ethnographic study was conducted. Data collection involved extensive observation of a nursing unit, 1:1 observations of nurses and follow-up interviews with the nurses. Data were analysed from unstructured field notes and interview transcripts. The definitions of interruption and culture guided coding, categorising and identification of themes. A framework was developed that describes the medical nursing unit as a complex culture full of unpredictable, nonlinear changes that affect the entire interconnected system, often in the form of an interruption. The cultural elements contributing to interruptions included (i) the value placed on excellence in patient care and meeting personal needs, (ii) the beliefs that the nurses had to do everything by themselves and that every phone call was important, (iii) the patterns of changing patients, patient transport and coordination of resources and (iv) the normative practices of communicating and adapting. Interruptions are an integral part of the culture of a medical nursing unit. Uniformly decreasing interruptions may disrupt current practices, such as communication to coordinate care, that are central to nursing work. In future research, the nursing work environment must be looked at through the lens of a complex system. Interventions to minimise the negative impact of interruptions must take into account the culture of the nursing as a complex adaptive system. Nurses should be educated on their own contribution to interruptions and issues addressed at a system level, rather than isolating the interruption as the central issue. © 2017 John Wiley & Sons Ltd.

Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study.

PubMed

Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E

2015-09-01

Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

Decision support system for nursing management control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ernst, C.J.

A knowledge representation approach for expert systems supporting decision processes in business is proposed. A description of a knowledge representation schema using a logic programming metalanguage is described, then the role of such a schema in a management expert system is demonstrated through the problem of nursing management control in hospitals. 18 references.

Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnographic study.

PubMed

Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

2017-12-28

Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision

A call for change: clinical evaluation of student registered nurse anesthetists.

PubMed

Collins, Shawn; Callahan, Margaret Faut

2014-02-01

The ability to integrate theory with practice is integral to a student's success. A common reason for attrition from a nurse anesthesia program is clinical issues. To document clinical competence, students are evaluated using various tools. For use of a clinical evaluation tool as possible evidence for a student's dismissal, an important psychometric property to ensure is instrument validity. Clinical evaluation instruments of nurse anesthesia programs are not standardized among programs, which suggests a lack of instrument validity. The lack of established validity of the instruments used to evaluate students' clinical progress brings into question their ability to detect a student who is truly in jeopardy of attrition. Given this possibility, clinical instrument validity warrants research to be fair to students and improve attrition rates based on valid data. This ex post facto study evaluated a 17-item clinical instrument tool to demonstrate the need for validity of clinical evaluation tools. It also compared clinical scores with scores on the National Certification Examination.

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

PubMed

Chang, Fang-Mei; Lee, Ting-Ting

2013-04-01

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

Disaster nursing experiences of Chinese nurses responding to the Sichuan Ya'an earthquake.

PubMed

Li, Y H; Li, S J; Chen, S H; Xie, X P; Song, Y Q; Jin, Z H; Zheng, X Y

2017-06-01

The aim of this study was to investigate the disaster experiences of nurses called to assist survivors one month after the 2013 Ya'an earthquake. China has experienced an increasing number of earthquake disasters in the past four decades. Although a health and disaster management system was initiated after the 2008 Wenchuan earthquake, nurses' roles and experiences in a disaster have been overlooked. The researchers used qualitative descriptive design that included 16 participants. Data were collected using semi-structured interviews and observation notes, after which a qualitative content analysis was conducted. Three major themes emerged: the process of being dispatched from hospitals to the disaster zone, the effort involved in getting to and working in the affected site and reflecting on the challenges they encountered. About half of the participants had received disaster nursing training before deploying to the disaster site, but they consistently expressed a lack of physical and psychological preparedness regarding the process of being dispatched from their hospitals to the disaster zone. This was a single-incident experience. Caution should be taken when trying to extend the findings to other parts of China. These findings highlighted the need for disaster in-service training as well as for having disaster plans in place. Hospital and nursing leaders should provide disaster training opportunities that included topics such as compiling resource inventories, formulating disaster drills and simulations, managing emergencies, and using emergency communication methods. Health policy-makers should be required to prioritize capacity-building training for front-line nurses as well as to develop and implement disaster management plans to better prepare nurses for future disasters. © 2016 International Council of Nurses.

How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

PubMed

McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

2015-09-01

Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can the Neuman Systems Model be adapted to the Malaysian nursing context?

PubMed

Shamsudin, Nafsiah

2002-04-01

Nursing in Malaysia is still developing as a profession. Issues such as using nursing conceptual models or frameworks in the delivery of nursing care have not been addressed by the majority of nurses. One reason for this has been the level of education and preparation of nurses, while another reason lies with the origins of existing nursing conceptual models. Most nursing conceptual models have their origins in North America. Their utility by nurses of different cultures and academic preparations might not be appropriate. Nursing is a social activity, an interaction between the nurse and the patient. It is carried out in a social environment within a particular culture. Conceptual models developed in one culture might not be readily implanted into another culture. This paper discusses how a conceptual model developed in North America; that is, the Neuman Systems Model, can be adapted into the Malaysian nursing context.

An evaluation of an attendance monitoring system for undergraduate nursing students.

PubMed

Doyle, Louise; O'Brien, Frances; Timmins, Fiona; Tobin, Gerard; O'Rourke, Frank; Doherty, Lena

2008-03-01

Internationally the preparation and ongoing education of nurses continues to evolve in response the changing nature of both nursing and health care. The move into third level structures that has taken place in countries such as the UK and the Republic of Ireland, results in new challenges to the historical fabric of nurse education. One such challenge is monitoring of nursing students' attendance. Viewed by students as a patriarchal and draconian measure, the nursing profession historically value their ability to ensure the public and professional bodies that nursing students fully engage with educational programmes. University class sizes and the increased perception of student autonomy can negate against formalised monitoring systems. This paper reports on an evaluation of one such monitoring system. The findings revealed that attendance was recognised implicitly by nurse educators as an important learning activity within these programmes results and that current methods employed were less than reliable and so did little to appropriately control the phenomenon. Subsequent to the evaluation; a standardised approach to the measurement of absenteeism was employed. Deliberate short-term absence was a feature of this group. Reasons cited included travelling long distances, dissatisfaction with programme timetables and personal reasons. Preventative measures employed included improvement in student timetable delivery.

Modeling a Nursing Guideline with Standard Terminology and Unified Modeling Language for a Nursing Decision Support System: A Case Study.

PubMed

Choi, Jeeyae; Jansen, Kay; Coenen, Amy

In recent years, Decision Support Systems (DSSs) have been developed and used to achieve "meaningful use". One approach to developing DSSs is to translate clinical guidelines into a computer-interpretable format. However, there is no specific guideline modeling approach to translate nursing guidelines to computer-interpretable guidelines. This results in limited use of DSSs in nursing. Unified modeling language (UML) is a software writing language known to accurately represent the end-users' perspective, due to its expressive characteristics. Furthermore, standard terminology enabled DSSs have been shown to smoothly integrate into existing health information systems. In order to facilitate development of nursing DSSs, the UML was used to represent a guideline for medication management for older adults encode with the International Classification for Nursing Practice (ICNP®). The UML was found to be a useful and sufficient tool to model a nursing guideline for a DSS.

Modeling a Nursing Guideline with Standard Terminology and Unified Modeling Language for a Nursing Decision Support System: A Case Study

PubMed Central

Choi, Jeeyae; Jansen, Kay; Coenen, Amy

2015-01-01

In recent years, Decision Support Systems (DSSs) have been developed and used to achieve “meaningful use”. One approach to developing DSSs is to translate clinical guidelines into a computer-interpretable format. However, there is no specific guideline modeling approach to translate nursing guidelines to computer-interpretable guidelines. This results in limited use of DSSs in nursing. Unified modeling language (UML) is a software writing language known to accurately represent the end-users’ perspective, due to its expressive characteristics. Furthermore, standard terminology enabled DSSs have been shown to smoothly integrate into existing health information systems. In order to facilitate development of nursing DSSs, the UML was used to represent a guideline for medication management for older adults encode with the International Classification for Nursing Practice (ICNP®). The UML was found to be a useful and sufficient tool to model a nursing guideline for a DSS. PMID:26958174

Can a comprehensive code of conduct discourage incivility in nursing students?

PubMed

Authement, Renae

2016-08-01

This article discusses problems associated with incivility in nursing education and a proposed implementation strategy designed to decrease uncivil acts of student behavior. Like most colleges across the nation, this nursing program was experiencing an increase in acts of student incivility. Incivility, also called bullying, may include behaviors such as name calling, side conversations, and condescending language. The sample consisted of 94 third-semester nursing students and 6 faculty members. The Incivility in Nursing Education survey was used as a tool to measure student and faculty perceptions. Data from pre- and postimplementation surveys demonstrated scientific evidence of both faculty and student perception and a significant decrease in acts of uncivil behavior in the nursing program. Because the study was limited to one nursing program and included only third-semester nursing students, the results of the study may not be transferable to all nursing programs. The study revealed a reduction in perceived uncivil acts of behavior in the nursing program by faculty and students.

Using On-scene EMS Responders' Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers.

PubMed

Scott, Greg; Clawson, Jeff; Fivaz, Mark C; McQueen, Jennie; Gardett, Marie I; Schultz, Bryon; Youngquist, Scott; Olola, Christopher H O

2016-02-01

Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews' patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a "hot" (lights-and-siren) transport. Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. With the exception of the low-acuity, ALPHA

Faculty Perceptions of Effective Practices for Utilizing a Framework to Develop a Concept-Based Curriculum in Nursing Education

ERIC Educational Resources Information Center

Magorian, Kathryn G.

2013-01-01

All programs of healthcare education face increasing change and daunting challenges to prepare new graduates for the real world of practice as care providers in complex systems. The necessity for change in nursing education is at a critical level, called on from a variety of sources. New nurses must be able to enter practice as competent, safe,…

Nurse employment contracts in Chinese hospitals: impact of inequitable benefit structures on nurse and patient satisfaction

PubMed Central

2014-01-01

Purpose Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of ‘bianzhi’ nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals. Methods This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics. Principal Results Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than ‘bianzhi’ nurses who have more job security (P <0.01). Contract-based nurses who were dissatisfied with their salary and benefits were more likely to intend to leave their current positions (P <0.01). Hospitals with high levels of dissatisfaction with salary and benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P < 0.05). Conclusions Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and ‘bianzhi’ nurses may adversely affect both nurse and

Examing nursing students' understanding of the cardiovascular system in a BSN program

NASA Astrophysics Data System (ADS)

Stuart, Parker Emerson

This study investigated the alignment of important cardiovascular system (CVS) concepts identified by expert nurses with nursing student's knowledge. Specifically, it focused on the prevalence of nursing students' alternative conceptions for these important concepts as a potential reason for a theory-practice gap in nursing (Corlett, 2000; Jordan, 1994). This is the first study to target nursing student alternative conceptions exclusively whereas other studies focused on diverse groups of undergraduates' CVS knowledge (Michael et al., 2002). The study was divided into two phases and used a case study approach with each phase of the study representing a single case. The first phase of the study sought to understand what CVS concepts expert nurses deemed relevant to their daily practice and how these experts used these concepts. The second phase identified nursing student alternative conceptions through the use of open-ended scenarios based on the results of phase I. For the first phase of the study involved four CVS expert nurses practicing in emergency rooms and cardiac intensive care units at two local hospitals. Interviews were used to elicit important CVS concepts. The expert nurses identified five broad concepts as important to their practice. These concepts were a) cardiovascular anatomical concepts; b) cardiovascular physiological concepts; c) homeostasis and diseases of the CVS; d) the interdependence and interaction of the CVS with other organ systems and e) the intersection of the CVS and technology in patient diagnosis and treatment. These finding reinforce concepts already being taught to nursing students but also suggest that instruction should focus more on how the CVS interacts with other organ systems and how technology and the CVS interact. The presence of alternative conceptions in the nursing students was examined through the use of open-ended questions. A total of 17 students fully completed the scenario questions. Results indicate that this

Mandate for the Nursing Profession to Address Climate Change Through Nursing Education.

PubMed

Leffers, Jeanne; Levy, Ruth McDermott; Nicholas, Patrice K; Sweeney, Casey F

2017-11-01

The adverse health effects from climate change demand action from the nursing profession. This article examines the calls to action, the status of climate change in nursing education, and challenges and recommendations for nursing education related to climate change and human health. Discussion paper. The integration of climate change into nursing education is essential so that knowledge, skills, and insights critical for clinical practice in our climate-changing world are incorporated in curricula, practice, research, and policy. Our Ecological Planetary Health Model offers a framework for nursing to integrate relevant climate change education into nursing curricula and professional nursing education. Nursing education can offer a leadership role to address the mitigation, adaptation, and resilience strategies for climate change. An ecological framework is valuable for nursing education regarding climate change through its consideration of political, cultural, economic, and environmental interrelationships on human health and the health of the planet. Knowledge of climate change is important for integration into basic and advanced nursing education, as well as professional education for nurses to address adverse health impacts, climate change responses policy, and advocacy roles. For current and future nurses to provide care within a climate-changing environment, nursing education has a mandate to integrate knowledge about climate change issues across all levels of nursing education. Competence in nursing practice follows from knowledge and skill acquisition gained from integration of climate change content into nursing education. © 2017 Sigma Theta Tau International.

Investigation of the Effects of a Nursing Information System by Using the Technology Acceptance Model.

PubMed

Hsu, Hung-Hsiou; Wu, Ya-Hui

2017-06-01

The purposes of this study are to investigate the effectiveness of implementing a nursing information system and to discuss several issues affecting its successful deployment from the perspectives of nurses, the major users of the system. The methodology was based on the theory of the technology acceptance model. This study adopted a cross-sectional study method to survey and collect data. In total, 167 questionnaires were distributed to subjects. Approximately 94.6%, or 158 valid questionnaires, were collected. The data were analyzed using SPSS and PLS software.The data analysis indicated that the factors that most significantly influenced the willingness of nurses to use the nursing information system were their degrees of satisfaction with the system and their perceptions of its usefulness. A nursing information system that can provide functions that are useful and convenient and that facilitate the avoidance of tedious repetitive writing and improve the quality of provided care can encourage nurse satisfaction with the system and thus stimulate their interest in using it for their work. The ease of use of the system can also affect the willingness of nurses to use it.

Toward a North-South dialogue: revisiting nursing theory (from the South).

PubMed

Santos Salas, Anna

2005-01-01

In nursing, the current world situation calls us to revisit our knowledge schemes and revise the extent to which they assist us in improving the health of the world peoples. In this discussion, I offer a Latin American nursing perspective to knowledge development in our discipline. I suggest that a persistent concern to develop elaborate conceptualizations has distracted our attention from the realities practicing nurses face throughout the world. In their abstractness, (North) American nursing theories have conveyed a view that presumingly universal imposes itself as hegemonic in the international nursing community. Yet the exportation of these theories to other countries introduces a view that is foreign to practicing nurses. The world situation as well as the disparate and concurrent human paths that we witness and experience calls for approaches that are more in tune with the local realities of nursing practices.

Global nurse leader perspectives on health systems and workforce challenges.

PubMed

Gantz, Nancy Rollins; Sherman, Rose; Jasper, Melanie; Choo, Chua Gek; Herrin-Griffith, Donna; Harris, Kathy

2012-05-01

As part of the 2011 annual American Organization of Nurse Executives conference held in San Diego, California, a session was presented that focused on nursing workforce and health systems challenges from a global perspective. This article includes content addressed during the session representing nurse leader perspectives from the UK, Singapore and the USA. Recent events in global economic markets have highlighted the interdependence of countries. There is now a global focus on health-care costs and quality as government leaders struggle to reduce budgets and remain solvent. Finding solutions to these complex problems requires that nurse leaders adopt more of a world view and network with one another as they look for best practices and creative strategies. Nursing leadership challenges such as staffing, competency development, ageing populations, reduced health-care funding and maintaining quality are now common global problems. There is a need for innovation in nursing practice to accommodate the enormous challenges facing nursing's future. Opportunities on an international scale for nurse leaders to have dialogue and network, such as the conference presentation discussed in this article, will become increasingly more important to facilitate the development of innovative leadership strategies. © 2012 Blackwell Publishing Ltd.

Factors influencing the implementation of evidence in Chinese nursing practice.

PubMed

Cheng, Lei; Broome, Marion E; Feng, Sheng; Hu, Yan

2017-12-01

To explore the influencing factors from staff nurses, nurse managers, nursing directors and a physician involved in nursing evidence implementation in Mainland China. Although the need for evidence-based nursing is well recognised, continuous efforts are needed to strive for closing the gap from evidence to action. Previous studies have explored influencing factors from individual and organisational perspectives in Western countries. However, it remains unclear what the influences (i.e., context and culture) in the developing countries as China. A grounded theory design using in-depth individual interviews was conducted. Interviews with 56 participants from 24 evidence-based nursing implementation projects were conducted in Mainland China. Constant comparative analysis was used to discover the concepts describing the influencing factors during the implementation process. Factors that influenced implementation of evidence-based practice in the Chinese context were identified. These included the leaders of the projects, the nature of the evidence, practising nurses, patients involved in the projects, the system where the projects were implemented, as well as the influence from outside of the system. A variety of factors influencing evidence implementation in Chinese nursing context were identified and further explored from the perspective of different project leaders and culture influence. There is apparently a strong demand for a supportive system, targeted strategies to facilitate various evidence implementations and integrated core elements of evidence-based practice at the point care. The blurred boundaries and complexity of influencing factors call for a systematic and dynamic perspective during implementation. The competitive priorities emphasise the importance of integration between clinical nursing care and evidence-based practice. © 2017 John Wiley & Sons Ltd.

Evaluation of the mining techniques in constructing a traditional Chinese-language nursing recording system.

PubMed

Liao, Pei-Hung; Chu, William; Chu, Woei-Chyn

2014-05-01

In 2009, the Department of Health, part of Taiwan's Executive Yuan, announced the advent of electronic medical records to reduce medical expenses and facilitate the international exchange of medical record information. An information technology platform for nursing records in medical institutions was then quickly established, which improved nursing information systems and electronic databases. The purpose of the present study was to explore the usability of the data mining techniques to enhance completeness and ensure consistency of nursing records in the database system.First, the study used a Chinese word-segmenting system on common and special terms often used by the nursing staff. We also used text-mining techniques to collect keywords and create a keyword lexicon. We then used an association rule and artificial neural network to measure the correlation and forecasting capability for keywords. Finally, nursing staff members were provided with an on-screen pop-up menu to use when establishing nursing records. Our study found that by using mining techniques we were able to create a powerful keyword lexicon and establish a forecasting model for nursing diagnoses, ensuring the consistency of nursing terminology and improving the nursing staff's work efficiency and productivity.

The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study.

PubMed

Eardley, Debra L; Krumwiede, Kelly A; Secginli, Selda; Garner, Linda; DeBlieck, Conni; Cosansu, Gulhan; Nahcivan, Nursen O

2018-06-01

Advancements in healthcare systems include adoption of health information technology to ensure healthcare quality. Educators are challenged to determine strategies to integrate health information technology into nursing curricula for building a nursing workforce competent with electronic health records, standardized terminology, evidence-based practice, and evaluation. Nursing informatics, a growing specialty field, comprises health information technology relative to the profession of nursing. It is essential to integrate nursing informatics across nursing curricula to effectively position competent graduates in technology-laden healthcare environments. Nurse scholars developed and evaluated a nursing informatics case study assignment used in undergraduate level public health nursing courses. The assignment included an unfolding scenario followed by electronic health record charting using standardized terminology to guide the nursing process. The assignment was delivered either online or in class. Seventy-two undergraduate students completed the assignment and a posttest. Fifty-one students completed a satisfaction survey. Results indicated that students who completed the assignment online demonstrated a higher level of content mastery than those who completed the assignment in class. Content mastery was based on posttest results, which evaluated students' electronic health record charting for the nursing assessment, evidence-based interventions, and evaluations. This innovative approach may be valuable to educators in response to the National Academy of Sciences recommendations for healthcare education reform.

The relationship of California's Medicaid reimbursement system to nurse staffing levels.

PubMed

Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene

2012-10-01

Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.

Towards Agent-Oriented Approach to a Call Management System

NASA Astrophysics Data System (ADS)

Ashamalla, Amir Nabil; Beydoun, Ghassan; Low, Graham

There is more chance of a completed sale if the end customers and relationship managers are suitably matched. This in turn can reduce the number of calls made by a call centre reducing operational costs such as working time and phone bills. This chapter is part of ongoing research aimed at helping a CMC to make better use of its personnel and equipment while maximizing the value of the service it offers to its client companies and end customers. This is accomplished by ensuring the optimal use of resources with appropriate real-time scheduling and load balancing and matching the end customers to appropriate relationship managers. In a globalized market, this may mean taking into account the cultural environment of the customer, as well as the appropriate profile and/or skill of the relationship manager to communicate effectively with the end customer. The chapter evaluates the suitability of a MAS to a call management system and illustrates the requirement analysis phase using i* models.

Help for the Burned-Out Nurse?

ERIC Educational Resources Information Center

Buechler, Donna K.

1985-01-01

A study was conducted to determine if a structured support group with a counseling format could prevent or reduce the burnout of professional nurses in an acute care institution. Results of the study were inconclusive, leading the author to call for more research on the subject of burnout in nurses. (CT)

[New ways of higher education in nursing: globalisation of nursing leadership and its teaching--dual degree in nursing].

PubMed

Pop, Marcel; Hollós, Sándor; Vingender, István; Mészáros, Judit

2009-03-08

Our paper is presenting a new initiative regarding an international cooperation willing to develop a dual degree program in nursing, the so-called Transatlantic Curriculum in Nursing. The candidates--after successful completion of their studies--will get a European and an American partner diploma in nursing. The objective is to prepare an internationally and culturally competent workforce; develop the practice of nursing students' exchange programs; process the model of dual degree independent of geographical, political or cultural borders; spread the evidence-based nursing standards in the daily practice. The partners in this initiative are Semmelweis University in Budapest, Hungary, Nazareth College of Rochester, NY, USA and Laurea University in Tikkurila, Finland. The planned activities in the framework of the program: mutual student and staff mobility, joint curriculum development and teaching process, determining joint standards. The expected outcomes are: to develop a standardised model for the enhancement and implementation of international educational programs in nursing; to improve institutional work culture; to improve professional terminology and cultural abilities; to create the model of a new type of nursing professional having a high level of cultural and language competence which are indispensable for participating in global programs.

Nurses with disabilities: can changing our educational system keep them in nursing?

PubMed

Neal-Boylan, Leslie J; Guillett, Sharron E

2008-01-01

A recent qualitative study revealed that registered nurses with physical disabilities experience discrimination in the workplace and frequently leave their jobs and the profession. In light of these findings, it is vital that nursing faculty begin to inculcate students with an appreciation for collegial support before they enter the workplace as registered nurses. The familiar refrain "nurses eat their young" is apparently also true of nurses who have physical limitations. This article will discuss the findings from a qualitative study and offer recommendations for how nurse educators can educate students to help prevent the loss of nurses with disabilities from the profession.

Nursing home costs, Medicaid rates, and profits under alternative Medicaid payment systems.

PubMed Central

Schlenker, R E

1991-01-01

This analysis compares nursing home costs, Medicaid payment rates, and profits under three Medicaid nursing home payment systems: case-mix, facility-specific, and class-rate systems. Data used were collected from 135 nursing homes in seven states. The association of case mix with costs, rates, and profits under the three payment systems was of particular interest. Case mix was more strongly associated (positively) with patient care cost and the Medicaid rate for the case-mix systems than for the other systems, particularly the class-rate systems. In contrast, case mix and profits were not associated in the case-mix or facility-specific systems, but were negatively associated in the class rate systems. Overall, the results suggest that case-mix systems have some important advantages over other payment systems, but further research is needed on larger samples and involving the newer case-mix systems. PMID:1743972

Ethics and Reverence for the Discipline of Nursing.

PubMed

Milton, Constance L

2017-01-01

Healthcare disciplines, including nursing, are emerging sciences that contain discipline-specific theories that guide the activities of research, practice, and education. The term nursing science calls forth meaning that has long been accepted and referred to as the extant nursing theories undergirded with philosophy of science. Recent writings dispute the purposes and future usage of nursing theoretical frameworks in the science of nursing. The author of this article proposes new thinking about the importance of reverence and ethical implications for the future of formal inquiry in nursing science.

Information Processing in Nursing Information Systems: An Evaluation Study from a Developing Country.

PubMed

Samadbeik, Mahnaz; Shahrokhi, Nafiseh; Saremian, Marzieh; Garavand, Ali; Birjandi, Mahdi

2017-01-01

In recent years, information technology has been introduced in the nursing departments of many hospitals to support their daily tasks. Nurses are the largest end user group in Hospital Information Systems (HISs). This study was designed to evaluate data processing in the Nursing Information Systems (NISs) utilized in many university hospitals in Iran. This was a cross-sectional study. The population comprised all nurse managers and NIS users of the five training hospitals in Khorramabad city ( N = 71). The nursing subset of HIS-Monitor questionnaire was used to collect the data. Data were analyzed by the descriptive-analytical method and the inductive content analysis. The results indicated that the nurses participating in the study did not take a desirable advantage of paper (2.02) and computerized (2.34) information processing tools to perform nursing tasks. Moreover, the less work experience nurses have, the further they utilize computer tools for processing patient discharge information. The "readability of patient information" and "repetitive and time-consuming documentation" were stated as the most important expectations and problems regarding the HIS by the participating nurses, respectively. The nurses participating in the present study used to utilize paper and computerized information processing tools together to perform nursing practices. Therefore, it is recommended that the nursing process redesign coincides with NIS implementation in the health care centers.

Evaluation of a training program for nurse supervisors who monitor nurses in an alternative-to-discipline program.

PubMed

Cadiz, David; Truxillo, Donald; OʼNeill, Chris

2012-01-01

Nurse alternative-to-discipline programs aim to protect the public from the harm of impaired practice and to support nurses in early recovery from substance use disorders. Supervisor observation of work behavior is one key monitoring activity that protects the public. We evaluate a supervisory training called "Fit to Perform" for nurse managers to help them monitor and manage nurses enrolled in an alternative-to-discipline program. We observed significant mean changes in knowledge, training utility, self-efficacy, and substance abuse stigma. The results suggest that the training positively affects knowledge about substance use disorders, confidence to supervise nurses enrolled in an alternative-to-discipline program, and reduces stigma, which may create a supportive workplace for nurses in recovery.

The Office of the National Nurse: leadership for a new era of prevention.

PubMed

Mills, Teri; Schneider, Alisa

2007-02-01

The American health care system is in a crisis of soaring costs and epidemics of preventable diseases; poor health literacy contributes to these problems. In spite of the need for change, the system is resistant. Efforts to address the crisis must focus on new ways of educating the public to understand their health and how to prevent illness. Nurses calling for leadership, innovation, and inspiration are uniting behind the proposal for an Office of the National Nurse to serve as the vehicle for the delivery of accurate and accessible health information to all Americans to reduce the incidence of preventable diseases.

The American Nurses Association Code of Ethics: a reflection on the ethics of respect and human dignity with nurse as expert.

PubMed

Milton, Constance L

2003-10-01

The American Nurses Association Code of Ethics for Nurses calls for the nurse to practice with compassion and respect for every individual. What are the ethics and challenges of practicing professional nursing with expertise and educating a new generation of nurses while incorporating the interpretive statements into practice? This column differentiates the traditional biomedical views on human dignity and respect while exploring the embedded ethics of respect and self-determination and what it truly means to be an expert of nursing from the theoretical perspective of the human becoming school of thought.

“Double culturedness”: the “capital” of Inuit nurses

PubMed Central

Møller, Helle

2013-01-01

Background The health and educational systems in Greenland and Nunavut are reflections of those in Denmark and Southern Canada, with the language of instruction and practise being Danish and English. This places specific demands on Inuit studying nursing. Objective This paper discusses the experiences of Inuit who are educated in nursing programmes and practise in healthcare systems located in the Arctic but dominated by EuroCanadian and Danish culture and language. Design Research was qualitative and ethnographic. It was conducted through 12 months of fieldwork in 5 Greenlandic and 2 Nunavut communities. Methods Observation, participant observation, interviews, questionnaires and document review were used. The analytical framework involved Bourdieu's concepts of capital and habitus. Results Participants experienced degrees of success and well-being in the educational systems that are afforded to few other Canadian and Greenlandic Inuit. This success appeared to be based on nurses and students possessing, or having acquired, what I call “double culturedness”; this makes them able to communicate in at least 2 languages and cultures, including the ability to understand, negotiate and interact, using at least 2 ways of being in the world and 2 ways of learning and teaching. Conclusion There continues to be a critical need for Inuit nurses with their special knowledge and abilities in the healthcare systems of the Arctic. Inuit nurses’ experiences will help inform the education and healthcare systems and point to areas in need of support and change in order to increase recruitment and retention of nursing students and practitioners. PMID:23986889

Assisted suicide: implications for nurses and nursing.

PubMed

Daly, B J; Berry, D; Fitzpatrick, J J; Drew, B; Montgomery, K

1997-01-01

Assisted suicide is an issue of great importance to nurses. This issue reflects our values and beliefs as a society, calls for a clear and precise response as a profession, and challenges individual nurses to think about their own moral views. The history of the debate and the compelling moral arguments on both sides attest to the complexity of the issue and also suggest that it will not soon be resolved. The current position of the profession, as expressed in the ANA Code for Nurses and a specific position statement, were reviewed. The dilemma faced by the individual nurse who perceives an obligation to adhere to the guidelines specified by his or her profession's code and yet whose conscience dictates an act in violation of this code has been discussed as an instance of conscientious objection. While this analysis has been necessarily brief, it was intended to illustrate the importance of being clear about one's personal moral views and equally clear about one's duty to fulfil the obligations stemming from the profession's public statements. It is essential that the profession continue to explore the moral issues involved in requests for assistance in dying and provide additional guidelines for practicing nurses, with sound rationale for the profession's position.

Preparing Global Trauma Nurses for Leadership Roles in Global Trauma Systems.

PubMed

Muñiz, Sol Angelica; Lang, Richard W; Falcon, Lisa; Garces-King, Jasmine; Willard, Suzanne; Peck, Gregory L

Trauma leads to 5.7 million annual deaths globally, accounting for 25%-33% of global unintentional deaths and 90% of the global trauma burden in low- and middle-income countries. The Lancet Commission on Global Surgery and the World Health Organization assert that emergent and essential surgical capacity building and trauma system improvement are essential to address the global burden of trauma. In response, the Rutgers Global Surgery program, the School of Nursing and Medicine, and the Robert Wood Johnson University Hospital faculty collaborated in the first Interprofessional Models in Global Injury Care and Education Symposium in June 2016. This 2-week symposium combined lectures, high-fidelity simulation, small group workshops, site visits to Level I trauma centers, and a 1-day training course from the Panamerican Trauma Society. The aim was to introduce global trauma nurses to trauma leadership and trauma system development. After completing the symposium, 10 nurses from China, Colombia, Kenya, Puerto Rico, and Uruguay were surveyed. Overall, 88.8% of participants reported high levels of satisfaction with the program and 100% stated being very satisfied with trauma lectures. Symposia, such as that developed and offered by Rutgers University, prepare nurses to address trauma within system-based care and facilitate trauma nursing leadership in their respective countries.

Nursing under the influence: a relational ethics perspective.

PubMed

Kunyk, Diane; Austin, Wendy

2012-05-01

When nurses have active and untreated addictions, patient safety may be compromised and nurse-health endangered. Genuine responses are required to fulfil nurses' moral obligations to their patients as well as to their nurse-colleagues. Guided by core elements of relational ethics, the influences of nursing organizational responses along with the practice environment in shaping the situation are contemplated. This approach identifies the importance of consistency with nursing values, acknowledges nurses interdependence, and addresses the role of nursing organization as moral agent. By examining the relational space, the tension between what appears to be opposing moral responsibilities may be healed. Ongoing discourse to identify authentic actions for the professional practice issue of nursing under the influence is called upon.

The American Organization of Nurse Executives System CNE task force: a work in progress.

PubMed

Rudisill, Pamela T; Thompson, Pamela A

2012-01-01

Health care is a complex industry, consequently requiring a diverse group of health care executives leading initiatives for efficiency and effectiveness in patient care delivery. Value-based purchasing and pay for performance are at the top of the list for indicators of success, and many hospitals are merging into health care systems. The role of the system chief nurse executive is an evolving role to lead health care systems in clinical, operational, patient safety, and patient satisfaction processes and outcomes. The American Organization of Nurse Executives, being the voice for nursing leadership, convened a group of system chief nurse executives to address the role, function, and competencies needed for this significant and emerging role in health care. This article describes the role statement and system chief nurse executive competencies needed for success in the role. In addition, the next steps for addressing the needs of this group will be outlined in this article.

Nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders.

PubMed

Kurki, Marjo; Anttila, Minna; Koivunen, Marita; Marttunen, Mauri; Välimäki, Maritta

2018-09-01

Internet-based applications are potentially useful and effective interventions to reach and support adolescents with mental health problems. Adolescents' commitment to the use of a new Internet-based intervention is closely related to the support they receive from healthcare professionals. This study describes nurses' experiences of the use of an Internet-based support system for adolescents with depressive disorders. Qualitative descriptive study design including individual interviews with nine nurses at two psychiatric outpatient clinics. The Technology Acceptance Model (TAM) was used as the theoretical background of the study. Nurses described several benefits of using the Internet-based support system in the care of adolescents with depressive disorders if the nurses integrate it into daily nursing practices. As perceived disadvantages the nurses thought that an adolescent's mental status might be a barrier to working with the support system. Perceived enablers could be organizational support, nurses' attitudes, and technology-related factors. Nurses' attitudes were identified as a barrier to supporting adolescents' use of the Internet-based support system. The findings suggest that the implementation plan and support from the organization, including that from nurse managers, are crucial in the process of implementing a technology-based support system.

The Meaning of Visual Thinking Strategies for Nursing Students

ERIC Educational Resources Information Center

Moorman, Margaret M.

2013-01-01

Nurse educators are called upon to provide creative, innovative experiences for students in order to prepare nurses to work in complex healthcare settings. As part of this preparation, teaching observational and communication skills is critical for nurses and can directly affect patient outcomes. Visual thinking strategies (VTS) are a teaching…

Who would want to be a nurse? Violence in the workplace--a factor in recruitment and retention.

PubMed

Jackson, D; Clare, J; Mannix, J

2002-01-01

In a climate of a declining nursing workforce where violence and hostility is a part of the day-to-day lives of most nurses, it is timely to name violence as a major factor in the recruitment and retention of registered nurses in the health system. Workplace violence takes many forms such as aggression, harassment, bullying, intimidation and assault. Violent acts are perpetrated against nurses from various quarters including patients, relatives, other nurses and other professional groups. Research suggests that nurse managers are implicated in workplace violence and bullying. Furthermore, there may be a direct link between episodes of violence and aggression towards nurses and sick leave, burnout and poor recruitment and retention rates. This paper explores what is known about workplace violence as it affects nurses, and calls for managerial support and policy to act to improve work environments for all nurses.

Is alarm calling risky? Marmots avoid calling from risky places.

PubMed

Collier, Travis C; Blumstein, Daniel T; Girod, Lewis; Taylor, Charles E

2010-12-01

Alarm calling is common in many species. A prevalent assumption is that calling puts the vocalizing individual at increased risk of predation. If calling is indeed costly, we need special explanations for its evolution and maintenance. In some, but not all species, callers vocalize away from safety and thus may be exposed to an increased risk of predation. However, for species that emit bouts with one or a few calls, it is often difficult to identify the caller and find the precise location where a call was produced. We analyzed the spatial dynamics of yellow-bellied marmot (Marmota flaviventris) alarm calling using an acoustic localization system to determine the location from which calls were emitted. Marmots almost always called from positions close to the safety of their burrows, and, if they produced more than one alarm call, tended to end their calling bouts closer to safety than they started them. These results suggest that for this species, potential increased predation risk from alarm calling is greatly mitigated and indeed calling may have limited predation costs.

Is alarm calling risky? Marmots avoid calling from risky places

PubMed Central

Collier, Travis C.; Blumstein, Daniel T.; Girod, Lewis; Taylor, Charles E.

2010-01-01

Alarm calling is common in many species. A prevalent assumption is that calling puts the vocalizing individual at increased risk of predation. If calling is indeed costly, we need special explanations for its evolution and maintenance. In some, but not all species, callers vocalize away from safety and thus may be exposed to an increased risk of predation. However, for species that emit bouts with one or a few calls, it is often difficult to identify the caller and find the precise location where a call was produced. We analyzed the spatial dynamics of yellow-bellied marmot (Marmota flaviventris) alarm calling using an acoustic localization system to determine the location from which calls were emitted. Marmots almost always called from positions close to the safety of their burrows, and, if they produced more than one alarm call, tended to end their calling bouts closer to safety than they started them. These results suggest that for this species, potential increased predation risk from alarm calling is greatly mitigated and indeed calling may have limited predation costs. PMID:21116460

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

PubMed Central

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

2012-01-01

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

Discussion on the Initial Use of Nursing Information Systems Related Factors of Satisfaction.

PubMed

Peng, Shu-Ting; Jhan, Shu-Jina; Chen, Siou-Jia

2016-01-01

Information technological advances to develop health care-related systems, Improve clinical efficiency through introducing information technology, Simplify processes to enhance the quality of nursing care. Study investigated the regional hospital nurses after initial information system the use of satisfaction surveys, Study for unit 50-bit nurse the use questionnaires collection, not satisfied is 30%, For analysis in found to be not satisfied. 1. Aged between 38-50 years old. 2. The operating practices are not familiar. 3. Typing is siow the fee time is more long. 4. The slow operation of the system. 5. Information ability is low. For the above reasons and after improvement and guidance dissatisfaction reduced to 5%, multi-enhancing information related to education and training in future, Increase nurses information literacy competency.

Assessment of nursing management and utilization of nursing resources with the RAFAELA patient classification system--case study from the general wards of one central hospital.

PubMed

Rainio, Anna-Kaisa; Ohinmaa, Arto E

2005-07-01

RAFAELA is a new Finnish PCS, which is used in several University Hospitals and Central Hospitals and has aroused considerable interest in hospitals in Europe. The aim of the research is firstly to assess the feasibility of the RAFAELA Patient Classification System (PCS) in nursing staff management and, secondly, whether it can be seen as the transferring of nursing resources between wards according to the information received from nursing care intensity classification. The material was received from the Central Hospital's 12 general wards between 2000 and 2001. The RAFAELA PCS consists of three different measures: a system measuring patient care intensity, a system recording daily nursing resources, and a system measuring the optimal nursing care intensity/nurse situation. The data were analysed in proportion to the labour costs of nursing work and, from that, we calculated the employer's loss (a situation below the optimal level) and savings (a situation above the optimal level) per ward as both costs and the number of nurses. In 2000 the wards had on average 77 days below the optimal level and 106 days above it. In 2001 the wards had on average 71 days below the optimal level and 129 above it. Converting all these days to monetary and personnel resources the employer lost 307,745 or 9.84 nurses and saved 369,080 or 11.80 nurses in total in 2000. In 2001 the employer lost in total 242,143 or 7.58 nurses and saved 457,615 or 14.32 nurses. During the time period of the research nursing resources seemed not have been transferred between wards. RAFAELA PCS is applicable to the allocation of nursing resources but its possibilities have not been entirely used in the researched hospital. The management of nursing work should actively use the information received in nursing care intensity classification and plan and implement the transferring of nursing resources in order to ensure the quality of patient care. Information on which units resources should be allocated to

Student nurses' recognition of early signs of abnormal vital sign recordings.

PubMed

Leonard, Martha M; Kyriacos, Una

2015-09-01

There is increasing urgency for nurses to recognize early signs of deterioration in patients and to take appropriate action to prevent serious adverse effects. To assess respondents' ability to identify abnormal recordings for respiratory and heart rate, oxygen saturation level, systolic blood pressure, level of consciousness, urinary output and normal temperature. A descriptive observational survey. A nursing college in Cape Town, South Africa. A sample of 77/212 (36.3%) fourth year students. A self-administered adapted questionnaire was employed to collect demographic data and respondents' selections of recorded physiological values for the purpose of deciding when to call for more skilled help. The median age for 62/77 (80.5%) of the respondents was 25years; 3/76 (3.9%) had a previous certificate in nursing. Most respondents were female (66/76, 85.7%). Afrikaans was the first language preference of 33 (42.9%) respondents, followed by isiXhosa (31/77, 40.3%) and English (10/77, 13.0%). Most respondents (48/77, 62.3%) recognized a normal temperature reading (35-38.4°C). However, overall there would have been delays in calling for more skilled assistance in 288/416 (69.2%) instances of critical illness for a high-score MEWS of 3 and in 226/639 (35.4%) instances at a medium-score MEWS of 2 for physiological parameters. In 96/562 (17.1%) instances, respondents would have called for assistance for a low-score MEWS of 1. Non-recognition of deterioration in patients' clinical status and delayed intervention by nurses has implications for the development of serious adverse events. The MEWS is recommended as a track-and-trigger system for nursing curricula in South Africa and for implementation in practice. Copyright © 2015. Published by Elsevier Ltd.

Implications of global budget payment system on nursing home costs.

PubMed

Di Giorgio, Laura; Filippini, Massimo; Masiero, Giuliano

2014-04-01

Pressure on health care systems due to the increasing expenditures of the elderly population is pushing policy makers to adopt new regulation and payment schemes for nursing home services. We consider the behavior of nonprofit nursing homes under different payment schemes and empirically investigate the implications of prospective payments on nursing home costs under tightly regulated quality aspects. To evaluate the impact of the policy change introduced in 2006 in Southern Switzerland - from retrospective to prospective payment - we use a panel of 41 homes observed over a 10-years period (2001-2010). We employ a fixed effects model with a time trend that is allowed to change after the policy reform. There is evidence that the new payment system slightly reduces costs without impacting quality. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema.

PubMed

Armer, Jane M; Shook, Robin P; Schneider, Melanie K; Brooks, Constance W; Peterson, Julie; Stewart, Bob R

2009-10-01

This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency.

Enhancing Supportive-Educative Nursing Systems to Reduce Risk of Post-Breast Cancer Lymphedema

PubMed Central

Armer, Jane M.; Shook, Robin P.; Schneider, Melanie K; Brooks, Constance W.; Peterson, Julie; Stewart, Bob R

2010-01-01

This study describes the use of data regarding self-care agency to enhance a supportive-educative nursing system for breast cancer survivors to reduce the risk of developing lymphedema post surgery. Impetus for this study came from the analysis of participant feedback from a parent study (Lance Armstrong Foundation pilot study) that sought to plan an educational program for nurses that will improve their supportive-educative nursing system when working with breast cancer survivors. The goal is to enable these women to reduce the risk of lymphedema post surgery. The parent study examined a bundled behavioral-educative intervention, which included standard lymphedema education coupled with Modified Manual Lymph Drainage (MMLD) to reduce the risk of developing lymphedema in newly-diagnosed breast cancer survivors. Based upon the feedback received from the parent study, the research team recognized that many of the participants were not fully following the recommendations of the intervention protocol. In order for nurses to help patients develop self-care agency (SCA) (Orem, 2001) to engage in actions that addressed the self-care requisites associated with post-breast cancer surgery, these nurses needed to refine their intervention skills. Prior to the development of a program for the nurses, the research team conducted a study to explore the state of power related to SCA of the study participants. The information obtained from this was then used in the development of an educational program for bundled intervention. Both motivational interviewing (Miller & Rollnick, 2002) and solution-focused therapy (Berg & DeJong, 1996) were incorporated into the educational program for the research nurse team to strengthen and improve supportive-educative nursing systems. Supportive-educative systems of care that integrate self-care deficit nursing theory, motivational interviewing, and solution-focused therapy can assist patients to develop and sustain self-care agency. PMID

The nurse's odyssey: the professional folktale in New Zealand backblocks nurses' stories, 1910-1915.

PubMed

Wood, Pamela J

2009-06-01

Nurses have a long tradition of storytelling. Nurses in the New Zealand government's Backblocks Nursing Service, established in 1909 for settlers in remote rural areas, related narratives of personal experience in articles, conference papers and letters to their chief nurse that were published in the country's nursing journal. Analysis of the 16 stories published between 1910 and 1915 revealed 14 had a common storyline and structure. Structural elements included a call, arduous journey, arrival and reconnaissance, trial (difficult case or circumstance), resolution and homily. Using a literary folkloristics approach, this article argues that repetition of the story by nurses in different regions traditionalised it as a professional folktale, 'The nurse's odyssey'. It enabled nurses to debrief from difficult cases and write-into-being this new role and practice. Striking differences in the practice setting ensured the story's reportability, while clinical details connected writer and readers through a common professional aesthetic context and strengthened the story's credibility. For the chief nurse who was also a journal editor, publishing the stories allowed her to potentially attract nurses to the service while alerting them to its harsh realities, and show policy-makers the profession's value in meeting new health service needs.

The Game Embedded CALL System to Facilitate English Vocabulary Acquisition and Pronunciation

ERIC Educational Resources Information Center

Young, Shelley Shwu-Ching; Wang, Yi-Hsuan

2014-01-01

The aim of this study is to make a new attempt to explore the potential of integrating game strategies with automatic speech recognition technologies to provide learners with individual opportunities for English pronunciation learning. The study developed the Game Embedded CALL (GeCALL) system with two activities for on-line speaking practice. For…

Implementation of a next-generation electronic nursing records system based on detailed clinical models and integration of clinical practice guidelines.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Chung, Eunja; Lee, Hyunsook

2013-12-01

The purpose of this paper is to describe the components of a next-generation electronic nursing records system ensuring full semantic interoperability and integrating evidence into the nursing records system. A next-generation electronic nursing records system based on detailed clinical models and clinical practice guidelines was developed at Seoul National University Bundang Hospital in 2013. This system has two components, a terminology server and a nursing documentation system. The terminology server manages nursing narratives generated from entity-attribute-value triplets of detailed clinical models using a natural language generation system. The nursing documentation system provides nurses with a set of nursing narratives arranged around the recommendations extracted from clinical practice guidelines. An electronic nursing records system based on detailed clinical models and clinical practice guidelines was successfully implemented in a hospital in Korea. The next-generation electronic nursing records system can support nursing practice and nursing documentation, which in turn will improve data quality.

Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography.

PubMed

Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

2016-09-01

Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse's practices and behavior patterns regarding the health economics. In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. ICU nurses' belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital

The development of an incident event reporting system for nursing students.

PubMed

Chiou, Shwu-Fen; Huang, Ean-Wen; Chuang, Jen-Hsiang

2009-01-01

Incident events may occur when nursing students are present in the clinical setting. Their inexperience and unfamiliarity with clinical practice put them at risk for making mistakes that could potentially harm patients and themselves. However, there are deficiencies with incident event reporting systems, including incomplete data and delayed reports. The purpose of this study was to develop an incident event reporting system for nursing students in clinical settings and evaluate its effectiveness. This study was undertaken in three phases. In the first phase, a literature review and focus groups were used to develop the architecture of the reporting system. In the second phase, the reporting system was implemented. Data from incident events that involved nursing students were collected for a 12-month period. In the third phase, a pre-post trial was undertaken to evaluate the performance of the reporting system. The ASP.NET software and Microsoft Access 2003 were used to create an interactive web-based interface and design a database for the reporting system. Email notifications alerted the nursing student's teacher when an incident event was reported. One year after installing the reporting system, the number of reported incident events increased tenfold. However, the time to report the incident event and the time required to complete the reporting procedures were shorter than before implementation of the reporting system. The incident event reporting system appeared to be effective in more comprehensively reporting the number of incident events and shorten the time required for reporting them compared to traditional written reports.

Use of Narrative Nursing Records for Nursing Research

PubMed Central

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

2012-01-01

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

Factors of accepting pain management decision support systems by nurse anesthetists

PubMed Central

2013-01-01

Background Pain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective. Methods A questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool. Results The results show that perceived information quality (γ=.451, p<.001), computer self-efficacy (γ=.315, p<.01), and organizational structure (γ=.210, p<.05), both significantly impact nurse anesthetists’ perceived usefulness of PM-DSS. Information quality (γ=.267, p<.05) significantly impacts nurse anesthetists’ perceptions of PM-DSS ease of use. Furthermore, both perceived ease of use (β=.436, p<.001, R2=.487) and perceived usefulness (β=.443, p<.001, R2=.646) significantly affected nurse anesthetists’ PM-DSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated. Conclusions The findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development. PMID:23360305

Clinical nurse specialist education: actualizing the systems leadership competency.

PubMed

Thompson, Cathy J; Nelson-Marten, Paula

2011-01-01

The purpose of this article was to show how sequenced educational strategies aid in the acquisition of systems leadership and change agent skills, as well as other essential skills for professional clinical nurse specialist (CNS) practice. Clinical nurse specialist education offers the graduate student both didactic and clinical experiences to help the student transition into the CNS role. Clinical nurse specialist faculty have a responsibility to prepare students for the realities of advanced practice. Systems leadership is an integral competency of CNS practice. The contemporary CNS is to be a leader in the translation of evidence into practice. To assist students to acquire this competency, all CNS students are expected to use research and other sources of evidence to identify, design, implement, and evaluate a specific practice change. Anecdotal comments from students completing the projects are offered. Student projects have been focused in acute and critical care, palliative care, and adult/gerontologic health clinical settings; community outreach has been the focus of a few change projects. Examples of student projects related to the systems leadership competency and correlated to the spheres of influence impacted are presented.

[Aromatherapy and nursing: historical and theoretical conception].

PubMed

Gnatta, Juliana Rizzo; Kurebayashi, Leonice Fumiko Sato; Turrini, Ruth Natalia Teresa; Silva, Maria Júlia Paes da

2016-02-01

Aromatherapy is a Practical or Complementary Health Therapy that uses volatile concentrates extracted from plants called essential oils, in order to improve physical, mental and emotional well-being. Aromatherapy has been practiced historically and worldwide by nurses and, as in Brazil is supported by the Federal Nursing Council, it is relevant to discuss this practice in the context of Nursing through Theories of Nursing. This study of theoretical reflection, exploratory and descriptive, aims to discuss the pharmacognosy of essential oils, the historical trajectory of Aromatherapy in Nursing and the conceptions to support Aromatherapy in light of eight Nursing Theorists (Florence Nightingale, Myra Levine, Hildegard Peplau, Martha Rogers, Callista Roy, Wanda Horta, Jean Watson and Katharine Kolcaba), contributing to its inclusion as a nursing care practice.

A nursing theory of personal system empathy: interpreting a conceptualization of empathy in King's interacting systems.

PubMed

Alligood, M R; May, B A

2000-07-01

This article presents a theory of empathy discovered through rational hermeneutic interpretation within King's personal system. Personal system concepts from King's general systems framework include perception, self, growth and development, body image, space, time, and learning. Propositions for each concept in the personal system were explicated and a theory of nursing empathy was developed. This nursing theory proposes that empathy organizes perceptions; facilitates awareness of self and others; increases sensitivity; promotes shared respect, mutual goals, and social awareness; cultivates understanding of individuals within a historical and social context; and affects learning.

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

PubMed

Remus, Sally; Kennedy, Margaret Ann

2012-12-01

In a recent brief to the Canadian Nurses Association's National Expert Commission on the Health of Our Nation, the Academy of Canadian Executive Nurses (ACEN) discussed leadership needs in the Canadian healthcare system, and promoted the pivotal role of nursing executives in transforming Canada's healthcare system into an integrated patient-centric system. Included among several recommendations was the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. This paper focuses on an emerging "avant-garde executive leadership competency" recommended for today's health leaders to guide health system transformation. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive. The authors of this paper propose that distinct nursing informatics competencies are required to augment traditional executive skills to support transformational outcomes of safe, integrated, high-quality care delivery through knowledge-driven care. International trends involving nursing informatics competencies and the evolution of new corporate informatics roles, such as chief nursing informatics officers (CNIOs), are demonstrating value and advanced transformational leadership as nursing executive roles that are informed by clinical data. Copyright © 2013 Longwoods Publishing.

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

PubMed

Pobocik, Tamara

2015-01-01

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

Social inclusion/exclusion as matters of social (in)justice: a call for nursing action.

PubMed

Yanicki, Sharon M; Kushner, Kaysi E; Reutter, Linda

2015-06-01

Social inclusion/exclusion involves just/unjust social relations and social structures enabling or constraining opportunities for participation and health. In this paper, social inclusion/exclusion is explored as a dialectic. Three discourses--discourses on recognition, capabilities, and equality and citizenship--are identified within Canadian literature. Each discourse highlights a different view of the injustices leading to social exclusion and the conditions supporting inclusion and social justice. An Integrated Framework for Social Justice that incorporates the three discourses is developed and used to critique the dominant focus on distributive justice within foundational Canadian nursing documents. We propose a broader conceptualization of social (in)justice that includes both relational and structural dimensions. Opportunities for multilevel interventions to promote social justice are identified. This framework is congruent with nursing's moral imperative to promote health equity and with the multiple roles played by nurses to promote social justice in everyday practice. © 2014 John Wiley & Sons Ltd.

NursingQuest: supporting an analysis of nursing issues.

PubMed

Bassendowski, Sandra L

2007-02-01

With the development and use of new strategies, practices, applications, and resources in technology, the teaching and learning context is shifting. Nurse educators are challenged to create instructional strategies that appeal to the newer generation of students and have the potential to enhance learning. Effective learning programs for these students require new digital communication skills, new pedagogies, and new practices. Nursing students should not be seeking the right answer as much as they should be seeking appropriate information and then developing approaches to issues or resolutions for problems. The focus of the teaching and learning context is shifting from the individual to the group, with the purpose of constructing new knowledge from available information. This article discusses the value of WebQuest activities as inquiry-oriented strategies and the process of adapting the WebQuest format for the development of a strategy called NursingQuest.

Interpersonal violence issues in the nursing classroom.

PubMed

Gagan, Mary Jo

2003-03-01

Interpersonal violence in the United States has been called a health issue of epidemic proportions (Rudman & Alpert, 2000). Reports of interpersonal violence appear daily in popular media, and specific cases have been sensationalized. The nursing profession traditionally has attempted to respond to major health issues through education, political activity, and direct patient care. So, what have nurse educators done to prepare nurses to address this issue in their clinical practices and communities?

Qualitative exploration of nurses' decisions to activate rapid response teams.

PubMed

Astroth, Kim S; Woith, Wendy M; Stapleton, Stephen J; Degitz, R Joseph; Jenkins, Sheryl H

2013-10-01

To identify barriers and facilitators to nurses' decisions regarding activation of rapid response teams (RRTs) in hospitals. Hospitalised patients in the United States who experience cardiopulmonary arrest seldom recover. Most of these patients show signs of clinical deterioration prior to cardiopulmonary arrest. RRTs have been shown to decrease the incidence of cardiopulmonary arrest by bringing needed resources to unstable patients. Despite the evidence in support of the activation of RRTs, nurses do not always use this resource. Nurses' decisions to activate or not to activate the RRT are not clearly understood. We used a qualitative design for this study. A purposive sample of 15 medical/surgical nurses was recruited from a small medical centre in the Midwest. Researchers used semistructured, open-ended questions to elicit subject responses regarding facilitators and barriers to activating RRTs. Themes emerged and were categorised as facilitators and barriers to calling the RRT. Facilitators and barriers were then subdivided into distinct subthemes: RRT characteristics and unit culture. The expertise of the RRT members and support and encouragement from nursing unit colleagues and leaders emerged as two potential facilitators. Communication of the RRT members and calling the physician first emerged as two potential barriers. We also identified educational factors that were not clearly facilitators or barriers to calling the RRT. Further study is needed using quantitative designs with larger sample sizes. Nurses can build upon knowledge of facilitators and barriers related to RRT characteristics and nursing unit culture. © 2013 Blackwell Publishing Ltd.

Recent Developments in Interactive and Communicative CALL: Hypermedia and "Intelligent" Systems.

ERIC Educational Resources Information Center

Coughlin, Josette M.

Two recent developments in computer-assisted language learning (CALL), interactive video systems and "intelligent" games, are discussed. Under the first heading, systems combining the use of a computer and video disc player are described, and Compact Discs Interactive (CDI) and Digital Video Interactive (DVI) are reviewed. The…

Development and Evaluation of a Systems Thinking Education Strategy for Baccalaureate Nursing Curriculum: A Pilot Study.

PubMed

Fura, Louise A; Wisser, Kathleen Z

Nurse educators are charged to develop and evaluate curricula on systems thinking to prepare future nurses to provide safe nursing care. The goal of this pilot study was to design and evaluate a four-hour educational strategy that prepares future professional nurses to use systems thinking approaches in the delivery of safe patient care. This study exposed prelicensure baccalaureate nursing students to systems thinking principles, which included didactic and experiential activities. A descriptive design was used to determine the effect of an on-campus educational strategy. A paired samples t-test revealed statistical significance from pretest to posttest.

Nursing's next advance: an internal classification for nursing practice.

PubMed

Clark, J; Lang, N

1992-01-01

An International Classification of Nursing Practice (ICNP) is needed to support the processes of nursing practice and advance the knowledge necessary for cost-effective delivery of quality nursing care. Below, the authors present their case for developing such a system that will provide nursing with a nomenclature, a language and a classification that can be used to describe and organize nursing data. It is their belief that this landmark project is achievable and that ICN should lead the work in collaboration with its member associations, the World Health Organization and key national, international, governmental and nongovernmental groups. But to ensure that the system will be adaptable across borders, nurses and organizations are being encouraged to share their ideas and research on such a system.

The RAFAELA system: a workforce planning tool for nurse staffing and human resource management.

PubMed

Fagerström, Lisbeth; Lønning, Kjersti; Andersen, Marit Helen

2014-05-01

The RAFAELA system was developed in Finland during the 1990s to help with the systematic and daily measurement of nursing intensity (NI) and allocation of nursing staff. The system has now been rolled out across almost all hospitals in Finland, and implementation has started elsewhere in Europe and Asia. This article describes the system, which aims to uphold staffing levels in accordance with patients' care needs, and its structure, which consists of three parts: the Oulu Patient Classification instrument; registration of available nursing resources; and the Professional Assessment of Optimal Nursing Care Intensity Level method, as an alternative to classical time studies. The article also highlights the benefits of using a systematic measurement of NI.

The Clinical Nurse Leader--new nursing role with global implications.

PubMed

Baernholdt, M; Cottingham, S

2011-03-01

This paper describes the development of the Clinical Nurse Leader (CNL ©) role and education, the CNL's impact and potential to improve quality globally. The need for clinical nurse leadership to improve the quality of health care systems while controlling costs is recognized in reports internationally. In the USA, a new nursing role, the CNL, was developed in response to such reports. CNLs are master's level nurse graduates (although not necessarily recruited from a nursing background) with the skills and knowledge to create change within complex systems and improve outcomes while they remain direct care providers. This innovative role can be adapted worldwide to improve the quality of health care systems. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

The globalization of the nursing workforce: Pulling the pieces together.

PubMed

Jones, Cheryl B; Sherwood, Gwen D

2014-01-01

The "globalization" of health care creates an increasingly interconnected workforce spanning international boundaries, systems, structures, and processes to provide care to and improve the health of peoples around the world. Because nurses comprise a large sector of the global health workforce, they are called upon to provide a significant portion of nursing and health care and thus play an integral role in the global health care economy. To meet global health care needs, nurses often move within and among countries, creating challenges and opportunities for the profession, health care organizations, communities, and nations. Researchers, policy makers, and industry and academic leaders must, in turn, grapple with the impacts of globalization on the nursing and health care workforce. Through this special issue, several key areas for discussion are raised. Although far from exhaustive, our intent is to expand and stimulate intra- and interprofessional conversations raising awareness of the issues, uncover unanticipated consequences, and offer solutions for shaping the nursing and health care workforce of the future. Copyright © 2014 Elsevier Inc. All rights reserved.

Multiple sclerosis pathways: an innovative nursing role in disease management.

PubMed

Madonna, M G; Keating, M M

1999-12-01

Multiple sclerosis (MS), a chronic disease of the central nervous system, is characterized by a variable and unpredictable course. The most common pattern of the disease is the relapsing-remitting form in which clearly defined relapses (also called exacerbations) are followed by complete or incomplete recovery. Interferon beta-1b (Betaseron), a drug that affects the natural course of the disease, was developed for the treatment of relapsing-remitting MS. Multiple Sclerosis Pathways (MSP), a disease management program, was developed to provide comprehensive and personal support to MS patients taking interferon beta-1b and to serve as an information resource for all people with MS, their families, and healthcare professionals. The MSP program includes personal patient assistance, reimbursement services, a 24-hour nurse hotline, training program, educational resources, and injection supplies. The nurse hotline counselor (NHC) utilizes the nursing process in a unique telephone nursing practice in this program. The positive impact of education and support on adherence to therapy has been validated by training and nurse hotline data.

Cultural Competence Integration in the Nursing Curriculum

ERIC Educational Resources Information Center

Stegman, Boniface C.

2013-01-01

With an increasingly diverse population, it is important to ensure that graduates of nursing programs are able to deliver culturally competent care (Krainovich-Miller et al., 2008; Allen, 2010). This study was undertaken to address this call to include cultural competence integration into nursing curriculum. The purpose of this study was to…

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

PubMed

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

2014-01-01

The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate. © 2014.

Nursing activities score.

PubMed

Miranda, Dinis Reis; Nap, Raoul; de Rijk, Angelique; Schaufeli, Wilmar; Iapichino, Gaetano

2003-02-01

The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and cost-effectiveness studies require the accurate evaluation of nursing activities. The aim of the study was to determine the nursing activities that best describe workload in the intensive care unit and to attribute weights to these activities so that the score describes average time consumption instead of severity of illness. To define by consensus a list of nursing activities, to determine the average time consumption of these activities by use of a 1-wk observational cross-sectional study, and to compare these results with those of the Therapeutic Intervention Scoring System-28. A total of 99 intensive care units in 15 countries. Consecutive admissions to the intensive care units. Daily recording of nursing activities at a patient level and random multimoment recording of these activities. A total of five new items and 14 subitems describing nursing activities in the intensive care unit (e.g., monitoring, care of relatives, administrative tasks) were added to the list of therapeutic interventions in Therapeutic Intervention Scoring System-28. Data from 2,041 patients (6,451 nursing days and 127,951 multimoment recordings) were analyzed. The new activities accounted for 60% of the average nursing time; the new scoring system (Nursing Activities Score) explained 81% of the nursing time (vs. 43% in Therapeutic Intervention Scoring System-28). The weights in the Therapeutic Intervention Scoring System-28 are not derived from the use of nursing time. Our study suggests that the Nursing Activities Score measures the consumption of nursing time in the intensive care unit. These results should be validated in independent databases.

The child welfare system: through the eyes of public health nurses.

PubMed

Schneiderman, Janet U

2005-01-01

This qualitative descriptive study investigates how public health nurses working within the child welfare system view the organization and the organization's effect on their case management practice. Semistructured interviews were conducted utilizing the Bolman-Deal Organizational Model. This model identifies four frames of an organization: symbolic, human resources, political, and structural. A purposive sample of nine nurses and one social worker was selected to participate in comprehensive interviews. Data analysis identified two main themes. The first theme was the presence of organizational structural barriers to providing case management. The second theme was the lack of political influence by the nurses to change the structure of the organization; hence, their skills could be more completely utilized. Public health nurses who work in child welfare will need to systematically analyze their role within the organization and understand how to work in "host settings." Nursing educators need to prepare public health nurses to work in non-health care settings by teaching organizational analysis.

Systems biology for nursing in the era of big data and precision health.

PubMed

Founds, Sandra

2017-12-02

The systems biology framework was previously synthesized with the person-environment-health-nursing metaparadigm. The purpose of this paper is to present a nursing discipline-specific perspective of the association of systems biology with big data and precision health. The fields of systems biology, big data, and precision health are now overviewed, from origins through expansions, with examples of what is being done by nurses in each area of science. Technological advances continue to expand omics and other varieties of big data that inform the person's phenotype and health outcomes for precision care. Meanwhile, millions of participants in the United States are being recruited for health-care research initiatives aimed at building the information commons of digital health data. Implications and opportunities abound via conceptualizing the integration of these fields through the nursing metaparadigm. Copyright © 2017 Elsevier Inc. All rights reserved.

Developing a data dictionary for the irish nursing minimum dataset.

PubMed

Henry, Pamela; Mac Neela, Pádraig; Clinton, Gerard; Scott, Anne; Treacy, Pearl; Butler, Michelle; Hyde, Abbey; Morris, Roisin; Irving, Kate; Byrne, Anne

2006-01-01

One of the challenges in health care in Ireland is the relatively slow acceptance of standardised clinical information systems. Yet the national Irish health reform programme indicates that an Electronic Health Care Record (EHCR) will be implemented on a phased basis. [3-5]. While nursing has a key role in ensuring the quality and comparability of health information, the so- called 'invisibility' of some nursing activities makes this a challenging aim to achieve [3-5]. Any integrated health care system requires the adoption of uniform standards for electronic data exchange [1-2]. One of the pre-requisites for uniform standards is the composition of a data dictionary. Inadequate definition of data elements in a particular dataset hinders the development of an integrated data depository or electronic health care record (EHCR). This paper outlines how work on the data dictionary for the Irish Nursing Minimum Dataset (INMDS) has addressed this issue. Data set elements were devised on the basis of a large scale empirical research programme. ISO 18104, the reference terminology for nursing [6], was used to cross-map the data set elements with semantic domains, categories and links and data set items were dissected.

Exploration of the facilitators of and barriers to work engagement in nursing.

PubMed

Freeney, Yseult M; Tiernan, Joan

2009-12-01

Engagement is couched as the opposite to burnout and while there have been numerous studies that have supported the relationship between organizational antecedents and employee engagement, nurse engagement is still inadequately understood. Recent papers in the nursing literature have called for more research on this construct to be conducted with nurses so that nurse leaders can be better informed about the impact of engagement on outcomes for the organization. To explore nurses' experiences of their work environments and to reveal factors in the workplace that may facilitate or act as barriers to nurse engagement. A qualitative methodology was employed with the data from focus groups with a total of 20 nurses working in both general and psychiatric nursing. Facilitators of and barriers to engagement center around six areas of organizational life, namely; workload, control, reward, fairness, community and values. Interventions aimed at fostering engagement are called for and through future research in the area of engagement, it is believed that nurses will gain more positive experiences from their work and subsequently a greater sense of well-being.

Evaluation of Acceptance of Nursing Information System in a German and American Hospital.

PubMed

Vollmer, Anne-Maria; Prokosch, Hans-Ulrich; Evans, Scott; Kuttler, Kathryn

2016-01-01

Nursing Information Systems (NIS) are not well-adopted and accepted in Germany. The evaluation of a NIS deployment in a German University Hospital supports this assumption. A second side study in the US should point out the differences regarding the technical and organizational differences. We use a questionnaire including standardized instruments like the Unified Theory of Acceptance (UTAUT). Results indicated that nurses in Germany compared to in the US do not use nursing process documentation to the same extent. The main reasons behind the low usage in comparison with the US are deficits in ease-of-use, system performance and the high expenditure of time and paper work for charting nursing plans.

Immunisation hotline calls as five-in-one vaccine introduced.

PubMed

Fisher-Jeffes, Lisa; Finlay, Fiona

2006-04-01

Announcement of the introduction of the five-in-one vaccine (DTaP/IPV/Hib) into the primary immunisation schedule was made on 9 August 2004. In this study all calls to the immunisation hotline were recorded between 9 August 2004 and 19 November 2004, noting who called and the nature of their enquiry. A total of 208 calls were received during the study period, and of these 23 (11.1%) related to the new vaccine. Calls were from parents (10/23, 43%), health visitors (9/23, 39%) and practice nurses (3/23, 13%). A variety of themes were covered in calls including local availability of the five-in-one vaccine, vaccine safety, mercury content and efficacy. Calls not connected with the new vaccine concerned mostly adolescent MMR (17.3%) as there was a local mumps epidemic. Others related to clarification of a child's immunisation status (13.5%), primary MMR immunisation (13.5%), vaccination scheduling or administration difficulties (12%), other schedule (12.5%) and non-schedule vaccines (2.4%), vaccine reactions (2.4%), travel vaccines (6%), BCG (6%), and a few miscellaneous queries (3%). Overall questions about the new five-in-one vaccine accounted for an extra 23 calls to the immunisation hotline during the study period (11.1% of calls).

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

PubMed

Poe, Laura

2008-01-01

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

Motivating factors among Iranian nurses

PubMed Central

Negarandeh, Reza; Dehghan-Nayeri, Nahid; Ghasemi, Elham

2015-01-01

Background: One of the most important challenges of Iranian health care system is “quality of care,” and it is assumed that motivated nurses are more ready to provide better care. There are limited studies investigating Iranian nurses’ motivations; however, factors which motivate them have not been studied yet. Identifying the motivating factors enables nurse managers to inspire nurses for continuous quality improvement. The aim of this study was to identify motivating factors for Iranian hospital nurses. Materials and Methods: This is a cross-sectional descriptive study in which 310 nurses working at 14 hospitals of Tehran University of Medical Sciences were selected by proportionate stratified random sampling. Data were collected in 2010 by a researcher-developed questionnaire. Descriptive statistics and independent t-test, analysis of variance, Tukey post-hoc test, Chi-Square and Fisher's exact test were used for statistical analysis by Statistical Package for Social Sciences (SPSS) version 16. Results: The mean score of motivation was 90.53 ± 10.76 (range: 59–121). Four motivating factors including “career development” (22.63 ± 5.66), “job characteristics” (34.29 ± 4), “job authority” (18.48 ± 2.79), and “recognition” (15.12 ± 2.5) were recognized. The least mean of the motivation score, considering the number of items, was 3.23 for career development, while the highest mean was 3.81 for job characteristics. Conclusions: The findings showed that motivation of nurses was at a medium level, which calls for improvement. The factors that have the greatest potential to motivate nurses were identified in this study and they can help managers to achieve the goal of continuous quality improvement. PMID:26257797

Caring Across the Continuum: A Call to Nurse Leaders to Manifest Values Through Action With Community Outreach.

PubMed

Dyess, Susan MacLeod; Opalinski, Andra; Saiswick, Kim; Fox, Valerie

2016-01-01

As health reform continues to advance, there is a need for nurse leaders to broaden their perspective related to possible nursing practice models and potential community partners in order to successfully address caring, accomplish the triple aim mandate, and achieve suitable metrics for maximum reimbursement. Intentional efforts must be made by nurse leaders to maximize caring and ensure that professional nurses are responding to the key drivers shifting health care delivery in the 21st century. Academic-practice collaboration (APC) and community-based participatory action research (CBPAR) align well. Together, they provide an ideal mechanism to pursue endeavors that extend evidence for caring services across the health care continuum. One APC/CBPAR model for community outreach that can maximize individual and population health outcomes is highlighted in this article. Furthermore, useful action steps are offered that could be taken by a nurse leader to develop and maintain any form of APC/CBPAR in order to manifest values through caring action across the health care continuum.

Refining process of nursing skill movie manual by peer comments of social network system.

PubMed

Majima, Yukie; Maekawa, Yasuko; Shimada, Satoshi; Izumi, Takako

2014-01-01

The nursing practical knowledge represented by nursing skill is highly tacit and is therefore difficult to verbalize. The purpose of this study is to build a new learning community for nursing education (nursing social e-learning model) that is refined and developed autonomously and continuously. We used the social network system (SNS) that can be participated in a variety of stakeholder of medical personnel in order to hear comments for the content of learning to practice nursing skill. We had the nurses make the nursing skill movie manual. Through this process to get the opinions about the movie contents from others, we inspected what kind of opinions and feelings occurred to the nurses. As a result, the nurses were able to see objectively the own nursing skills, to do self-reflection. They had the awareness to improve the nursing skills.

Growing gratitude in undergraduate nursing students: Applying findings from social and psychological domains to nursing education.

PubMed

Fournier, Ann; Sheehan, Caryn

2015-12-01

Millennial students are often characterized as technology focused multitaskers, yet young nursing students are expected to focus on and thoughtfully engage with the person at the center of their caring efforts. Developing gratitude practices requires quiet contemplation and focus. Cultivating an attitude of gratitude in millennial nursing students may be one avenue to address concerns surrounding the provision of relationship based person-centered care by young nurses. In other disciplines, gratitude work has been studied extensively and is associated with several positive outcomes. Assignments included in most nursing programs can easily be modified to include a gratitude focus. Examples of gratitude assignments and the student reflection of these assignments are included here as a call for nurse educators to further study this concept. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

DTIC Science & Technology

1986-03-01

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

76 FR 63356 - Proposed Information Collection (Locality Pay System for Nurses and Other Health Care Personnel...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... (Locality Pay System for Nurses and Other Health Care Personnel) Activity; Comment Request AGENCY: Veterans... to determine locality pay rates for nurses at VA facilities. DATES: Written comments and... forms of information technology. Title: Locality Pay System for Nurses and Other Health Care Personnel...

Cultivating nursing leadership for our envisioned future.

PubMed

Galuska, Lee A

2012-01-01

Nurses have been called upon to lead and partner in the transformation of health care. Leadership is a component of the scope of nursing practice; however, the optimal approach to development of leadership competency has not been established. A metasynthesis of qualitative studies on leadership development was conducted to enhance an understanding of conditions that nurses reported to support or hinder their development as leaders. Noblit and Hare's approach was used for the metasynthesis process. Three overarching themes emerged. Opportunity structure, the relationship factor, and organizational culture are essential factors contributing to the successful cultivation of leadership competencies in nurses.

Twenty years of staffing, practice environment, and outcomes research in military nursing.

PubMed

Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski

Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.

Impact of a computerized physician order entry system on nurse-physician collaboration in the medication process.

PubMed

Pirnejad, Habibollah; Niazkhani, Zahra; van der Sijs, Heleen; Berg, Marc; Bal, Roland

2008-11-01

Due to their efficiency and safety potential, computerized physician order entry (CPOE) systems are gaining considerable attention in in-patient settings. However, recent studies have shown that these systems may undermine the efficiency and safety of the medication process by impeding nurse-physician collaboration. To evaluate the effects of a CPOE system on the mechanisms whereby nurses and physicians maintain their collaboration in the medication process. SETTING AND METHODOLOGY: Six internal medicine wards at the Erasmus Medical Centre were included in this study. A questionnaire was used to record nurses' attitudes towards the effectiveness of the former paper-based system. A similar questionnaire was used to evaluate nurses' attitudes with respect to a CPOE system that replaced the paper-based system. The data were complemented and triangulated through interviews with physicians and nurses. Response rates for the analyzed questions in the pre- and post-implementation questionnaires were 54.3% (76/140) and 52.14% (73/140). The CPOE system had a mixed impact on medication work: while it improved the main non-supportive features of the paper-based system, it lacked its main supportive features. The interviews revealed more detailed supportive and non-supportive features of the two systems. A comparison of supportive features of the paper-based system with non-supportive features of the CPOE system showed that synchronisation and feedback mechanisms in nurse-physician collaborations have been impaired after the CPOE system was introduced. This study contributes to an understanding of the affected mechanisms in nurse-physician collaboration using a CPOE system. It provides recommendations for repairing the impaired mechanisms and for redesigning the CPOE system and thus for better supporting these structures.

Reviewing Tribunal cases and nurse behaviour: putting empathy back into nurse education with Bloom's taxonomy.

PubMed

Doyle, Kerrie; Hungerford, Catherine; Cruickshank, Mary

2014-07-01

Recent events in the UK and Australia have shown how poor patient outcomes are achieved when the behaviour of nurses lacks empathy. The UK's Francis Inquiry and the Keogh Report both call for an increase in the 'caring and compassion' of health care workers. A review of cases presented to the nurses' disciplinary tribunal in New South Wales' (Australia) also suggests that the majority of complaints against nurses in this jurisdiction is the result of callousness or lack of empathy. Such events reinforce the need for nurse educators to support nursing students to develop the affective attributes of caring and empathy. This paper considers how to raise the awareness of undergraduate students as a first step to developing empathy by using Bloom's Taxonomy of Educational Objectives; and includes a description of how to facilitate interactions with undergraduate nursing students about caring with empathy. Enculturating empathy is an evidence-based method of increasing compassionate care in health organisations generally. Copyright © 2014 Elsevier Ltd. All rights reserved.

Advancing diversity through inclusive excellence in nursing education.

PubMed

Bleich, Michael R; MacWilliams, Brent R; Schmidt, Bonnie J

2015-01-01

Nurse leaders call for a more diverse nursing workforce, but too few address the concept of inclusion as a recruitment and retention strategy or as part of improving the academic learning milieu. This article addresses organizational considerations of diversity and inclusion as part of the agenda established by the Association of American Colleges and Universities for inclusive excellence, building on the idea that academic environments only become excellent when an inclusive climate is reached. Six organizational strategies to inclusion are presented from the authors' experiences, some structural and others behavioral: admissions processes, invisibility, absence of community, promotion and tenure, exclusion, and tokenism. A call for structural and behavioral adaptions within nursing education to advance an inclusive excellence agenda is presented. Copyright © 2015 Elsevier Inc. All rights reserved.

Use of a telephone nursing line in a pediatric neurology clinic: one approach to the shortage of subspecialists.

PubMed

Letourneau, Megan A; MacGregor, Daune L; Dick, Paul T; McCabe, E J; Allen, Anita J; Chan, Valerie W; MacMillan, Lynn J; Golomb, Meredith R

2003-11-01

There are not enough pediatric neurologists to meet the many needs of pediatric neurology patients. The Hospital for Sick Children has responded by expanding the nursing role in the pediatric neurology outpatient clinic. The objective of this study was to examine the use of a telephone nursing line in this hospital-based pediatric neurology clinic. A cross-sectional study was performed on all telephone call records collected during a 2-week study period. Each initial incoming call concerning a patient was counted as an index call. Associations between clinic type or diagnosis and length of telephone calls were assessed using the chi(2) test. A total of 208 index calls were received, generating a total of 597 incoming and outgoing calls. The most common clinic types were Epilepsy clinic (35.6%) and General Neurology clinic (32.7%), and the most common patient diagnoses were epilepsy (63.5%) and developmental delay (45.2%). Most patients were between the ages of 1 and <7 years (33.9%) and 12 and <18 years (32.8%) and male (55.2%). Most calls were made by mothers (57.2%) to ask about medical administrative issues (28.4%) and/or symptoms (27.9%). Physicians were notified for 47.1% of calls; nurses were twice as likely to notify physicians for calls concerning new symptoms (relative risk: 2.1; 95% confidence interval: 1.6-2.7). Most calls required between 1 and 5 minutes (49.0%). Long telephone calls (>10 minutes) were strongly associated with a diagnosis of epilepsy. There is a high demand for the neurology nursing line in our clinic. Most telephone calls and most long telephone calls concerned patients with epilepsy. Nurses managed more than half of all telephone calls without physician assistance. Use of a nursing line can aid in the provision of care to complicated subspecialty patients. Additional strategies are needed to optimize delivery of care to high-need medical populations.