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…

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.

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.

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.

[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.

A 360 degrees evaluation of a night-float system for general surgery: a response to mandated work-hours reduction.

PubMed

Goldstein, Michael J; Kim, Eugene; Widmann, Warren D; Hardy, Mark A

2004-01-01

New York State Code 405 and societal/political pressure have led the RRC and ACGME to mandate strict limitations on resident work hours. In an attempt to meet these limitations, we have switched from the previous Q3 call schedule to a specialized night float (NF) system, the continuity-care system (CCS). The purpose of this CCS is to maximize resident duty time spent on direct patient care, operative experience, and outpatient clinics, while reducing duty hours spent on performing routine tasks and call coverage. The implementation of the CCS is the fundamental step in the restructuring of our residency program. In addition to a change in the call system, we added physician assistants to aid in performing some service tasks. We performed a 360 degrees evaluation of this work in progress. In May 2002, the standard Q3 call system was abolished on the general surgery services at the New York Presbyterian Hospital, Columbia campus. Two dedicated teams were created to provide day and night coverage, a day continuity-care team (DCT) and a night continuity-care team (NCT). The DCTs, consisting of PGY1-5 residents, provide daily in-house coverage from 6 AM to 5 PM with no regular weekday night-call responsibilities. The DCT residents provide Friday night, Saturday, and daytime Sunday call coverage 3 to 4 days per month. The NCT, consisting of 5 PGY1-5 residents, provides nightly continuous care, 5 PM to 6 AM, Sunday through Thursday, with no other weekend call responsibilities. This system creates a schedule with less than 80 duty hours per week, on average, with one 24-hour period off a week, one complete weekend off per month, and no more than 24 hours of consecutive duty time. After 1 year of use, the system was evaluated by a 360 degrees method in which residents, residents' spouses, nurses, and faculty were surveyed using a Likert-type scale. Statistical significance was calculated using the Student t-test. Patient satisfaction was measured both by internal review of a patient complaint database as well as by the Press Ganey patient satisfaction surveys. Twenty-one residents, 10 residents' spouses, 11 general surgery faculty, and 16 nurses were surveyed. Statistically significant findings included reduced resident fatigue noted by all groups (residents, p = 0.01; resident spouses, p = 0.05; faculty, p < 0.0001; nurses, p < 0.0001). Further, residents reported more time for sleep at home (p = 0.0005) and more time for independent reading (p = 0.01). Residents' spouses reported increased availability for family events (p = 0.01). Nurses reported increased availability of residents (p = 0.0002), shorter times to physician identification of patient problems (p = 0.0086), improved resident-nursing communications (p = 0.0096), and increased ease of nursing duties (p < 0.0001). Faculty were the only responders who felt that continuity of patient care suffered with the new system (p = 0.02). The Press Ganey review showed improvement in the quality of care rendered as perceived by patients. The institution of a specialized NF or CCS for in-house coverage of general surgical services in a large metropolitan university hospital has had initial success in meeting the mandated changes in resident work hours. The CCS reduced resident fatigue, improved quality of resident life, and improved patient care as judged by patients and nurse.

Using an integrated information system to reduce interruptions and the number of non-relevant contacts in the inpatient pharmacy at tertiary hospital.

PubMed

Binobaid, Saleh; Almeziny, Mohammed; Fan, Ip-Shing

2017-07-01

Patient care is provided by a multidisciplinary team of healthcare professionals intended for high-quality and safe patient care. Accordingly, the team must work synergistically and communicate efficiently. In many hospitals, nursing and pharmacy communication relies mainly on telephone calls. In fact, numerous studies have reported telephone calls as a source of interruption for both pharmacy and nursing operations; therefore, the workload increases and the chance of errors raises. This report describes the implementation of an integrated information system that possibly can reduce telephone calls through providing real-time tracking capabilities and sorting prescriptions urgency, thus significantly improving traceability of all prescriptions inside pharmacy. The research design is based on a quasi-experiment using pre-post testing using the continuous improvement approach. The improvement project is performed using a six-step method. A survey was conducted in Prince Sultan Military Medical City (PSMMC) to measure the volume and types of telephone calls before and after implementation to evaluate the impact of the new system. Beforehand of the system implementation, during the two-week measurement period, all pharmacies received 4466 calls and the majority were follow-up calls. Subsequently of the integrated system rollout, there was a significant reduction ( p  > 0.001) in the volume of telephone calls to 2630 calls; besides, the calls nature turned out to be more professional inquiries ( p  > 0.001). As a result, avoidable interruptions and workload were decreased.

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.

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.

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.

Leading lights.

PubMed

2001-06-01

Christine Hancock led a delegation of nurses to Surrey Ambulance Service NHS Trust last month as one of her last engagements as RCN general secretary. Leading nurses from across the south east visited the trust, which has established a traffic light system so that A&E nurses divert ambulance crews from busy units. Trust managers also hope to cut referrals to A&E by 40 per cent by using a 'whole-system' approach to treating patients. (Left to right) RCN council member for Oxford region Debbie Pearman, senior call co-ordinator Linda Tee, Miss Hancock and RCN A&E Nursing Association chair Lynda Holt.

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.

More features, greater connectivity.

PubMed

Hunt, Sarah

2015-09-01

Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

The Effect of Perceiving a Calling on Pakistani Nurses' Organizational Commitment, Organizational Citizenship Behavior, and Job Stress.

PubMed

Afsar, Bilal; Shahjehan, Asad; Cheema, Sadia; Javed, Farheen

2018-03-01

People differ considerably in the way in which they express and experience their nursing careers. The positive effects associated with having a calling may differ substantially based on individuals' abilities to live out their callings. In a working world where many individuals have little to no choice in their type of employment and thus are unable to live out a calling even if they have one, the current study examined how perceiving a calling and living a calling interacted to predict organizational commitment, organizational citizenship behavior, and job stress with career commitment mediating the effect of the interactions on the three outcome variables. The purpose of the study is to investigate the mediating effect of career commitment between the relationships of calling and (a) nurses' attitudes (organizational commitment), (b) behaviors (organizational citizenship behavior), and (c) subjective experiences regarding work (job stress). Using a descriptive exploratory design, data were collected from 332 registered nurses working in Pakistani hospitals. Descriptive analysis and hierarchical regression analysis were used for data analysis. Living a calling moderated the effect of calling on career commitment, organizational citizenship behavior, and job stress, and career commitment fully mediated the effect of calling on organizational commitment, organizational citizenship behavior, and job stress. Increasing the understanding of calling, living a calling, and career commitment may increase nurses' organizational commitment and organizational citizenship behavior and decrease job stress. The study provided evidence to help nursing managers and health policy makers integrate knowledge and skills related to calling into career interventions and help nurses discover their calling.

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.

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 likely to recommend patients for follow-up (OR 3.17, 95% CI 1.18–5.55). Conclusion Nurse characteristics were associated with disposition of triage calls to within practice follow-up. Nurse practitioners or those who reported feeling ‘more prepared’ for the role were more likely to manage the call definitively. Practices considering nurse triage should ensure that nurses transitioning into new roles feel adequately prepared. While standardised training is necessary, it may not be sufficient to ensure successful implementation. PMID:27087294

Enhancing Critical Thinking Via a Clinical Scholar Approach.

PubMed

Simpson, Vicki; McComb, Sara A; Kirkpatrick, Jane M

2017-11-01

Safety, quality improvement, and a systems perspective are vital for nurses to provide quality evidence-based care. Responding to the call to prepare nurses with these perspectives, one school of nursing used a clinical scholar approach, enhanced by systems engineering to more intentionally develop the ability to clinically reason and apply evidence-based practice. A two-group, repeated-measures control trial was used to determine the effects of systems engineering content and support on nursing students' clinical judgment and critical thinking skills. Findings indicated this approach had a positive effects on student's clinical judgment and clinical reasoning skills. This approach helped students view health care issues from a broader perspective and use evidence to guide solution development, enhancing the focus on evidence-based practice, and quality improvement. Intentional integration of an evidence-based, systems perspective by nursing faculty supports development of nurses who can function safely and effectively in the current health care system. [J Nurs Educ. 2017;56(11):679-682.]. Copyright 2017, SLACK Incorporated.

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.

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,…

Helping parents with mental illnesses and their children: a call for family-focused mental health care.

PubMed

Mason, Carolyn; Subedi, Sree

2006-07-01

1. Large numbers of individuals with mental illnesses are parents to minor children. 2. Recommendations to improve services suggest that services provided by the adult mental health system and child service agencies be coordinated. 3. Nursing care intersects both the adult and child systems, and nurses have the expertise to offer a variety of services. 4. There is an urgent need to improve family-focused mental health nursing care to benefit parents with mental illnesses, their children and families, and the overall community and society.

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.

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

Influencing and impacting the profession through governance opportunities.

PubMed

Drenkard, Karen N

2015-01-01

In addition to board leadership of health care organizations and corporations, there are strategic opportunities for nurses to participate in professional association boards and commissions and expert panels. These boards have specific and unique challenges and opportunities, and it is important for nurse leaders to serve in shaping the direction of the profession. Nursing as a profession has an opening to solve many of the care delivery issues that face the country. A strategic contribution to association boards and commissions can influence the health care delivery system changes needed to improve quality of care, access to care, and reducing costs. This article describes similarities and differences of service on association boards and commissions compared with organizational and corporate boards. Through these leadership roles, the larger community can observe influential nurses in an essential role. These leadership opportunities, including membership boards, commissions, and content expert panels, call for a special understanding of those governance structures and the contributions that nurse leaders can make to impact health care. Association and membership organizations have undergone many changes in the past 10 years, and new models of governance and leadership have been called into play. There are challenges and opportunities in serving on these boards and commissions. Maximizing the leadership and governance roles of this type of service is a critical contribution that nurses can make to impact the profession of nursing and the greater health care system.

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.

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.

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.

An Intervention to Improve the Comfort And Satisfaction of Nurses in the Telephone Triage of Child Maltreatment Calls.

PubMed

Hunter, Julie

2015-01-01

Nurses are mandated reporters of actual or suspected child maltreatment or the threat thereof. The purpose of this quality improvement project was to determine the knowledge and comfort of nurses in telephone triage in pediatric clinics when dealing with suspected or actual child abuse calls. Nurses (N = 17) from three pediatric primary care clinics and one specialty care orthopedic clinic were surveyed. Based on results of the survey showing a lack of knowledge and adequate referral resources perceived by the nursing staff, resources and staff education were developed, along with a script for guiding maltreatment calls toward standardization of care. Following the intervention, nurses reported an increased comfort level when doing telephone triage for child maltreatment calls, an increase in knowledge of risk factors for county resources. Further, they reported a substantial shift in opinion about the need for a standardized script when responding to child maltreatment telephone calls. Nurses undertaking telephone triage of high-risk child maltreatment calls can improve their comfort and knowledge through a survey of their needs and directed education and resource development for the management of child maltreatment telephone triage.

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.

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.

Opening the door to coordination of care through teachable moments.

PubMed

Berg, Gregory D; Korn, Allan M; Thomas, Eileen; Klemka-Walden, Linda; Bigony, Marysanta D; Newman, John F

2007-10-01

The challenge for care coordination is to identify members at a moment in time when they are receptive to intervention and provide the appropriate care management services. This manuscript describes a pilot program using inbound nurse advice calls from members to engage them in a care management program including disease management (DM). Annual medical claims diagnoses were used to identify members and their associated disease conditions. For each condition group for each year, nurse advice call data were used to calculate inbound nurse advice service call rates for each group. A pilot program was set up to engage inbound nurse advice callers in a broader discussion of their health concerns and refer them to a care management program. Among the program results, both the call rate by condition group and the correlation between average costs and call rates show that higher cost groups of members call the nurse advice service disproportionately more than lower cost members. Members who entered the DM programs through the nurse advice service were more likely to stay in the program than those who participated in the standard opt-in program. The results of this pilot program suggest that members who voluntarily call in to the nurse advice service for triage are at a "teachable moment" and highly motivated to participate in appropriate care management programs. The implication is that the nurse advice service may well be an innovative and effective way to enhance participation in a variety of care management programs including DM.

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 unstable patients in a shift may be considered in predicting workload. The training of nurses may improve patient safety and decrease demand for clinical procedure. PMID:27583910

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 in a shift may be considered in predicting workload. The training of nurses may improve patient safety and decrease demand for clinical procedure.

Perspectives of Nurses and Patients on Call Light Technology.

PubMed

Galinato, Jose; Montie, Mary; Patak, Lance; Titler, Marita

2015-08-01

Call lights are prevalent in inpatient healthcare facilities across the nation. While call light use directly influences the delivery of nursing care, there remain significant gaps both in research and technology that can affect the quality of care and patient satisfaction. This study examines nurse and patient perceptions of the use of a new call communication solution, Eloquence, in the acute care inpatient setting. Eighteen patients were recruited for the study and participated in individual semistructured interviews during their hospital stay. Eighteen nurses were recruited and participated in focus groups for this study. Qualitative descriptive methods were used to analyze the data. Results revealed themes of usability, improved communication, and suggestions for improvement to the alpha prototype design. After a demonstration of the use and capability of Eloquence, nurse and patient participants found Eloquence as a welcomed advancement in nurse call technology that has the potential to improve workflow and patient outcomes. In addition, the participants also proposed ideas on how to further develop the technology to improve its use.

Safety of clinical and non-clinical decision makers in telephone triage: a narrative review.

PubMed

Wheeler, Sheila Q; Greenberg, Mary E; Mahlmeister, Laura; Wolfe, Nicole

2015-09-01

Patient safety is a persistent problem in telephone triage research; however, studies have not differentiated between clinicians' and non-clinicians' respective safety. Currently, four groups of decision makers perform aspects of telephone triage: clinicians (physicians, nurses), and non-clinicians (emergency medical dispatchers (EMD) and clerical staff). Using studies published between 2002-2012, we applied Donabedian's structure-process-outcome model to examine groups' systems for evidence of system completeness (a minimum measure of structure and quality). We defined system completeness as the presence of a decision maker and four additional components: guidelines, documentation, training, and standards. Defining safety as appropriate referrals (AR) - (right time, right place with the right person), we measured each groups' corresponding AR rate percentages (outcomes). We analyzed each group's respective decision-making process as a safe match to the telephone triage task, based on each group's system structure completeness, process and AR rates (outcome). Studies uniformly noted system component presence: nurses (2-4), physicians (1), EMDs (2), clerical staff (1). Nurses had the highest average appropriate referral (AR) rates (91%), physicians' AR (82% average). Clerical staff had no system and did not perform telephone triage by standard definitions; EMDs may represent the use of the wrong system. Telephone triage appears least safe after hours when decision makers with the least complete systems (physicians, clerical staff) typically manage calls. At minimum, telephone triage decision makers should be clinicians; however, clinicians' safety calls for improvement. With improved training, standards and CDSS quality, the 24/7 clinical call center has potential to represent the national standard. © The Author(s) 2015.

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

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 component of intervention was significantly related to consumer satisfaction. The present study pioneers the way to rate the quality of the advice nurses' interactions with consumers, and lays the groundwork for further investigations of health care provider behavior and consumer outcomes. Further studies are recommended to investigate predictors of consumer satisfaction, and cost-benefit in terms of consumer expenditures of time, funds, and energy.

They answered the call: Nebraska nurses join the ranks in World War II.

PubMed

Schmeiding, Verna E; Anderson, Mary L; Bradley, Eileen

On December 7, 1941, there were fewer than 1,000 nurses in the Army Nurse Corps. That infamous day, 82 of those brave nurses were stationed in Hawaii. Their bravery, leadership and calmness under extreme duress foreshadowed the amazing role nurses would play in World War II. In the months and years that followed Japan's bombing of Pearl Harbor, over 59,000 American nurses would answer the call and join the Army Nurse Corps. Courageous Nebraskan women were among them.

Interdisciplinary collaboration and the electronic medical record.

PubMed

Green, Shayla D; Thomas, Joan D

2008-01-01

To examine interdisciplinary collaboration via electronic medical records (EMRs) with a focus on physicians' perception of nursing documentation. Quality improvement project using a survey instrument. Tertiary care pediatric hospital. Thirty-seven physicians. Physicians perceptions of nursing documentation after EMR implementation Physicians desire nursing documentation with greater clarity and additional information. Physicians indicate checklists alone for patient assessment and intervention data are insufficient for effective nurse/physician collaboration. Narrative nursing summaries are invaluable references that guide medical treatment decisions. Physicians see detailed assessments and well-described interventions of nurses' as critical to their ability to effectively practice medicine. Health care technology is called to develop EMRs that enable nurses to document detailed patient data in a swift and straightforward manner. Joint collaboration between nurses, physicians, and technology specialists is recommended to develop effective EMR systems.

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.

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 of dutch-early-nurse-worry-indicator-score indicators showed higher positive predictive values. Dutch-early-nurse-worry-indicator-score indicators alert in an early stage of deterioration, before reaching the trigger threshold to call a rapid response team and can improve interdisciplinary communication on surgical wards during regular rounds, and when calling for assistance. Dutch-early-nurse-worry-indicator-score structures communication and recording of signs known to be associated with a decline in a patient's condition and can empower nurses to call assistance on the 'worry' criterion in an early stage of deterioration. © 2016 John Wiley & Sons Ltd.

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.

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.

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.

Perspectives of Nurses and Patients on Call Light Technology

PubMed Central

Galinato, Jose; Montie, Mary; Patak, Lance; Titler, Marita

2015-01-01

Call lights are prevalent in inpatient healthcare facilities across the nation. While call light use directly influences the delivery of nursing care, there remain significant gaps both in research and technology that can impact the quality of care and patient satisfaction. This study examines the perception of nurses and patients on the use of a new call communication solution, Eloquence™, in the acute care inpatient setting. Eighteen patients were recruited for the study and participated in individual semi-structured interviews during their hospital stay. Eighteen nurses were recruited and participated in focus groups for this study. Qualitative descriptive methods were used to analyze the data. Results revealed themes of usability, improved communication, and suggestions for improvement to the alpha prototype design. After a demonstration of the use and capability of Eloquence™, nurse and patient participants found Eloquence™ as a welcomed advancement in nurse call technology that has the potential to improve workflow and patient outcomes. In addition, the participants also proposed ideas on how to further develop the technology to improve its use. PMID:26176639

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.

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.

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.

Feeling like a nurse: re-calling the spirit of nursing.

PubMed

Spence, Deborah; Smythe, Elizabeth

2008-12-01

To explore the essential meaning of being a nurse. Nine registered nurses were each asked to write a story of a time when they felt like a nurse. Analysis was informed by Heideggerian hermeneutic philosophy, seeking to reveal the phenomenon of "feeling like a nurse." As part of a workshop on phenomenological methodology, participants were invited to reflect on a personal experience of feeling like a nurse. These documents were analyzed according to the method of van Manen. Participants were kept informed throughout each phase. Feelings announce primordial meaning of feeling like a nurse. Nurses experience the call as mood attuned by an anxiety that creates possibilities for authentic caring. It is a way of being that encompasses watching and acting, doing to and caring for, and taking over and giving back. Moreover, it is after the encounter that the essential meaning is more clearly revealed. We argue that there is value in continuing to question the meaning of "being a nurse." Amid a complex and increasingly technological world, this calls the profession to remember the human encounter at the heart of all nursing.

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.

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.

Chair alarm for patient fall prevention based on gesture recognition and interactivity.

PubMed

Knight, Heather; Lee, Jae-Kyu; Ma, Hongshen

2008-01-01

The Gesture Recognition Interactive Technology (GRiT) Chair Alarm aims to prevent patient falls from chairs and wheelchairs by recognizing the gesture of a patient attempting to stand. Patient falls are one of the greatest causes of injury in hospitals. Current chair and bed exit alarm systems are inadequate because of insufficient notification, high false-alarm rate, and long trigger delays. The GRiT chair alarm uses an array of capacitive proximity sensors and pressure sensors to create a map of the patient's sitting position, which is then processed using gesture recognition algorithms to determine when a patient is attempting to stand and to alarm the care providers. This system also uses a range of voice and light feedback to encourage the patient to remain seated and/or to make use of the system's integrated nurse-call function. This system can be seamlessly integrated into existing hospital WiFi networks to send notifications and approximate patient location through existing nurse call systems.

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.

Calling to Nursing: Concept Analysis.

PubMed

Emerson, Christie

The aims of this article are (a) to analyze the concept of a calling as it relates nursing and (b) to develop a definition of calling to nursing with the detail and clarity needed to guide reliable and valid research. The classic steps described by Walker and Avant are used for the analysis. Literature from several disciplines is reviewed including vocational psychology, Christian career counseling, sociology, organizational management, and nursing. The analysis provides an operational definition of a calling to nursing and establishes 3 defining attributes of the concept: (a) a passionate intrinsic motivation or desire (perhaps with a religious component), (b) an aspiration to engage in nursing practice, as a means of fulfilling one's purpose in life, and (c) the desire to help others as one's purpose in life. Antecedents to the concept are personal introspection and cognitive awareness. Positive consequences to the concept are improved work meaningfulness, work engagement, career commitment, personal well-being, and satisfaction. Negative consequences of having a calling might include willingness to sacrifice well-being for work and problems with work-life balance. Following the concept analysis, philosophical assumptions, contextual factors, interdisciplinary work, research opportunities, and practice implications are discussed.

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

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.

38 CFR 59.50 - Priority list.

Code of Federal Regulations, 2014 CFR

2014-07-01

... systems or features is necessary to remedy a cited threat to the lives or safety of residents and program... utility systems or features; such applications will be prioritized in accordance with the criteria in...) All other projects (e.g., nurse call systems, patient lifts). (ii) Priority group 1—subpriority 2. An...

38 CFR 59.50 - Priority list.

Code of Federal Regulations, 2013 CFR

2013-07-01

... systems or features is necessary to remedy a cited threat to the lives or safety of residents and program... utility systems or features; such applications will be prioritized in accordance with the criteria in...) All other projects (e.g., nurse call systems, patient lifts). (ii) Priority group 1—subpriority 2. An...

The role of a nurse telephone call to prevent no-shows in endoscopy.

PubMed

Childers, Ryan E; Laird, Amy; Newman, Lisa; Keyashian, Kian

2016-12-01

Preventing missed appointments, or "no-shows," is an important target in improving efficient patient care and lowering costs in gastrointestinal endoscopy practices. We aimed to investigate whether a nurse telephone call would reduce no-show rates for endoscopic appointments, and to determine if hiring and maintaining a nurse dedicated to pre-endoscopy phone calls is economically advantageous. Our secondary aim was to identify predictors of no-shows to endoscopy appointments. We hired and trained a full-time licensed nurse to make a telephone call to patients 7 days before their scheduled upper endoscopy or colonoscopy. We compared this intervention with a previous reminder system involving mailed reminders. The effect of the intervention and impact of other predictors of no-shows were analyzed in 2 similar preintervention and postintervention patient cohorts. A mixed effects logistic regression model was used to estimate the association of the odds of being a no-show to the scheduled appointment and the characteristics of the patient and visit. An analysis of costs was performed that included the startup and maintenance costs of the intervention. We found that a nurse phone call was associated with a 33% reduction in the odds of a no-show visit (odds ratio, 0.67; 95% confidence interval, 0.50-0.91), adjusting for gender, age, partnered status, insurer type, distance from the endoscopy center, and visit type. The recovered reimbursement during the study period was $48,765, with net savings of $16,190 when accounting for the maintenance costs of the intervention; this resulted in a net revenue per annum of $43,173. We found that endoscopy practices may increase revenue, improve scheduling efficiency, and maximize resource utilization by hiring a nurse to reduce no-shows. Predictors of no-shows to endoscopy included unpartnered or single patients, commercial or managed care, being scheduled for colonoscopy as opposed to upper endoscopy, and being scheduled for a screening or surveillance colonoscopy. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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.

Nursing work in NHS Direct: constructing a nursing identity in the call-centre environment.

PubMed

Snelgrove, Sherrill Ray

2009-12-01

The introduction of nurse-led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call-centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call-centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional 'hands-on' models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries.

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.

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.

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.

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.

A new venous infusion path monitoring system utilizing electrostatic induced potential.

PubMed

Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Caldwell, W Morton

2008-01-01

A new venous infusion pathway monitoring system has been developed for hospital and home use. The system consists of linear and digital integrated circuits and a low-power 8-bit single chip microcomputer which constantly monitors the infusion pathway intactness. A 330 kHz AC voltage, which is induced on the patient's body by electrostatic coupling from a 330 kHz pulse oscillator, can be recorded by main and reference electrodes wrapped around the infusion polyvinyl chloride tube. If the injection needle or infusion tube becomes detached, then the system detects changes in the induced AC voltages and alerts the nursing station, via the nurse call system or PHS (personal handy phone system).

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 explanation and support of health professionals. Introduction of consumer-activated programmes within rapid response systems appears likely to improve outcomes for patients experiencing deterioration. © 2015 John Wiley & Sons Ltd.

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.

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.

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.

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.

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

PubMed

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

Human capital strategy: talent management.

PubMed

Nagra, Michael

2011-01-01

Large organizations, including the US Army Medical Department and the Army Nurse Corps, are people-based organizations. Consequently, effective and efficient management of the human capital within these organizations is a strategic goal for the leadership. Over time, the Department of Defense has used many different systems and strategies to manage people throughout their service life-cycle. The current system in use is called Human Capital Management. In the near future, the Army's human capital will be managed based on skills, knowledge, and behaviors through various measurement tools. This article elaborates the human capital management strategy within the Army Nurse Corps, which identifies, develops, and implements key talent management strategies under the umbrella of the Corps' human capital goals. The talent management strategy solutions are aligned under the Nurse Corps business strategy captured by the 2008 Army Nurse Corps Campaign Plan, and are implemented within the context of the culture and core values of the organization.

The imperative for new approaches for managing and leading in healthcare for the 21st century--observations from the Canadian Nurses Association's National Expert Commission Experience and Report.

PubMed

McTeer, Maureen

2014-12-01

The Canadian healthcare system must change to meet current and future realities, particularly to respond effectively to changing age and cultural demographics and new medical/scientific technologies. To meet its ongoing policy role, the Canadian Nurses Association established a National Expert Commission in 2011, mandated to prepare a report on healthcare reform and transformation, with a clear focus on the role individual nurses and the nursing profession generally could play in ensuring better health, better care and better value for Canadians. In this paper, Commission co-chair, health law specialist Maureen McTeer, outlines the key findings and recommendations of their final report, titled A Nursing Call to Action: The Health of our Nation, the Future of our Health System which she and co-chair Dr. Marlene Smadu presented originally at the CNA's biennial meeting in Vancouver, in June, 2012. The discussion focuses on the rationale behind the commission's recommendation for a new registered nursing education curriculum and approach to training.

[The nurse's thought for a significant social contribution by the production and use of scientific knowledge].

PubMed

Pépin, Jacinthe

2015-06-01

The social contribution of nurses to the health of the population is mainly defined by the knowledge supporting their actions. Conceptualization in nursing guides the production and utilisation of scientific knowledge within the discipline. The purpose of this paper is to present the recent thoughts on nursing theory and to provide some strategies to integrate them within the activities of knowledge mobilization, in practice, research, and education. When nurses are engaged in mobilizing theoretical and empirical knowledge in answering nursing practice questions and in discussing social health issues, they participate in persons, families, and communities health improvement, while affirming their disciplinary and social identity. Called to be change agents in health care systems, with other professional team members, it is important that nurses be prepared to mobilize knowledge and to engage in critical reasoning, and ethical conduct. Their social contribution will be as strong as the value they assign to nursing knowledge and their participation in producing it.

Delivering heart failure disease management in 3 tertiary care centers: key clinical components and venues of care.

PubMed

Shah, Monica R; Whellan, David J; Peterson, Eric D; Nohria, Anju; Hasselblad, Vic; Xue, Zhenyi; Bowers, Margaret T; O'Connor, Christopher M; Califf, Robert M; Stevenson, Lynne W

2008-04-01

Little data exist to assist to help those organizing and managing heart failure (HF) disease management (DM) programs. We aimed to describe the intensity of outpatient HF care (clinic visits and telephone calls) and medical and nonpharmacological interventions in the outpatient setting. This was a prospective substudy of 130 patients enrolled in STARBRITE in HFDM programs at 3 centers. Follow-up occurred 10, 30, 60, 90, and 120 days after discharge. The number of clinic visits and calls made by HF cardiologists, nurse practitioners, and nurses were prospectively tracked. The results were reported as medians and interquartile ranges. There were a total of 581 calls with 4 (2, 6) per patient and 467 clinic visits with 3 (2, 5) per patient. Time spent per patient was 8.9 (6, 10.6) minutes per call and 23.8 (20, 28.3) minutes per clinic visit. Nurses and nurse practitioners spent 113 hours delivering care on the phone, and physicians and nurse practitioners spent 187.6 hours in clinic. Issues addressed during calls included HF education (341 times [52.6%]) and fluid overload (87 times [41.8%]). Medical interventions included adjustments to loop diuretics (calls 101 times, clinic 156 times); beta-blockers (calls 18 times, clinic 126 times); vasodilators (calls 8 times, clinic 55 times). More than a third of clinician time was spent on calls, during which >50% of patient contacts and HF education and >39% of diuretic adjustments occurred. Administrators and public and private insurers need to recognize the amount of medical care delivered over the telephone and should consider reimbursement for these activities.

A new infusion pathway monitoring system utilizing electrostatic induced potential.

PubMed

Maki, Hiromichi; Yonezawa, Yoshiharu; Ogawa, Hidekuni; Ninomiya, Ishio; Sada, Kouji; Hamada, Shingo; Hahn, Alien W; Caldwell, W Morton

2006-01-01

We have developed a new infusion pathway monitoring system employing linear integrated circuits and a low-power 8-bit single chip microcomputer. The system is available for hospital and home use and it constantly monitors the intactness of the pathway. The sensor is an electro-conductive polymer electrode wrapped around the infusion polyvinyl chloride infusion tube. This records an AC (alternating current) voltage induced on the patient's body by electrostatic coupling from the normal 100 volt, 60 Hz AC power line wiring field in the patient's room. If the injection needle or infusion tube becomes detached, then the system detects changes in the induced AC voltage and alerts the nursing station, via the nurse call system or PHS (personal handy phone System).

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.

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)

CE: Original research: hospital system barriers to rapid response team activation: a cognitive work analysis.

PubMed

Braaten, Jane Saucedo

2015-02-01

The goal of rapid response team (RRT) activation in acute care facilities is to decrease mortality from preventable complications, but such efforts have been only moderately successful. Although recent research has shown decreased mortality when RRTs are activated more often, many hospitals have low activation rates. This has been linked to various hospital, team, and nursing factors. Yet there is a dearth of research examining how hospital systems shape nurses' behavior with regard to RRT activation. Making systemic constraints visible and modifying them may be the key to improving RRT activation rates and saving more lives. The purpose of this study was to use cognitive work analysis to describe factors within the hospital system that shape medical-surgical nurses' RRT activation behavior. Cognitive work analysis offers a framework for the study of complex sociotechnical systems. This framework was used as the organizing element of the study. Qualitative descriptive design was used to obtain data to fill the framework's five domains: resources, tasks, strategies, social systems, and worker competency. Data were obtained from interviews with 12 medical-surgical nurses and document review. Directed content analysis was used to place the obtained data into the framework's predefined domains. Many system factors affected participants' decisions to activate or not activate an RRT. Systemic constraints, especially in cases of subtle or gradual clinical changes, included a lack of adequate information, the availability of multiple strategies, the need to justify RRT activation, a scarcity of human resources, and informal hierarchical norms in the hospital culture. The most profound constraint was the need to justify the call. Justification was based on the objective or subjective nature of clinical changes, whether the nurse expected to be able to "handle" these changes, the presence or absence of a physician, and whether there was an expectation of support from the RRT team. The need for justification led to delays in RRT activation. Although it's generally thought that RRTs are activated without hesitation, this study found the opposite was true. All of the aforementioned constraints increase the cognitive processing load on the nurse. The value of the RRT could be increased by modifying these constraints-in particular, by lifting the need to justify calls, improving protocols, and broadening the range of culturally acceptable triggers-and by involving the RRT earlier in patient cases through discussion, consultation, and collaboration.

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.

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.

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.

[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.

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.

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.

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.

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.

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.

Development and practice of a Telehealthcare Expert System (TES).

PubMed

Lin, Hanjun; Hsu, Yeh-Liang; Hsu, Ming-Shinn; Cheng, Chih-Ming

2013-07-01

Expert systems have been widely used in medical and healthcare practice for various purposes. In addition to vital sign data, important concerns in telehealthcare include the compliance with the measurement prescription, the accuracy of vital sign measurements, and the functioning of vital sign meters and home gateways. However, few expert system applications are found in the telehealthcare domain to address these issues. This article presents an expert system application for one of the largest commercialized telehealthcare practices in Taiwan by Min-Sheng General Hospital. The main function of the Telehealthcare Expert System (TES) developed in this research is to detect and classify events based on the measurement data transmitted to the database at the call center, including abnormality of vital signs, violation of vital sign measurement prescriptions, and malfunction of hardware devices (home gateway and vital sign meter). When the expert system detects an abnormal event, it assigns an "urgent degree" and alerts the nursing team in the call center to take action, such as phoning the patient for counseling or to urge the patient to return to the hospital for further tests. During 2 years of clinical practice, from 2009 to 2011, 19,182 patients were served by the expert system. The expert system detected 41,755 events, of which 22.9% indicated abnormality of vital signs, 75.2% indicated violation of measurement prescription, and 1.9% indicated malfunction of devices. On average, the expert system reduced by 76.5% the time that the nursing team in the call center spent in handling the events. The expert system helped to reduce cost and improve quality of the telehealthcare service.

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.

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.

Child to nurse communication in paediatric post-acute hospital care: evaluation of the VerbalCare tablet application.

PubMed

Crowley, Ruth A; Dumas, Helene M; Fragala-Pinkham, Maria A; Dougherty, Donald N; Hull, Ellen M; Hughes, Mary Laurette; Hsaio, Eric

2017-07-01

VerbalCare is a mobile software platform for hospital patients and nursing staff to communicate in real-time. The purposes of this study were to (1) identify and evaluate icons for the VerbalCare tablet application and (2) examine use and satisfaction with this tablet application in a paediatric post-acute hospital. Hospital nursing staff were surveyed to identify the most common reasons children use the "nursing call bell". Icons for the VerbalCare tablet application were developed to match the identified call bell requests and be understood by children. Through structured interview, three children provided feedback on the icons. Following staff training, the system was implemented for five patients (8-18 years). Data on frequency of use, types and timing of requests were collected via the internal software. Satisfaction surveys were completed at discharge. The VerbalCare application was used most frequently to communicate the need to use the bathroom (24%) and the need to get something (21%). Request frequency was consistent across morning, afternoon and evening and the tablet was used 40% of available days. These results indicate that children in a paediatric post-acute care hospital were able to use a tablet application for communicating with their nurse and reported satisfaction with the experience. Implications for Rehabilitation The VerbalCare tablet application was developed to allow patients to convey specific messages to nursing staff who are not in the patient's room. Children of varying ages were able to use the VerbalCare tablet application to communicate varying messages to hospital nursing staff and were satisfied with its use.

New Zealand rural primary health care workforce in 2005: more than just a doctor shortage.

PubMed

Goodyear-Smith, Felicity; Janes, Ron

2008-02-01

To obtain a 2005 snapshot of New Zealand (NZ) rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. Postal questionnaires, November 2005. NZ-wide rural general practices and community pharmacies. Rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists. Self-reported data: demographics, country of training, years in practice, business ownership, hours worked including on-call, intention to leave rural practice. General practices: response rate 95% (206/217); 70% GP-owned, practice size ranged from one GP/one nurse to 12 GPs/nine nurses. PHARMACIES: Response rate 90% (147/163). Majority had one (33%) or two (32%) pharmacists; <10% had more than three pharmacists. GPs: response rate 64% (358/559), 71% male, 73% aged >40, 61% full-time, 79% provide on-call, 57% overseas-trained, 78% male and 57% female GPs aged >40; more full-time male GPs (76%) than female (37%) . Nurses: response rate 65% (445/685), 97% female, 72% aged >40, 31% full-time, 28% provide on-call, 84% NZ-trained, 45% consulted independently in 'nurse-clinics' within practice setting. Pharmacists: response rate 96% (248/258), 52% male, 66% aged >40, 71% full-time, 33% provide on-call, 92% NZ-trained, 55% sole/partner pharmacy owners. Many intend to leave NZ rural practice within 5 years: GPs (34%), nurses (25%) and pharmacists (47%). This is the first NZ-wide rural workforce survey to include a range of rural primary health care providers (GPs, nurses and pharmacists). Ageing rural primary health care workforce and intentions to leave herald worsening workforce shortages.

“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

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.

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 ...

Hacked off.

PubMed

1988-05-28

The new book on occupational health for nurses called Nurses At Risk written by [illegible word] Salvage, former Nursing Standard journalist and Rosemary Rogers, currently our Clinical News Editor, received widespread press coverage.

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.

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.

Understanding Whole Systems Change in Health Care: Insights into System Level Diffusion from Nursing Service Delivery Innovations--A Multiple Case Study

ERIC Educational Resources Information Center

Berta, Whitney; Virani, Tazim; Bajnok, Irmajean; Edwards, Nancy; Rowan, Margo

2014-01-01

Our study responds to calls for theory-driven approaches to studying innovation diffusion processes in health care. While most research on diffusion in health care is situated at the service delivery level, we study innovations and associated processes that have diffused to the system level, and refer to work on complex adaptive systems and whole…

Comparison of Student Outcomes before and after Introduction of High-Fidelity Simulation in a Nursing School Curriculum

ERIC Educational Resources Information Center

Decker, Teresa Frances O'Hara

2014-01-01

Nursing profession accrediting agencies and associations, including the National League for Nursing, the American Association of Colleges of Nursing, the National Council of State Boards of Nursing, and the Institute of Medicine, have called for the implementation and evaluation of educational innovations. Many nursing schools have attempted to be…

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.

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.

Environmental Health: Advancing Emancipatory Policies for the Common Good.

PubMed

Valentine-Maher, Sarah K; Butterfield, Patricia G; Laustsen, Gary

Human health is substantially impacted by the state of the environment, and environmental degradation has a disproportionate impact on persons with less immediate access to financial and social power. This article calls for upstream nursing action to address the natural environment in order to turn about health injustices and improve health for all. Such action would move nursing towards a greater actualization of the nursing environmental domain. The health impacts of climate change, air and water quality, and toxic chemical exposure are substantiated and specific policy leadership recommendations are proposed. Recommended actions include work to build environmental health literacy and empowerment, advocacy for regulatory protection and enforcement, and environmental engagement within health care systems.

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.

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

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.

A new infusion pathway intactness monitoring system.

PubMed

Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Ninomiya, Ishio; Sata, Koji; Hamada, Shingo; Caldwell, W Morton

2006-01-01

A new infusion pathway monitoring system has been developed for hospital and home use. The system consists of linear integrated circuits and a low-power 8-bit single chip microcomputer which constantly monitors the infusion pathway intactness. An AC (alternating current) voltage is induced on the patient's body by electrostatic coupling from the normal 100 volt, 60 Hz AC power line wiring field in the patient's room. The induced AC voltage can be recorded by a main electrode wrapped around the infusion polyvinyl chloride tube. A reference electrode is wrapped on the electrode to monitor the AC voltage around the main electrode. If the injection needle or infusion tube becomes detached, then the system detects changes in the induced AC voltages and alerts the nursing station, via the nurse call system or PHS (personal handy phone system).

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.

Nursing Practice, Research and Education in the West: The Best Is Yet to Come.

PubMed

Young, Heather M; Bakewell-Sachs, Susan; Sarna, Linda

This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing. Challenges abound: U.S. healthcare remains expensive, with poorer outcomes than other developed countries; costs of higher education are high; our profession does not reflect the diversity of the population; and health disparities persist. Pressing health issues, such as increases in chronic disease and mental health conditions and substance abuse, coupled with aging of the population, pose new priorities for nursing and healthcare. Changes are needed in practice, research, and education. In practice, innovative, cocreated, evidence-based models of care can open new roles for registered nurses and advanced practice registered nurses who have knowledge, leadership, and team skills to improve quality and address system change. In research, data can provide a foundation for clinical practice and expand our knowledge base in symptom science, wellness, self-management, and end-of-life/palliative care, as well as behavioral health, to demonstrate the value of nursing care and reduce health disparities. In education, personalized, integrative, and technology-enabled teaching and learning can lead to creative and critical thinking/decision-making, ethical and culturally inclusive foundations for practice, ensure team and communication skills, quality and system improvements, and lifelong learning. The role of the Western Institute of Nursing is more relevant than ever as we collectively advance nursing, health, and healthcare through education, clinical practice, and research.

I have no peace of mind-psychosocial distress expressed by rural women living with HIV in India as part of a mobile health intervention-a qualitative study.

PubMed

Chandra, Prabha S; Parameshwaran, Soumya; Satyanarayana, Veena A; Varghese, Meiya; Liberti, Lauren; Duggal, Mona; Singh, Pushpendra; Jeon, Sangchoon; Reynolds, Nancy R

2018-03-17

This qualitative study assessed psychosocial concerns that rural women with HIV who had multiple psychosocial vulnerabilities were able to express and communicate during a mobile phone intervention delivered by nurses. The study is part of a pilot randomised controlled trial of an mHealth self-care intervention by nurses for women living with HIV in rural India. For the trial, 60 women were randomised to receive the mHealth intervention. All calls were recorded and call logs were maintained. Call logs of 59 women based on 1186 calls were scanned for psychosocial themes. Audio recordings of 400 calls rich in content were then transcribed and translated for analysis. Themes and subthemes were identified by two independent raters. Majority of the women had low literacy and more than half were widowed. Clinical depression was found in 18.6%. Of the 1186 call logs analysed, 932 calls had a record of at least one psychosocial concern and 493 calls recorded two psychosocial concerns. Some of the major themes that women discussed with nurses included worries about their own and their children's future; loneliness; stigma; inadvertent disclosure; death and dying; abandonment by partner; financial difficulties; body image; poor social support; emotions such as sadness, guilt, and anger; and need for social services. Almost all expressed appreciation for the intervention. Findings indicate the usefulness of mHealth-based self-care interventions delivered by nurses in hard to reach women in low- and middle-income countries, especially those with multiple psychosocial vulnerabilities.

Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran.

PubMed

Salarvand, Shahin; Azizimalekabadi, Maryam; Jebeli, Azadeh Akbari; Nazer, Mohamadreza

2017-04-01

The Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses' challenges in implementing healthcare reform in Iran. A qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software. Challenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people's misconceptions and solutions. The Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for.

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…

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.

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…

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.

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.

[The role of the "infection control nurse (ICN)" in an outbreak].

PubMed

Morishita, Sachiko

2004-01-01

The nosocomial infection and its expansion is a big problem for both customers and healthcare organizations. It is one of the most important tasks for the infection control team to prevent spreadng the hospital infection and to minimize its damage for clients and healthcare organizations. Japanese nurse association (JNA) has established the system of the certified nurses who finished authorized certification program in 15 areas including infection control in 1999. They are called "Certified Expert nurse (CEN)" and the number of CEN concerning about infection control (ICN) has reached 146 nurses in Japan in 2004. ICNs should have an ability to predict the possibility of an outbreak and to take measures to meet the situation, practically direct intervention and research for the outbreak. In this literature I have summarized the roles of ICN, introducing our experience of the scabies outbreak in our affiliated intermediate care facility for the senior citizens. It is important for ICN to research and analyze the outbreak, at the same time we have to feedback effectively to the healthcare stuffs to change their attitude and develop the system to discover the outbreak earlier by educating them.

The impact of clinical nurse specialists on clinical pathways in the application of evidence-based practice.

PubMed

Gurzick, Martha; Kesten, Karen S

2010-01-01

The purpose of this article was to address the call for evidence-based practice through the development of clinical pathways and to assert the role of the clinical nurse specialist (CNS) as a champion in clinical pathway implementation. In the current health care system, providing quality of care while maintaining cost-effectiveness is an ever-growing battle that institutions face. The CNS's role is central to meeting these demands. An extensive literature review has been conducted to validate the use of clinical pathways as a means of improving patient outcomes. This literature also suggests that clinical pathways must be developed, implemented, and evaluated utilizing validated methods including the use of best practice standards. Execution of clinical pathways should include a clinical expert, who has the ability to look at the system as a whole and can facilitate learning and change by employing a multitude of competencies while maintaining a sphere of influence over patient and families, nurses, and the system. The CNS plays a pivotal role in influencing effective clinical pathway development, implementation, utilization, and ongoing evaluation to ensure improved patient outcomes and reduced costs. This article expands upon the call for evidence-based practice through the utilization of clinical pathways to improve patient outcomes and reduce costs and stresses the importance of the CNS as a primary figure for ensuring proper pathway development, implementation, and ongoing evaluation. Copyright 2010 Elsevier Inc. All rights reserved.

Evaluation of a problem-specific SBAR tool to improve after-hours nurse-physician phone communication: a randomized trial.

PubMed

Joffe, Erel; Turley, James P; Hwang, Kevin O; Johnson, Todd R; Johnson, Craig W; Bernstam, Elmer V

2013-11-01

After-hours telephone communications are common in patient management. Patterns of communication of key information during after-hours phone calls were evaluated, and the utility of problem-specific Situation, Background, Assessment, Recommendation (SBAR) forms in improving this communication was assessed. In a randomized trial using a simulated on-call setting, 20 nurses called physicians regarding six cases adapted from inpatient records and based on the six most common reasons for after-hours nurse-physician communication. Three of the cases were handled without the SBAR forms (control cases), and three cases were handled with the forms (SBAR cases). Two cue types of communication were evaluated: situation cues, which conveyed the patient's situation (for example, a patient is confused), and background cues, which conveyed problem-specific data indicated on the SBAR forms (for example, the patient has a low sodium level). Ninety-two phone calls were analyzed (43 SBAR/49 controls). Most of the nurses reported the situation cues (SBAR 88%, control 84%, p = .60) but not the background cues. There was a trend toward fewer background cues communicated in the SBAR cases (14% versus 31%, p = .08). In 14% of the cases, on average, nurses omitted information or reported wrong information regarding the background cue. Physicians asked questions that resulted in the communication of the cues in a minority of the cases when the background cues were not originally provided by the nurses (SBAR 6%, control 16%, p = .39). In after-hours phone communication between physicians and nurses, significant information was often not communicated and physicians did not elicit the necessary information. Simply providing an SBAR-based form did not ensure complete communication of key information.

Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

PubMed

Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

2016-02-01

To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote safe and efficient communication. Nurses should empower patients to address concerns directly with providers through use of devices including health passports. © 2016 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

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.

Building A High Quality Oncology Nursing Workforce Through Lifelong Learning: The De Souza Model.

PubMed

Esplen, Mary Jane; Wong, Jiahui; Green, Esther; Richards, Joy; Li, Jane

2018-01-05

AbstractCancer is one of the leading causes of death in the world. Along with increased new cases, cancer care has become increasingly complex due to advances in diagnostics and treatments, greater survival, and new models of palliative care. Nurses are a critical resource for cancer patients and their families. Their roles and responsibilities are expanding across the cancer care continuum, calling for specialized training and support. Formal education prepares nurses for entry level of practice, however, it does not provide the specialized competencies required for quality care of cancer patients. There is urgent need to align the educational system to the demands of the health care system, ease transition from formal academic systems to care settings, and to instill a philosophy of lifelong learning. We describe a model of education developed by de Souza Institute in Canada, based on the Novice to Expert specialty training framework, and its success in offering structured oncology continuing education training to nurses, from undergraduate levels to continued career development in the clinical setting. This model may have global relevance, given the challenge in managing the demand for high quality care in all disease areas and in keeping pace with the emerging advances in technologies.

The Culture Care Meaning of Comfort for Ethnically Diverse Pre-Licensure Baccalaureate Nursing Students in the Educational Setting

ERIC Educational Resources Information Center

Zajac, Lynne K.

2010-01-01

The nursing profession is calling for enhanced diversity within the ranks of registered nurses to meet the health care needs of an increasingly diverse society. Nursing education is faced with the challenge of retaining ethnically diverse nursing students. Students who are ethnically diverse face unique challenges in addition to the universal…

Going to the Doctor

MedlinePlus

... you weigh the right amount . What Does the Nurse Check? A checkup may start when a nurse calls you and your parent from the waiting ... the air drains out of the cuff, the nurse will watch the numbers to get your reading. ...

Developing a Theoretical Framework Using a Nursing Perspective to Investigate Perceived Health in the "Sandwich Generation" Group.

PubMed

Oulevey Bachmann, Annie; Danuser, Brigitta; Morin, Diane

2015-10-01

Coexisting workloads from professional, household and family, and caregiving activities for frail parents expose middle-aged individuals, the so-called "Sandwich Generation", to potential health risks. Current trends suggest that this situation will continue or increase. Thus SG health promotion has become a nursing concern. Most existing research considers coexisting workloads a priori pathogenic. Most studies have examined the association of one, versus two, of these three activities with health. Few studies have used a nursing perspective. This article presents the development of a framework based on a nursing model. We integrated Siegrist's Effort-Reward Imbalance middle-range theory into "Neuman Systems Model". The latter was chosen for its salutogenic orientation, its attention to preventive nursing interventions and the opportunity it provides to simultaneously consider positive and negative perceptions of SG health and SG coexisting workloads. Finally, it facilitated a theoretical identification of health protective factors. © The Author(s) 2015.

Active learning as a path to critical thinking: are competencies a roadblock?

PubMed

Tedesco-Schneck, Mary

2013-01-01

Nursing educators are called to graduate students who are critical thinkers able to face the challenge of negotiating increasingly complex health care systems (Candela, 2011; Cerullo and da Cruz, 2010). Active learning has been incited as a mechanism to foster critical thinking skills (Michel et al., 2009; Pascarella, 2005; Walker, 2003). Yet despite evidence and academic applause in favor of active pedagogies, passive pedagogies continue to dominant the nursing education landscape (Brown et al., 2009; Burbach et al., 2004; Schnell, 2005). Although, scholarly literature in nursing and education substantiate existence of various obstacles that inhibit faculty incorporation of active pedagogies, perhaps the insidious culture of competencies in nursing education is what truly engenders a milieu for the continued use of passive pedagogies. In this article, I aim to stimulate debate about the culture of competencies in nursing education as the overriding force which perpetuates use of passive pedagogies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Public telesurveillance service for frail elderly living at home, outcomes and cost evolution: a quasi experimental design with two follow-ups.

PubMed

Vincent, Claude; Reinharz, Daniel; Deaudelin, Isabelle; Garceau, Mathieu; Talbot, Lise R

2006-07-07

Telesurveillance is a technologically based modality that allows the surveillance of patients in the natural setting, mainly home. It is based on communication technologies to relay information between a patient and a central call center where services are coordinated. Different types of telesurveillance systems have been implemented, some being staffed with non-health professionals and others with health professional, mainly nurses. Up to now, only telesurveillance services staffed with non-health professionals have been shown to be effective and efficient. The objective of this study was to document outcomes and cost evolution of a nurse-staffed telesurveillance system for frail elderly living at home. A quasi experimental design over a nine-month period was done. Patients (n = 38) and caregivers (n = 38) were selected by health professionals from two local community health centers. To be eligible, elders had to be over 65, live at home with a permanent physical, slight cognitive or motor disability or both and have a close relative (the caregiver) willing to participate to the study. These disabilities had to hinder the accomplishment of daily life activities deemed essential to continue living at home safely. Three data sources were used: patient files, telesurveillance center's quarterly reports and personal questionnaires (Modified Mini-Mental State, Functional Autonomy Measurement System, Life Event Checklist, SF-12, Life-H, Quebec User Evaluation of Satisfaction with Assistive Technology, Caregiver Burden). The telesurveillance technology permitted, among various functionalities, bi-directional communication (speaker-receiver) between the patient and the response center. A total of 957 calls for 38 registered clients over a 6-month period was recorded. Only 48 (5.0%) of the calls were health-related. No change was reported in the elders' quality of life and daily activity abilities. Satisfaction was very high. Caregivers' psychological burden decreased substantially. On a 3 months period, length of hospital stays dropped from 13 to 4 days, and home care services decreased from 18 to 10 visits/client. Total cost of health and social public services used per client dropped by 17% after the first 3 months and by 39% in the second 3 months. The ratio of 0.50 calls per client to the call center for health events is three times higher than that reported in the literature. This difference is probably attributable to the fact that nurses rather than non-health professional personnel were available to answer the clients' questions about their health and medications. Cost evolution showed that registering older adults at a telesurveillance center staffed by nurses, upon a health professional recommendation, costs the health care system less and does not have any negative effects on the well-being of the individuals and their families. Telesurveillance for the elderly is effective and efficient.

Evaluating the Impact of a Patient-centered Remote Monitoring Program on Adherence to Negative Pressure Wound Therapy.

PubMed

Griffin, Leah; Casillas, Laura Leyva

2018-03-01

A remote therapy monitoring (RTM) system has been developed for use with a negative pressure wound therapy (NPWT) unit for patients in the home care setting. In conjunction with RTM, a network of trained professionals call patients when their NPWT usage is low and provide education to assist with therapy adherence. The objective of this evaluation is to examine the relationship between the RTM system and patient adherence. One hundred ninety-eight home care patients receiving NPWT with RTM between December 2016 and April 2017 were included. A total of 979 calls were made, with an average of 4.9 calls per patient. Among 198 patients, 195 received a welcome call, 157 received a call due to low adherence, and 35 had an escalation call made to their treating nurse. Of the 157 patients who required at least 1 call due to low adherence, 153 were successfully contacted at least once. The day following the patient call, adherence increased 73% of the time by an average of 8.5 hours. This evaluation suggests there is an ability to influence patient adherence through active engagement, potentially improving outcomes and reducing wound costs.

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.

Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces.

PubMed

Munyewende, Pascalia O; Rispel, Laetitia C

2014-01-01

South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC). Nursing managers will play a critical role in these reforms. The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. During 2012, a sub-set of 22 PHC nursing managers was selected randomly from a larger nurses' survey in two South African provinces. After informed consent, participants were requested to keep individual diaries for a period of 6 weeks, using a clear set of diary entry guidelines. Reminders consisted of weekly short message service reminders and telephone calls. Diary entries were analysed using thematic content analysis. A diary feedback meeting was held with all the participants to validate the findings. Fifteen diaries were received, representing a 68% response rate. The majority of respondents (14/15) were female, each with between 5 and 15 years of nursing experience. Most participants made their diary entries at home. Diaries proved to be cathartic for individual nursing managers. Although inter-related and not mutually exclusive, the main themes that emerged from the diary analysis were health system deficiencies; human resource challenges; unsupportive management environment; leadership and governance; and the emotional impact of clinic management. Diaries are an innovative method of capturing the work experiences of managers at the PHC level, as they allow for confidentiality and anonymity, often not possible with other qualitative research methods. The expressed concerns of nursing managers must be addressed to ensure the success of South Africa's health sector reforms, particularly at the PHC level.

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.

Using technology to improve and support communication and workflow processes.

PubMed

Bahlman, Deborah Tuke; Johnson, Fay C

2005-07-01

In conjunction with a large expansion project, a team of perioperative staff members reviewed their workflow processes and designed their ideal patient tracking and communication system. Technologies selected and deployed included a passive infrared tracking system, an enhanced nurse call system, wireless telephones, and a web-based electronic grease board. The new system provides staff members with an easy way to obtain critical pieces of patient information, as well as track the progress of patients and locate equipment.

Uniform emergency codes: will they improve safety?

PubMed

2005-01-01

There are pros and cons to uniform code systems, according to emergency medicine experts. Uniformity can be a benefit when ED nurses and other staff work at several facilities. It's critical that your staff understand not only what the codes stand for, but what they must do when codes are called. If your state institutes a new system, be sure to hold regular drills to familiarize your ED staff.

The Past, the Present, and the Future of Associate Degree Nursing Education.

ERIC Educational Resources Information Center

Arlton, Donna

A review of the history of associate degree nursing (ADN) education is presented, along with a discussion of contemporary problems faced by ADN educators. The paper first notes the practical, hospital-based nature of early nursing education programs; reviews early studies calling for school-based programs to prepare nurses for different levels of…

Mentorship: A Model of Nursing

DTIC Science & Technology

1991-01-01

model was role specific modeling/ teaching. The mentor’s functions were to assist the protege in writing the grant proposal, in planning and conducting...producing role expectations ( Urbano , 1986). Called the creeping, crawling phase (Gunderson and Kenner, 1988), the protege tries to adjust to a new...form with Mentor 39 colleagues ( Urbano , 1986). Called sitting, standing phase, the nurse develops fine motor skills necessary to connect knowledge with

A usability evaluation exploring the design of American Nurses Association state web sites.

PubMed

Alexander, Gregory L; Wakefield, Bonnie J; Anbari, Allison B; Lyons, Vanessa; Prentice, Donna; Shepherd, Marilyn; Strecker, E Bradley; Weston, Marla J

2014-08-01

National leaders are calling for opportunities to facilitate the Future of Nursing. Opportunities can be encouraged through state nurses association Web sites, which are part of the American Nurses Association, that are well designed, with appropriate content, and in a language professional nurses understand. The American Nurses Association and constituent state nurses associations provide information about nursing practice, ethics, credentialing, and health on Web sites. We conducted usability evaluations to determine compliance with heuristic and ethical principles for Web site design. We purposefully sampled 27 nursing association Web sites and used 68 heuristic and ethical criteria to perform systematic usability assessments of nurse association Web sites. Web site analysis included seven double experts who were all RNs trained in usability analysis. The extent to which heuristic and ethical criteria were met ranged widely from one state that met 0% of the criteria for "help and documentation" to states that met greater than 92% of criteria for "visibility of system status" and "aesthetic and minimalist design." Suggested improvements are simple yet make an impact on a first-time visitor's impression of the Web site. For example, adding internal navigation and tracking features and providing more details about the application process through help and frequently asked question documentation would facilitate better use. Improved usability will improve effectiveness, efficiency, and consumer satisfaction with these Web sites.

Tuning the light in senior care: Evaluating a trial LED lighting system at the ACC Care Center in Sacramento, CA

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

Davis, Robert G.; Wilkerson, Andrea M.

This report summarizes the results from a trial installation of light-emitting diode (LED) lighting systems in several spaces within the ACC Care Center in Sacramento, CA. The Sacramento Municipal Utility District (SMUD) coordinated the project and invited the U.S. Department of Energy (DOE) to document the performance of the LED lighting systems as part of a GATEWAY evaluation. DOE tasked the Pacific Northwest National Laboratory (PNNL) to conduct the investigation. SMUD and ACC staff coordinated and completed the design and installation of the LED systems, while PNNL and SMUD staff evaluated the photometric performance of the systems. ACC staff alsomore » track behavioral and health measures of the residents; some of those results are reported here, although PNNL staff were not directly involved in collecting or interpreting those data. The trial installation took place in a double resident room and a single resident room, and the corridor that connects those (and other) rooms to the central nurse station. Other spaces in the trial included the nurse station, a common room called the family room located near the nurse station, and the ACC administrator’s private office.« less

Nursing Ethics and the 21st-Century Armed Conflict: The Example of Ciudad Juárez.

PubMed

O'Connor, Kathleen

2017-01-01

The purpose of this article is to call attention to the lack of caregiver safety in conflict settings; to bring awareness to nurses and health care professionals of new challenges, specifically the deliberate targeting of health care professionals, that they may encounter in local armed conflict situations; and to address a gap in knowledge about the social and cultural factors surrounding 21st-century armed conflict that directly affect the provision of health care. I argue that these are of interest to transcultural nursing in that violent actors belong to a dangerous subculture, the understanding of which is important to transcultural nursing practice and caregiver safety. The article calls for increased focus on the protection of the nursing workforce and renewed attention on international humanitarian law and the Geneva Conventions that mandate the safety of global health care workers. © The Author(s) 2015.

Increasing Role of Nurse Practitioners in House Call Programs.

PubMed

Yao, Nengliang Aaron; Rose, Karen; LeBaron, Virginia; Camacho, Fabian; Boling, Peter

2017-04-01

Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work. An observational study using secondary data. Medicare Provider Utilization and Payment Data. Medicare beneficiaries. Medicare payments for home and domiciliary care visits, the number of residence-based medical visits, provider volume, geographical distribution of full-time house call providers. About 3,300 NPs performed over 1.1 million home and domiciliary care visits in 2013, accounting for 22% of all residential visits to Medicare fee-for-service beneficiaries. A total of 310 NPs individually made more than 1,000 residential visits (defined as a full-time house call provider); among full-time house call providers, including physicians, NPs are now the most common provider type. There are substantial variations in the geographic distribution of full-time house call NPs, internists, and family physicians. Full time NP's service area is about 30% larger than family physicians and internists. Nursing home residents are far more likely to receive NP visits than are homebound persons receiving home visits. NPs are now the largest type of provider delivering residence-based care and NPs provide care over the largest geographical service area. However, the vast majority of frail Americans are more likely to receive NP's care in a nursing facility versus at home. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Health Advocacy Project: Evaluating the Benefits of Service Learning to Nursing Students and Low Income Individuals Involved in a Community-Based Mental Health Promotion Project.

PubMed

Samuels-Dennis, Joan; Xia, Liudi; Secord, Sandra; Raiger, Amelia

2016-10-08

Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.

Electronic Assessment and Feedback Tool in Supervision of Nursing Students during Clinical Training

ERIC Educational Resources Information Center

Mettiäinen, Sari

2015-01-01

The aim of this study was to determine nursing teachers' and students' attitudes to and experiences of using an electronic assessment and feedback tool in supervision of clinical training. The tool was called eTaitava, and it was developed in Finland. During the pilot project, the software was used by 12 nursing teachers and 430 nursing students.…

Research considerations when studying disasters.

PubMed

Cox, Catherine Wilson

2008-03-01

Nurses play an integral role during disasters because they are called upon more than any other health care professional during disaster response efforts; consequently, nurse researchers are interested in studying the issues that impact nurses in the aftermath of a disaster. This article offers research considerations for nurse scientists when developing proposals related to disaster research and identifies resources and possible funding sources for their projects.

A new venous infusion pathway monitoring system.

PubMed

Maki, Hiromichi; Yonezawa, Yoshiharu; Ogawa, Hidekuni; Ninomiya, Ishio; Sata, Koji; Hamada, Shingo; Caldwell, W Morton

2007-01-01

A new infusion catheter pathway monitoring system employing linear integrated circuits and a low-power 8-bit single chip microcomputer has been developed for hospital and home use. The sensor consists of coaxial three-layer conductive tapes wrapped around the polyvinyl chloride infusion tube. The inner tape is the main electrode, which records an AC (alternating current) voltage induced on the patient's body by electrostatic coupling from the normal 100 volt, 60 Hz AC power line wiring field in the patient's room. The outside tape layer is a reference electrode to monitor the AC voltage around the main electrode. The center tape layer is connected to system ground and functions as a shield. The microcomputer calculates the ratio of the induced AC voltages recorded by the main and reference electrodes and if the ratio indicates a detached infusion, alerts the nursing station, via the nurse call system or low transmitting power mobile phone.

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.

Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces

PubMed Central

Munyewende, Pascalia O.; Rispel, Laetitia C.

2014-01-01

Background South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC). Nursing managers will play a critical role in these reforms. Objective The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. Design During 2012, a sub-set of 22 PHC nursing managers was selected randomly from a larger nurses’ survey in two South African provinces. After informed consent, participants were requested to keep individual diaries for a period of 6 weeks, using a clear set of diary entry guidelines. Reminders consisted of weekly short message service reminders and telephone calls. Diary entries were analysed using thematic content analysis. A diary feedback meeting was held with all the participants to validate the findings. Results Fifteen diaries were received, representing a 68% response rate. The majority of respondents (14/15) were female, each with between 5 and 15 years of nursing experience. Most participants made their diary entries at home. Diaries proved to be cathartic for individual nursing managers. Although inter-related and not mutually exclusive, the main themes that emerged from the diary analysis were health system deficiencies; human resource challenges; unsupportive management environment; leadership and governance; and the emotional impact of clinic management. Conclusions Diaries are an innovative method of capturing the work experiences of managers at the PHC level, as they allow for confidentiality and anonymity, often not possible with other qualitative research methods. The expressed concerns of nursing managers must be addressed to ensure the success of South Africa's health sector reforms, particularly at the PHC level. PMID:25537937

A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial.

PubMed

Black, Jeanne T; Romano, Patrick S; Sadeghi, Banafsheh; Auerbach, Andrew D; Ganiats, Theodore G; Greenfield, Sheldon; Kaplan, Sherrie H; Ong, Michael K

2014-04-13

Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic characteristics. Once completed, the study will be a rich resource of information on how best to use remote technology in the care management of patients with chronic heart failure. ClinicalTrials.gov # NCT01360203.

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

PubMed

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

2013-08-01

To explore nurses' views on the role of nurses in screening and monitoring for physical care of consumers with serious mental illness, at a regional mental health care service. People with serious mental illness experience heightened incidence of preventable and treatable physical illnesses such as cardiovascular disease and diabetes. Screening and monitoring are considered universal clinical safeguards. Nurses can potentially facilitate systematic screening, but their views on physical health care practices are rarely investigated. Qualitative exploratory study. Focus group interviews with 38 nurses of a regional mental health care service district of Australia. To facilitate discussion, participants were presented with a screening system, called the Health Improvement Profile (HIP), as an exemplar of screening of physical health risks by nurses. Inductive data analysis and theme development were guided by a thematic analysis framework. Nurses argued that treatable and preventable physical health problems were common. Four main themes were identified: screening - essential for good practice; the policy-practice gap; 'screening then what?' and, is HIP the answer? Screening and monitoring were considered crucial to proper diagnosis and treatment, however, were not performed systematically or consistently. Nurse readiness for an enhanced role in screening was shaped by: role and responsibility issues, legal liability concerns, funding and staff shortages. Participants were concerned that lack of follow up would limit effectiveness of these interventions. Screening was considered an important clinical step in effective diagnosis and treatment; however, identified barriers need to be addressed to ensure screening is part of a systemic approach to improve physical health of consumers with serious mental illness. Nurses have potential to influence improvement in physical health outcomes for consumers of mental health services. Such potential can only be realised if a systematic approach to physical health care is taken. © 2013 John Wiley & Sons Ltd.

[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.

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.

[Personality and work of Florence Nightingale--creator of modern nursing and public health pioneer].

PubMed

Milutinović, Dragana; Sumonja, Sanja; Maksimović, Jovan

2012-01-01

Through her "calling to service", Florence Nightingale worked as a nurse, manager, researcher, reformer, writer and teacher. The aim of this study is to present Florence Nightingale in all these roles, pointing out all complexity and multidimensionality of nursing profession. Having come from an aristocratic English family, Florence Nightingale was very educated She considered knowledge as a way, and statistical method as an instrument for discovering the rules of the world. Her work during the Crimean War was one of her most important deeds and made her a national hero. After the war, she devoted herself to reforming nursing and public health in Britain and in the world. Since she was bedbound after the Crimean War due to her illness, writing became the most powerful tool she had in achieving her goals. Florence Nightingale wrote many letters to politicians and statesmen, many newspaper and scientific articles. One of her greatest works "Notes on Nursing" was not written only for nurses, but for all women. By founding Nursing school at St. Thomas Hospital in 1860 she aspired to train and educate nurses. Her complete and lifelong devotion to the ,,calling" directed all her activities, contributions and achievements, not only towards nursing but also towards statistics, epidemiology, public health and social sciences.

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)

QNI celebrates 125 years.

PubMed

White, Alison

2012-07-01

The Queen's Nursing Institute was founded in 1887 with the grant of £70000 by Queen Victoria from the Women's Jubilee Fund. Originally called the 'Queen Victoria's Jubilee Institute for Nurses', it was set up with the objective of providing the 'training, support, maintenance and supply' of nurses for the sick poor.

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…

76 FR 38342 - Medicare Program; Clinical Laboratory Fee Schedule: Signature on Requisition

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... cases, the physician may keep abreast of the patient's condition by calling the nursing staff. If a patient's condition indicates that a clinical diagnostic laboratory test is required, the nursing staff... signature on the requisition. Another example that occurs in many settings, including nursing homes, all...

Mobile Phone Training Platform for the Nursing Staff in the Emergency Department.

PubMed

Liu, Xueqing; Cheng, Jing; Huang, Sufang

2018-05-09

Continuous education is required for nursing staff, but continuous education can be complicated for nurses working shifts, such as those in the emergency department (ED). To explore the effectiveness of the ED Training Platform of Tongji Hospital for conventional continuing education of emergency nurses. The training completion rate and training outcomes were validated. This was a retrospective study of all in-service emergency nurses working at the Tongji Medical College of Huazhong University of Science and Technology between August 2016 and August 2017. The training results of the previous year of the same group were used as controls. The platform used was an online system called JikeXuetang ( www.jkxuetang.com/ ), using the WeChat application as a carrier. The training completion rate and pass rate were compared with the control data. Among 124 nurses, the training completion rate increased from <60% to 100%, and the passing rate was 100%. Among 121 nurses, 92.5% considered that the mobile phone platform was more convenient than conventional training course; 89.7% believed it as an effective tool of learning, and intended to join public courses after completion; and 63.4% nurses expressed the wish to receive push services once or twice weekly for training course. The outcome of emergency nurse training was improved using the mobile training platform. This approach was more feasible and easier for training.

Rheumatology telephone advice line - experience of a Portuguese department.

PubMed

Ferreira, R; Marques, A; Mendes, A; da Silva, J A

2015-01-01

Telephone helplines for patients are tool for information and advice. They can contribute to patient's satisfaction with care and to the effectiveness and safety of treatments. In order to achieve this, they need to be adequately adapted to the target populations, as to incorporate their abilities and expectations. a) Evaluate the adherence of patients to a telephone helpline managed by nurses in a Portuguese Rheumatology Department, b) Analyse the profile of users and their major needs, c) Analyse the management of calls by the nurses. The target population of this phone service are the patients treated at Day Care Hospital and Early Arthritis Clinic of our department. Nurses answered phone calls immediately between 8am and 4pm of working days. In the remaining hours messages were recorded on voice mail and answered as soon as possible. Details of the calls were registered in a dedicated sheet and patients were requested permission to use data to improve the service, with respect for their rights of confidentiality, anonymity and freedom of decision. In 18 months 173 calls were made by 79 patients, with a mean age of 47.9 years (sd=9.13). Considering the proportions of men and women in the target population, it was found that men called more frequently (M= 32.7% vs F= 20.4%, p=.016). The reasons for these calls can be divided into three categories: instrumental help, such as the request for results of complementary tests or rescheduling appointments (43.9% of calls); counselling on side effects or worsening of the disease/pain (31.2 %); counselling on therapy management (24.9%). Neither sex nor patient age were significantly related to these reasons for calling. Nurses resolved autonomously half (50.3%) of the calls and in 79.8% of the cases there was no need for patient referral to other health services. About a quarter of patients adhered to the telephone helpline.. Patients called to obtain support in the management of disease and therapy or to report side effects and/or symptom aggravation in addition to reasonable instrumental reasons. This suggests that this service may provide important health gains, in addition to comfort for the patient.

The challenge of multimorbidity in nurse education: an international perspective.

PubMed

Rushton, Claire A; Green, Julie; Jaarsma, Tiny; Walsh, Pauline; Strömberg, Anna; Kadam, Umesh T

2015-01-01

The rise in prevalence of chronic diseases has become a global healthcare priority and a system wide approach has been called for to manage this growing epidemic. Whilst healthcare reform to tackle the scale of chronic disease and other long term conditions is still in its infancy, there is an emerging recognition that in an ageing society, people often suffer from more than one chronic disease at the same time. Multimorbidity poses new and distinct challenges and was the focus of a global conference held by the Organization of Economic Cooperation and Development (OECD) in 2011. Health education was raised as requiring radical redesign to equip graduates with the appropriate skills to face the challenges ahead. We wanted to explore how different aspects of multimorbidity were addressed within pre-registration nurse education and held an international (United Kingdom-Sweden) nurse workshop in Linköping, Sweden in April 2013, which included nurse academics and clinicians. We also sent questionnaire surveys to final year student nurses from both countries. This paper explores the issues of multimorbidity from a patient, healthcare and nurse education perspective and presents the preliminary discussions from the workshop and students' survey. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Around-the-clock nursing care for the elderly in Japan.

PubMed

Murashima, S; Zerwekh, J V; Yamada, M; Tagami, Y

1998-01-01

To describe the first phase of creating a Japanese model of community-based long-term care, called around-the-clock care (ACC), by operationally defining the components of ACC, identifying those eligible for the program, clarifying methods of planning and organization, and exploring outcomes. Exploratory evaluation for the population of frail elderly Japanese citizens living at home. A convenience sample of 44 patients receiving care from four visiting-nurse-service stations during 3 months in 1994 was used. Needs assessments; record reviews of patient encounters; evaluations by patients, families, and visiting nurses; and reviews of administrative data. Nurses perceived that ACC stabilized medical status, reduced the emotional and physical burden of treatment, and improved hygiene. It also reduced family caregiving burdens and the stress of family caregivers' employment responsibilities. The highest rating of ACC by patient and families was for those with the most complex physical needs. Skilled nursing at home permitted early identification and treatment of problems before they became crises or required hospitalization. Early findings suggest 24-hour nurse-home helper teamwork may be an effective system of community-based long-term care and should be considered a key element of future Japanese health policy.

Making chicken pox prevention a priority.

PubMed

Domachowske, Joseph B

2004-01-01

School nurses are the IDEAL professionals to catch those kids without a history of chicken pox (varicella illness) who have not been immunized, thereby falling into the susceptible range. We handle charts daily. We have both illness history (if it was provided) and immunization dates. We can call parents. We can talk to kids. Wouldn't it be easy if we could do that and then call (or email) the primary care provider? But there is no longer an "easy" way to communicate health information. Doing things the easy way could be perceived by some as "tattling" and by others as "reporting without permission." Instead, the school nurse must take the time-consuming (and better long range) path of education ... of the student, and the parent. And the priority can slip down below other school nurse requirements such as getting kids their required immunizations, first aid and illness care, individualized health care plans for students with medical problems, parent and teacher phone calls, and endless conversations. It takes a village to raise a child though, and the school nurse is a village resident. The following information is vital to the knowledge base of today's school nurse. Please read it, store it and consider it when planning and intervening with your students in the day-to-day interaction that promotes optimal health and wellness.

Improving Access to Human Milk in the NICU (and Beyond).

PubMed

Szulecki, Diane

2016-06-01

As part of its Raise the Voice campaign to showcase nurses who are key players in transforming health care, the American Academy of Nursing has identified nurses they call edge runners-"practical innovators who have led the way in bringing new thinking and new methods to a wide range of health care challenges." This is the sixth in AJN's series of profiles of these nursing innovators. Read and be proud of what nurses can accomplish.

Cultivating quality: implementing standardized reporting and safety checklists.

PubMed

Stevens, James D; Bader, Mary Kay; Luna, Michele A; Johnson, Linda M

2011-05-01

Developing processes to create a culture of safety. It's estimated that as many as 98,000 hospitalized patients lose their lives each year in the United States because of medical errors that could have been prevented. While standardized reporting and safety checklists have been shown to improve communication and patient safety, implementation of these tools in hospitals remains challenging. To implement standardized nurse-to-nurse reporting along with safety checklists at Mission Hospital, a 522-bed facility in Mission Viejo, California, using Lewin's change theory and Knowles's adult learning theory. Nurses were tested to assess their knowledge of the standardized nurse-to-physician reporting method called SBAR (Situation, Background, Assessment, Recommendation), their understanding of the concept of the nurse-to-nurse reporting method called SBAP (Situation, Background, Assessment, Plan), and the use of safety checklists. Then, after viewing a 22-minute educational video, they were retested. A total of 482 nurses completed the pretest and posttest. On the pretest, the nurses' mean score was 15.935 points (SD, 3.529) out of 20. On the posttest, the mean score was 18.94 (SD, 1.53) out of 20. A Wilcoxon matched-pairs signed-rank test was performed; the two-tailed P value was < 0.001. The application of Lewin's change theory and Knowles's adult learning theory was successful in the process of implementing standardized nurse-to-nurse reporting and safety checklists at Mission Hospital.

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.

Flipping the classroom to teach population health: Increasing the relevance.

PubMed

Simpson, Vicki; Richards, Elizabeth

2015-05-01

In recent years, there have been multiple calls to enhance the population health and health promotion aspects of nursing programs. Further impetus has been provided by passage of the Affordable Care Act in 2010 with its focus on prevention. The need to develop students who can critically think and apply knowledge learned is crucial to the development of nurses who can integrate and apply the concepts of population-focused practice in society and a healthcare system undergoing transformation. This coupled with the ever changing needs of learners requires a different approach to content delivery and presentation. Flipped classroom courses, with an online component, offer the flexibility and technology desired by current undergraduate students. The use of a flipped classroom approach to re-design a population health course in a Midwestern nursing program resulted in stronger course evaluations from students and reflected better student understanding of the relevance of such content in a nursing curriculum. Copyright © 2015 Elsevier Ltd. All rights reserved.

Directed Bee Colony Optimization Algorithm to Solve the Nurse Rostering Problem.

PubMed

Rajeswari, M; Amudhavel, J; Pothula, Sujatha; Dhavachelvan, P

2017-01-01

The Nurse Rostering Problem is an NP-hard combinatorial optimization, scheduling problem for assigning a set of nurses to shifts per day by considering both hard and soft constraints. A novel metaheuristic technique is required for solving Nurse Rostering Problem (NRP). This work proposes a metaheuristic technique called Directed Bee Colony Optimization Algorithm using the Modified Nelder-Mead Method for solving the NRP. To solve the NRP, the authors used a multiobjective mathematical programming model and proposed a methodology for the adaptation of a Multiobjective Directed Bee Colony Optimization (MODBCO). MODBCO is used successfully for solving the multiobjective problem of optimizing the scheduling problems. This MODBCO is an integration of deterministic local search, multiagent particle system environment, and honey bee decision-making process. The performance of the algorithm is assessed using the standard dataset INRC2010, and it reflects many real-world cases which vary in size and complexity. The experimental analysis uses statistical tools to show the uniqueness of the algorithm on assessment criteria.

Reflective Journaling for Critical Thinking Development in Advanced Practice Registered Nurse Students.

PubMed

Raterink, Ginger

2016-02-01

Critical thinking, clinical decision making, and critical reflection have been identified as skills required of nurses in every clinical situation. The Educating Nurses: A Call for Radical Transformation report suggested that critical reflection is a key to improving the educational process. Reflective journaling is a tool that helps develop such skills. This article presents the tool of reflective journaling and the use of this process by educators working with students. It describes the use of reflective journaling in graduate nursing education, as well as a scoring process to evaluate the reflection and provide feedback. Students and faculty found the journaling to be helpful for reflection of a clinical situation focused on critical thinking skill development. The rubric scoring tool provided faculty with a method for feedback. Reflective journaling is a tool that faculty and students can use to develop critical thinking skills for the role of the advanced practice RN. A rubric scoring system offers a consistent format for feedback. Copyright 2016, SLACK Incorporated.

Directed Bee Colony Optimization Algorithm to Solve the Nurse Rostering Problem

PubMed Central

Amudhavel, J.; Pothula, Sujatha; Dhavachelvan, P.

2017-01-01

The Nurse Rostering Problem is an NP-hard combinatorial optimization, scheduling problem for assigning a set of nurses to shifts per day by considering both hard and soft constraints. A novel metaheuristic technique is required for solving Nurse Rostering Problem (NRP). This work proposes a metaheuristic technique called Directed Bee Colony Optimization Algorithm using the Modified Nelder-Mead Method for solving the NRP. To solve the NRP, the authors used a multiobjective mathematical programming model and proposed a methodology for the adaptation of a Multiobjective Directed Bee Colony Optimization (MODBCO). MODBCO is used successfully for solving the multiobjective problem of optimizing the scheduling problems. This MODBCO is an integration of deterministic local search, multiagent particle system environment, and honey bee decision-making process. The performance of the algorithm is assessed using the standard dataset INRC2010, and it reflects many real-world cases which vary in size and complexity. The experimental analysis uses statistical tools to show the uniqueness of the algorithm on assessment criteria. PMID:28473849

[Potential of specialized outpatient palliative care].

PubMed

Geist, M J P; Bardenheuer, H J; Weigand, M A; Frankenhauser, S; Kessler, J

2018-05-01

Palliative care patients with incurable advanced disease suffering from complex symptoms can receive specialized outpatient palliative care in addition to the existing ambulatory care system. Qualified physicians and nurses care for patients and their dependents in cooperation with other professionals. In addition to a 24/7 on-call service for emergencies or acute crises, patients and their dependents are offered regular visits.

Audit report from Greenland on nurses' tasks and perceived competency.

PubMed

Nexøe, J; Skifte, E; Niclasen, B; Munck, A

2012-01-01

Despite all efforts, recruitment of healthcare personnel has become increasingly difficult in Greenland as in other remote areas. The aim of this observational study was to describe the extent of health care delivered by nurses in Greenland's healthcare system. Reasons for encounter, diagnostic procedures, treatments and need for a physician's assistance, as well as the nurses' self-perceived competency, were also analysed. A total of 42 nurses registered all patient encounters for 10 days in late autumn 2006 in 14 out of 16 healthcare districts in Greenland. Nurses treated 1117 encounters (60%) singlehandedly. The nurses felt competent in what they were doing in 1415 encounters (76%). In 525 encounters (31%), a physician's advice was sought. Either the physician was asked to come or the physician's advice was obtained by telephone. In four cases the nurses did not feel completely competent, but did not seek advice from the physician on call. Feeling competent did not depend on length of experience in Greenland. In Greenland, nurses independently receive, diagnose and treat a substantial number of primary healthcare patients. The nurses take care of the patients and perform a number of clinical and laboratory procedures with great confidence. There has been speculation that part of the difficulty in recruiting doctors and healthcare personnel in remote areas may be due to uneasiness about professional responsibilities and, to some extent, lack of confidence. At least among the registering nurses in this study, this did not seem to be a problem.

Religion and gender in a men's hospital and school of nursing, 1866-1969.

PubMed

Wall, Barbra Mann

2009-01-01

This article explores religious beliefs, practices, and representations of the Alexian Brothers, a religious order of Catholic nursing brothers, and the role of gender in this discourse. Nursing in the United States developed within a cultural framework of caring as part of women's roles in families and communities. Yet, a study of the Alexian Brothers challenges the dominance of the "female" in most gender analyses of nursing. Historical methodology is used to evaluate and interpret data within the broader framework of historiographical literature on gender, religion, and nursing. In analyzing nursing, religion, and gender, attention has been paid to representations, mainly of women, through photographs and written literature. In this article, the same sources are used for men. The story of the Alexian Brothers and the men they educated is a testament to the power of gender and religion in nursing history. These men carved out a system of caring that recognized it as a responsibility not only of women but also of men. As they asserted that their paid work was a Christian calling, they renegotiated dominant notions of masculinity. In doing so, male nurses navigated among an array of representations, from nurse, to school administrator, to military soldier, to religious person, to professional practitioner of scientific medicine. These self-representations in the masculine spaces of the hospital and nursing school were designed to debunk stereotypes of feminine men, and they challenged traditional spatial boundaries.

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.

Reevaluating simulation in nursing education: beyond the human patient simulator.

PubMed

Schiavenato, Martin

2009-07-01

The human patient simulator or high-fidelity mannequin has become synonymous with the word simulation in nursing education. Founded on a historical context and on an evaluation of the current application of simulation in nursing education, this article challenges that assumption as limited and restrictive. A definition of simulation and a broader conceptualization of its application in nursing education are presented. The need for an ideological basis for simulation in nursing education is highlighted. The call is made for theory to answer the question of why simulation is used in nursing to anchor its proper and effective application in nursing education.

Perspectives on Policy and the Value of Nursing Science in a Big Data Era.

PubMed

Gephart, Sheila M; Davis, Mary; Shea, Kimberly

2018-01-01

As data volume explodes, nurse scientists grapple with ways to adapt to the big data movement without jeopardizing its epistemic values and theoretical focus that celebrate while acknowledging the authority and unity of its body of knowledge. In this article, the authors describe big data and emphasize ways that nursing science brings value to its study. Collective nursing voices that call for more nursing engagement in the big data era are answered with ways to adapt and integrate theoretical and domain expertise from nursing into data science.

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 already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Thoughts About Nursing Conceptual Models and the "Medical Model".

PubMed

Fawcett, Jacqueline

2017-01-01

This essay, written to celebrate the 30th anniversary of Nursing Science Quarterly, focuses on the distinctions between the discipline of nursology and the trade of medicine. The distinctions are drawn from content found in nursing conceptual models and from literature about the elusive content of the so-called "medical model."

Ethnic diversity in the nurse workforce: a literature review.

PubMed

Otto, Laureen A; Gurney, Cindy

2006-01-01

In the 2000-2003 New York State Nurses Association Strategic Plan, the Board of Directors called for an assessment of the progress made toward achieving an ethnically diverse nursing workforce as reflected in the literature. In this paper the authors have responded to that request and offer a snapshot of progress as well as standstills in the journey toward diversity. Although the literature has tended to focus on cultural competency of the healthcare worker, and includes numerous calls for action to diversify the nurse workforce, very little scholarly work has been conducted that rigorously evaluates such diversification activities. The purpose of this literature review is to explore existing scholarly work in ethnic diversity at three levels: in the general workforce, the healthcare workforce, and the nursing workforce. The authors explored the literature as it addresses two aspects: academic and career factors influencing diversity; and recruitment, retention, and other strategies employed to diversify the workforce. By exploring the existing research, gaps can be identified in order to either direct further research, or target funding to recruitment strategies to effectively enhance a more ethnically diverse nurse workforce.

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.

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?

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.

Leading change: a concept analysis.

PubMed

Nelson-Brantley, Heather V; Ford, Debra J

2017-04-01

To report an analysis of the concept of leading change. Nurses have been called to lead change to advance the health of individuals, populations, and systems. Conceptual clarity about leading change in the context of nursing and healthcare systems provides an empirical direction for future research and theory development that can advance the science of leadership studies in nursing. Concept analysis. CINAHL, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Health Business Elite and Business Source Premier databases were searched using the terms: leading change, transformation, reform, leadership and change. Literature published in English from 2001 - 2015 in the fields of nursing, medicine, organizational studies, business, education, psychology or sociology were included. Walker and Avant's method was used to identify descriptions, antecedents, consequences and empirical referents of the concept. Model, related and contrary cases were developed. Five defining attributes of leading change were identified: (a) individual and collective leadership; (b) operational support; (c) fostering relationships; (d) organizational learning; and (e) balance. Antecedents were external or internal driving forces and organizational readiness. The consequences of leading change included improved organizational performance and outcomes and new organizational culture and values. A theoretical definition and conceptual model of leading change were developed. Future studies that use and test the model may contribute to the refinement of a middle-range theory to advance nursing leadership research and education. From this, empirically derived interventions that prepare and enable nurses to lead change to advance health may be realized. © 2016 John Wiley & Sons Ltd.

An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study.

PubMed

Wu, Robert; Rossos, Peter; Quan, Sherman; Reeves, Scott; Lo, Vivian; Wong, Brian; Cheung, Mark; Morra, Dante

2011-08-29

Communication between clinicians is critical to providing quality patient care but is often hampered by limitations of current systems. Smartphones such as BlackBerrys may improve communication, but studies of these technologies have been limited to date. Our objectives were to describe how smartphones were adopted for clinical communication within general internal medical wards and determine their impact on team effectiveness and communication. This was a mixed-methods study that gathered data from the frequency of smartphone calls and email messages, clinicians' interviews, and ethnographic observations of clinical communication interactions. Triangulation of qualitative and quantitative data was undertaken to develop common themes that encompass comprehensive and representative insights across different methods. Findings from our study indicated that over a 24-hour period, nurses sent on average 22.3 emails to the physicians mostly through the "team smartphone," the designated primary point of contact for a specific medical team. Physicians carrying the team smartphone received on average 21.9 emails and 6.4 telephone calls while sending out 6.9 emails and initiating 8.3 telephone calls over the 24-hour period. Our analyses identified both positive and negative outcomes associated with the use of smartphones for clinical communication. There was a perceived improvement in efficiency over the use of pagers for clinical communication for physicians, nurses, and allied health professionals. In particular, residents found that the use of smartphones helped to increase their mobility and multitasking abilities. Negative outcomes included frequent interruptions and discordance between what doctors and nurses considered urgent. Nurses perceived a worsening of the interprofessional relationships due to overreliance on messaging by text with a resulting decrease in verbal communication. Unprofessional behaviors were observed in the use of smartphones by residents. Routine adoption of smartphones by residents appeared to improve efficiency over the use of pagers for physicians, nurses, and allied health professionals. This was balanced by negative communication issues of increased interruptions, a gap in perceived urgency, weakened interprofessional relationships, and unprofessional behavior. Further communication interventions are required that balance efficiency and interruptions while maintaining or even improving interprofessional relationships and professionalism.

Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study

PubMed Central

Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris

2016-01-01

ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p < .01). Protocol adaptations addressed barriers (e.g., health records approval, creating pocket versions, distributing with telephone messages). Chart audits revealed that protocols used were documented for 11% to 47% of patient calls. Sustained use requires organizational alignment and ongoing leadership support. Linking Evidence to Action Protocol uptake was similar to trials that have evaluated tailored interventions to improve professional practice by overcoming identified barriers. Collaborating with knowledge users facilitated interpretation of findings, aided protocol adaptation, and supported implementation. Protocol implementation in nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use of evidence‐informed protocols during telephone calls with patients about symptoms. Training and other interventions improved nurses’ confidence with using COSTaRS protocols and their uptake was evident in some documented telephone calls. Protocols could be adapted for use by patients and nurses globally. PMID:27243574

The nurse's lived experience of becoming an interprofessional leader.

PubMed

Stiles, Kim A; Horton-Deutsch, Sara L; Andrews, Catherine A

2014-11-01

In the current complex health care environment, nurses in all practice settings are called on to be leaders in advocating for a healthier future. Health care reform, the rise of the evidence-based practice movement, and the proliferation of new educational options are opening opportunities as never before for nurses to expand their leadership capacity to an interprofessional level. This interpretive phenomenological study conducted with eight nurse participants describes their experience of becoming an interprofessional leader. A team of three nurse researchers interpreted the texts individually and collectively. Interview texts were analyzed hermeneutically to uncover the common shared experience of moving toward common ground with interprofessional leadership as a process, one that not only took time, but also called for self-reflection, deliberate actions, and a new mind-set. This study develops the evidence base for leadership preparation at a time when there is a strong need for interprofessional leaders and educators in health care. Copyright 2014, SLACK Incorporated.

Teaching the Practice of Compassion to Nursing Students within an Online Learning Environment: A Qualitative Study Protocol

ERIC Educational Resources Information Center

Hofmeyer, Anne; Toffoli, Luisa; Vernon, Rachael; Taylor, Ruth; Fontaine, Dorrie; Klopper, Hester C.; Coetzee, Siedine Knobloch

2016-01-01

Background: There is an increasing global demand for higher education to incorporate flexible delivery. Nursing education has been at the forefront of developing flexible online education and offering programs "anywhere and anytime". In response to calls to teach compassion in nursing education, there is an abundance of literature…

Bed Bug Guidance for School Nurses

EPA Pesticide Factsheets

School nurses are often called upon to provide vital information to students, parents, teachers, and administrators. These tips on identifying, managing and preventing bed bugs will help you to effectively respond if bed bugs appear in your school.

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.

"Sign here": nursing value and the process of informed consent.

PubMed

Cook, Wesley E

2014-01-01

Protecting patient autonomy is a key nursing role. The Code of Ethics (American Nurses Association, 2010), contextualizes the nurse's call to advocacy within the doctrine of informed consent. This article offers a primer on the legal, ethical, and practical aspects of procedural informed consent and examines the value of nursing's role within the process. The theory of nursing's value is sound, but the literature lacks data. Higher levels of evidence are necessary to make sound decisions about best practice for the process of informed consent. As such, this article concludes that adding nursing research to the current discourse should prove most valuable to patients, providers, and the nursing profession as a whole.

Understanding the Code: acting in a patient's best interests.

PubMed

Griffith, Richard

2015-09-01

The revised Code of the Nursing and Midwifery Council (NMC), the statutory professional regulator for registered district nurses, makes clear that while district nurses can interpret the values and principles for use in community settings, the standards are not negotiable or discretionary. They must be applied or the district nurse's fitness to practice will be called into question. In this article in the continuing series analysing the legal implications of the Code on district nurse practice, the author considers the fourth standard that requires district nurses to act in the best interests of people at all times.

Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran

PubMed Central

Salarvand, Shahin; Azizimalekabadi, Maryam; Jebeli, Azadeh Akbari; Nazer, Mohamadreza

2017-01-01

Introduction The Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses’ challenges in implementing healthcare reform in Iran. Methods A qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software. Results Challenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people’s misconceptions and solutions. Conclusions The Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for. PMID:28607646

[Sick bodies textualized through images: what contemporary intensive care units can teach us].

PubMed

Vargas, Mara Ambrosina de Oliveira; Meyer, Dagmar Estermann

2003-01-01

This paper belongs to a dissertation in which, what we have call "nursing worker cyborgizing" in intensive therapy is discussed. In order to carry out this discussion we based our work on cultural theorizing, as well as on Donna Haraway understanding of cyborg. For the corpses analysis manuals and assistance protocols were used. The methodological approach used in this work is the cultural analysis, as it has been used in the Poststructuralist Cultural Studies, in order to describe and analyze the production of images of sick bodies and its decoding process through a complex monitoring system in which sick bodies, machines and nursing practitioners, connect in different ways and effects. We have concluded that it is useful and relevant to consider and discuss these instances of production and diffusion of meanings attributed to the body, life, and the Nursing care.

Examining the benefits of learning based on an audience response system when confronting emergency situations.

PubMed

Fernández-Alemán, José Luis; García, Ana Belén Sánchez; Montesinos, María José López; Jiménez, Juan José López

2014-05-01

This article presents an empirical study on the effectiveness of the use of an audience response system called SIstema De Respuesta inmediata de la Audiencia on a nursing course. A total of 130 students of mixed gender, age, and computer experience and educational background on a third-year course in nursing administration and management participated in the study. The benefits of an audience response system as regards learning how to confront emergency situations were studied. The innovative aspect of the proposal is twofold: (1) the use of a smartphone to respond to the questions and (2) the analysis of the students' response time when confronting critical situations while managing nursing resources. A positive impact on the students' performance was revealed in their final assessments. Our findings show that SIstema De Respuesta inmediata de la Audiencia increases student participation and aids in identifying and correcting misconceptions. The students found SIstema De Respuesta inmediata de la Audiencia to be very motivating and wanted it to be used in additional lectures. Further research is required to study the effectiveness of SIstema De Respuesta inmediata de la Audiencia for it to be widely used in other disciplines.

Enacting connectedness in nursing education: moving from pockets of rhetoric to reality.

PubMed

McGregor, Alix

2005-01-01

Nursing education research points to lack of faculty support as a factor in nursing students' voluntary or involuntary withdrawal from nursing education programs. Moreover, despite global trends toward educational processes grounded in humanism that foster egalitarian and liberating student-teacher relationships, nursing students continue to report that some nursing faculty struggle to enact the caring philosophy they espouse. This article showcases how a fourth-year nursing student, interviewed for a study of students who experienced failure or its threat in their nursing program, found strength as she navigated her way through nursing faculty abuse. An interpretative analysis of the student's experiences with a group of faculty whom she describes as intent on failing her calls for future research on student-teacher relationships.

It is important that they care - older persons' experiences of telephone advice nursing.

PubMed

Holmström, Inger K; Nokkoudenmäki, Mai-Britt; Zukancic, Selma; Sundler, Annelie J

2016-06-01

The aim of the study was to explore older persons' experiences of telephone advice nursing at primary healthcare centres. Telephone advice nursing is expanding worldwide, and the older population is increasing. Little is known about older persons' experiences of telephone advice nursing provided by primary healthcare. This study has a descriptive design with a qualitative inductive approach. Data were collected via interviews with a purposive sample of 10 older persons in 2014. The data were analysed using qualitative content analysis. The older persons' experiences were described in two themes: the patient-friendly aspects of telephone advice nursing and the patient-unfriendly aspects of telephone advice nursing. The themes can be understood as two sides of the same coin; the differences point to both the advantages and disadvantages of the service and are further illuminated through seven subthemes. This study contributes to increased awareness of the advantages and disadvantages of the telephone advice nursing system as experienced by older persons. To be the focus of attention during calls was highlighted as important; and clear communication was deemed crucial. When the communication between the nurse and the older persons was perceived as good and the perspective of the caller was the focus, an experience of safety and satisfaction was described. Older persons had great confidence in the telephone nurses' competence and perceived their ability to access the service as mostly good, even if it was sometimes difficult to use the service. The communicative competence of telephone nurses is essential when providing telephone advice nursing to older persons. In addition, a person-centred approach is important to provide optimal care in telephone advice nursing. © 2016 John Wiley & Sons Ltd.

Education, leadership and partnerships: nursing potential for Universal Health Coverage

PubMed Central

Mendes, Isabel Amélia Costa; Ventura, Carla Aparecida Arena; Trevizan, Maria Auxiliadora; Marchi-Alves, Leila Maria; de Souza-Junior, Valtuir Duarte

2016-01-01

Objective: to discuss possibilities of nursing contribution for universal health coverage. Method: a qualitative study, performed by means of document analysis of the World Health Organization publications highlighting Nursing and Midwifery within universal health coverage. Results: documents published by nursing and midwifery leaders point to the need for coordinated and integrated actions in education, leadership and partnership development. Final Considerations: this article represents a call for nurses, in order to foster reflection and understanding of the relevance of their work on the consolidation of the principles of universal health coverage. PMID:26959333

[Assessment of geriatric patients' care needs based on sosia classification: the reality of the lombardy region in nursing home.

PubMed

Vanalli, Mariangela

2016-11-01

The increased demand to care that originates from demographic changes called in Italy a rapid development in Nursing Home with particular emergency the problem of programme the welfare response. It is essential the development of a classification system able to describe the stratification of the case mix on the basis of the care requirements, allowing a remuneration in function of the complexity care. Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini-Mental State Examination on the basis of three indicators (mobility, cognition, comorbidity) is evaluated in eight classes of frailty. However, it is not any research project was published in order to assess the agreement between SOSIA classification and other measuring instruments. Although various methods exist by which researchers have attempted to measure the need for nursing care, there is no nationally accepted system for determining the total amount of registered nursing resources required by residents in long-term care. The aim of this study was to evaluate the correlation between SOSIA and filing systems widely used, such as the degree of Barthel disability rating scale, the Mini-Mental State Examination to offer care appropriate for the case-mix. Only the higher complexity care has classified in the first two classes, while the remaining levels has categorized in the lowest paid. Misclassification therefore induces an underestimation of the real care needs and, consequently, inadequate remuneration.

Changing times: the role of academe in health reform.

PubMed

Hewlett, Peggy O'Neill; Bleich, Michael; Cox, Mary Foster; Hoover, Kim Welch

2009-01-01

What is the role of nursing educators in the politics surrounding health reform? This critical question is posed, and exemplars of how nurse faculty can and should become more involved in the political arena are shared. The authors issue a call to action for every nurse educator in the country to become actively engaged in health reform discussions to bring this all-important perspective to the table. Recognizing and overcoming traditional roles and barriers for nurse faculty on university campuses are essential parts of the political activism that must be assumed. Opening the doors for increased patient access will result in higher utilization of health care providers, and if the nursing shortage is not abated, then bottlenecking of qualified students in programs with critical faculty shortages will create immense pressure in an overloaded care delivery system. The full impact of legislated health reform changes on academe may not be fully realized until after the fact-and as often experienced in the past, this may come too late for policy makers to adequately address questions that should have been raised by the faculty corps beforehand. The time to get involved is now.

Recalling the Doctor to Action--Two Requesting Formats Employed by a Nurse for Making Relevant the Doctor's Intervention

ERIC Educational Resources Information Center

Sterie, Anca Cristina

2015-01-01

At the hospital, nurses' telephone calls to doctors mostly revolve around obtaining doctors' intervention in a medical case. To achieve this, nurses need to make the doctor's intervention relevant, by explicitly requesting it or, more indirectly, by reporting a medical problem. Two recorded telephone conversations have been selected for analysis…

Nurse-led 24-h hotline for patients with chronic obstructive pulmonary disease reduces hospital use and is safe.

PubMed

Roberts, M M; Leeder, S R; Robinson, T D

2008-05-01

Despite recent advances in the management of patients with chronic obstructive pulmonary disease (COPD), interventions to reduce hospitalization have had only modest success. The aim of this study was to report the outcomes of a novel, nurse-led 24-h telephone support line (hotline) for patients with COPD. Observational study of patients' use of hotline between September 2002 and November 2004. All patients with COPD referred to a Respiratory Ambulatory Care programme over this period (n = 458) were given access to the hotline. The number and time of calls to the hotline, outcomes of hotline calls and safety of hotline, were assessed. The characteristics of hotline callers and non-callers were compared using an unpaired Student's t-test for normally distributed variables, a chi(2) test for categorical variables and a Mann-Whitney test for non-normally distributed variables. Over the period studied, 675 calls were made to the hotline by 118 patients and 56% of calls were made after hours. For 78 calls (12%), advice and interventions given by hotline staff averted potential 000 calls by patients/carers. Specific advice about interventions for acute exacerbations of COPD (AECOPD) was given in a further 117 calls (17%). Callers had more severe COPD than non-callers (worse lung function, lower exercise capacity and higher prescription of home oxygen, all P < 0.05). No adverse events related to use of the hotline were documented. A nurse-led 24-h hotline for patients with COPD is safe, is used by patients and carers and, when used, reduces hospital presentations with AECOPD.

Developing a medical emergency team running sheet to improve clinical handoff and documentation.

PubMed

Mardegan, Karen; Heland, Melodie; Whitelock, Tifany; Millar, Robert; Jones, Daryl

2013-12-01

During medical emergency team (MET) and cardiac arrest calls, a scribe usually records events on a running sheet. There is more agreement on what data should be recorded in cardiac arrest calls than for MET calls. In addition, handoff (handover) from ward staff to the arriving MET may be variable. In a quality improvement project, a novel MET running sheet was developed to document events and therapies administered during MET calls. Key characteristics of the form were improved form layout, increased space for event documentation, and prompts to assist handoff to the arriving MET using the Identity Situation, Background, Assessment, Request (ISBAR) format. Ward nurses commonly involved in MET activation were surveyed to assess their perceptions of the new MET running sheet. Files of 100 consecutive MET calls were reviewed to assess compliance. Of 109 nurses invited to complete the survey, 103 did so (94.5% response rate). Overall, 87 (84.5%) of the 103 respondents agreed or strongly agreed that the new MET running sheet was better than the previous form for documenting MET management, and 58 (57.4%) of 101 respondents agreed or strongly agreed that it assisted handoff. The form was completed in 91 of a sample of 100 consecutive MET calls. Areas of less complete documentation included aspects of the ISBAR handover to the arriving MET and notification of the next of kin and usual clinicians at the completion of the call. The MET running sheet, tailored to the clinical events that occur during episodes of MET review, may assist handoff from ward nurses to the arriving MET and event documentation.

Callers' Ability to Understand Advice Received from a Telephone Health-Line Service: Comparison of Self-Reported and Registered Data

PubMed Central

Leclerc, Bernard-Simon; Dunnigan, Lise; Côté, Harold; Zunzunegui, Maria-Victoria; Hagan, Louise; Morin, Diane

2003-01-01

Objective To validate users' perception of nurses' recommendations to look for another health resource among clients seeking teleadvice. To analyze the effects of different users' and call characteristics on the incorrectness of the self-report. Data Sources/Study Setting This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted in 1997 among users of Info-Santé CLSC, a no-charge telenursing health-line service (THLS) available all over the province of Québec. Study Design/Data Collection Self-reported advice from follow-up survey phone interviews, conducted within 48 to 120 hours after the participant's call, were compared to the data consigned by the nurse in the computerized call record. Covariables concerned characteristics of callers, context of the calls, and satisfaction about the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses. Principal Findings Advice to consult were recorded by the nurse in 42 percent of cases, whereas 39 percent of callers stated they had received one. Overall disagreement between the two sources is 27 percent (12 percent by false positive and 15 percent by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR=2.5), calls relating to psychological problems (OR=2.8), perceived seriousness (OR=∼2.6), as well as others, were associated with inaccurate reports. Conclusions Telephone health-line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, insure better understanding of advice by callers, and contribute to more effective service. PMID:12785568

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 patient satisfaction in hospitals. Our study provides empirical support for the ‘equal pay for equal work’ policy emphasized by the China Ministry of Health’s recent regulations, and calls for efforts in Chinese hospitals to eliminate the disparities between ‘bianzhi’ and contract-based nurses. PMID:24418223

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 empirical support for the 'equal pay for equal work' policy emphasized by the China Ministry of Health's recent regulations, and calls for efforts in Chinese hospitals to eliminate the disparities between 'bianzhi' and contract-based nurses.

Evidence-based nursing: a stereotyped view of quantitative and experimental research could work against professional autonomy and authority.

PubMed

Bonell, C

1999-07-01

In recent years, there have been calls within the United Kingdom's National Health Service (NHS) for evidence-based health care. These resonate with long-standing calls for nursing to become a research-based profession. Evidence-based practice could enable nurses to demonstrate their unique contribution to health care outcomes, and support their seeking greater professionalization, in terms of enhanced authority and autonomy. Nursing's professionalization project, and, within this, various practices comprising the 'new nursing', whilst sometimes not delivering all that was hoped of them, have been important in developing certain conditions conducive to developing evidence-based practice, notably a critical perspective on practice and a reluctance merely to follow physicians' orders. However, nursing has often been hesitant in its adoption of quantitative and experimental research. This hesitancy, it is argued, has been influenced by the propounding by some authors within the new nursing of a stereotyped view of quantitative/experimental methods which equates them with a number of methodological and philosophical points which are deemed, by at least some of these authors, as inimical to, or problematic within, nursing research. It is argued that, not only is the logic on which the various stereotyped views are based flawed, but further, that the wider influence of these viewpoints on nurses could lead to a greater marginalization of nurses in research and evidence-based practice initiatives, thus perhaps leading to evidence-based nursing being led by other groups. In the longer term, this might result in a form of evidence-based nursing emphasizing routinization, thus--ironically--working against strategies of professional authority and autonomy embedded in the new nursing. Nursing research should instead follow the example of nurse researchers who already embrace multiple methods. While the paper describes United Kingdom experiences and debates, points raised about the importance of questioning stereotyped views of research should have international relevance.

Lowering risk of CMV.

PubMed

Pearce, Lynne

Teenager Alicia Parks' severe disabilities are the result of being born with congenital cytomegalovirus (CMV). Alicia's mother, paediatric nurse Mandy Parks, is calling for greater awareness of CMV among nurses. She explains the simple precautions that can reduce the spread of this common infection.

[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.

Impact of telepharmacy in a multihospital health system.

PubMed

Garrelts, James C; Gagnon, Mark; Eisenberg, Charlese; Moerer, Janell; Carrithers, Joe

2010-09-01

The impact of telepharmacy in a multihospital health system was evaluated. Telepharmacy services were implemented at five hospitals within a Catholic, nonprofit, integrated delivery network health system. Telepharmacy services were provided by seven pharmacists employed by the health system. Using a virtual private network or terminal server, pharmacists directly accessed hospital servers and information systems to conduct their work. Telephone calls were automatically routed to the telepharmacist so that handling of nursing and other calls would be transparent to staff. Hours of telepharmacy service were 5 p.m. to 2 a.m. Monday through Friday evenings at four of the hospitals and 8 p.m. to 10 p.m. at the rural hospital. Order-processing time for routine orders was reduced from 26.8 to 14 minutes (p < 0.0001), while stat order processing was shortened from 11.6 to 8.8 minutes (p = 0.007). For routine orders, turnaround times greater than 60 minutes became almost nonexistent after telepharmacy services were implemented. The number of clinical interventions documented increased by 42%, from 619 to 881, equivalent to a net annualized saving of $1,132,144. A significant improvement in nurses' global satisfaction with pharmacist availability for unit consultations was reported (3.0 versus 4.0 on a 5.0 Likert scale; p = 0.028). The implementation of telepharmacy services in a multihospital health system expanded hours of service, improved the speed of processing of physician medication orders, and increased clinical pharmacy services and cost avoidance. Surveys of health care staff found that telepharmacy services were well received.

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.

Active Care Management Supported by Home Telemonitoring in Veterans With Type 2 Diabetes

PubMed Central

Stone, Roslyn A.; Rao, R. Harsha; Sevick, Mary Ann; Cheng, Chunrong; Hough, Linda J.; Macpherson, David S.; Franko, Carol M.; Anglin, Rebecca A.; Obrosky, D. Scott; DeRubertis, Frederick R.

2010-01-01

OBJECTIVE We compared the short-term efficacy of home telemonitoring coupled with active medication management by a nurse practitioner with a monthly care coordination telephone call on glycemic control in veterans with type 2 diabetes and entry A1C ≥7.5%. RESEARCH DESIGN AND METHODS Veterans who received primary care at the VA Pittsburgh Healthcare System from June 2004 to December 2005, who were taking oral hypoglycemic agents and/or insulin for ≥1 year, and who had A1C ≥7.5% at enrollment were randomly assigned to either active care management with home telemonitoring (ACM+HT group, n = 73) or a monthly care coordination telephone call (CC group, n = 77). Both groups received monthly calls for diabetes education and self-management review. ACM+HT group participants transmitted blood glucose, blood pressure, and weight to a nurse practitioner using the Viterion 100 TeleHealth Monitor; the nurse practitioner adjusted medications for glucose, blood pressure, and lipid control based on established American Diabetes Association targets. Measures were obtained at baseline, 3-month, and 6-month visits. RESULTS Baseline characteristics were similar in both groups, with mean A1C of 9.4% (CC group) and 9.6% (ACM+HT group). Compared with the CC group, the ACM+HT group demonstrated significantly larger decreases in A1C at 3 months (1.7 vs. 0.7%) and 6 months (1.7 vs. 0.8%; P < 0.001 for each), with most improvement occurring by 3 months. CONCLUSIONS Compared with the CC group, the ACM+HT group demonstrated significantly greater reductions in A1C by 3 and 6 months. However, both interventions improved glycemic control in primary care patients with previously inadequate control. PMID:20009091

Quality of nurses' work life: strategies for enhancement.

PubMed

Davis, B; Thorburn, B

1999-01-01

The radical transformation resulting from health care reform, with its emphasis on restructuring, reorganizing and downsizing, has impacted on the nursing profession and has profoundly effected the quality of nurses' work life. The Health Care Corporation of St. John's experienced the stress associated with change when it simultaneously merged eight health care sites and introduced a programmed-based management structure. This article reviews the strategies developed in response to this transition by the Nurses' Quality of Worklife Team, to help reduce stress and enhance the quality of nurses' work life. In particular, it highlights the development and implementation of a professional support network called the Nursing Peer Support Program.

A sharing in critical thought by nursing faculty.

PubMed

Hendricks-Thomas, J; Patterson, E

1995-09-01

A critical analysis of nurse education programmes has revealed an overt and covert curriculum; the overt being the one underpinned by values which espouse humanism and critical thought; the covert being the one which reflects the patriarchal system and is directed by a means-end rationality. In response to this dilemma the 'curriculum revolution' mandate for change, which occurred in the latter half of the last decade, called for nurse educators to unveil, understand and criticize the assumptions and values which guided their practice, so that they, and consequently their students, could be more responsive to the needs of society, value subjective experience, acknowledge theoretical pluralism, and share an egalitarian relationship. This paper explores the formation of a 'critical collective' of nurse academics who came together believing that, 'if you always do what you've always done, you'll always get what you've already got'. The major concern of this collective was to facilitate change within their work environment, through the development of strategies, so that the ideas of the 'revolution' were not lost to the mere rhetoric of curriculum documents.

Best Practices for Pressure Ulcer Prevention in the Burn Center.

PubMed

Warner, Julia; Ann Raible, Mary; Hajduk, Gina; Collavo, Jacqueline

The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent. Nurses demonstrated varied levels of knowledge about products used for prevention. It became imperative to examine processes within the unit and provide nursing with education, access to skin care supplies, and advanced skin/wound care products for maintaining skin integrity. Creation of evidence-based guidelines was necessary to improve patient outcomes. A collaborative team approach influenced nursing and physician awareness of pressure ulcer risk. Evidence-based prevention guidelines were developed, and consistency in early intervention was achieved, supporting our culture of safety. A change in interprofessional collaborative practice and positive trend in pressure ulcer incidence data supports the success of our program.

How to Prevent Tooth Decay in Your Baby

MedlinePlus

... life-threatening infections. Tooth decay (called early childhood caries) is the most common chronic infectious disease of childhood. Tooth decay may also be called nursing caries or baby bottle tooth decay . Healthy dental habits ...

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.

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.

Motives that head and neck cancer patients have for contacting a specialist nurse - an empirical study.

PubMed

Salander, Pär; Isaksson, Joakim; Granström, Brith; Laurell, Göran

2016-11-01

The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a specialist nurse during two years postdiagnosis. Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer. Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse. Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included. In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals. The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals. When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspective. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable. © 2016 John Wiley & Sons Ltd.

Stress amongst nurses working in a healthcare telephone-advice service: relationship with job satisfaction, intention to leave, sickness absence, and performance.

PubMed

Farquharson, Barbara; Allan, Julia; Johnston, Derek; Johnston, Marie; Choudhary, Carolyn; Jones, Martyn

2012-07-01

This paper is a report of a study, which assessed levels of stress amongst nurses working in a healthcare telephone-advice service. We explored whether stress related to performance, sickness absence, and intention to leave. Nurses report high levels of stress, as do call-centre workers. The emergence of telephone health advice services means many nurses now work in call-centres, doing work that differs markedly from traditional nursing roles. Stress associated with these roles could have implications for nurses, patients, and service provision. This paper reports cross-sectional survey results. The design of the overall study included longitudinal elements. A comprehensive study of stress was conducted amongst nurses working for a telephone-advice service in Scotland (2008-2010). All nurse-advisors were approached by letter and invited to participate. A total of 152 participants (33%) completed a questionnaire including General Health Questionnaire-12, Work Family Conflict Questionnaire, Job Satisfaction Scale and a measure of intention to leave the telephone-advice service and rated the perceived stress of 2 working shifts. Nurses' employers provided data on sickness absence and performance. Overall levels of psychological distress were similar to those found amongst Scottish women generally. In multiple regression, work-family conflict was identified as a significant predictor of job satisfaction and intention to leave, and significantly related to sickness absence. There were significant correlations between General Health Questionnaire scores and perceived stress of shifts and some performance measures. Work-family conflict is a significant predictor of job satisfaction, intention to leave, and sickness absence amongst telephone helpline nurses. Minimizing the impact of nurses' work on their home lives might reduce turnover and sickness absence. © 2012 Blackwell Publishing Ltd.

Results of the 2005 AORN salary survey--trends for perioperative nursing.

PubMed

Bacon, Donald

2005-12-01

AORN conducted its annual compensation survey for perioperative nurses in August 2005. A multiple regression model was used to examine how a variety of variables, including job title, education level, certification, experience, and geographic region, affect nursing compensation. This survey also examines the effect of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differential) on average base compensation rates.

Results of the 2006 AORN salary survey: trends for perioperative nursing.

PubMed

Bacon, Donald

2006-12-01

AORN CONDUCTED ITS ANNUAL compensation survey for perioperative nurses in August 2006. MULTIPLE REGRESSION MODEL was used to examine how a variety of variables, including job title, education level, certification, experience, and geographic region, affect nursing compensation. THIS SURVEY ALSO EXAMINES the effect of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differential) on average base compensation rates.

Accredited Baccalaureate Nursing Programs Utilization of an Academic Plan Model and the Factors That Influence Curriculum Decision Making

ERIC Educational Resources Information Center

Holmquist, Traci McDonald

2012-01-01

Curriculum reform is a topic seen in research for decades, and nursing education has not been excluded in this call for reform (Benner, Sutphen, Leonard, & Day, 2009; Diekelmann, Ironside, & Gunn, 2005; Dracup, 2011). The issue in nursing education relates to the lack of guidance in how to proceed with this radical change process (Benner,…

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.

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.

Power sharing. A transformational strategy for nurse retention, effectiveness, and extra effort.

PubMed

Trofino, Joan

2003-01-01

Power sharing with staff nurses is an essential strategy for organizational transformation. The current competitive health care environment requires a powerful team of participants, including staff at all levels, to provide health care in mutual partnership. The challenges of today's competitive and global environment call for collegial relationships among nurse executive leadership, middle nurse managers, and staff nurses. Research has demonstrated that middle nurse managers maintain primary responsibility for staff nurse retention. A higher retention rate was reported among nurses who were very satisfied with their nurse managers. Nurses considered favorably nurse managers who value staff contributions, promote information sharing, and exert influence for a stable work environment. Furthermore, as staff nurse satisfaction increased, effectiveness and extra effort also increased when staff nurses perceived transformational leadership strategies. Strategies for power sharing include serving as role models and mentors, energizing staff, resisting attitudes of staff ownership, reducing staff nurse stress of leader presence, and information sharing and commendations at meetings.

Story sharing: restoring the reciprocity of caring in long-term care.

PubMed

Heliker, Diane

2007-07-01

Residents in long-term care facilities often experience an interruption in the reciprocity of caring, inadvertently cut off when they enter the unfamiliar surroundings of a residential health care system. This transition from the give and take of caring to being completely cared for often leads to a breakdown of meaning, a loss of identity, and loneliness. This article addresses how an intervention called story sharing can restore the reciprocity of caring. Beginning with a review of the significance and functions of storytelling and listening, a specific story sharing intervention-the mutual sharing of everyday experiences among nurse aides and the nursing home residents for whom they care-is described. The theoretical and practice implications of story sharing are discussed.

Low back pain among nurses in Slovenian hospitals: cross-sectional study.

PubMed

Skela-Savič, B; Pesjak, K; Hvalič-Touzery, S

2017-12-01

The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings. © 2017 International Council of Nurses.

The Hidden Curriculum: What Are We Actually Teaching about the Fundamentals of Care?

PubMed

MacMillan, Kathleen

2016-01-01

The issues of missed or inadequately provided basic nursing care and related complications are being identified as worldwide phenomena of interest. Without being aware of it, educators and practicing nurses may be teaching nursing students that fundamental nursing care is unimportant, uncomplicated and not really nursing's responsibility. This paper explores the concept of the "hidden curriculum" in nursing education, as it relates to fundamental nursing care and calls for greater partnerships between education and service to uncover the hidden curriculum; to effectively shape it to achieve alignment between classroom and practice; and, ultimately, to improve care processes and patient outcomes through collaboration. A renewed focus on the vital importance of what is considered "basics" to patient outcomes is required in nursing education. Copyright © 2016 Longwoods Publishing.

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.

Nurse Education and Professional Work: Transition Problems?

ERIC Educational Resources Information Center

Kapborg, Inez D.; Fischbein, Siv

1998-01-01

Eight nursing students kept diaries during their transition from school to professional work. Common problems included management of paperwork, heavy workload, difficulty feeling relaxed when off duty, difficulty in determining what to delegate and when to call for doctors, and tending to seriously ill patients. (SK)

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.

Infiltration and extravasation.

PubMed

Hadaway, Lynn

2007-08-01

The Infusion Nurses Society's national standards of practice require that a nurse who administers IV medication or fluid know its adverse effects and appropriate interventions to take before starting the infusion. A serious complication is the inadvertent administration of a solution or medication into the tissue surrounding the IV catheter--when it is a nonvesicant solution or medication, it is called infiltration; when it is a vesicant medication, it is called extravasation. Both infiltration and extravasation can have serious consequences: the patient may need surgical intervention resulting in large scars, experience limitation of function, or even require amputation. Another long-term effect is complex regional pain syndrome, a neurologic syndrome that requires long-term pain management. These outcomes can be prevented by using appropriate nursing interventions during IV catheter insertion and early recognition and intervention upon the first signs and symptoms of infiltration and extravasation. Nursing interventions include early recognition, prevention, and treatment (including the controversial use of antidotes, and heat and cold therapy). Steps to manage infiltration and extravasation are presented.

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.

A Review and Critique of Advances in Nursing Science Articles That Focus on Sexual Health and Sexual Rights: A Call to Leadership and Policy Development.

PubMed

Rew, Lynn; Thurman, Whitney; McDonald, Kari

Sexual health and sexual rights are integral to nursing science but ignored in nursing publications. We searched Advances in Nursing Science for prevalence of these topics. Fifteen articles (1.3%) met our criteria. No nursing theories were used as frameworks, and few concrete suggestions were made for further theory development. Discussion of sociopolitical influences on sexual health and/or sexual rights was limited, mostly unrelated to health care. Information to influence nursing practice, theory development, further research, or policy across the life span, for both males and females, and for variant-gender individuals, was limited. We urge authors to contribute further to this field of discourse in nursing.

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.

Leadership by collaboration: Nursing's bold new vision for academic-practice partnerships.

PubMed

Sebastian, Juliann G; Breslin, Eileen T; Trautman, Deborah E; Cary, Ann H; Rosseter, Robert J; Vlahov, David

In 2016 the American Association of Colleges of Nursing issued a report, Advancing Healthcare Transformation: A New Era for Academic Nursing that included recommendations for more fully integrating nursing education, research, and practice. The report calls for a paradigm shift in how nursing leaders in academia and practice work together and with other leaders in higher education and clinical practice. Only by doing so can we realize the full benefits of academic nursing in this new era in which integration and collaboration are essential to success. In this paper we: 1) examine how academic nursing can contribute to healthcare innovation across environments; 2) explore leadership skills for deans of nursing to advance the goals of academic nursing in collaboration with clinical nursing partners, other health professions and clinical service leaders, academic administrators, and community members; and, 3) consider how governance structures and policy initiatives can advance this work. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Sailing the "Seven C's" of Leadership.

PubMed

Weismuller, Penny C; Willgerodt, Mayumi A; McClanahan, Rachel; Helm-Remund, Terri

2016-01-01

Nurses are increasingly being called upon to lead changes within health care. How do nurses and, in particular, school nurses become leaders? School nurses lead daily in their work but often do not recognize themselves as leaders. The "Five C's of Leadership"-character, commitment, connectedness, compassion, and confidence-identified by Kowalski and Yoder-Wise are foundational to the development of leadership and are particularly relevant to school nurses and their role. Two additional attributes found in the literature-courage and capacity-also undergird school nursing practice. In this article, we describe how school nurses already embody these leadership qualities. Each leadership attribute is reviewed in light of the literature, followed by specific examples to demonstrate how school nurses provide leadership. Through these illustrations, school nurses can recognize and embrace their present leadership abilities. In addition, by using the "Seven C's" of leadership, school nurses can enhance their inherent leadership abilities. © 2015 The Author(s).

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.

Call to action for Scottish health care.

PubMed

2001-03-07

SCOTLAND'S NEWLY published strategy for nursing and midwifery, Caring for Scotland, is a reminder of how different professional life can be for nurses across the UK. For example, while developments in telehealth and telemedicine facilities are certainly not unique to the remote rural areas of Scotland, there can be few nurses who can claim to be the sole health professional on a non-doctor island. One such district nurse looks forward with optimism to seeing the effect of the World Health Organization pilot family health nursing programme on her professional credibility. Perhaps not surprisingly, there is a fair bit of emphasis on helping nurses who work in remote and rural areas to develop their practice.

Getting past widgets and digits: the fundamental transformation of the foundations of nursing practice.

PubMed

Porter-O'Grady, Tim

2014-01-01

Health reform and transformation now call for the creation of a new landscape for nursing practice based on intentional translation application of value-driven measures of service, quality, and price. Nursing is a central driver in the effective recalibration of health care within the rubric of health transformation under the aegis of the Patient Protection and Affordable Care Act. Increasingly relying on a growing digital infrastructure, the nursing profession must now reframe both its practice foundations and patterns of practice to reflect emerging value-driven, health-grounded service requisites. Specific nursing responses are suggested, which position nursing to best coordinate, integrate, and facilitate health delivery in the emerging value-driven service environment.

All the young men gone: losing men in the gentrification of Australian nursing circa 1860-1899.

PubMed

Barber, J

1996-12-01

Men played an important role in nursing in colonial Australia. However the number of men undertaking nursing duties declined dramatically in the second half of the nineteenth century. Reasons for this are explored in relation to ramifications of the introduction of the Nightingale pattern of nurse training in Australia, which occurred within the Victorian ethos of gentility and decorum. In this context, nursing came to be seen as a calling that was natural and appropriate for women. The controlled, decorous ambience of nursing, its subservient relationship to medicine and the attractiveness to employers of female pay rates are all associated with the decline in male participation over this period.

Longitudinal analysis of personal and work-related factors associated with turnover among nurses.

PubMed

Estryn-Behar, Madeleine; van der Heijden, Beatrice I J M; Fry, Clementine; Hasselhorn, Hans-Martin

2010-01-01

Although many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. This longitudinal study examines specific determinant factors that differentiate between so-called "stayers" and "leavers" within the nursing profession and identifies risk factors for premature leaving by comparing nurses who have left their job or the nursing profession with nurses who stay. This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions and was composed of two measurements with a 1-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their healthcare institution. Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months than those among nurses who stayed (24.0% vs. 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were (a) working conditions (e.g., relationship problems, emotional difficulties, time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) and (b) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave. Healthcare organizations should pay attention to preventive measures to protect labor market potential. Recommendations are made for human resource development in healthcare organizations and for further empirical research to better understand to what extent different policy systems across the European countries explain variance in outcomes.

A salaried compensation model for postanesthesia nurses.

PubMed

Mushala, M E; Henderson, M A

1995-08-01

Health care organizations involved in innovative and creative work redesign projects may find traditional pay structures inadequate to meet the needs of the changing environment. The idea of salaried compensation for registered nurses is not unprecedented. However, few salaried compensation models for nurses are described in the literature. This article presents a model that we believe will be of particular interest to nurses in PACUs, because its design allows for adequate call coverage plus flexibility in scheduling. In addition, this compensation model eliminates incidental overtime, thus allowing for a more predictable salary budget.

Using quantum principles to develop independent continuing nursing education programs.

PubMed

Zurlinden, Jeffrey; Pepsnik, Dawn

2013-01-01

Innovations in health care call for fresh approaches to continuing nursing education that support lateral relationships, teamwork, and collaboration. To foster this transformation, we devised the following education principles: Everyone teaches, everyone learns; embrace probability; information is dynamic; and trust professionals to practice professionally. These principles guided the development of seven independent, practice-specific, evidence-based continuing nursing education programs totaling 21.5 contact hours for casual-status nurses who practiced as childbirth educators. The programs were popular, promoted teamwork, and increased communication about evidence-based practice.

An examination of the sustainable adoption of whole-person care (WPC).

PubMed

Joseph, M Lindell; Laughon, Debbie; Bogue, Richard J

2011-11-01

This study illustrates how King's theory of goal attainment was used to focus an examination of whole-person care (WPC) and to extend the range of knowledge needed for WPC and nursing practice. Leadership implemented a faith-based innovation using continuing education for patient care that incorporates body-mind-spirit and eight principles called CREATION. Three questions arose: (1) Is there an evidence-based framework to determine whether the philosophy supports the discipline of nursing? (2) How extensive is the adoption and application of WPC? (3) Does the model make a difference in the context of nurse-patient interactions and outcomes in support of Magnet recognition criteria? Interpretative phenomenology was used and an interview protocol was developed to examine the adoption and movement toward a culture of WPC. WPC was 'lived.' it is a relationship-oriented patient care model. However, except in direct patient care, the principles of creation were poorly diffused. These results contribute to nursing leadership's roles in fostering a workplace climate that enables the diffusion of innovative models of care. In addition, these results support the Institute of Medicine's call for nurses to take the lead in adopting innovations and provides leaders with actionable strategies. © 2011 Blackwell Publishing Ltd.

The impact of simulation education on self-efficacy towards teaching for nurse educators.

PubMed

Garner, S L; Killingsworth, E; Bradshaw, M; Raj, L; Johnson, S R; Abijah, S P; Parimala, S; Victor, S

2018-03-23

The objective of this study was to assess the impact of a simulation workshop on self-efficacy towards teaching for nurse educators in India. Additionally, we sought to revise and validate a tool to measure self-efficacy in teaching for use with a global audience. Simulation is an evidence-based teaching and learning method and is increasingly used in nursing education globally. As new technology and teaching methods such as simulation continue to evolve, it is important for new as well as experienced nurse educators globally to have confidence in their teaching skills and abilities. The study included (1) instrument revision, and measures of reliability and validation, (2) an 8-h faculty development workshop intervention on simulation, (3) pre- and post-survey of self-efficacy among nurse educators, and (4) investigation of relationship between faculty socio-demographics and degree of self-efficacy. The modified tool showed internal consistency (r = 0.98) and was validated by international faculty experts. There were significant improvements in total self-efficacy (P < 0.001) and subscale scores among nurse educators after the simulation workshop intervention when compared to pre-survey results. No significant relationships were found between socio-demographic variables and degree of self-efficacy. Strong self-efficacy in teaching among nurse educators is crucial for effective learning to occur. Results indicated the simulation workshop was effective in significantly improving self-efficacy towards teaching for nurse educators using an internationally validated tool. The Minister of Health in India recently called for improvements in nursing education. Introducing nursing education on simulation as a teaching method in India and globally to improve self-efficacy among teachers is an example of a strategy towards meeting this call. © 2018 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

Ontology-based reusable clinical document template production system.

PubMed

Nam, Sejin; Lee, Sungin; Kim, James G Boram; Kim, Hong-Gee

2012-01-01

Clinical documents embody professional clinical knowledge. This paper shows an effective clinical document template (CDT) production system that uses a clinical description entity (CDE) model, a CDE ontology, and a knowledge management system called STEP that manages ontology-based clinical description entities. The ontology represents CDEs and their inter-relations, and the STEP system stores and manages CDE ontology-based information regarding CDTs. The system also provides Web Services interfaces for search and reasoning over clinical entities. The system was populated with entities and relations extracted from 35 CDTs that were used in admission, discharge, and progress reports, as well as those used in nursing and operation functions. A clinical document template editor is shown that uses STEP.

United We Stand, Divided We Fall: Increasing Response Capability in Kentucky through Regionalization and Leadership

DTIC Science & Technology

2011-03-01

trust (Yang & Mossholder, 2010). In “Disaster and Emergency Management: Canadian Nurses ’ Perceptions of Preparedness on Hospital Front Lines,” the...authors examined nurses ’ perceptions in terms of their confidence rating of their level of preparedness, awareness of hospital plans, perceptions of...significant role in the ice storm response. Public health nurses worked in shelters; environmentalists were called upon to ensure that restaurants with

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.

[(Re)configuration of the nursing field in the new state (1937-1945)].

PubMed

Barreira, Ieda de Alencar; Baptista, Suely de Souza

2002-01-01

The subject of this study is the changes the nursing field went through during the period called Novo Estado. Analyze the nursing environment in the Federal Capital during the period mentioned; discuss the effects of the influence of the Catholic Church and nurses of the American government in the Brazilian nursing environment. Documents obtained from the Documentation Center in Anna Nery/UFRJ School of Nursing and from literature on the topic. The interpretation of the findings was based on the Theory of the Social World by Pierre Bourdieu. Results showed deep changes in terms of professional education, labor market and institutionalization of the nursing assistance in a period (after the World War II) in which the Catholic Church and the United States had increased their power and influence. This new context determined the reconfiguration of the identity of Brazilian nurses and of the nursing field.

75 FR 59720 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... instruments, e-mail [email protected] or call the HRSA Reports Clearance Officer on (301) 443-1129. Comments... Nursing Education Loan Repayment Program Application (OMB No. 0915-0140)--[Revision] This is a request for revision of the Nursing Education Loan Repayment Program (NELRP) application and participant monitoring...

Using Angels and Devils: A Board Game Developed for Play in Nursing Homes.

ERIC Educational Resources Information Center

Corbin, Sandra; Nelson, Thomas M.

1980-01-01

Studied effects on nursing home residents playing a discussion-stimulating board game called "Angels and Devils." Results indicate a high incidence of sensory deprivation and social isolation effects. These do not correlate with length of institutionalization, amount of social contact, or degree of medical restriction. (Author)

Psychological Factors Associated with Paranursing Expertise.

ERIC Educational Resources Information Center

Brammer, Robert; Haller, Katherine

The psychological factors associated with paranursing expertise were examined in a study of 135 certified nursing assistants (CNAs) at a geriatric nursing facility in Amarillo, Texas. Data were collected through a project-developed screening tool called the Geriatric Employee Screening Tool (GEST), which is a true-false instrument patterned after…

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.

Neonatal Nurses Experience Unintended Consequences and Risks to Patient Safety With Electronic Health Records.

PubMed

Dudding, Katherine M; Gephart, Sheila M; Carrington, Jane M

2018-04-01

In this article, we examine the unintended consequences of nurses' use of electronic health records. We define these as unforeseen events, change in workflow, or an unanticipated result of implementation and use of electronic health records. Unintended consequences experienced by nurses while using electronic health records have been well researched. However, few studies have focused on neonatal nurses, and it is unclear to what extent unintended consequences threaten patient safety. A new instrument called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire has been validated, and secondary analysis using the tool explored the phenomena among neonatal nurses (N = 40). The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record, changes to the workflow, and altered communication patterns. Neonatal nurses used workarounds most often with motivation to better assist patients. Teamwork was moderately related to higher unintended consequences including patient safety risks (r = 0.427, P = .007), system design (r = 0.419, P = .009), and technology barriers (r = 0.431, P = .007). Communication about patients was reduced when patient safety risks were high (r = -0.437, P = .003). By determining the frequency with which neonatal nurses experience unintended consequences of electronic health record use, future research can be targeted to improve electronic health record design through customization, integration, and refinement to support patient safety and better outcomes.

Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.

PubMed

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

2015-05-20

Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the 'worry or concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses' worry or concern about a patient's condition. We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: 'nurses', 'worry/concern' and 'deterioration'. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014. The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs. The signs and symptoms we found in the literature reflect the nature of nurses' worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration.

Nurse Educator Attitudes Toward People With Disabilities.

PubMed

Lyon, Lori; Houser, Rick

As educators strongly influence the attitudes of their students, the purpose of this study was to determine nurse educator attitudes toward people with disabilities. Inadequate education of health professionals is a known barrier to care for people with disability. Continuing calls for improved education of health professionals compel an assessment of nurse educator attitudes. This was a cross-sectional, correlational web-based survey of nurse educators (n = 126). Nurse educator attitudes were analyzed using descriptive statistics, analysis of variance, and multiple regression analysis. Nurse educators held discriminatory attitudes toward people with disabilities, though most preferred a biopsychosocial model of disability. Forty-four percent lacked knowledge of disability-related aims, objectives, or outcomes within the curriculum. To advance equity in health care, nurse educators must confront personal bias and teach competent care of people with disabilities.

Challenges to research productivity of doctoral program nursing faculty.

PubMed

Smeltzer, Suzanne C; Sharts-Hopko, Nancy C; Cantrell, Mary Ann; Heverly, Mary Ann; Wise, Nancy J; Jenkinson, Amanda; Nthenge, Serah

2014-01-01

The Institute of Medicine, responding to a national health care crisis and related nursing labor force concerns, has called for an increase in the proportion of registered nurses with baccalaureate or higher degrees to 80% and a doubling of the number of nurses with doctorates by 2020. Simultaneously, large numbers of senior faculty are starting to retire, whereas the movement of doctorally prepared nurses into academia is insufficient to replace them. Issues associated with the efforts of nursing programs to increase their capacity to respond to the Institute of Medicine's recommendations, particularly the effect on scholarly productivity among nursing faculty in doctoral programs, are examined in this article. Creative strategies for promoting scholarly productivity among doctoral program faculty are identified. Copyright © 2014 Elsevier Inc. All rights reserved.

[Longitudinal analysis of personal and work-related factors associated with turnover among nurses].

PubMed

Estryn-Behar, Madelaine; Van Der Heijden, Béatrice I J M; Fry, Clémentine; Hasselhorn, Hans-Martin

2010-12-01

While many scholars have acknowledged the relationship between personal and work-related factors associated with job search and actual turnover, there is a lack of longitudinal designs that test this relationship empirically. This longitudinal study examines specific determinant factors that differentiate between so-called 'stayers' and 'leavers' within the nursing profession, and identifies risk factors for premature leaving by comparing nurses who have left their job, or the nursing profession, with nurses who stay. This cross-national exploratory European survey included 34,587 nurses (baseline measurement) working in 623 hospitals, nursing homes, and home care institutions, and comprised two measurements with a one-year time interval. The final samples for the follow-up measurement included 14,016 stayers and 866 leavers. As regards the leavers, the participating nurses were asked to indicate to what extent personal and work-related factors had contributed to the decision to leave their health care institution. Nurses' intent-to-leave scores were higher in the baseline measurement among those who left the organization during the following 12 months, than among those who stayed (24.0% versus 13.5%). A majority of nurses (86.8%) left their profession voluntarily. Involuntary departure occurred more often in Eastern European countries. Nurses indicated that the reasons for leaving were: working conditions (e.g., relationship problems, emotional difficulties,time pressure and quality of care, dissatisfaction with use of one's competence and lack of autonomy, work schedule difficulties, and dissatisfaction with pay) family reasons (e.g., caring for relatives). For a considerable number of nurses, health reasons and the desire for continuing education added to their decision to leave. Health care organizations should pay attention to preventive measures in order to protect labor market potential. Recommendations are made for human resource development in health care organizations and for further empirical research to better understand to what extent different policy systems across the European countries explain variance in outcomes.

[Learning by doing? The restructuring of nursing education after 1945].

PubMed

Kreutzer, Susanne

2007-01-01

This study deals with the reform of nursing education on a day-to-day level and exemplifies the dramatic change in the image of nursing in the 1960s, when the erstwhile religious calling was transformed into a modern-day female profession. The analysis is based on interviews with two different groups of nurses who were educated between the 1930s and 1960s. The first group is composed of the deaconesses of a Protestant mother-house in Hannover (Henriettenstiftung). The second group is formed by nurses who were noted for their important role in the professionalisation of nursing in West Germany. The methodology of this study draws on the experiences of the practice of oral history which reflects the actual context of the narratives, the problem of commemoration and the relationship between individual and collective memory. Nursing education, as late as the 1950s, was based on practical experience. The nursing students were responsible for a certain number of patients from the very first day of their training. Comparison of the different narratives shows that such an experience-based training principle was bound to a specific, family-like concept of nursing which was supported by the sisterhoods. This traditional system of nursing education changed essentially in the 1960s when knowledge based on experience lost a great deal of its meaning, while a theory-based training took preference. Furthermore, the regulation and fragmentation of nursing education increased significantly. The outcome was that continuity in caring for patients decreased dramatically in the 1960s and it became much more difficult to learn how to observe the sick and to demand confidence in dealing with patients. The reform of nursing education also had far-reaching consequences for the construction of everyday life in the wards as the students had previously undertaken a major part of the work.

A successful Minority Retention Project.

PubMed

Gardner, Janelle D

2005-12-01

Racial and ethnic minorities are underrepresented in the nursing profession. The high attrition rate of minority students from nursing schools contributes to this problem. Academic leaders are calling for change in nursing education and asking educators to work diligently to retain minority students. This article describes a Minority Retention Project that included interventions designed to enhance the integration of minority students into a supportive learning environment, assist them in using the available resources, and help them feel connected and supported by their peers and faculty. At the end of the first year of the project, the nursing school experienced 100% retention of minority nursing students. Increasing the retention and graduation of minority nursing students supports the continued effort to provide culturally competent health care.

Management and leadership: analysis of nurse manager's knowledge.

PubMed

Lourenço, Maria Regina; Shinyashiki, Gilberto Tadeu; Trevizan, Maria Auxiliadora

2005-01-01

Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager's knowledge regarding management and leadership. A structured questionnaire containing twenty-seven questions was applied to twelve Brazilian nurse managers of primary care center called "Family Basic Health Units". Data analysis suggested that the nurse manager lower knowledge in management and leadership is related to visionary leadership, management and leadership conceptual differences, leader's behavior, and situational leadership. And, nurse manager greater knowledge is related to power; team work, and coherence between values and attitudes.

Conducting a study of Internet-based video conferencing for assessing acute medical problems in a nursing facility.

PubMed Central

Weiner, Michael; Schadow, Gunther; Lindbergh, Donald; Warvel, Jill; Abernathy, Greg; Perkins, Susan M.; Dexter, Paul R.; McDonald, Clement J.

2002-01-01

We expect the use of real-time, interactive video conferencing to grow, due to more affordable technology and new health policies. Building and implementing portable systems to enable conferencing between physicians and patients requires durable equipment, committed staff, reliable service, and adequate protection and capture of data. We are studying the use of Internet-based conferencing between on-call physicians and patients residing in a nursing facility. We describe the challenges we experienced in constructing the study. Initiating and orchestrating unscheduled conferences needs to be easy, and requirements for training staff in using equipment should be minimal. Studies of health outcomes should include identification of medical conditions most amenable to benefit from conferencing, and outcomes should include positive as well as negative effects. PMID:12463950

[An educational software development proposal for nursing in neonatal cardiopulmonary resuscitation].

PubMed

Rodrigues, Rita de Cassia Vieira; Peres, Heloisa Helena Ciqueto

2013-02-01

The objective of this study was to develop an educational software program for nursing continuing education. This program was intended to incorporate applied methodological research that used the learning management system methodology created by Galvis Panqueva in association with contextualized instructional design for software design. As a result of this study, we created a computerized educational product (CEP) called ENFNET. This study describes all the necessary steps taken during its development. The creation of a CEP demands a great deal of study, dedication and investment as well as the necessity of specialized technical personnel to construct it. At the end of the study, the software was positively evaluated and shown to be a useful strategy to help users in their education, skills development and professional training.

"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 Journal compilation © 2013, The American Geriatrics Society.

Turnover intention among hospital-based registered nurses in the Eastern Caribbean.

PubMed

Lansiquot, Beverley Anne; Tullai-McGuinness, Susan; Madigan, Elizabeth

2012-06-01

Vacancy rates for nurses in the English-speaking Caribbean are estimated at 30% with turnover typically associated with migration. The purpose of this study was to describe the characteristics of hospital-based registered nurses (RNs) in the sub-region, their practice environment and turnover intention in two and five years, respectively, and to determine the relationships among practice environment characteristics and turnover intention. A descriptive correlational design was used with self-reported questionnaires from a convenience sample of 301 RNs working in hospitals in four English speaking Eastern Caribbean countries. Single-item visual analog scales (VAS) were used to measure turnover intention in 2 years and 5 years. The Practice Environment Scale of the Nursing Work Index (PES-NWI) measured the characteristics in the practice environment. The mean age of the nurses was 32.5 (SD = 6.75) years. Most nurses (58.8%) were single and 91.4% had relatives living abroad. Nurses scored three PES-NWI subscales < 2.5, indicating a less positive practice environment: resource adequacy, nurse participation in hospital affairs, and nurse managers' ability, leadership, and support. The subscale for collegial nurse-physician relations received the best rating (mean = 2.61, SD = .62). For 2-year intention to leave, the mean rating on the 100-mm VAS was 63.2, while that for the 5-year intention to leave was 65.6. No significant correlations were found among four of the five PES-NWI subscales and turnover intention in 2 and 5 years. The practice environment, while generally unfavorable, is not associated with the nurses' intention to leave their jobs. These findings support the current policy position that calls for managing turnover among nurses. Nursing and health system administrators should assess, plan, and implement workforce policies to slow the outflow of nurses. Initiatives to improve the work environment and the delivery of high-quality care are important to RNs in the Eastern Caribbean. Managing the negative impact of continuous outflow of nurses through turnover requires long-term coordinated policy and human resource development and management initiatives to sustain the supply of RNs in the subregion. © 2012 Sigma Theta Tau International.

A multi-disciplinary approach to medication safety and the implication for nursing education and practice.

PubMed

Adhikari, Radha; Tocher, Jennifer; Smith, Pam; Corcoran, Janet; MacArthur, Juliet

2014-02-01

Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in pharmacological knowledge to junior nursing staff and pre-registration nursing students. This paper argues that the 'five rights' principle during medication administration is not enough for holistic medication safety and explains two reasons why there is a need for strengthened multi-disciplinary team-work to achieve greater patient safety. To accomplish this, nurses need to have sufficient knowledge of pharmacology and medication safety issues. These findings have important educational implications and point to the requirement for the incorporation of medication management and pharmacology in to the teaching curriculum for nursing students. There is also a call for continuing professional development opportunities for nurses working in clinical settings. © 2014.

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

PubMed

Monroe, Heidi; Plylar, Peggy; Krugman, Mary

2014-01-01

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

Exploring an asset-based approach to nursing.

PubMed

Henry, Heather

This article explores a different perspective on perceived "failings" in the nursing profession. It takes learning from an asset-based community development approach called Connecting Communities to find out whether the problems and solutions that we observe in vulnerable communities can help us better understand what might be happening in the nursing community. The ideas presented are evidence-based community development theories that are currently used across the world and are now influencing the commissioning for health improvement/health inequalities.

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 Good Ole' Girls' Nursing Club": The Male Student Perspective.

PubMed

Carnevale, Teresa; Priode, Kimberly

2018-05-01

Diversity in nursing remains limited with little progress made in the recruitment of males. The purpose of this research was to garner the male nursing students' perspectives of their lived experiences while enrolled in their undergraduate program. A phenomenological group focus approach was utilized with male nursing students regarding their lived experiences of what factors support or negate their being successful in completing a nursing program. Four themes were interpreted: exclusion, gender bias, career expectations, and acceptance. Exclusion and gender bias were seen as negative impact factors, while career expectations was both a motivating factor and a negating factor. Acceptance was interpreted as an important positive factor. A call for change to the profession of nursing from a culture of the "good ole' girls' nursing club" to one of "great nurses from both genders and all ethnicities" is critical for the future growth of the profession.

The role of internationally educated nurses in a quality, safe workforce.

PubMed

D Sherwood, Gwen; Shaffer, Franklin A

2014-01-01

Migration and globalization of the nursing workforce affect source countries and destination countries. Policies and regulations governing the movement of nurses from one country to another safeguard the public by ensuring educational comparability and competence. The global movement of nurses and other health care workers calls for quality and safety competencies that meet standards such as those defined by the Institute of Medicine. This article examines nurse migration and employment of internationally educated nurses (IENs) in the context of supporting and maintaining safe, quality patient care environments. Migration to the United States is featured as an exemplar to consider the following key factors: the impact of nurse migration on the nursing workforce; issues in determining educational comparability of nursing programs between countries; quality and safety concerns in transitioning IENs into the workforce; and strategies for helping IENs transition as safe, qualified members of the nursing workforce in the destination country. Copyright © 2014 Elsevier Inc. All rights reserved.

Using an interview guide to identify effective nurse managers: phase II, outcomes.

PubMed

Fosbinder, D; Everson-Bates, S; Hendrix, L

2000-01-01

The investigators report validation of a survey tool called the Interview Guide to assist in the selection of nurses who will be effective as managers. Nurse administrators rated nurse managers at six months and two years after hire. The Interview Guide rated the management qualities "seeing the big picture" and potential for "rehire" as the best predictors of managerial success. After two years, a good "self-concept" or a "flexible attitude" was the best predictor. The ability to manage conflict was the most significant competency for predicting rehire at both six months and two years.

Reflections on leadership talent: a void or an opportunity?

PubMed

Erickson, Jeanette Ives

2013-01-01

Nurses, the largest group of clinicians in the health care workforce, are increasingly called on to fill a number of strategic leadership roles. As nurses' roles and prominence in health care increase, the development of future generations of nurse leaders becomes ever more vital. Learning how to thrive, not simply survive, in this era of health care reform that is changing the landscape of care across the continuum requires all leaders and managers to possess new knowledge and skills. Preparing tomorrow's leaders must now begin with an organizational commitment to inspire the next generation of nurse leaders.

Advancing adolescent maternal development: a grounded theory.

PubMed

Atkinson, Leah D; Peden-McAlpine, Cynthia J

2014-01-01

This paper reports a substantive grounded theory called the theory of Advancing Adolescent Maternal Development. A grounded theory approach was used. Thirty public health nurses working with adolescent clients in a state public health nurse home visiting program volunteered to participate in this study. The basic social psychological problem that emerged from the data was incomplete and at risk adolescent maternal development. Social support and public health nursing interventions are central in the problem resolution process which occurs in stages. Study results can be used to inform the nursing care of pregnant and parenting adolescents. © 2014.

How Could I Balance Continuing to Work While Pursuing a Degree?

PubMed

Kofstad, Laurie B

2017-02-01

In October 2010, the Institute of Medicine released the report The Future of Nursing: Leading Change, Advancing Health, which called for 80% of all nurses to have a BSN degree by 2020. This expectation was overwhelming and, in the beginning, I felt like it was an insult. I have had my associate degree in nursing for more than 20 years. All I could ask was: How can I have worked so many years and now be considered a subpar nurse? Regardless, the fact remained that I needed to return to college and obtain a higher degree.

Breastfeeding knowledge, attitudes, and practices among providers in a medical home.

PubMed

Szucs, Kinga A; Miracle, Donna J; Rosenman, Marc B

2009-03-01

Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services. We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors. We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission. This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

Making the Change: From a Teacher-Centered to a Learner-Centered Environment--A Phenomenological Study

ERIC Educational Resources Information Center

Roof, Patty L.

2012-01-01

Nursing education is calling for transformation in teaching practices which includes learner-centered environments. The purpose of this qualitative phenomenological study was to explore 15 nursing faculty life experiences as they relate to the choice of a learning environment. Participants expressed their life experiences through interview…

Trajectories of At-Homeness and Health in Usual Care and Small House Nursing Homes

ERIC Educational Resources Information Center

Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.

2011-01-01

Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…

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.…

Managing Chemotherapy Side Effects: Infection

MedlinePlus

... nurse before you take any medicine. This includes aspirin, acetaminophen (such as Tylenol®), or ibuprofen (such as Advil®). ● ● Check with your doctor or nurse before you get any shot or vaccine. Call right away if you have: ● ● Fever that is 100.5° F (38° C) or higher. Ask how ...

A Shovel-Ready Solution to Fill the Nursing Data Gap in the Interdisciplinary Clinical Picture.

PubMed

Keenan, Gail M; Lopez, Karen Dunn; Sousa, Vanessa E C; Stifter, Janet; Macieira, Tamara G R; Boyd, Andrew D; Yao, Yingwei; Herdman, T Heather; Moorhead, Sue; McDaniel, Anna; Wilkie, Diana J

2018-01-01

To critically evaluate 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. Healthcare literature. AAN's plan will not generate the nursing data needed to participate in big data science initiatives in the short term because Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine - Clinical Terms are not yet ripe for generating interoperable data. Well-tested viable alternatives exist. Authors present recommendations for revisions to AAN's plan and an evidence-based alternative to generating interoperable nursing data in the near term. These revisions can ultimately lead to the proposed terminology goals of the AAN's plan in the long term. © 2017 NANDA International, Inc.

Mandatory overtime regulations and nurse overtime.

PubMed

Bae, Sung-Heui; Brewer, Carol

2010-05-01

A descriptive study used data from the 2004 National Sample Survey of Registered Nurses to examine the nature and occurrence of RN mandatory, voluntary overtime, paid on-call, and total work hours and their association with mandatory overtime regulations in United States. About half of the nurses worked more than 40 hrs per week. Nurses working in states regulating mandatory overtime reported lower levels of mandatory overtime hours than states without regulations or states restricting total work hours. The percent of RNs working 61 hrs and over per week in states without regulations was lower than that in states with regulations. Nurses working in nursing homes reported higher levels of the percentage of mandatory overtime hours worked than those working in hospitals. This suggested that governments need to continuously supervise healthcare institutions, including both hospitals and nursing homes, to ensure adherence to mandatory overtime regulations.

Florida Nurse Leader Survey Findings: Key Leadership Competencies, Barriers to Leadership, and Succession Planning Needs.

PubMed

Denker, Ann-Lynn; Sherman, Rose O; Hutton-Woodland, Michael; Brunell, Mary Lou; Medina, Pamela

2015-01-01

This study examined barriers to nursing leadership and succession planning needs for nurse leaders in Florida. The Florida Action Coalition responded to the call to prepare and enable nurses to lead change to advance health, through a grant supported by the Robert Wood Johnson Foundation and Florida Blue Foundation. This is a nurse leader subset of a 56-item statewide survey of actively licensed RNs and advanced RN practitioners in Florida conducted via a cross-sectional, exploratory descriptive research design. Key findings included a description of leadership competencies, barriers, and succession planning practices. Florida nurse leaders are aging and less diverse than the general population and report limited utilization of succession planning by their organizations. In Florida, attention must be directed to resources and strategies to develop skilled nurse leaders and plan succession.

Experiences of first-year nursing students during an education redesign: findings from the Oregon Consortium for Nursing Education.

PubMed

Ostrogorsky, Tanya L; Raber, Anjanette M

2014-01-01

The aim of this article is to summarize first-year students' (n = 908) experience during a nursing education redesign. Oregon Consortium for Nursing Education (OCNE) began its redesign of nursing education in 2000, long before the current national calls for nursing education reform. As OCNE moved from planning to implementation, a comprehensive evaluation of the students, the program, and curriculum ensued. Data were collected from first-year nursing students each spring from 2007-2010 using a standardized survey instrument that included demographic, attitudinal, and opinion-based survey items. Results indicated fellow students, course lectures and interaction, and faculty and courses were rated areas of satisfaction. Areas needing improvement included advising and facilities, administration, quality of instruction and curriculum, and overall program effectiveness. Mean scaled and open-ended responses from each area are reported.

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.

Clinicians’ and Patients’ Experiences and Satisfaction with Unscheduled, Nighttime, Internet-based Video Conferencing for Assessing Acute Medical Problems in a Nursing Facility

PubMed Central

Weiner, Michael; Schadow, Gunther; Lindbergh, Donald; Warvel, Jill; Abernathy, Greg; Perkins, Susan M.; Fyffe, Joanne; Dexter, Paul R.; McDonald, Clement J.

2003-01-01

Videoconferencing between patients and their physicians can increase patients’ access to healthcare. Unscheduled videoconferencing can benefit patients with acute medical problems but has not been studied extensively. We conducted a clinical trial of unscheduled, nighttime videoconferencing in a nursing home, where on-call physicians usually provide care by telephone from remote locations. Although most calls for medical problems did not lead to videoconferencing, physicians and nursing-home residents were satisfied with videoconferencing when it did occur, and physicians reported that making medical decisions was easier with videoconferencing. Videoconferencing was most often conducted to assess residents with changes in mental status, abnormal laboratory values, or falls. Physicians often lacked immediate access to videoconferencing equipment when medical problems with residents occurred. This application could benefit from improved access and portability of equipment. PMID:14728265

The experiences of patients and carers living.

PubMed

Leeder, Stephen R; Jowsey, Tanisha; McNab, Justin W

2018-01-01

Non-communicable diseases (NCDs) are increasing in prevalence and straining health systems globally. This creates a so-called 'burden of disease', which can be traced in terms of fiscal health system matters and in terms of quality of life and lived experiences of people with NCDs. The United Nations has called for a global agenda to manage NCDs and reduce their burden. The purpose of this article is to summarise key findings from the Serious and Continuing Illness Policy and Practice Study concerning patients’ and carers’ experiences of multimorbid NCDs in Australia. We focus on the relevance of findings for policy and general practitioners in Australia. We suggest that a complex multimorbidity policy is needed to contextualise and guide single-illness NCD policies. Our research suggests that specialist NCD nurses and allied health professionals could have important roles in improving care coordination between general practices and community health centres.

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.

Futurism in nursing: Technology, robotics and the fundamentals of care.

PubMed

Archibald, Mandy M; Barnard, Alan

2018-06-01

To explore the concept of futurism and the emergence of robotics in relation to the fundamentals of care, highlighting how nurses need a more anticipatory and contemporary position towards technology to maintain relevance in the future. The future of nursing in Western countries will soon be linked with the emergence of robotics for efficient and cost-effective provision of fundamental care. Their emergence and roles with care of the body and more broadly assisting people with their daily living activities has enormous implications for the profession and health care. Despite this importance, how nursing understands and will respond to technological trends and developments is insufficiently reflected in the professions discourse. A discursive article. Literature from nursing fundamentals of care/fundamental care, information science, technology, humanities and philosophy informed the arguments in this article. This article examines the intersection of futurism and the fundamentals of care, and how adopting an anticipatory and posthuman perspective towards technological-care integration is necessary amidst a robot revolution in the techno-era. Nurses are currently challenged to understand, prioritise and deliver fundamental care. Health systems are challenged by a lack of care predicated by shortfalls in skilled staff and deficiencies in staff mobilisation. Both challenges can be compounded or alleviated by further integration of technology, but to maximise benefit requires forethought and understanding. This article can help open needed dialogue around planning for the future and is a call to action for the nursing profession to conceptualise its position on exponential technological growth and fundamental care provision. © 2017 John Wiley & Sons Ltd.

Direct cellular vs. indirect pager communication during orthopaedic surgical procedures: a prospective study.

PubMed

Ortega, Gil R; Taksali, Sudeep; Smart, Ryan; Baumgaertner, Michael R

2009-01-01

Cellular phone use within the hospital setting has increased as physicians, nurses, and ancillary staff incorporate wireless technologies in improving efficiencies, cost, and maintaining patient safety and high quality healthcare [11]. Through the use of wireless, cellular communication, an overall improvement in communication accuracy and efficiency between intraoperative orthopaedic surgeons and floor nurses may be achieved. Both communication types occurred while the surgeon was scrubbed in the operating room (OR). Indirect communication occurred when the pager call was answered by the OR circulating nurse with communication between the surgeon, circulating nurse, and floor nurse. Direct communication consisted of cell phone and Jabra Bluetooth BT200 wireless ear piece used by the surgeon. The surgeon answered the floor nurse's cellular call by phone ring-activated automatic answering. The study was conducted during scheduled orthopaedic procedures. An independent observer measured time variables with a stop-watch while orthopaedic nurses randomly called via pager or cell phone. The nurses asked for patient caregiver confirmation and answers to 30 different patient-care questions. Sixty trials were performed with 30 cell and 30 page communications. Direct cellular communication showed a better response rate than indirect page (Cell 100%, Page 73%). Indirect page communication allowed a 27% and 33% error rate with patient problem and surgeon solution communications, respectively. There were no reported communication errors while using direct wireless, cellular communication. When compared to page communications, cellular communications showed statistically significant improvements in mean time intervals in response time (Cell = 11s, Page = 211s), correct patient identification (Cell = 5s, Page = 172s), patient problem and solution time (Cell = 13s, Page = 189s), and total communication time (Cell = 32s, Page = 250s) (s = seconds, all P < 0.001). Floor nurse satisfaction ratings (dependent on communication times and/or difficulties) were improved with direct cellular communication (Cell = 29 excellent, Page = 11 excellent). Intraoperative case interruptions (defined as delaying surgical progress) were more frequent with indirect page communication (10 page v. 0 cell). Our study demonstrates that direct wireless communication may be used to improve intraoperative communication and enhance patient safety. Direct wireless, cellular intraoperative communication improves communication times, communication accuracy, communication satisfaction, and minimizes intraoperative case interruption. As a result of this study, we hope to maintain our transition to direct wireless, cellular intraoperative orthopaedic communication to reduce medical errors, improve patient care, and enhance both orthopaedic surgeon and nursing efficiencies.

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

'Do no harm'? Professional regulation of disabled nursing students and nurses in Great Britain.

PubMed

Sin, Chih Hoong; Fong, Janice

2008-06-01

This paper is a report of the findings of a General Formal Investigation launched by the Disability Rights Commission, Great Britain into the impact of regulatory fitness standards on disabled people, and on nursing students and nurses in particular. The potential for systemic discrimination against disabled nursing professionals lies in the existence and nature of regulatory fitness standards, as well as in how these are interpreted and implemented in practice. A review of relevant legislation, regulation and guidance was conducted to explore the interaction of the regulatory framework with the Disability Discrimination Act. A formal call to key national stakeholder organizations solicited information on perceptions of the regulatory framework and the adequacy of guidance issued. Independent research was commissioned on disabled people's disclosure of disability, informal and formal decision-making around fitness within the educational, and employment contexts. An Inquiry Panel examined all evidence sources, solicited further oral evidence from key organizations, and developed recommendations. No mention was found of the Disability Discrimination Act in any regulation and guidance governing nursing prior to 2006. There are particular requirements for 'good health and good character'. Respondents from key national stakeholder organizations, higher educational institutions and employers struggle to interpret the fitness requirements consistently. Implementation is variable, with reliance on ad hoc self-initiated strategies. The variability of interpretation and implementation can lead to discrimination against disabled people. The imprecision of fitness requirements and variability of implementation raise serious doubts about their utility in managing risk.

Night work and health status of nurses and midwives. cross-sectional study.

PubMed

Burdelak, Weronika; Bukowska, Agnieszka; Krysicka, Jolanta; Pepłońska, Beata

2012-01-01

The aim of this study was to assess the association between night shift work and the prevalence of diseases and conditions among nurses and midwives. The study included 725 subjects (354 working on night shifts and 371 working only during the day). The data were collected via an interview based on the "Standard Shiftwork Index". We analyzed the frequency of diseases and conditions and the relative risk expressed as the odds ratio (adjusted for important confounding factors). The most common diseases in the study population were chronic back pain (47.2%), hypertension (24.5%) and thyroid diseases (21.2%). We found no statistically significant increased relative risk of any diseases and conditions among the night shift nurses, compared to the day shift ones. The duration of the work performed on night shifts was significantly associated with the relative risk of thyroid diseases--increased almost two times in the women working for 15 or more years in such system (p for trend: 0.031). The analysis showed the significantly increased (more than eight times higher) relative risk of feet swelling in the women with 8 or more night duties per month, compared to the women having fewer night shifts. We did not observe a higher frequency of diseases in the night shift nurses, compared to the day shift nurses. These results may be related to the so-called "Healthy Worker Effect". There is a need for further long-term observational studies in the populations of nurses.

Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative.

PubMed

Whitson, Heather E; Hastings, S Nicole; McConnell, Eleanor S; Lekan-Rutledge, Deborah A

2006-09-01

To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. Descriptive pilot project. Extended Care and Rehabilitation Center (ECRC), Durham VA Medical Center, Durham, North Carolina. Eight of 20 registered or licensed practical nurses and 4 of 6 geriatric medicine fellows voluntarily participated in this quality improvement project. In two 45-minute focus groups, participants were asked to discuss 3 open-ended questions related to telephone medicine. Comments were recorded during the discussions; topical themes were identified by the authors. Participant comments could be categorized into 4 domains describing the characteristics of nurses and physicians who practice the best telephone medicine: (1) provides the appropriate medical component of patient care; (2) appreciates contextual issues; (3) respects the other party's time and resources; and (4) possesses a collaborative attitude. The focus groups identified 5 quality improvement goals: (1) better nursing assessment and provision of patient information; (2) minimization of non-urgent calls after hours; (3) more decisive physician action (or explanation of inaction); (4) better physician familiarity with facility policies/logistics; and (5) better communication/paging system. The discussion format allowed nurses and physicians to identify and respond to potential barriers to improving quality in each area. Nurses and physicians appreciate unique aspects of long-term care telephone medicine and identify distinct barriers to improving practice. Interdisciplinary focus groups were a productive step toward understanding the telephone medicine experience in our facility and developing quality improvement interventions for both nurses and physicians.

Art as a scaffolding teaching strategy in baccalaureate nursing education.

PubMed

Hydo, Sharon K; Marcyjanik, Diane L; Zorn, CeCelia R; Hooper, Nicole M

2007-01-01

Although the use of art in nursing education is well highlighted, most of the literature is anecdotal or focuses on development of a reflective nursing practice with clients. In this study, art was used as a scaffold to infuse liberal nursing education by helping baccalaureate nursing students (n = 91) create a personal expression of nursing and move toward greater self-awareness. Scaffolding is a metaphor for supporting learners as they develop higher levels of thinking. Using naturalistic inquiry to analyze students' written responses in a course activity, four themes emerged from the data: art and creativity, teamwork, boundaries and horizons within self, and boundaries and horizons in the profession. Student's individual expressions of art served as the "calling forth" of processes that opened the door to each student's personal expression.

The expanded role nurse in geriatrics.

PubMed

McNamara, C; Vandewater, D

1999-05-01

The first experience in Halifax with the expanded role nurse (ERN) was in 1993, when Victoria General Hospital established an ERN position in the cardiology program. A few years later the adult hospitals in the city merged into a new 900-bed, multi-site facility--the Queen Elizabeth II Health Sciences Centre (QEII). In the Geriatrics Department, called the Centre for Health Care of the Elderly (CHCE), the director of nursing and the medical director also began to consider establishing such a position.

The ecologies of community caring.

PubMed

Bent, K N

1999-06-01

Caring has been called the interactive exemplar of nursing in that it relates other foundational concepts of person, health, and environment within the profession and discipline. However, to reflect the dynamic praxis of knowing, being, and doing that is community health nursing, caring must include a focus on communities, the environment, and the global society. The concepts of community and community interventions remain complex and difficult, thus, community caring remains unclear. This article will explore the concept and offer a model of caring praxis in community health nursing.

[The art of Leonardo Da Vinci as a resource to science and the ideal of nursing care].

PubMed

Nascimento, Maria Aparecida de Luca; de Brito, Isabela Jorge; Dehoul, Marcelo da Silva

2003-01-01

Theoretical reflection whose goal is to demonstrate the art a nursing team is required to show in order to perform a technical procedure for transfer of solutions from a normal vial to a microdrops vial, based on Leonardo Da Vinci's theoretical referential, inspired by his work called "Vitruvian Man", so that body harmony is kept. The authors emphasize its relationship to nursing care, viewing it from its broadest sense, and its own motto--"Science, Art and Ideal".

Frequently observed risk factors for fall-related injuries and effective preventive interventions: a multihospital survey of nurses' perceptions.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2013-01-01

There is an urgent need to prioritize the risk factors for injurious falls and effective interventions in nursing practice. Registered nurses perceived that the most frequently observed risk factors were confusion, gait problems, Alzheimer disease, disorientation, and inability to follow safety instructions. The most effective interventions were keeping hospital bed brakes locked, keeping floor surfaces clean/dry, using appropriate footwear for patients, maintaining a call light within reach, and reducing tripping hazards.

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

PubMed

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

2013-09-01

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

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.

Picturing the nurse-person/family/community process in the year 2050.

PubMed

Mitchell, Gail J

2007-01-01

How will nurses relate with persons in the year 2050? And, how might technology enable or limit the nursing process with persons, families, and communities? These are the questions addressed in this column. Imaging practice in light of the technological imaginings and projections is facilitated by a possible scenario that includes robotics that not only monitor human biological processes, they also emote compassion and caring that may one day be dosed according to the latest diagnostic prescription. Three nurses in this column present their views of how nursing might evolve. Karnick, aligned with the human becoming school of thought, imagines a practice anchored in respect for humanity and quality of life and an accompanying respect for nursing knowledge and nursing work. Senesac and Sato, aligned with Roy's adaptation model, call for nurses to envision and choose the future they want to have. Clear in both perspectives is a reverence for human values and human experience and for the critical role of nursing knowledge as we move toward the not-yet of 2050.

Strengthening Moral Courage Among Nurse Leaders.

PubMed

Edmonson, Cole

2015-02-17

Moral distress among practicing nurses is frequently discussed in the nursing literature, along with well-developed recommendations for increasing moral courage in practicing nurses. Implementing these recommendations depends on nurse leaders being morally fit to lead and to create an environment in which moral courage actions can emerge. The literature is lacking pertaining to nurse leaders' preparation to lead in a morally courageous and transformational manner in our current corporate environments and hierarchies of healthcare. In this article, the author reviews the literature addressing moral distress and moral courage among direct care nurses; describes the development of an intervention to strengthen the moral courage of nurse leaders; reports a study that involved implementing this intervention; presents the findings of this study; evaluates the effectiveness of the intervention; and discusses the findings in terms of lessons learned and future directions. He concludes with a call for healthcare leaders to demonstrate moral courage and create environments that promote morally courageous acts that enable nurses to remain centered on the patients, families, and communities we serve.

Student professional suitability: lessons from how the regulator handles fitness to practise cases.

PubMed

Unsworth, John

2011-07-01

A self regulating profession, such as nursing, has to have in place systems which deal with practitioners considered unfit to practise. In addition, students studying to enter the profession may also be subject to systems to address concerns about their professional suitability. While the NMC have left it up to each Higher Education Institution (HEI) to identify the systems which should be in place for students, there is a body of case law and statutory legislation which governs how the NMC deals with fitness to practise amongst qualified nurses and midwives. This paper examines the content of fitness to practise policies in place across HEIs and compares this with how the regulator handles fitness to practise cases. Data was collected using unobtrusive methods and was analysed using content analysis. The results suggest that many HEI's policies have significant gaps which may result in challenges to decision making. In addition, the power of some Vice Chancellors to overturn fitness to practise decisions on appeals calls into question the whole notion of professional self regulation. Copyright © 2010 Elsevier Ltd. All rights reserved.

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.

What is this thing called 'Internet'?

PubMed

Coleman, N J

1996-04-01

According to a survey conducted by the Australian Journal of Nursing in 1994, 43% of nurses owned personal computers and another 28% were considering the purchase of one in the next year. Given such a high ownership rate, and the interest in the 'Net' itself, some understanding of the fundamentals of online computing and the Internet would seem timely.

Addressing the Social Determinants of Health: A Call to Action for School Nurses

ERIC Educational Resources Information Center

Schroeder, Krista; Malone, Susan Kohl; McCabe, Ellen; Lipman, Terri

2018-01-01

Social determinants of health (SDOH), the conditions in which children are born, grow, live, work or attend school, and age, impact child health and contribute to health disparities. School nurses must consider these factors as part of their clinical practice because they significantly and directly influence child well-being. We provide clinical…

[Nursing stance in the face of Jinn possession in Mayotte].

PubMed

Gillard-Berthod, Claire

2013-01-01

Caregivers and nursing students practising in Mayotte can find themselves in a difficult position when faced with patients believing themselves to be possessed by spirits called Jinn. Through a multidisciplinary roundtable, different perspectives and practices can be shared leading to a more enlightened treatment of patients which respects their beliefs, blending traditional and modern medicine.

The dimensions of leadership: a foundation for caring competency.

PubMed

O'Connor, Mary

2008-01-01

The Institute of Medicine (as recorded in their publication, Keeping Patients Safe: Transforming the Work Environment of Nurses), the American Nurses Credentialing Center's Magnet Recognition Program, and the American Organization of Nurse Executives have all called for the attention of caring competencies for nurse leaders. These competencies include skills and behaviors such as communication, relationship management, and building and sustaining trust. The Center for Nursing Leadership's 9 dimensions of leadership-holding the truth, [recognizing the] intellectual and emotional self, discovery of potential, [the] quest for the adventure toward knowing, diversity as a vehicle to wholeness, appreciation of ambiguity, knowing something of life, holding multiple perspectives without judgment, and keeping commitments to oneself-are applied to the behavior and performance of nurse leaders across settings and scope of practice. This article illustrates the embodiment of caring competencies by nurse leaders through the use of the dimensions of leadership.

Internal marketing and the antecedents of nurse satisfaction and loyalty.

PubMed

Peltier, James W; Pointer, Lucille; Schibrowsky, John A

2008-01-01

Employee satisfaction and retention are critical issues that influence the success of any organization. Yet, one of the most critical problems facing the worldwide health care industry is the shortage of qualified nurses. Recent calls have been made within the traditional nursing literature for research that utilizes marketing and business models to better understand nurse satisfaction and retention. The purpose of this study is to develop scales that can be used to empirically test a model of the proposed antecedents of nurse job satisfaction and loyalty which have been used widely in the internal marketing and the relationship-marketing literature. Specifically, the study will investigate the degree to which structural bonding, social bonding, financial bonding activities, and quality of care impact how well nurses are satisfied with their job and their commitment to the organization. The results show that quality of care most impacted nurse satisfaction and loyalty, followed by structural, social, and financial bonds.

Information technologies and the transformation of nursing education.

PubMed

Skiba, Diane J; Connors, Helen R; Jeffries, Pamela R

2008-01-01

Higher education is facing new challenges with the emergence of the Internet and other information and communication technologies. The call for the transformation of higher education is imperative. This article describes the transformation of higher education and its impact on nursing education. Nursing education, considered by many a pioneer in the use of educational technologies, still faces 3 major challenges. The first challenge is incorporation of the Institute of Medicine's recommendation of 5 core competencies for all health professionals. The second challenge focuses on the preparation of nurses to practice in informatics-intensive healthcare environments. The last challenge is the use of emerging technologies, such as Web 2.0 tools, that will help to bridge the gap between the next generation and faculty in nursing schools. Nurse educators need to understand and use the power of technologies to prepare the next generation of nurses.

Perspectives on statistics education: observations from statistical consulting in an academic nursing environment.

PubMed

Hayat, Matthew J; Schmiege, Sarah J; Cook, Paul F

2014-04-01

Statistics knowledge is essential for understanding the nursing and health care literature, as well as for applying rigorous science in nursing research. Statistical consultants providing services to faculty and students in an academic nursing program have the opportunity to identify gaps and challenges in statistics education for nursing students. This information may be useful to curriculum committees and statistics educators. This article aims to provide perspective on statistics education stemming from the experiences of three experienced statistics educators who regularly collaborate and consult with nurse investigators. The authors share their knowledge and express their views about data management, data screening and manipulation, statistical software, types of scientific investigation, and advanced statistical topics not covered in the usual coursework. The suggestions provided promote a call for data to study these topics. Relevant data about statistics education can assist educators in developing comprehensive statistics coursework for nursing students. Copyright 2014, SLACK Incorporated.

[Developing knowledge and a profession: 70 years of the Revista Brasileira de Enfermagem].

PubMed

Germano, Raimunda Medeiros

2002-01-01

Revista Brasileira de Enfermagem-REBEn (Brazilian Journal of Nursing) is now 70 years old. It was created in 1932, and was initially called Anais de Enfermagem. Its main purpose was to be a communication link among Brazilian professionals of nursing. REBEn, which is directly linked to ABEn (Brazilian Association of Nursing), also has as its objective the publicizing of scientific production in different fields of knowledge which can be of interest for the nursing profession. The journal went through many difficulties before achieving the current status of most important publishing in the field of nursing in Brazil. The periodical was developed along many generations and has now achieved intellectual maturity which guaranteed its inclusion in the international indexation of scientific periodicals.

Social justice as a framework for professional nursing.

PubMed

Boutain, Doris M

2005-09-01

A persistent connection exists between health disparity and societal inequality. Since more research is designed to document, rather than alter, those trends, nurses are called on to reinvest in a social justice agenda. An educational focus on social justice is necessary to prepare future nurses to address health concerns related to how societies are structured. This article reports on how social justice was used as a framework to teach concepts related to professional nursing. The course structure is described, a focus on how the course content was taught is outlined, and conclusions are drawn. Linking content on social justice to professional nursing is important because research indicates that, if societal relationships are more equal, population health indicators between diverse groups become more stable nationally and globally.

Power, discourse, and resistance: Poststructuralist influences in nursing.

PubMed

Holmes, Dave; Gagnon, Marilou

2018-01-01

Based on our respective research programs (psychiatry, forensic psychiatry, public health, HIV/AIDS, harm reduction) this article aims to use purposely non-conventional means to present the substantial contribution of poststructuralist perspectives to knowledge development in nursing science in general and in our current research in particular. More specifically, we call on the work of Michel Foucault and Deleuze & Guattari to politicize nursing science using examples from our empirical research programs with marginal and often highly marginalized populations. We discuss the concepts of power, discourse, and resistance to illustrate the essential contribution of poststructuralism to marginal, even "nomadic", nursing research. © 2017 John Wiley & Sons Ltd.

Rational suicide in the terminally ill.

PubMed

Fontana, Joyce S

2002-01-01

To examine the current debate over the right to die specific to the rational suicide of terminally ill patients. Literature was reviewed for information concerning historical end-of-life practices and the past acceptance of suicide. Another review showed philosophical opinions and perspectives that spanned from ancient Greece and the Roman Empire to modern philosophical discourse. A case study of a terminally ill woman who chose suicide is presented to apply the history and philosophy to nursing care today. As more nursing care is delivered in patients' homes, nurses will face this situation with increasing frequency. A call is made for organizations to provide guidelines for nursing practice.

Religion, bioethics and nursing practice.

PubMed

Fowler, Marsha D

2009-07-01

This article calls nursing to engage in the study of religions and identifies six considerations that arise in religious studies and the ways in which religious faith is expressed. It argues that whole-person care cannot be realized, neither can there be a complete understanding of bioethics theory and decision making, without a rigorous understanding of religious-ethical systems. Because religious traditions differ in their cosmology, ontology, epistemology, aesthetic, and ethical methods, and because religious subtraditions interact with specific cultures, each religion and subtradition has something distinctive to offer to ethical discourse. A brief example is drawn from Native American religions, specifically their view of ;speech' and ;words'. Although the example is particular to an American context, it is intended to demonstrate a more general principle that an understanding of religion per se can yield new insights for bioethics.

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.

Solution-focused conversations: a new therapeutic strategy in well child health nursing telephone consultations.

PubMed

Polaschek, Linda; Polaschek, Nick

2007-07-01

This paper is a report of a study to explore well child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. Well child nurses (health visitors) in some services provide a separate telephone consultation service for parents who need immediate advice or are unable to visit the clinic. As well as purely physical issues suggesting infant pathology, these consultations address a range of other concerns relating to parenting and child behaviour. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of well child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognize the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of well child telenurses. Solution-focused conversation is a suitable approach for the single, relatively short, interactions involved in telephone nursing. Other communication strategies could be appropriate for nurses in different clinical situations.

[Nurse's concept in the managerial conception of a basic health unit].

PubMed

Passos, Joanir Pereira; Ciosak, Suely Itsuko

2006-12-01

This study is part of a larger survey called "Use of indicators in nurses' managerial practice in Basic Health Care Units in the city of Rio de Janeiro", which was carried out in the Basic Health Care Units of the Planning Area 5.3 and whose objectives were to identify nurses' conception regarding the tools required for management in those units and to discuss the role of management in organizing health services. The study is descriptive and data were collected in interviews with seven nurse managers. The results show that health services actions are organized and directed to the purpose of the working process through the relationship established between the object, the instruments and the final product, and that for those nurses the end result to be achieved is client's satisfaction and the quality of medical and nursing care.

Automated detection of physiologic deterioration in hospitalized patients

PubMed Central

Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

2015-01-01

Objective Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. Materials and methods A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Results Nurses reported the positive predictive value of alerts was 91–100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. Conclusions We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before–after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. PMID:25164256

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.

Nursing research in heart failure care: a position statement of the american association of heart failure nurses (AAHFN).

PubMed

Stamp, Kelly D; Prasun, Marilyn; Lee, Christopher S; Jaarsma, Tiny; Piano, Mariann R; Albert, Nancy M

Heart Failure (HF) is a public health problem globally affecting approximately 6 million in the United States. A tailored position statement was developed by the American Association of Heart Failure Nurses (AAHFN) and their Research Consortium to assist researchers, funding institutions and policymakers with improving HF clinical advancements and outcomes. A comprehensive review was conducted using multiple search terms in various combinations to describe gaps in HF nursing science. Based on gaps described in the literature, the AAHFN made recommendations for future areas of research in HF. Nursing has made positive contributions through disease management interventions, however, quality, rigorous research is needed to improve the lives of patients and families while advancing nursing science. Advancing HF science is critical to managing and improving patient outcomes while promoting the nursing profession. Based on this review, the AAHFN is putting forth a call to action for research designs that promote validity, sustainability, and funding of future nursing research. Copyright © 2018 Elsevier Inc. All rights reserved.

Experiences of Nursing Personnel Using PDAs in Home Health Care Services in Norwegian Municipalities

PubMed Central

Hansen, Linda M.; Fossum, Mariann; Söderhamn, Olle; Fruhling, Ann

2012-01-01

Although nursing personnel have used personal digital assistants (PDAs) to support home health care services for the past ten years, little is known about their experiences. This study was conducted to examine experiences of nursing personnel using a specialized home health care computer software application called Gerica. In addition, this research analyzed how well this application aligned with the workflow of the nursing personnel in their daily care of patients. The evaluation methods included user observations and learnability testing. Nursing personnel from two different municipalities were observed while performing real tasks in natural settings. This study shows that the nursing personnel were satisfied with the PDA user interface and the Gerica software; however, they identified areas for improvement. For example, the nursing personnel were concerned about trusting the reliability of the PDA in order to eliminate the need for handwritten documentation. Solutions to meet these shortcomings for nursing managers and vendors are discussed. PMID:24199073

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.

Conference call.

PubMed

2002-03-01

The RCN A&E Nursing Association, Black Country A&E professional development group and University of Wolverhampton school of health are holding the Emergency Nursing Research 2002 conference on March 6 in Wolverhampton. For more information, contact Alastair Gray by phone on 01902 307999 ext 2055 or by email at a.d.gray@wlv.ac.uk. Details available at www.man.ac.uk/rcn/conference/enrc2002.doc.

Psychological, Behavioral, and Educational Considerations for Children with Classified Disabilities and Diabetes within the School Setting

ERIC Educational Resources Information Center

Wyckoff, Leah; Hanchon, Timothy; Gregg, S. Renee

2015-01-01

School nurses are answering a call to action to provide day-to-day care for an increasing number of students diagnosed with chronic illnesses. Diabetes mellitus is one of the most prevalent chronic health conditions identified among school-age children and presents a host of complex challenges for the school nurse, educators, and other support…

[Effect of postpartum breast-feeding support by nurse on the breast-feeding prevalence].

PubMed

Jang, Gun Ja; Kim, Sun Hee; Jeong, Kyung Soon

2008-02-01

The purpose of this study was to investigate the effects of the professional nurse's postpartum breast-feeding support on breast-feeding prevalence for mothers who delivered in Baby-Friendly Hospitals (BFH). This quasi experimental study was designed with a nonequivalent control group post test. The subjects of this study were 55 mothers who were hospitalized in the delivery room of a university hospital which was selected as a BFH in Daegu from October 1, 2005 to June 30, 2006. Twenty nine mothers were assigned to the experimental group and 26 mothers to the control group. Postpartum breast-feeding support by nurses' telephone calls to the experimental group was provided once a week for 4 weeks postpartum and then once a month for 16 weeks postpartum. Four post tests were given at postpartum week 4, 8, 12, and 16. The control group was given a telephone call at postpartum week 4, 8, 12, and 16. The breastfeeding prevalence of the experimental group was significantly higher than that of the control group for each period. Postpartum breast-feeding support by nurses may be a useful intervention to increase breast-feeding prevalence.

A prospective study of psychomotor performance of driving among two kinds of shift work in Iran

PubMed Central

Saadat, Soheil; Karbakhsh, Mojgan; Saremi, Mahnaz; Alimohammadi, Iraj; Ashayeri, Hassan; Fayaz, Mahsa; Rostami, Reza

2018-01-01

Background and aim Driving after a night shift imposes a risk on health care professionals and other road users. The aim of this study was to measure psychomotor performance of driving of night shift nurses compared to day-shift nurses. Methods Forty-seven volunteer female nurses working at Sina hospital in Tehran, Iran, with a call in all departments of hospital, participated in this study (23 night shift and 24 day shift nurses) in 2016. The tests included RT for simple reaction time, ATAVT for perceptual speed, LVT for visual orientation and ZBA for time anticipation. Data collection tools were individual characteristics, 11-item circadian type inventory (CTI), Stanford sleepiness scale (SSS), and Swedish occupational fatigue inventory (SOFI-20) questionnaires. Psychomotor driving performance was assessed using validated computerized traffic psychological battery of Vienna Test System (VTS), before and after the shifts. Data analysis was performed using paired-samples t-test and Linear Regression. Results The mean age of day and night-shift nurses were 31.4±5.6 and 28.7±3.9 years respectively, no significant difference between two groups. Thirty percent of night shift and 16.7% of day shift nurses reported traffic accidents in the past year. The results revealed that, scores based on viewing times in visual orientation test (p=0.005), and median reaction time score in choice reaction time and reactive stress tolerance test (p=0.045), had a significant association with a 12-hour night shift with a 3-hour nap. Conclusions Twelve-hour night shift work impairs choice reaction time and visual orientation in nurses, even though they take a 3- hour nap during the shift. These skills are required for safe driving. PMID:29629067

Engaging general practice nurses in chronic disease self-management support in Australia: insights from a controlled trial in chronic obstructive pulmonary disease.

PubMed

Walters, Julia A E; Courtney-Pratt, Helen; Cameron-Tucker, Helen; Nelson, Mark; Robinson, Andrew; Scott, Jenn; Turner, Paul; Walters, E Haydn; Wood-Baker, Richard

2012-01-01

The growing burden of chronic disease will increase the role of primary care in supporting self-management and health behaviour change. This role could be undertaken to some extent by the increased practice nurse workforce that has occurred over recent years. Mixed methods were used to investigate the potential for general practice nurses to adopt this role during a 12-month randomised controlled study of telephone-delivered health mentoring in Tasmanian practices. Nurses (general practice and community health) were trained as health mentors to assist chronic obstructive pulmonary disease patients to identify and achieve personal health related goals through action plans. Of 21% of invited practices that responded, 19 were allocated to health mentoring; however, general practice nurses were unable to train as health mentors in 14 (74%), principally due to lack of financial compensation and/or workload pressure. For five general practice nurses trained as health mentors, their roles had previously included some chronic disease management, but training enhanced their understanding and skills of self-management approaches and increased the focus on patient partnership, prioritising patients' choices and achievability. Difficulties that led to early withdrawal of health mentors were competing demands, insufficient time availability, phone calls having lower priority than face-to-face interactions and changing employment. Skills gained were rated as valuable, applicable to all clinical practice and transferable to other health care settings. Although these results suggest that training can enhance general practice nurses' skills to deliver self-management support in chronic disease, there are significant system barriers that need to be addressed through funding models and organisational change.

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-level seizure cases, the ALPHA-level patients are suitable to transfer for secondary triage in a best-practices, accredited, emergency medical dispatch center that utilizes the MPDS at very high compliance rates. The secondary nurse triage process should identify the few at-risk patients that exist in the low-acuity calls.

Educational and service partnerships: an example of global flattening.

PubMed

Finkelman, Anita; Kenner, Carole

2008-01-01

Educational and service partnerships are not new, but many of these partnerships occurred in the same town or state in the past. Today, with the heightened use of technology, these partnerships are spanning the globe (e.g., outsourcing of services is growing, with India becoming the call center for the world). What does this global flattening trend mean for nursing education and service? How will this trend impact nursing faculty and service shortages? We explored the current global flattening and its use as a potential strategy to combat nursing workforce issues.

Art, science and social science in nursing: occupational origins and disciplinary identity.

PubMed

Rafferty, A M

1995-09-01

This paper forms part of a wider study examining the history and sociology of nursing education in England between 1860 and 1948. It argues that the question of whether nursing was an art, science and/or social science has been at the 'heart' of a wider debate on the occupational status and disciplinary identity of nursing. The view that nursing was essentially an art and a 'calling', was championed by Florence Nightingale. Ethel Bedford Fenwick and her allies insisted that nursing, like other professions, was a 'scientific' and technical enterprise. Social scientists later came to challenge nursing's claim to professionalism by analysing nursing work first within the context of industrial psychology. But they also advocated a rapprochement between nursing, health services and social science research, a challenge which we are in nursing, still striving to meet. This paper argues for a strong coalition of nursing with its former nineteenth century ally, social science, in the continuing struggle for change within nursing and health care policy. Rather than searching for some rarified and purified essence of nursing knowledge, it argues that nurses need to join forces with sociologists and economists in striving to shape the agenda for health services research and provide the evidential basis for health policy transformation more generally.

[Preoperative structured patient education].

PubMed

Lamarche, D

1993-04-01

This article describes the factors that motivated the nursing staff of the cardiac surgery unit at the Royal Victoria Hospital in Montreal, to revise their preoperative teaching program. The motivating factors described are the length of the preoperative waiting period; the level of preoperative anxiety; the decreased length of hospital stay; the dissatisfaction of the nursing staff with current patient teaching practices; and the lack of available resources. The reorganization of the teaching program was based upon the previously described factors combined with a review of the literature that demonstrated the impact of preoperative anxiety, emotional support and psycho-educational interventions upon the client's recovery. The goals of the new teaching program are to provide the client and the family with cognitive and sensory information about the client's impending hospitalization, chronic illness and necessary lifestyle modifications. The program consists of a system of telephone calls during the preoperative waiting period; a videotape viewing; a tour of the cardiac surgery unit; informal discussion groups; and the availability of nursing consultation to decrease preoperative anxiety. The end result of these interventions is more time for client support and integration of necessary information by the client and family. This kind of program has the potential to provide satisfaction at many levels by identifying client's at risk; increasing client knowledge; increasing support; decreasing anxiety during the preoperative waiting period; and decreasing the length of hospital stay. The nursing staff gained a heightened sense of accomplishment because the program was developed according to the nursing department's philosophy, which includes primary nursing.(ABSTRACT TRUNCATED AT 250 WORDS)

A controlled trial of an expert system and self-help manual intervention based on the stages of change versus standard self-help materials in smoking cessation.

PubMed

Aveyard, Paul; Griffin, Carl; Lawrence, Terry; Cheng, K K

2003-03-01

To examine the population impact and effectiveness of the Pro-Change smoking cessation course based on the Transtheoretical Model (TTM) compared to standard self-help smoking cessation literature. Randomized controlled trial. Sixty-five West Midlands general practices. Randomly sampled patients recorded as smokers by their general practitioners received an invitation letter and 2471 current smokers agreed. Responders were randomized to one of four interventions. The control group received standard self-help literature. In the Manual intervention group, participants received the Pro-Change system, a self-help workbook and three questionnaires at 3-monthly intervals, which generated individually tailored feedback. In the Phone intervention group, participants received the Manual intervention plus three telephone calls. In the Nurse intervention group, participants received the Manual intervention plus three visits to the practice nurse. Biochemically confirmed point prevalence of being quit and 6-month sustained abstinence, 12 months after study commencement. A total of 9.1% of registered current smokers participated, of whom 83.0% were not ready to quit. Less than half of participants returned questionnaires to generate second and third individualized feedback. Telephone calls reached 75% of those scheduled, but few participants visited the nurse. There were small differences between the three Pro-Change arms. The odds ratio (95% confidence intervals) for all Pro-Change arms combined versus the control arm were 1.50 (0.85-2.67) and 1.53 (0.76-3.10), for point prevalence and 6-month abstinence, respectively. This constitutes 2.1% of the TTM group versus 1.4% of the control group achieving confirmed 6-month sustained abstinence. There was no statistically significant benefit of the intervention apparent in this trial and the high relapse of quitters means that any population impact is small.

The nurse of parasites: gender concepts in Patrick Manson's parasitological research.

PubMed

Li, Shang-Jen

2004-01-01

Patrick Manson (1844-1922), the so-called father of tropical medicine, played a pivotal role in making that discipline into a specialty. During his early career in China he discovered that the mosquito was the intermediate host of the filarial parasite and he somewhat peculiarly called the mosquito the "nurse" of the filarial worm. The discovery contributed greatly to the intellectual foundation of modern parasitology. In this paper I situate Manson's nomenclature in the context of nineteenth-century biological research on reproductive mech-anisms and argue that Manson's concept of the "nurse" was derived from nineteenth-century theories of sexual division of labor in nature's economy. The way he framed the relation between the mosquito and the parasite, moreover, can be understood in the terms of the domestic arrangement of the colonial European household. Manson's research demonstrates the significant exchange between medical concerns over European women's procreative role in the tropics and biological studies of parasitic reproduction.

[Program about therapeutics education. Roll-playing exercise].

PubMed

Salinas, Carmen Martín

2011-05-01

This article presents a program about therapeutics education aimed at a patient with diabetes mellitus type 2, associated with hypertension, dyslipidemia and obesity The association of these factors constitutes the so-called metabolic syndrome, which entails an increase in the risk of heart disease. This roll-playing exercise is used in the subject Nutrition and Dietetics, given in the second academic year of the Nursing University School La Paz of Madrid, Spain, in order to strengthen self-directed learning. Solving the case comprises evaluation of the patient's self-care agency identification of the self-care deficit and those nurse interventions which are considered necessary to treat that deficit. Both three Diagnosis Taxonomy by the North American Nursing Diagnosis Association, Nursing Intervention Classification and Nursing Result Classification were used to solve it.

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

Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

PubMed

Feo, Rebecca; Conroy, Tiffany; Marshall, Rhianon J; Rasmussen, Philippa; Wiechula, Richard; Kitson, Alison L

2017-04-01

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. © 2016 John Wiley & Sons Ltd.

Growth and development issues in adolescents with ostomies: a primer for the WOC nurses.

PubMed

Mohr, Lynn D

2012-01-01

Caring for the adolescent (13-18 years of age) with an ostomy presents multiple challenges. The purpose of this article is to provide strategies to assist the WOC nurse in minimizing the potential impact on growth and development for this age group with an ostomy. This is relevant to the WOC nurse since it is estimated that between 6% and 14% of all adolescents have symptoms of irritable bowel disease, and many will require an ostomy. Thus the WOC nurse will be called upon to provide care to this age group. This article discusses normal adolescent growth and development and provides strategies to support the normal growth and development.

Theatrical entertainments and kind words: nursing the insane in Western North Carolina, 1882-1907.

PubMed

Streeter, C

2011-12-01

This paper argues that at the turn of the 19th century, nurses at the State Hospital in Morganton, North Carolina (now called Broughton Hospital) played critical roles in successfully implementing the best-known therapeutic methods of the time. They were also instrumental in developing the hospital's visibility and acceptance in rural western North Carolina. When the Hospital established its first nurse training school in 1895, this corps of first-generation western North Carolinians practising institutional nursing was highly esteemed in their field. Their skills not only served the community outside of the Hospital's walls, but were also sought out by other private and state asylums. © 2011 Blackwell Publishing.

Emergency thoracotomy. Care of the patient in the OR: a case study.

PubMed

Singer, N

1987-12-01

As an OR staff nurse at Cook County Hospital, some of my most challenging and rewarding nursing experiences have come from caring for emergency open-chest trauma patients. From the moment we receive a call that an open-chest patient is on the way, everyone assigned is in a high state of tension. Every decision takes on exaggerated importance. The circulating nurse, by virtue of his or her position during an emergency, is the "hub of the wheel" of activity. He or she is privy to all facets of care that are being administered to the patient. The nursing challenge of the emergency open-chest trauma is great, but it is not an impossible task.

Sisterhood's ordeals: shared interests and divided loyalties in Finnish wartime nursing.

PubMed

Henriksson, L

1999-01-01

The aim of this article is to highlight early Finnish nursing in a special wartime context. Occupational development of nursing is envisioned by addressing at a more general level women's mutual relationships and the opportunities and obstacles of the process of occupational development. The article debates two main issues. Establishing occupational domains was a process of selecting suitable labour force and training women morally, as well. The hierarchical order of nursing is manifested especially in the questions of auxiliary labour and the so-called amateur scare. War was still a time of romanticism with visible military and religious models, but women also struggled for their right to have rights.

A normative analysis of nursing knowledge.

PubMed

Zanotti, Renzo; Chiffi, Daniele

2016-03-01

This study addresses the question of normative analysis of the value-based aspects of nursing. In our perspective, values in science may be distinguished into (i) epistemic when related to the goals of truth and objectivity and (ii) non-epistemic when related to social, cultural or political aspects. Furthermore, values can be called constitutive when necessary for a scientific enterprise, or contextual when contingently associated with science. Analysis of the roles of the various forms of values and models of knowledge translation provides the ground to understand the specific role of values in nursing. A conceptual framework has been built to classify some of the classical perspectives on nursing knowledge and to examine the relationships between values and different forms of knowledge in nursing. It follows that adopting a normative perspective in the analysis of nursing knowledge provides key elements to identify its proper dimension. © 2015 John Wiley & Sons Ltd.

Nurses leading change to advance health.

PubMed

Polansky, Patricia; Gorski, Mary Sue; Green, Alexia; Perez, G Adriana; Wise, Robert P

The article includes a review of selected past and current leadership initiatives as well as a summary of three leadership meetings convened by The Center to Champion Nursing in America, a partnership of the Robert Wood Johnson Foundation (RWJF), AARP and the AARP Foundation. These "Leadership in Action" meetings were designed to address the Campaign for Action's (CFA) goal to increase the number of nurse leaders in health- and health care-related boardrooms at the local, state and national levels. RWJF supported key nursing organizations in initial discussions around integrating state and national efforts to get more nurses onto boards leading to a active vibrant coalition making significant progress. This article concludes with a call to action encouraging all nurses to consider board service as an essential component of improving health and health care and to do their part to help build a Culture of Health in the United States. Copyright © 2017 Elsevier Inc. All rights reserved.

"Never in All My Years... ": Nurses' Education About LGBT Health.

PubMed

Carabez, Rebecca; Pellegrini, Marion; Mankovitz, Andrea; Eliason, Mickey; Ciano, Mark; Scott, Megan

2015-01-01

In spite of recent calls for patient-centered care and greater attention to the needs of lesbian, gay, bisexual, and transgender (LGBT) patients, nurses still lack basic education about LGBT patient care and, as a result, may have negative attitudes, endorse stereotypes, and/or feel uncomfortable providing care. This study reports on education/training of practicing nurses and explores some of the reasons for nurses reporting feelings of discomfort with LGBT patient care. Transcripts from structured interviews with 268 nurses in the San Francisco Bay Area revealed that 80% had no education or training on LGBT issues. Although most said they were comfortable with LGBT patient care, some of their comments indicated that they might not be providing culturally sensitive care. Implications for nursing education and for policies and procedures of health care institutions are addressed. Copyright © 2015 Elsevier Inc. All rights reserved.

Satisfaction with nursing care in drug users: the evolution of a scale.

PubMed

Seabra, Paulo Rosário Carvalho; Sá, Luis Octávio; Amendoeira, José Joaquim Penedos; Ribeiro, Ana Leonor

2017-07-13

To identify the degree of satisfaction with nursing care, the significant variables and contribute to the evolution of the scale. Descriptive, correlational, cross study, with 180 drug users. Data collected using the scale called "Satisfaction of users with the Nursing Health Center26", between February and December 2012 in three treatment units in the region of Lisbon and Vale do Tejo, Portugal. Users indicated 83.3% satisfaction. The dimension "Information individualization" was the most marked (98.5%). The more stability in the programs, abstinence from stimulants and benzodiazepines and more nursing interventions, the greater the satisfaction. Better working conditions, specializing in mental health, younger ages and less experience of nurses also contributed to satisfaction. Four items of the scale were extracted, assuming new SUCECS22 designation. Satisfaction was high, influenced by structural variables of users, nurses and working conditions. The scale has proved suitable for assessment in this population.

Improving School Nurse Pain Assessment Practices for Students With Intellectual Disability.

PubMed

Quinn, Brenna L; Smolinski, Megan

2017-01-01

School nurses are afforded minimal resources related to assessing pain in students with intellectual disability (ID) and have called for continuing education. The purpose of this study was to measure the effectiveness of an education program regarding best practices for assessing pain in students with ID. Educational sessions were presented to 248 school nurses. Pre-, post-, and follow-up surveys measured (1) difficulty school nurses face when assessing pain, (2) knowledge and use of pain assessment methods, and (3) intent to change and actual changes to professional practices. Participants experienced less difficulty assessing pain following the educational program. Almost all participants intended to change pain assessment practices, but large caseloads limited new practice adoption. Policy makers must consider population size and acuity when determining school nurse staffing. Trainings and other resources should be made available to school nurses in order to make pain assessments for students with ID more thorough and efficient.

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.

[Contribution of psychoanalysis to geriatric care for institutionalized patients].

PubMed

Charazac, Pierre-Marie

2014-06-01

The contribution of psychoanalysis to geriatric care in nursing home is discussed in three directions: its conception of care, specially on its negative sides; its implication in geriatric units, in their conception and in the analysis of their management of care; the holding of care-givers and nurses by making clear what we call transference and conter-transference and their reflection on their function.

[Service robots in elderly care. Possible application areas and current state of developments].

PubMed

Graf, B; Heyer, T; Klein, B; Wallhoff, F

2013-08-01

The term "Service robotics" describes semi- or fully autonomous technical systems able to perform services useful to the well-being of humans. Service robots have the potential to support and disburden both persons in need of care as well as nursing care staff. In addition, they can be used in prevention and rehabilitation in order to reduce or avoid the need for help. Products currently available to support people in domestic environments are mainly cleaning or remote-controlled communication robots. Examples of current research activities are the (further) development of mobile robots as advanced communication assistants or the development of (semi) autonomous manipulation aids and multifunctional household assistants. Transport robots are commonly used in many hospitals. In nursing care facilities, the first evaluations have already been made. So-called emotional robots are now sold as products and can be used for therapeutic, occupational, or entertainment activities.

Ready for the World: preparing nursing students for tomorrow.

PubMed

Callen, Bonnie L; Lee, Jan L

2009-01-01

In 2004, a 5-year plan of international and intercultural education was developed by the University of Tennessee, Knoxville (UTK) to help students become ready for the changing world in which they will live. This program is called "Ready for the World." The University of Tennessee College of Nursing in Knoxville has integrated many of the suggestions from this program into the undergraduate nursing curriculum to prepare students for the world by making the world their classroom. Intercultural learning includes both a solid base of knowledge obtained in the classroom and multiple experiences that involve cultural interaction. Experiences begin on UTK's diverse campus and expand to the surrounding city of Knoxville, including interactions with vulnerable populations such as the homeless or elderly persons, then to nearby Appalachian communities, and on to Central America. Many of these experiences are offered for credit in the Community Health Nursing or the Transcultural Nursing courses. The knowledge nursing students acquire and their varied experiences will help them gain cultural competence for their future nursing practice.

Decision Making in Nursing Practice: A Concept Analysis.

PubMed

Johansen, Mary L; O'Brien, Janice L

2016-01-01

The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed. © 2015 Wiley Periodicals, Inc.

Nurse-client interactions in community-based practice: creating common ground.

PubMed

Kristjanson, L; Chalmers, K

1990-12-01

Although research activity is increasingly aimed at examining health outcomes of community health nursing care, little empirical literature systematically describes the nurse-client interaction. In this pilot study nurse-client interactions were evaluated to describe their detailed elements. Nineteen such interactions occurring in a Canadian public health department were videotaped by a professional filming crew. The clinical situations included home visits, school health interviews and screening, health classes, and clinic work. The audio portion of the nurse-client exchanges were transcribed from the videotapes onto a computer and analyzed using content analysis. Semi-structured interviews were conducted with nurses and clients after the filming to elicit their perceptions of the interactions. Field notes describing nonverbal and contextual data were also collected and analyzed. The central process identified during the interactions was called "creating common ground." This integrating conceptual schema captured the give and take as each participant defined territory and revealed information. The process varied depending on care context, process skills of the nurse, and willingness of the client to engage.

Simulating care: technology-mediated learning in twenty-first century nursing education.

PubMed

Diener, Elizabeth; Hobbs, Nelda

2012-01-01

The increased reliance on simulation classrooms has proven successful in learning skills. Questions persist concerning the ability of technology-driven robotic devices to form and cultivate caring behaviors, or sufficiently develop interactive nurse-client communication necessary in the context of nursing. This article examines the disconnects created by use of simulation technology in nursing education, raising the question: "Can learning of caring-as-being, be facilitated in simulation classrooms?" We propose that unless time is spent with human beings in the earliest stages of nursing education, transpersonal caring relationships do not have space to develop. Learning, crafting, and maturation of caring behaviors threatens to become a serendipitous event or is no longer perceived as an essential characteristic of nursing. Technology does not negate caring-the isolation it fosters makes transpersonal caring all the more important. We are called to create a new paradigm for nursing education that merges Nightingale's vision with technology's promise. © 2012 Wiley Periodicals, Inc.

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.

1863 Letter from Ralph Waldo Emerson about Walt Whitman

ERIC Educational Resources Information Center

Potter, Lee Ann

2004-01-01

Biographers have called Walt Whitman "America's most influential and innovative poet" and some have even called him "the greatest of all American poets." But in the winter of 1862-63, even as he was gaining a reputation as a talented poet, Whitman was forty-three years old, volunteering as a nurse in Union hospitals, and…

Effectiveness of an audience response system in teaching pharmacology to baccalaureate nursing students.

PubMed

Vana, Kimberly D; Silva, Graciela E; Muzyka, Diann; Hirani, Lorraine M

2011-06-01

It has been proposed that students' use of an audience response system, commonly called clickers, may promote comprehension and retention of didactic material. Whether this method actually improves students' grades, however, is still not determined. The purpose of this study was to evaluate whether a lecture format utilizing multiple-choice PowerPoint slides and an audience response system was more effective than a lecture format using only multiple-choice PowerPoint slides in the comprehension and retention of pharmacological knowledge in baccalaureate nursing students. The study also assessed whether the additional use of clickers positively affected students' satisfaction with their learning. Results from 78 students who attended lecture classes with multiple-choice PowerPoint slides plus clickers were compared with those of 55 students who utilized multiple-choice PowerPoint slides only. Test scores between these two groups were not significantly different. A satisfaction questionnaire showed that 72.2% of the control students did not desire the opportunity to use clickers. Of the group utilizing the clickers, 92.3% recommend the use of this system in future courses. The use of multiple-choice PowerPoint slides and an audience response system did not seem to improve the students' comprehension or retention of pharmacological knowledge as compared with those who used solely multiple-choice PowerPoint slides.

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 Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The end of an era. 1952.

PubMed

Ramsay, Alma Gaines

2012-01-01

This historical reprint from Public health nursing (Ramsay, ) summarizes the history of public health nursing services rendered by the Red Cross from its creation in 1912 until their termination in June 1951. The author was a public relations writer for the Red Cross. The paper is historically important for it provides chronology and perspective on the role of the Red Cross institutionalizing public health nursing and home nursing care in the United States during the first half of the 20(th) century. Of note are the three nursing services through which the Red Cross operated, each denoting a particular time and focus. Although Jane A. Delano is credited with the creation of the Red Cross nursing service, the initial organization was called Rural Nursing Service and was led by Fannie Clement. Within a short time, however, the Town and Country Nursing Service was created in recognition that not all of the public health nursing provided by the Red Cross was rendered in rural settings. The final transformation came when the service was again renamed, this time to highlight its more fundamental mission, as the Red Cross Public Health Nursing Service. The article is reprinted in its entirety. © 2012 Wiley Periodicals, Inc.

Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study.

PubMed

Tang, Charmaine J; Zhou, Wen T; Chan, Sally W-C; Liaw, Sok Y

2018-01-01

To explore the collaboration experiences of junior physicians and nurses in the general ward setting. Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. Nineteen junior physicians and nurses were interviewed in 2012 and 2013. Interviews were transcribed and analysed using thematic analysis. Junior physicians and nurses acknowledged the importance of working collaboratively to achieve better patient care, but they are struggling to cope due to heavy clinical workload, organisational constraints and differing power relationships. Nurses have to take on more responsibilities in the decision-making process of patients' care to foster effective interprofessional collaboration. The study calls for educational and organisational strategies to improve interprofessional collaboration between junior physicians and nurses. Nurse leaders should ensure that ward nurses are given a designated time to participate in ward rounds with physicians and have access to a communication tool that assists them in contributing proactively in the decision-making process of patient care. © 2017 John Wiley & Sons Ltd.

American Psychiatric Nurses Association-Transitions in Practice Certificate Program: Bridging the Knowledge Gap in Caring for Psychiatric Patients Within the General Nursing Workforce.

PubMed

Adams, Susie M; Black, Patricia

2016-01-01

The purpose of this article is to publicize an important new Web-based educational program. Recognizing the growing gap in psychiatric-mental health knowledge and the need to better prepare new graduates and nurses transitioning from other service lines into psychiatric inpatient nursing settings, the American Psychiatric Nurses Association developed a 15-hour, modularized curriculum to provide foundational psychiatric-mental health knowledge. This modularized curriculum, called American Psychiatric Nurses Association Transitions in Practice (ATP) focuses on the knowledge and skills to insure the success of nurses new to psychiatric-mental health nursing settings and to improve the overall care for persons with mental health and substance use disorders. The ATP program is also proving to be useful content for nurses in emergency departments, hospitals, and other health settings to improve their care of patients with psychiatric and mental health needs. A summary of the program modules and a toolkit with suggested measures for nurses, patients, and agency outcomes is described. Feedback from participants completing the ATP program within the first 6 months is overwhelmingly positive and holds promise for widespread application across a variety of health care settings.

[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.

Integrating quality and safety education into clinical nursing education through a dedicated education unit.

PubMed

Masters, Kelli

2016-03-01

The Institute of Medicine and American Association of Colleges of Nursing are calling for curriculum redesign that prepares nursing students with the requisite knowledge and skills to provide safe, high quality care. The purpose of this project was to improve nursing students' knowledge of quality and safety by integrating Quality and Safety Education for Nurses into clinical nursing education through development of a dedicated education unit. This model, which pairs nursing students with front-line nursing staff for clinical experiences, was implemented on a medical floor in an acute care hospital. Prior to implementation, nurses and students were educated about the dedicated education unit and quality and safety competencies. During each clinical rotation, students collaborated with their nurses on projects related to these competencies. Students' knowledge was assessed using questions related to quality and safety. Students who participated in the dedicated education unit had higher scores than those with traditional clinical rotations. Focus groups were held mid-semester to assess nurses' perceptions of the experience. Five themes emerged from the qualitative data including thirsting for knowledge, building teamwork and collaboration, establishing trust and decreasing anxiety, mirroring organization and time management skills, and evolving confidence in the nursing role. Copyright © 2015 Elsevier Ltd. All rights reserved.

The experiences of patients and carers living with multimorbid, non-communicable diseases

PubMed

Leeder, Stephen R; Jowsey, Tanisha; McNab, Justin W

2018-01-01

Non-communicable diseases (NCDs) are increasing in prevalence and straining health systems globally. This creates a so-called 'burden of disease', which can be traced in terms of fiscal health system matters and in terms of quality of life and lived experiences of people with NCDs. The United Nations has called for a global agenda to manage NCDs and reduce their burden. The purpose of this article is to summarise key findings from the Serious and Continuing Illness Policy and Practice Study concerning patients’ and carers’ experiences of multimorbid NCDs in Australia. We focus on the relevance of findings for policy and general practitioners in Australia. We suggest that a complex multimorbidity policy is needed to contextualise and guide single-illness NCD policies. Our research suggests that specialist NCD nurses and allied health professionals could have important roles in improving care coordination between general practices and community health centres.

Transfusing our lifeblood: Reframing research impact through inter-disciplinary collaboration between health geography and nurse education.

PubMed

Kyle, Richard G; Atherton, Iain M; Kesby, Mike; Sothern, Matthew; Andrews, Gavin

2016-11-01

Geographers have long grappled with how their research can positively impact individuals, communities and society. Demonstrating research impact is an increasingly important aspect of academic life internationally. In this paper we argue that agendas for encouraging 'impact' would be well-served if impact through teaching was identified and stimulated more explicitly, and if academics better recognised and seized the opportunities that already exist for such impact. We take engagement between health geography and nurse education as an example of how social scientists could demonstrate research impact through inter-disciplinary involvement in the education of health care professionals, and specifically student nurses. We begin by showing how the UK's Research Excellence Framework (widely regarded as the key reference point for research performance management regimes internationally) has tended to produce an undervaluation of impact via education in many disciplines. A comprehensive overview of international scholarship at the intersection between geography and nursing is then presented. Here we trace three 'waves of enquiry' that have focused on research interactions before calling for a fourth focused on critical pedagogy. To illustrate the possibilities of this fourth wave, we sketch a case study that outlines how engagement with research around blood donation could help provide a foundation for critical pedagogy that challenges student nurses to practice reflexively, think geographically and act justly. Finally, we call for closer engagement between health geography and nurse education, by encouraging educators to translate, teach, and transfuse ideas and people between health geography and nurse education. In so doing, we argue that work at this interface can be mutually beneficial and demonstrate impact both within and beyond research assessment rubrics. Hence, our ideas are relevant beyond nurse education and geography insofar as this paper serves as an example of how reframing research impact can recover the importance of impact through education. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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.

Strategies to address the nursing shortage in Saudi Arabia.

PubMed

Aboshaiqah, A

2016-09-01

To investigate the nursing shortage in Saudi Arabia and specifically the shortage of Saudi nurses in the healthcare workforce and to propose solutions. Literature published from 1993 to 2013 providing relevant information on the nursing shortage, cultural traditions and beliefs, and nursing education and policies in Saudi was accessed from multiple sources including Medline, CINAHL Plus and Google Scholar and from official Saudi government document and was reviewed. Saudi Arabia depends largely on an expatriate workforce, and this applies to nursing. Saudi Arabia is experiencing a nursing shortage in common with most countries in the world and a shortage of Saudi nationals, especially women, in the healthcare workforce. The world shortage of nursing is extrinsic to Saudi, but intrinsic factors include a poor image of the nursing profession in the country that is exacerbated by cultural factors. With the call for the Saudization of the workforce to replace the imported workforce by Saudi nationals, including nurses, through the 1992 Royal Decree, Saudi Arabia faces a problem in attracting and retaining Saudi nationals in the nursing workforce. Solutions are suggested that are aimed at improving the public image of nursing through education and the use of the media and improvements in the workplace by addressing working processes such as teamwork, ensuring adequate staffing levels and addressing some aspects of culture which may make working in nursing more compatible with being a Saudi national. © 2016 International Council of Nurses.

Well-being of intensive care nurses (WEBIC): a job analytic approach.

PubMed

Le Blanc, P M; de Jonge, J; de Rijk, A E; Schaufeli, W B

2001-11-01

This paper presents the results of a validation study of the so-called well-being of intensive care nurses (WEBIC)-questionnaire that is designed to perform a detailed job analysis of intensive care unit (ICU) nurses' jobs. The WEBIC-questionnaire is based on modern sociotechnical systems theory, and distinguishes four integrated task categories: (1) operational, (2) organizing, (3) preparatory, and (4) supportive tasks. For each task, the WEBIC assesses (1) how demanding this task is, and (2) how satisfying the performance of this task is. Using the WEBIC, information is gathered about ICU nurses' qualitative workload, and typical job-related risks for ICU nurses' well-being at work can be mapped. A cross-sectional survey on work and well-being of almost 2000 ICU-nurses in 13 different European areas was conducted. Exploratory factor analyses were performed to study the validity of the factorial structure of the WEBIC-questionnaire. The construct validity of the WEBIC-questionnaire was studied by performing hierarchical multiple regression analyses of the WEBIC-factors on two types of job-related well-being, i.e. burnout and general job satisfaction. Results of the exploratory factor analyses showed that the hypothesized four-factor structure of the WEBIC is confirmed by our data. Internal consistencies of the different factors varied from 0.77 to 0.91. Intensive care unit nurses' most central (operational) tasks turned out to pose the greatest demands, but also seemed to drive their satisfaction. With respect to the relationships between the four WEBIC-factors, and burnout and general job satisfaction, it was found that, especially for the satisfying tasks, significant relationships with these outcomes were found. The reliability and construct validity of the WEBIC-questionnaire can be considered satisfactory. Furthermore, the questionnaire provides a systematical and detailed coverage of ICU nurses' tasks. In relation to this, the questionnaire is not only useful for scientific purposes but also for practical use.

Evaluating in political turmoil: nursing challenges in prevention programs.

PubMed

Laperrière, Hélène

2007-03-01

The concrete insertion of nurses into the context of an inquiry contributes to empirical evaluation research of health promotion programs. As interveners and concrete actors in social movements, nurses are in a privileged position to give realism to a local understanding of the political and cultural context of evaluative research. Drawing on the practice of empirical evaluation research, this paper seeks to generate new methodological approaches in a way that broadens nursing inquiries in community health nursing. It explores new ways of thinking about epistemology and knowledge production in nursing practice. For 5 months an evaluative research project adopting a participatory-action research approach was conducted with local community actors in an AIDS prevention project in Amazonas (Brazil) in a prostitution setting. An auto-ethnographic journal was used as a reflective approach for the critical analysis of nursing research activities. This paper calls for a closer relationship between scientific research settings and the sociopolitical and the sociocultural aspects of nursing practice. It increases an incorporation of popular, social and professional experiential learning and skill acquisition in embedded knowledge production.

Study abroad as a tool for promoting cultural safety in nursing education.

PubMed

Mkandawire-Valhmu, Lucy; Doering, Jennifer

2012-01-01

Nurse educators are calling for the transformation of nursing education toward curricula that promote clinical reasoning through reflective practice and understanding of patient experiences in an effort to motivate students to become change agents. Study abroad programs can play an important role in this transformation through educating nurses in the delivery of culturally safe health care in a diverse world. Exposing nursing students to study abroad experiences that are guided by critical approaches such as a postcolonial feminist framework provides nursing students with opportunities to be immersed in the life and culture of people who have a completely different positioning and location while reflecting on the "us" versus "them" phenomenon that is pervasive in modern Western society and generates negative cultural comparisons. Attention to the design and implementation of such programs is important if nursing schools in the Western world are to uphold ethical standards, promote equality in relationships with host communities and avoid inadvertent exploitation and marginalization of vulnerable peoples. We present the development and implementation of a community health study abroad program for American nursing students in Malawi, Africa using a postcolonial feminist framework.

Enhancing assertiveness in district nurse specialist practice.

PubMed

Green, Julie

2016-08-02

District nurse (DN) care delivery has undergone substantial change in recent years due to changing demographics and service delivery demands that have called for a move of care delivery from secondary to primary care. The title District Nurse is recorded with the Nursing and Midwifery Council (NMC) on completion of the Specialist Practice Qualification in District Nursing (SPQ DN), which purports to be a 'transformational' course that prepares future caseload holders to manage their team and prioritise care delivery effectively. This article explores the need for assertiveness skills in this role in response to Australian research, and outlines the pedagogic interventions implemented during the SPQ DN course to enhance this skill. Assertiveness scores were monitored for the duration of the course and demonstrated a significant increase-a topic that is now the subject of a future, funded study.

Quality of nursing home care in Cyprus: are elder residents content with their treatment?

PubMed

Georgiades, Savvas

2008-01-01

Responding to a conspicuous dearth of knowledge on the quality of elder services in Cyprus, this study ventured to document Cypriot elders' feelings and experiences with nursing home care in Cyprus. Explicitly, four different types of nursing homes were called on (a governmental, a community-run, a faith-based, and a private one) to interview residents (n = 73; a response rate of 100%). Results suggest that Cypriot elders are clearly content with the level of primary care they receive in nursing homes, as mirrored in the quality of nutrition, medical treatment, staff professionalism, and sanitation of nursing home environment. However, the preponderance of residents feels loneliness and denial of essential entertainment opportunities in these institutions and a consequential motivational depletion. Finding implications for domestic and international policy, social work practice, and future research are explored.

[The mixed design in nursing sciences or when a question of research calls for qualitative and quantitative strategies].

PubMed

Bourgault, Patricia; Gallagher, Frances; Michaud, Cécile; Saint-Cyr-Tribble, Denise

2010-12-01

The use of a mixed method research design raises many questions, especially regarding the paradigmatic position. With this paradigm, we may consider the mixed method design as the best way of answering a research question and the latter orients to one of the different subtypes of mixed method design. To illustrate the use of this kind of design, we propose a study such as conducted in nursing sciences. In this article, the challenges raised by the mixed method design, and the place of this type of research in nursing sciences is discussed.

Supporting Faculty During Pedagogical Change Through Reflective Teaching Practice: An Innovative Approach.

PubMed

Armstrong, Deborah K; Asselin, Marilyn E

Given the recent calls for transformation of nursing education, it is critical that faculty be reflective educators. Reflective teaching practice is a process of self-examination and self-evaluation to gain insight into teaching to improve the teaching-learning experience. Limited attention has been given to this notion in the nursing education literature. An innovative reflective teaching practice approach for nursing education is proposed, consisting of question cues, journaling, and a process of facilitated meetings. The authors describe their perceptions of using this approach with faculty during the implementation of a new pedagogy and suggest areas for further research.

[The grounded theory as a methodological alternative for nursing research].

PubMed

dos Santos, Sérgio Ribeiro; da Nóbrega, Maria Miriam

2002-01-01

This study presents a method of interpretative and systematic research with appliance to the development of studies in nursing called "the grounded theory", whose theoretical support is the symbolic interactionism. The purpose of the paper is to describe the grounded theory as an alternative methodology for the construction of knowledge in nursing. The study highlights four topics: the basic principle, the basic concepts, the trajectory of the method and the process of analysis of the data. We conclude that the systematization of data and its interpretation, based on social actors' experience, constitute strong subsidies to generate theories through this research tool.

Results of the 2017 AORN Salary and Compensation Survey.

PubMed

Bacon, Donald R; Stewart, Kim A

2017-12-01

AORN conducted its 15th annual compensation survey for perioperative nurses in June 2017. A multiple regression model was used to examine how several variables, including job title, educational level, certification, experience, and geographic region, affect nurse compensation. Comparisons between the 2017 data and data from previous years are presented. The effects of other forms of compensation (eg, on-call compensation, overtime, bonuses, shift differentials, benefits) on base compensation rates are examined. Additional analyses explore the current state of the nursing shortage and the sources of job satisfaction and dissatisfaction. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

A Case Review: Integrating Lewin’s Theory with Lean’s System Approach for Change

PubMed

Wojciechowski, Elizabeth; Pearsall, Tabitha; Murphy, Patricia; French, Eileen

2016-05-31

The complexity of healthcare calls for interprofessional collaboration to improve and sustain the best outcomes for safe and high quality patient care. Historically, rehabilitation nursing has been an area that relies heavily on interprofessional relationships. Professionals from various disciplines often subscribe to different change management theories for continuous quality improvement. Through a case review, authors describe how a large, Midwestern, rehabilitation hospital used the crosswalk methodology to facilitate interprofessional collaboration and develop an intervention model for implementing and sustaining bedside shift reporting. The authors provide project background and offer a brief overview of the two common frameworks used in this project, Lewin’s Three-Step Model for Change and the Lean Systems Approach. The description of the bedside shift report project methods demonstrates that multiple disciplines are able to utilize a common framework for leading and sustaining change to support outcomes of high quality and safe care, and capitalize on the opportunities of multiple views and discipline-specific approaches. The conclusion discusses outcomes, future initiatives, and implications for nursing practice.

Automated detection of physiologic deterioration in hospitalized patients.

PubMed

Evans, R Scott; Kuttler, Kathryn G; Simpson, Kathy J; Howe, Stephen; Crossno, Peter F; Johnson, Kyle V; Schreiner, Misty N; Lloyd, James F; Tettelbach, William H; Keddington, Roger K; Tanner, Alden; Wilde, Chelbi; Clemmer, Terry P

2015-03-01

Develop and evaluate an automated case detection and response triggering system to monitor patients every 5 min and identify early signs of physiologic deterioration. A 2-year prospective, observational study at a large level 1 trauma center. All patients admitted to a 33-bed medical and oncology floor (A) and a 33-bed non-intensive care unit (ICU) surgical trauma floor (B) were monitored. During the intervention year, pager alerts of early physiologic deterioration were automatically sent to charge nurses along with access to a graphical point-of-care web page to facilitate patient evaluation. Nurses reported the positive predictive value of alerts was 91-100% depending on erroneous data presence. Unit A patients were significantly older and had significantly more comorbidities than unit B patients. During the intervention year, unit A patients had a significant increase in length of stay, more transfers to ICU (p = 0.23), and significantly more medical emergency team (MET) calls (p = 0.0008), and significantly fewer died (p = 0.044) compared to the pre-intervention year. No significant differences were found on unit B. We monitored patients every 5 min and provided automated pages of early physiologic deterioration. This before-after study found a significant increase in MET calls and a significant decrease in mortality only in the unit with older patients with multiple comorbidities, and thus further study is warranted to detect potential confounding. Moreover, nurses reported the graphical alerts provided information needed to quickly evaluate patients, and they felt more confident about their assessment and more comfortable requesting help. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

When the body is past fixing: caring for bodies, caring for people.

PubMed

Melia, Kath M

2014-03-01

To discuss the social context within which end-of-life nursing care takes place and to consider palliative options of last resort and the differences between societal and professional views on these. The distinction between life and death is not so straightforward as was once the case. Resuscitation and the increasing capability of intensive care to 'save' patients have implications for nursing practice in a society where there is an increasing demand that individuals should be able to choose the time of their death. This is a discursive paper. There are differences between the professional view on end-of-life options and the societal debates calling for a more libertarian approach. The problem for professionals is that the call for choice of the individual involves a different approach to end-of-life care, an approach that does not sit well with current professional ethics. One way forward might be a gradual reconsidering of what end-of-life care might reasonably encompass. Nurses are the healthcare workers who have the most prolonged and intimate contact with bodies. The way in which we conceptualise the body is central to much of the work carried out in the transition between life and death and is an important part of nursing. © 2013 John Wiley & Sons Ltd.

The Energy Employees Occupational Illness Compensation Program Act: new legislation to compensate affected employees.

PubMed

Silver, Ken

2005-06-01

Nurses make a bureaucracy work on behalf of clients. Occupational health nurses who are already versed in basic concepts applicable to EEOICPA--confidence intervals, occupational histories, exposure assessment, and dose response--can play constructive, caring roles in assisting claimants in securing benefits under this landmark program. Occupational health nurses know that chronically ill employees have a finite number of hours a week to make phone calls, visit providers, and advocate on their own behalf. Thoughtful referrals to occupational health providers who are both experienced and supportive can come from an occupational health nurse or a family physician. Involvement of university-based programs in projects to empower organizations representing EEOICP claimants would be a welcome development.

Conjoint analysis: using a market-based research model for healthcare decision making.

PubMed

Mele, Nancy L

2008-01-01

Conjoint analysis is a market-based research model that has been used by businesses for more than 35 years to predict consumer preferences in product design and purchasing. Researchers in medicine, healthcare economics, and health policy have discovered the value of this methodology in determining treatment preferences, resource allocation, and willingness to pay. To describe the conjoint analysis methodology and explore value-added applications in nursing research. Conjoint analysis methodology is described, using examples from the healthcare and business literature, and personal experience with the method. Nurses are called upon to increase interdisciplinary research, provide an evidence base for nursing practice, create patient-centered treatments, and revise nursing education. Other disciplines have met challenges like these using conjoint analysis and discrete choice modeling.

Visualising nursing data using correspondence analysis.

PubMed

Kokol, Peter; Blažun Vošner, Helena; Železnik, Danica

2016-09-01

Digitally stored, large healthcare datasets enable nurses to use 'big data' techniques and tools in nursing research. Big data is complex and multi-dimensional, so visualisation may be a preferable approach to analyse and understand it. To demonstrate the use of visualisation of big data in a technique called correspondence analysis. In the authors' study, relations among data in a nursing dataset were shown visually in graphs using correspondence analysis. The case presented demonstrates that correspondence analysis is easy to use, shows relations between data visually in a form that is simple to interpret, and can reveal hidden associations between data. Correspondence analysis supports the discovery of new knowledge. Implications for practice Knowledge obtained using correspondence analysis can be transferred immediately into practice or used to foster further research.

Why the history of nursing ethics matters.

PubMed

Fowler, Marsha D

2017-05-01

Modern American nursing has an extensive ethical heritage literature that extends from the 1870s to 1965 when the American Nurses Association issued a policy paper that called for moving nursing education out of hospital diploma programs and into colleges and universities. One consequence of this move was the dispersion of nursing libraries and the loss of nursing ethics textbooks, as they were largely not brought over into the college libraries. In addition to approximately 100 nursing ethics textbooks, the nursing ethics heritage literature also includes hundreds of journal articles that are often made less accessible in modern databases that concentrate on the past 20 or 30 years. A second consequence of nursing's movement into colleges and universities is that ethics was no longer taught by nursing faculty, but becomes separated and placed as a discrete ethics (later bioethics) course in departments of philosophy or theology. These courses were medically identified and rarely incorporated authentic nursing content. This shift in nursing education occurs contemporaneously with the rise of the field of bioethics. Bioethics is rapidly embraced by nursing, and as it develops within nursing, it fails to incorporate the rich ethical heritage, history, and literature of nursing prior to the development of the field of bioethics. This creates a radical disjunction in nursing's ethics; a failure to more adequately explore the moral identity of nursing; the development of an ethics with a lack of fit with nursing's ethical history, literature, and theory; a neglect of nursing's ideal of service; a diminution of the scope and richness of nursing ethics as social ethics; and a loss of nursing ethical heritage of social justice activism and education. We must reclaim nursing's rich and capacious ethics heritage literature; the history of nursing ethics matters profoundly.

The extent, variability, and attitudes towards volunteering among undergraduate nursing students: Implications for pedagogy in nurse education.

PubMed

Dyson, S E; Liu, L; van den Akker, O; O'Driscoll, Mike

2017-03-01

In the aftermath of the Francis Report nurses are being called to account for an apparent lack of care and compassion, leading to debate around pedagogy in nurse education. Absent from this debate is a consideration of student volunteering within undergraduate nursing programmes and its potential to promote student nurses self-esteem and to enhance the development of critical thinking skills. The aim of this study was therefore to understand the extent of and attitudes towards volunteering among nursing students. A mixed methods approach using a specifically developed questionnaire, followed by in-depth interviews to ascertain extent, variability, and attitudes towards volunteering revealed low levels of volunteering among nursing students. Limited time, limited access, and lack of academic support were cited as reasons. Nevertheless, students displayed positive attitudes towards volunteering. While volunteering has been shown to impact upon students abilities to think critically, to develop personal values and respond to the needs of others, volunteering within the UK undergraduate nursing programme considered here is neither structured nor formalized. Nurse educators should pay attention to the positive benefits of volunteering for nursing students and consider ways in which volunteering might be incorporated into the curriculum. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perspectives on global nursing leadership: international experiences from the field.

PubMed

Buckner, E B; Anderson, D J; Garzon, N; Hafsteinsdóttir, T B; Lai, C K Y; Roshan, R

2014-12-01

Nursing leaders from six countries engaged in a year-long discussion on global leadership development. The purpose of these dialogues was to strengthen individual and collective capacity as nursing leaders in a global society. Field experiences in practice and education were shared. Perspectives on global leadership can strengthen nurses' contributions to practice, workplace and policy issues worldwide. Transformational leadership empowers nurses' increasing confidence. Mentoring is needed to stimulate leadership development but this is lacking in many settings where nurses practice, teach and influence policy. Organizations with global mission provide opportunity for nurses' professional growth in leadership through international dialogues. Dialogues among participants were held monthly by conference calls or videoconferences. Example stories from each participant illustrated nursing leadership in action. From these exemplars, concepts were chosen to create a framework. Emerging perspectives and leadership themes represented all contexts of practice, education, research and policy. The cultural context of each country was reflected in the examples. Themes emerged that crossed global regions and countries. Themes were creativity, change, collaboration, community, context and courage. Relationships initially formed in professional organizations can be extended to intentionally facilitate global nursing leadership development. Exemplars from the dialogues demonstrated nursing leadership in health policy development within each cultural context. Recommendations are given for infrastructure development in organizations to enhance future collaborations. © 2014 International Council of Nurses.

Computer simulation of the human respiratory system for educational purposes.

PubMed

Botsis, Taxiarhis; Halkiotis, Stelios-Chris; Kourlaba, Georgia

2004-01-01

The main objective of this study was the development of a computer simulation system for the human respiratory system, in order to educate students of nursing. This approach was based on existing mathematical models and on our own constructed specific functions. For the development of this educational tool the appropriate software packages were used according to the special demands of this process. This system is called ReSim (Respiratory Simulation) and consists of two parts: the first part deals with pulmonary volumes and the second one represents the mechanical behavior of lungs. The target group evaluated ReSim. The outcomes of the evaluation process were positive and helped us realize the system characteristics that needed improvements. Our basic conclusion is that the extended use of such systems supports the educational process and offers new potential for learning.

The Policy and the Practice: Early-Career Doctors and Nurses as Leaders and Followers in the Delivery of Health Care

ERIC Educational Resources Information Center

Barrow, Mark; McKimm, Judy; Gasquoine, Sue

2011-01-01

There are increasing calls, from a range of stakeholders in the health sector, for healthcare professionals to work more collaboratively to provide health care. In response, education institutions are adopting an interprofessional education agenda in an attempt to provide health professionals ready to meet such calls. This article considers the…

China confidential: methodological and ethical challenges in global nursing historiography.

PubMed

Grypma, Sonya; Wu, Na

2012-01-01

As the history of nursing as a field of scholarship expands its global consciousness, it seems timely to join other scholars of international history in rethinking conventional approaches to historiography. The lament by mission scholars at the invisibility of nurses and indigenous workers in historical mission records coincides with calls by China scholars to reconsider traditional reliance on English-language data generation and interpretation for an English-speaking audience. In a similar way, nursing scholars are challenging historians of nursing to find ways to build a body of scholarship and a cadre of scholars that can open up new linguistic and cultural space for vibrant discussion and dialogue. Drawing on Sonya Grypma's research on the role of missionary nurses in the development of modern nursing in China and based on a series of interviews by the authors in China of participants with ties to a former Canadian mission hospital, we explore methodological and ethical challenges in global nursing historiography. By offering insights gleaned from our early attempts to capture voices not included in conventional mission records, we hope to stimulate more dialogue about conceptual and structural issues central to a "new" global nursing historiography.

Academic report on burnout among Japanese nurses.

PubMed

Kitaoka, Kazuyo; Masuda, Shinya

2013-12-01

Japanese nurses have increasingly experienced "burnout" in the past several years. Studies on Japanese nurses are required in order to explore how to prevent nursing burnout. The objectives of this report were to: (i) introduce the concept, definition, and measurement of burnout; (ii) look at an overview of the prevalence, possible causes, and consequences of burnout among Japanese nurses; and (iii) explore how to prevent burnout among nurses. The authors and co-researchers have been studying burnout among Japanese workers for more than 15 years. Therefore, previously performed studies were reviewed and summarized. In Japan, approximately 36% of human services professionals, such as nurses, were burned out compared to 18% of civil servants, and 12% of company employees. It was quite obvious that nurses are prone to burnout. The possible causes and consequences of burnout among Japanese nurses were reviewed. Excessive workloads and interpersonal conflict in the workplace were possible causes of burnout among Japanese nurses. The consequences of nurse burnout are potentially very serious, including medical accidents/errors. Issues to prevent nursing burnout were then reviewed. Enhancement of cognitive coping skills for female nurses and problem-solving skills for male nurses could contribute to prevention of burnout in nurses. The authors' previous study revealed that the new model of the organizational context of burnout developed by Leiter and Maslach could be applied to Japanese. Further examination is needed. This report supports the call to scale up burnout prevention strategy for Japanese nurses. © 2012 The Authors. Japan Journal of Nursing Science © 2012 Japan Academy of Nursing Science.

Reducing perceived barriers to nursing homes data entry in the advancing excellence campaign: the role of LANEs (Local Area Networks for Excellence).

PubMed

Bakerjian, Debra; Bonner, Alice; Benner, Carol; Caswell, Cheryl; Weintraub, Alissa; Koren, Mary Jane

2011-09-01

Advancing Excellence (AE) is a coalition-based campaign concerned with how society cares for its elderly and disabled citizens. The purpose of this project was to work with a small group of volunteer nursing homes and with local quality improvement networks called LANEs (Local Area Networks for Excellence) in 6 states in a learning collaborative. The purpose of the collaborative was to determine effective ways for LANEs to address and mitigate perceived barriers to nursing home data entry in the national Advancing Excellence campaign and to test methods by which local quality improvement networks could support nursing homes as they enter data on the AE Web site. A semistructured telephone survey of nursing homes was conducted in 6 states. Participants included LANEs from California, Georgia, Massachusetts, Michigan, Oklahoma, and Washington. Facility characteristics were obtained from a series of questions during the telephone interview. Three states (GA, MA, OK) piloted a new spreadsheet and process for entering data on staff turnover, and 3 states (CA, MI, WA) piloted a new spreadsheet and process for entering data on consistent assignment. Many of the nursing homes we contacted had not entered data for organizational goals on the national Web site, but all were able to do so with telephone assistance from the LANE. Eighty-five percent of nursing homes said they would be able to collect information on advance directives if tools (eg, spreadsheets) were provided. Over 40% of nursing homes, including for-profit homes, were willing to have staff and residents/families enter satisfaction data directly on an independent Web site. Nursing homes were able to convey concerns and questions about the process of goal entry, and offer suggestions to the LANEs during semistructured telephone interviews. The 6 LANEs discussed nursing home responses on their regularly scheduled calls, and useful strategies were shared across states. Nursing homes reported that they are using Advancing Excellence target setting and goal entry to improve care, and that they would use new tools such as those for measuring satisfaction, consistent assignment, and advance directives. Having LANE members contact nursing homes directly by telephone engaged the nursing homes in providing valuable feedback on new Advancing Excellence goals and data entry. It also provided an opportunity to clarify issues related to the campaign and ongoing quality improvement efforts, including culture change. Published by Elsevier Inc.

Florence Nightingale: a 19th-century mystic.

PubMed

Dossey, Barbara M

2010-03-01

Florence Nightingale (1820-1910) received a clear and profoundly moving Call to serve God at the age of 16. Through a lifetime of hard work and discipline, she became a practicing mystic in the Western tradition, thereby becoming an instrument of God's love, which was the primarily source of her great energy and the fabled "Nightingale power." To understand the life and work of this legendary healer, who forever changed human consciousness, the role of women, and nursing and public health systems in the middle of the 19th century, it is necessary to understand her motivation and inspiration. This article will discuss her life and work in the context of her mystical practice and to show the parallels between her life and the lives of three recognized women mystics. In her epic Crimean war mission (1854-1856) of leading and directing women nurses in the army hospital at Scutari, Turkey, Florence Nightingale burst into world consciousness as a spiritual beacon of hope and compassion for all who suffered. Her historic breakthrough achievement--pioneering the modern administrative role of nurse superintendent with measurable outcomes supported by irrefutable data--in the face of incredible adversity was merely the cornerstone of her life work.

A new intelligent bed care system for hospital and home patients.

PubMed

Yonezawa, Yoshiharu; Miyamoto, Yasuaki; Maki, Hiromichi; Ogawa, Hidekuni; Ninomiya, Ishio; Sada, Kouji; Hamada, Shingo; Caldwell, W Morton

2005-01-01

An intelligent bed-care system has been developed for monitoring patient movements and behavior in the hospital and at home in order to prevent injuries from falls, a major problem in health care facilities. Falls, as well as patient activity immediately preceding falls (i.e. exiting the bed), are especially dangerous when infusion extubation also occurs. This new system detects in-bed infusion fluid leaks, bleeding due to infusion-tube pullout, and urine resulting from incontinence. It employs stainless steel tape and wire noncontacting electrodes, several linear integrated circuits, and a low-power, 8-bit single-chip microcomputer The electrodes are installed between the bed mattress and sheet to record changes in an always-present alternating current (AC) voltage, which is induced on the patient's body by electrostatic coupling from a 100-V, 60-Hz alternating current power line around the bed. The microcomputer uses changes in the induced alternating current voltage to detect the patient's movements before and after leaving the bed, as well as any fluid leakage. The microcomputer alerts the nursing station, via the nurse call system or personal handy phone (PHS), that the patient is in an active state; has a dangerous posture on the bed; is contaminating the sheet due to leaking, bleeding or incontinence; or is out of bed.

Inpatient satisfaction and usage patterns of personalized smart bedside station system for patient-centered service at a tertiary university hospital.

PubMed

Ryu, Borim; Kim, Seok; Lee, Kee-Hyuck; Hwang, Hee; Yoo, Sooyoung

2016-11-01

Bedside stations, also known as bedside terminals, are in place to enhance the quality and experience of a hospital's healthcare service delivery. The purpose of this study was to identify information needs and overall satisfaction with the personalized patient bedside system, called Smart Bedside Station (SBS) system, embedded in a tertiary general university hospital. End-user responses on the satisfaction survey and system usage logs of the SBS system were collected and analyzed. For the user opinion survey, 156 nurses and 1914 patients, their family members, or caregivers participated during the evaluation period of 2013 to 2014 in this study. All working nurses in the SBS-installed ward were answered the paper-based evaluation, for complete enumeration survey. Inpatients were voluntary participated to deliver the online questionnaire on the SBS menu. We also explored system log data including page calls and usage time from December 2013 to 2015. Regarding the relationship of overall satisfaction of the SBS with patient's characteristics, patient's education status and degree of familiarity with the smart device were statistically significant. From the analysis of system logs, Personalized My Menu(28.0%) was the most frequently used menu item (except for TV and Internet entertainment service use of 62.7%),it provides individual health information, such as laboratory test results, hospital fee check, message logs, daily medication information, and meal information. Next frequently used menus were information support(4.9%) which deliver hospital guide and health information and convenience service ordering(4.4%) such as meal order, bed sheet change. Satisfaction survey results and log data results show that the personalized service enhances the user satisfaction during hospital admission. Our post-implementation experience and subsequent assessment of SBS system is capable of providing insights into improving the hospital information system and service contents for patient-centered services. Further research should be directed at developing sophisticated patient-centered services as a communication tool between the hospital and the patient. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Communication Coaching: A Case Study of Family Caregiver Burden.

PubMed

Wittenberg, Elaine; Ferrell, Betty; Koczywas, Marianna; Ferraro, Catherine

2017-04-01

Problematic communication among providers, patients, and their family members can affect the quality of patient care, causing stress to all parties involved and decreased opportunities for collaborative decision making.
. The purpose of this article is to present one case from a pilot study of a family caregiver intervention focused on communication. 
. The nurse-delivered communication intervention includes a written communication guide for family caregivers, as well as a one-time nurse communication coaching call. The call is aimed at identifying caregiver communication concerns, providing communication education, and role playing problematic communication.
. Psychological distress and caregiver confidence in communication were improved for the caregiver. Data presented from the case study demonstrate the need for family caregiver communication support and training and the potential benefits of such training.

Basic nursing care: The most provided, the least evidence based - A discussion paper.

PubMed

Zwakhalen, Sandra M G; Hamers, Jan P H; Metzelthin, Silke F; Ettema, Roelof; Heinen, Maud; de Man-Van Ginkel, Janneke M; Vermeulen, Hester; Huisman-de Waal, Getty; Schuurmans, Marieke J

2018-06-01

To describe and discuss the "Basic Care Revisited" (BCR) research programme, a collaborative initiative that contributes to evidence-based basic nursing care and raises awareness about the importance of basic nursing care activities. While basic nursing care serves nearly all people at some point in their lifetime, it is poorly informed by evidence. There is a need to prioritise and evaluate basic nursing care activities to improve patient outcomes and improve the quality of care. Discussion paper METHOD: The discussion presented in this paper is based on nursing literature and theory and supported by the authors' clinical and research experiences. We present the developmental process and content of a research programme called "Basic Care Revisited" (BCR) as a solution to move forward and improve basic nursing care. To prioritise basic nursing care, we propose a research programme entitled "Basic Care Revisited" that aims to create awareness and expand knowledge on evidence-based basic nursing care by addressing four basic nursing care themes (bathing and dressing, communication, mobility, and nutrition) in different settings. The paper discusses a pathway to create a sustainable and productive research collaborative on basic nursing care and addresses issues to build research capacity. Revaluation of these important nursing activities will not only positively influence patient outcomes, but also have an impact on staff outcomes and organisational outcomes. © 2018 John Wiley & Sons Ltd.

Quasi-experimental evaluation of a substance use awareness educational intervention for nursing students.

PubMed

Cadiz, David M; O'Neill, Chris; Butell, Sue S; Epeneter, Beverly J; Basin, Basilia

2012-07-01

This article reports on a study that evaluated the effectiveness of an educational intervention, Addressing Nurse Impairment, for addressing nursing students' knowledge acquisition, changes in self-efficacy to intervene, and changes in substance abuse stigma. A gap exists in nursing students' education regarding the risks of addiction within the profession and how to handle a colleague suspected of having a substance use disorder. The seminar was adapted from an existing evidence-based prevention program called Team Awareness, as well as information from focus groups and a pilot test. A quasi-experimental pretest-posttest design was used to evaluate the effect of the seminar. When the control and experimental groups were compared, the results indicated that the seminar significantly affected knowledge and self-efficacy to intervene but did not significantly affect stigma. This research contributes to the body of evidence related to educational interventions for nursing students regarding substance abuse in the nursing profession. Copyright 2012, SLACK Incorporated.

Nurses Writing about Psychiatric Nurses' Involvement in Killings during the Nazi Era: A Preliminary Discourse Analysis.

PubMed

Holmes, Colin A; McAllister, Margaret; Crowther, Andrew

2016-01-01

Nurses actively killed people in Nazi Europe between 1939 and 1945. The so-called ‘science of eugenics’ underpinned Nazi ideology, used to further the Nazi racist agenda. Edicts sanctioned selection and medically supervised killing of people, and nurses, principally in mental hospitals, participated in the killing of between 100–300 thousand patients. Erroneously termed ‘euthanasia', there were three phases: the initial programme involving children, the T4 adult programme, and ‘wild euthanasia'. Unofficial killings also took place before 1939. This paper uses discourse analysis to map and analyse published texts which explore the role of nurses in Nazi Germany. The aim is to identify its characteristics as a body of literature, to note strengths and weaknesses, emphases and silences, and to note aspects that need further exploration. It acknowledges that how these events are to be understood and represented in contemporary discourse constitutes a significant problem for historians of nursing.

[REBEn in the context of the history of Brazilian nursing: the significance of remembering Dr. Glete de Alcântara].

PubMed

Mendes, Isabel Amélia Costa; Leite, Joséte Luzia; Leite, Juçara Luzia; Trevizan, Maria Auxiliadora

2002-01-01

This is a Social History study which aims at recuperating the professional trajectory of Glete de Alcântara in the Revista Brasileira de Enfermagem/REBEn (Brazilian Journal of Nursing), initially called Anais de Enfermagem. It is based on the concept of memory of Maurice Halbwach, and on the concept of generation of Daniel Pécaut. The study contextualizes the professional development of Glete de Alcântara in the history of the Brazilian nursing, highlighting the creation of the Nursing School of the University of São Paulo (EERP/USP) in Ribeirão Preto. The sources for the study were documents obtained in the Centro de Memória da Escola de Enfermagem (Memory Center of the School of Nursing) of Ribeirão Preto and in ABEN (Brazilian Association of Nursing) in Brasília. Data obtained in this association were mainly collected from its record books the journals.

A critical exploration of how English language learners experience nursing education.

PubMed

Mulready-Shick, N

2013-01-01

With nursing education reform calling for greater numbers of graduates from diverse backgrounds, this study explored the experiences of students who identified as English language learners (ELs). Educators may view students from underrepresented groups at the margins of nursing education. Minimal research on the experiences of students identifying as ELs exists. Interpretive phenomenological and critical methodologies were used to explore students' lived experiences in the nursing classroom. Academic progress involved additional time and effort dedicated to learning English and the languages of health care and nursing. Traditional and monocultural pedagogical practices, representing acts of power and dominance, thwarted learning. Yet students made progress despite less effective pedagogical practices and socioeconomic realities. This inquiry began with one notion of identity, "English-learners," but evolved to students' perceptions of "being-in-the-world," wholeness, and future endeavors. This study counters the dominant view that students without a greater command of English are not ready for the rigors of nursing education.

Diabetes management: optimizing roles for nurses in insulin initiation

PubMed Central

Levich, Bridget R

2011-01-01

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

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.

Barriers to critical thinking: workflow interruptions and task switching among nurses.

PubMed

Cornell, Paul; Riordan, Monica; Townsend-Gervis, Mary; Mobley, Robin

2011-10-01

Nurses are increasingly called upon to engage in critical thinking. However, current workflow inhibits this goal with frequent task switching and unpredictable demands. To assess workflow's cognitive impact, nurses were observed at 2 hospitals with different patient loads and acuity levels. Workflow on a medical/surgical and pediatric oncology unit was observed, recording tasks, tools, collaborators, and locations. Nineteen nurses were observed for a total of 85.2 hours. Tasks were short with a mean duration of 62.4 and 81.6 seconds on the 2 units. More than 50% of the recorded tasks were less than 30 seconds in length. An analysis of task sequence revealed few patterns and little pairwise repetition. Performance on specific tasks differed between the 2 units, but the character of the workflow was highly similar. The nonrepetitive flow and high amount of switching indicate nurses experience a heavy cognitive load with little uninterrupted time. This implies that nurses rarely have the conditions necessary for critical thinking.

Is higher nursing home quality more costly?

PubMed

Giorgio, L Di; Filippini, M; Masiero, G

2016-11-01

Widespread issues regarding quality in nursing homes call for an improved understanding of the relationship with costs. This relationship may differ in European countries, where care is mainly delivered by nonprofit providers. In accordance with the economic theory of production, we estimate a total cost function for nursing home services using data from 45 nursing homes in Switzerland between 2006 and 2010. Quality is measured by means of clinical indicators regarding process and outcome derived from the minimum data set. We consider both composite and single quality indicators. Contrary to most previous studies, we use panel data and control for omitted variables bias. This allows us to capture features specific to nursing homes that may explain differences in structural quality or cost levels. Additional analysis is provided to address simultaneity bias using an instrumental variable approach. We find evidence that poor levels of quality regarding outcome, as measured by the prevalence of severe pain and weight loss, lead to higher costs. This may have important implications for the design of payment schemes for nursing homes.

The struggle for methodological orthodoxy in nursing research: the case of mental health.

PubMed

White, Edward

2003-06-01

This paper is not intended as an exhaustive review of contemporary mental health nursing research. Rather, the intention is to explore some of the competing arguments for different methodological approaches in social research, using mental health nursing as a case example. The paper questions the extent to which the artificially dichotomized debate over quantitative versus qualitative research impacts upon the working lives of practitioners, managers and policy makers. In particular, the paper traces the development of survey method, during this its centennial anniversary year. It also traces its subsequent decline, in favour of what will be referred to as the new methodological orthodoxy in nursing research. It is also interwoven with occasional accounts of personal experience, drawn from an international perspective. The paper calls for a reapproachement between different wings of methodological opinion, in deference to a publicly unified position for nursing research in which the achievement of quality becomes the over-arching concern.

Thirteen years and counting: Outcomes of a concurrent ASN/BSN enrollment program.

PubMed

Heglund, Stephen; Simmons, Jessica; Wink, Diane; D'Meza Leuner, Jean

In their 2011 report, The Future of Nursing, the Institute of Medicine called for 80% of the nursing workforce to be comprised of baccalaureate prepared Registered Nurses by the year 2020. One suggested approach to achieve this goal is the creation of programs that allow students to progress through associate and baccalaureate nursing preparation simultaneously. This paper describes the University of Central Florida's 13-year experience after implementing a Concurrent Enrollment Program. Development and structure of the program, advisement and curriculum details, facilitators and barriers are described. Data on National Council Licensure Examination for Registered Nurses pass rates, completion rates, comparison with traditional RN-BSN students, and progression to graduate school are also included. The Concurrent Program model described here between a specific university and state college partners, demonstrated positive outcomes that support achievement of the Institute of Medicine's goals. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

[Preliminarily application of content analysis to qualitative nursing data].

PubMed

Liang, Shu-Yuan; Chuang, Yeu-Hui; Wu, Shu-Fang

2012-10-01

Content analysis is a methodology for objectively and systematically studying the content of communication in various formats. Content analysis in nursing research and nursing education is called qualitative content analysis. Qualitative content analysis is frequently applied to nursing research, as it allows researchers to determine categories inductively and deductively. This article examines qualitative content analysis in nursing research from theoretical and practical perspectives. We first describe how content analysis concepts such as unit of analysis, meaning unit, code, category, and theme are used. Next, we describe the basic steps involved in using content analysis, including data preparation, data familiarization, analysis unit identification, creating tentative coding categories, category refinement, and establishing category integrity. Finally, this paper introduces the concept of content analysis rigor, including dependability, confirmability, credibility, and transferability. This article elucidates the content analysis method in order to help professionals conduct systematic research that generates data that are informative and useful in practical application.

The Fundamentals of Care Framework as a Point-of-Care Nursing Theory.

PubMed

Kitson, Alison L

Nursing theories have attempted to shape the everyday practice of clinical nurses and patient care. However, many theories-because of their level of abstraction and distance from everyday caring activity-have failed to help nurses undertake the routine practical aspects of nursing care in a theoretically informed way. The purpose of the paper is to present a point-of-care theoretical framework, called the fundamentals of care (FOC) framework, which explains, guides, and potentially predicts the quality of care nurses provide to patients, their carers, and family members. The theoretical framework is presented: person-centered fundamental care (PCFC)-the outcome for the patient and the nurse and the goal of the FOC framework are achieved through the active management of the practice process, which involves the nurse and the patient working together to integrate three core dimensions: establishing the nurse-patient relationship, integrating the FOC into the patient's care plan, and ensuring that the setting or context where care is transacted and coordinated is conducive to achieving PCFC outcomes. Each dimension has multiple elements and subelements, which require unique assessment for each nurse-patient encounter. The FOC framework is presented along with two scenarios to demonstrate its usefulness. The dimensions, elements, and subelements are described, and next steps in the development are articulated.

Using social media to engage nurses in health policy development.

PubMed

O'Connor, Siobhan

2017-11-01

To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development. Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence. A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software. The framework approach aided thematic analysis to draw out themes. Sixty-four people took part in the Twitter chat (#CNOScot) and posted 444 tweets. Nurses called for investment in technology, nursing research, education and mental health. Primary care and advanced practice roles to support older adults with complex health and social care needs were also seen as vital to develop further. Social media can help reach and engage nurses in policy discussion and ensure there is better continuity between policy and practice but some groups risk being excluded using this digital medium. Nursing leaders should consider social media as one of many engagement strategies to ensure nurses and other stakeholders participate in policy debate that informs health strategy development. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

The examination of nursing work through a role accountability framework.

PubMed

White, Deborah E; Jackson, Karen; Besner, Jeanne; Norris, Jill M

2015-07-01

To use work analysis data to describe the amount of time registered nurses (RNs) and health care aides (HCA) spent on key clinical role accountabilities and other work activities. Health care providers are not effectively utilized. To improve their efficiency and effectiveness, it is necessary to understand how nursing providers enact their role accountabilities. Using palm pilot Function Analysis technology, observers recorded the activities of 35 registered nurse and 17 health care aides shifts on a second-by-second basis over 5 days. Work activities were classified using the Nursing Role Effectiveness Model, which conceptualizes nursing practice in terms of clinical role accountabilities. The registered nurses spent a considerable amount of time on bio-medical assessment/surveillance, relatively little time was spent on patient and family psycho-social-cultural-spiritual assessment/surveillance and support. Unlike other work sampling studies, this research project examined nursing work within a role accountability framework; an important first step in the call for the measurement of the impact of nursing care. Changes to how registered nurses and health care aides enact their role will require a clear vision by unit managers and their staff of their role accountabilities, and the gap between ideal and actual practice. © 2013 John Wiley & Sons Ltd.

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.

[A discussion of nursing management philosophy in the light of Mo-tzu's concept of love without distinction].

PubMed

Hsiao, Hung-En

2005-10-01

When one mentions the word, "management," people all too easily conclude that one is referring to the question of how to create profit for a business enterprise. This is because, in business, that is indeed the precise purpose of management. So what should the aim of management be in nursing? That is to say, how does the function of management apply to the nursing profession? It is not difficult to understand that behind the implementation of any practice is a key thought or guiding principle. To investigate the central idea or key thought about nursing management requires research into the philosophy of nursing management. The writer believes that the teaching of Mo-tzu, who advocated love without distinction, in ancient (pre-Chin) China, is the fundamental idea of nursing management, because that philosophy emphasizes impartial love of every person. It does not stress investigations of different levels of abstract theories; but simply calls for the practical application of the idea. The goal of nursing management is to care about patients impartially and strengthen nursing care. The aim of nursing care is completely different from that of business enterprises. We can also say that it is precisely because nursing means taking care of sick people, that the goal of nursing management is to care about achieving the recovery of body, mind, and spirit of a patient. The management of nursing, therefore, and the goal of nursing are united harmoniously into one in nursing care.

Development of a PTSD Population Registry

DTIC Science & Technology

2012-09-01

due to the different roles that women had in the military at that time (primarily nursing and clerical), the different types of stressors to which...they were exposed, and to their higher educational levels. In a study of PTSD among female Vietnam veterans who served as nurses , war trauma and...called and asked to reschedule the phone interview (see appendix C for script). 6. If the participant wants to reschedule the interview and complete

Principles of cancer prevention.

PubMed

Meyskens, Frank L; Tully, Patricia

2005-11-01

To summarize the scientific principles underlying cancer prevention. Articles, text books, personal communications, and experience. The scientific basis of cancer prevention is complex and involves experimental and epidemiologic approaches and clinical trials. As more information becomes available regarding proven and potential cancer-prevention strategies, oncology nurses are regularly called upon to guide patients and others in making choices regarding preventative options. It is important for oncology nurses to stay abreast of this growing body of knowledge.

Nursing Academic Administrators' Lived Experiences With Incivility and Bullying From Faculty: Consequences and Outcomes Demanding Action.

PubMed

LaSala, Kathleen B; Wilson, Vicki; Sprunk, Elizabeth

2016-01-01

There are an increasing number of nursing academic administrators who identify themselves as victims of faculty incivility. This study examined experiences that academic administrators encountered with faculty incivility using a phenomenological research design. Three major themes emerged: faculty inappropriate behaviors, consequences of faculty behaviors on administrator targets, and administrators call for action. Findings revealed that incivility had devastating effects on administrators personally and professionally.

Results of the 2008 AORN Salary Survey.

PubMed

Bacon, Donald

2008-12-01

AORN conducted its sixth annual compensation survey for perioperative nurses in August of 2008. A multiple regression model was used to examine how a variety of variables including job title, education level, certification, experience, and geographic region affect nursing compensation. Comparisons between the 2008 and previous years' data are presented. The effects of other forms of compensation, such as on-call compensation, overtime, bonuses, and shift differentials on average base compensation rates also are examined.

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.

Psychometric testing of inventory of beliefs and attitudes on domestic violence.

PubMed

Hutchinson, Marie; Doran, Frances

2017-06-22

Background Domestic violence (DV) is an international public health issue associated with adverse health outcomes for adults and children. There have been widespread calls to increase nurses' capacity to respond to DV and improve undergraduate nursing education in this area. However, there are few valid, reliable and contemporary measures of nursing attitudes towards and beliefs concerning DV that are suited for use in evaluating education programmes. Aim To establish the psychometric properties of a newly developed inventory designed to measure nursing students' beliefs about and attitudes towards DV. Discussion Exploratory factor analysis identified five factors, with a Cronbach's alpha of 0.646. The few factors loading>.80 suggest that the instrument has good discriminate validity. The absence of cross-loadings indicate good convergent validity. Conclusion The inventory provides one of the first validated and reliable measures for examining undergraduate nursing students' attitudes towards and beliefs about DV. Implications for practice The instrument is suited for use by nurse educators in assessing the influence of curriculum design and teaching strategies on student beliefs and attitudes. It would also be useful in studies investigating nurses' clinical practice on domestic violence.

Evidence-based practice: how nurse leaders can facilitate innovation.

PubMed

Shirey, Maria R

2006-01-01

Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action.

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

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.

Evaluation of a technology-enhanced integrated care model for frail older persons: protocol of the SPEC study, a stepped-wedge cluster randomized trial in nursing homes.

PubMed

Kim, Hongsoo; Park, Yeon-Hwan; Jung, Young-Il; Choi, Hyoungshim; Lee, Seyune; Kim, Gi-Soo; Yang, Dong-Wook; Paik, Myunghee Cho; Lee, Tae-Jin

2017-04-18

Limited evidence exists on the effectiveness of the chronic care model for people with multimorbidity. This study aims to evaluate the effectiveness of an information and communication technology- (ICT-)enhanced integrated care model, called Systems for Person-centered Elder Care (SPEC), for frail older adults at nursing homes. SPEC is a prospective stepped-wedge cluster randomized trial conducted at 10 nursing homes in South Korea. Residents aged 65 or older meeting the inclusion/exclusion criteria in all the homes are eligible to participate. The multifaceted SPEC intervention, a geriatric care model guided by the chronic care model, consists of five components: comprehensive geriatric assessment for need/risk profiling, individual need-based care planning, interdisciplinary case conferences, person-centered care coordination, and a cloud-based information and communications technology (ICT) tool supporting the intervention process. The primary outcome is quality of care for older residents using a composite measure of quality indicators from the interRAI LTCF assessment system. Outcome assessors and data analysts will be blinded to group assignment. Secondary outcomes include quality of life, healthcare utilization, and cost. Process evaluation will be also conducted. This study is expected to provide important new evidence on the effectiveness, cost-effectiveness, and implementation process of an ICT-supported chronic care model for older persons with multiple chronic illnesses. The SPEC intervention is also unique as the first registered trial implementing an integrated care model using technology to promote person-centered care for frail older nursing home residents in South Korea, where formal LTC was recently introduced. ISRCTN11972147.

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.

Then Came the Fire: Personal Accounts From the Pentagon, 11 September 2001

DTIC Science & Technology

2011-01-01

office to let folks there know what had happened. Maj. Lorie A. Brown was the Chief Nurse of the DiLorenzo Clinic at the Pentagon. She was... nurse , three medics—grab vests, grab radios, grab this. “Go, you’re going to three and four. Call me when you get there and let me know what you...volunteers coming in—”I’m a doc,” “I’m a nurse ,” “I’m here to help. What can I do?” “Okay, here’s a vest, here’s a bag. You’re going to”—you know

Violence in the workplace in Nursing: consequences overview.

PubMed

Bordignon, Maiara; Monteiro, Maria Inês

2016-01-01

to reflect on the consequences of workplace violence experienced by nursing professionals. this is a reflection paper based on recent publications related to the subject, particularly researches carried out in Brazil and in other countries. exposure to workplace violence has been associated with health problems in nursing professionals, which may be physical damage, emotional manifestations, and psychic disorders. It also affects the employee performance, his or her family and social interactions. this phenomenon is potentially noxious and costly, for it leads to suffering, illness, absence from work, and even death. This reflection calls attention moreover to the importance of a safe and adequate health care work environment.

Nurses need a standard definition of a deprivation of liberty.

PubMed

Griffith, Richard

The House of Commons health committee has called for an urgent review of the implementation of the deprivation of liberty safeguards. They are particularly concerned that nurses, as gatekeepers of the safeguards, often do not know when a deprivation of liberty occurs in practice. In this article the author argues that given the lack of a standard definition of what amounts to a deprivation of liberty and the introduction by the courts of often contradictory factors that nurses are required to consider when determining if a patient is being deprived of their liberty it is little wonder that confusion is common place.

Overcoming barriers to cancer-helpline professionals providing decision support for callers: an implementation study.

PubMed

Stacey, Dawn; Chambers, Suzanne K; Jacobsen, Mary Jane; Dunn, Jeff

2008-11-01

To evaluate the effect of an intervention on healthcare professionals' perceptions of barriers influencing their provision of decision support for callers facing cancer-related decisions. A pre- and post-test study guided by the Ottawa Model of Research Use. Australian statewide cancer call center that provides public access to information and supportive cancer services. 34 nurses, psychologists, and other allied healthcare professionals at the cancer call center. Participants completed baseline measures and, subsequently, were exposed to an intervention that included a decision support tutorial, coaching protocol, and skill-building workshop. Strategies were implemented to address organizational barriers. Perceived barriers and facilitators influencing provision of decision support, decision support knowledge, quality of decision support provided to standardized callers, and call length. Postintervention participants felt more prepared, confident in providing decision support, and aware of decision support resources. They had a stronger belief that providing decision support was within their role. Participants significantly improved their knowledge and provided higher-quality decision support to standardized callers without changing call length. The implementation intervention overcame several identified barriers that influenced call center professionals when providing decision support. Nurses and other helpline professionals have the potential to provide decision support designed to help callers understand cancer information, clarify their values associated with their options, and reduce decisional conflict. However, they require targeted education and organizational interventions to reduce their perceived barriers to providing decision support.

Elder mistreatment and the Elder Justice Act.

PubMed

Falk, Nancy L; Baigis, Judith; Kopac, Catharine

2012-09-01

Elder mistreatment is unrecognized, hidden, and underreported. Studies show that health professionals, nurses among them, are largely unaware of the various forms of elder mistreatment that take place and of the proper course of action to pursue when mistreatment is suspected. In this article, we describe elder mistreatment policies, examining them in the light of the United States national elder abuse policies with a focus on important provisions of the Elder Justice Act. Next, we review the various types of abuse, the identification of abuse, and the nurses role in addressing elder mistreatment. We present an example of a case of physical abuse and conclude by discussing nurses' advocacy role and issuing a call to action, challenging nurses to ‘"act now" to protect the well being of elders.

Critical Care Nurses' Perceptions of End-of-Life Care Obstacles: Comparative 17-Year Data.

PubMed

Beckstrand, Renea L; Lamoreaux, Nicole; Luthy, Karlen E; Macintosh, Janelle L B

Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end of life (EOL). Providing high-quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made for the last 17 years. The aims of this study were to determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether meaningful changes have occurred since data were first gathered in 1998. A quantitative-qualitative mixed methods design was used. A random, geographically dispersed sample of 2000 members of the American Association of Critical-Care Nurses was surveyed. Five obstacle items increased in mean score and rank as compared with 1999 data including (1) family not understanding what the phrase "lifesaving measures" really means, (2) providing lifesaving measures at families' requests despite patient's advance directive listing no such care, (3) family not accepting patient's poor prognosis, (4) family members fighting about the use of life support, and (5) not enough time to provide EOL care because the nurse is consumed with lifesaving measures attempting to save the patient's life. Five obstacle items decreased in mean score and rank compared with 1999 data including (1) physicians differing in opinion about care of the patient, (2) family and friends who continually call the nurse rather than calling the designated family member, (3) physicians who are evasive and avoid families, (4) nurses having to deal with angry families, and (5) nurses not knowing their patient's wishes regarding continuing with tests and treatments. Obstacles in EOL care, as perceived by critical care nurses, still exist. Family-related obstacles have increased over time. Obstacles related to families may not be easily overcome as each family, dealing with a dying family member in an ICU, likely has not previously experienced a similar situation. On the basis of the current top 5 obstacles, recommendations for possible areas of focus include (1) improved health literacy assessment of families followed by earlier directed, appropriate, and specific EOL information; (2) improved physician/team communication; and (3) ensuring patients' wishes are followed as written. In general, patient- and family-centered care using clear and open EOL communication regarding wishes and desires between patients and families, their physicians, and nurses will help decrease common obstacles, thus improving the quality of EOL care provided to dying patients and families.

National Comprehensive Cancer Network

MedlinePlus

... Session - Call for Abstracts NCCN Academy for Excellence & Leadership in Oncology™ NCCN 2018 Nursing Program: Advancing Oncology ... Congress: Hematologic Malignancies™ NCCN Global Academy for Excellence & Leadership in Oncology™ NCCN Corporate Council Next Meeting, March ...

Exposing Baccalaureate Nursing Students to Transitional Care.

PubMed

OʼConnor, Melissa; Arcamone, Angelina; Amorim, Frances; Hoban, Mary Beth; Boyd, Regina M; Fowler, Lauren; Marcelli, Theresa; Smith, Jacalyn; Nassar, Kathleen; Fitzpatrick, M Louise

2016-10-01

Management and facilitation of care transitions from hospital to alternative settings requires skill and attention to avoid adverse events. Several interprofessional organizations and nurse leaders have called for the expansion and redesign of undergraduate nursing curricula to include care transitions. Yet there is little evidence describing how undergraduate baccalaureate nursing students are educated on this critical topic or how successful they are in improving student knowledge about care transitions. To address this gap, an in-classroom and clinical experience was implemented to prepare students to manage and facilitate care transitions from the hospital to alternative settings-including the home. Perceptions of undergraduate nursing students and home healthcare nurse preceptors were assessed via an electronic survey that was emailed to participants. Forty-eight responses to the survey were received. Students agreed this experience contributed to their understanding of caring for adults and older adults who are experiencing a care transition and they had a good understanding of care transitions to apply to their future nursing courses. Home healthcare nurse preceptors agreed they were able to demonstrate transitional care and that students were engaged. Future work should include expanding transitional care immersion to other care settings as well as the inclusion of additional healthcare disciplines in care transition education.

Implementing a night-shift clinical nurse specialist.

PubMed

Becker, Dawn Marie

2013-01-01

Night-shift nurses receive fewer educational opportunities and less administrative support than do day-shift staff, tend to be newer, with less experience and fewer resources, and experience greater turnover rates, stress, and procedural errors. In an attempt to bridge the gap between day- and night-shift nursing, a night-shift clinical nurse specialist (CNS) position was created in a midsized, community teaching hospital. The goal was to provide an advanced practice presence to improve patient outcomes, communication, education, and cost-effectiveness. The night-shift CNS participated in nursing education and skill certifications, communicated new procedures and information, and created a communication committee specifically for night-shift nurses. Through regular rounding and on-call notification, the CNS was available to every area of the hospital for consultation and clinical assistance and assisted with rapid responses, codes, and traumas. Providing education during night shift reduced overtime costs and increased morale, positively affecting turnover rates. The night-shift CNS position has improved morale and equalized support for night-shift nurses. More research, most notably in specific night-shift metrics, is necessary, and with the implementation of the role in additional facilities, more can be understood about improving patient care and nursing staff satisfaction during night shift.

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.

[Relationships amongst work values, job characteristics and job involvement in "net generation" nurses].

PubMed

Chen, Sue-Hui; Chiou, Chii-Jun

2010-04-01

Children of the so-called "net generation" began joining the nurse workforce from the mid-1990s. Studies on the characteristics of this generation have been done primarily outside of Taiwan, and results may not adequately reflect conditions in Taiwan due to cultural differences. This study aimed to investigate the relationships amongst work values, job characteristics and job involvement in "net generation" nurses. This study employed a cross-sectional design. A randomized sample of 370 nurses born between 1977 and 1985 working in a medical center or a community hospital in Southern Taiwan accepted our invitation to join this study. A structured questionnaire was used to collect data. (1) Variables including work values, job characteristics, head nurse leadership qualities, job structure and opportunities for in-service education all correlated significantly with job involvement. (2) Regression analysis showed work values, job characteristics, head nurse leadership and religious belief to be significant predictors of job involvement, explaining 22.6% of the variance. This study provides insights that may be of potential value to nursing administrators. We suggest that administrators adopt democratic management practices, build diverse learning methods, strengthen autonomy, completeness, and feedback, and provide appropriate work guidance for nurses to increase job involvement.

Critical discourse analysis of social justice in nursing's foundational documents.

PubMed

Valderama-Wallace, Claire P

2017-07-01

Social inequities threaten the health of the global population. A superficial acknowledgement of social justice by nursing's foundational documents may limit the degree to which nurses view injustice as relevant to nursing practice and education. The purpose was to examine conceptualizations of social justice and connections to broader contexts in the most recent editions. Critical discourse analysis examines and uncovers dynamics related to power, language, and inequality within the American Nurses Association's Code of Ethics, Scope and Standards of Practice, and Social Policy Statement. This analysis found ongoing inconsistencies in conceptualizations of social justice. Although the Code of Ethics integrates concepts related to social justice far more than the other two, tension between professionalism and social change emerges. The discourse of professionalism renders interrelated cultural, social, economic, historical, and political contexts nearly invisible. Greater consistency would provide a clearer path for nurses to mobilize and engage in the courageous work necessary to address social injustice. These findings also call for an examination of how nurses can critique and use the power and privilege of professionalism to amplify the connection between social institutions and health equity in nursing education, practice, and policy development. © 2017 Wiley Periodicals, Inc.

A randomized controlled study about the use of eHealth in the home health care of premature infants.

PubMed

Gund, Anna; Sjöqvist, Bengt Arne; Wigert, Helena; Hentz, Elisabet; Lindecrantz, Kaj; Bry, Kristina

2013-02-09

One area where the use of information and communication technology (ICT), or eHealth, could be developed is the home health care of premature infants. The aim of this randomized controlled study was to investigate whether the use of video conferencing or a web application improves parents' satisfaction in taking care of a premature infant at home and decreases the need of home visits. In addition, nurses' attitudes regarding the use of these tools were examined. Thirty-four families were randomized to one of three groups before their premature infant was discharged from the hospital to home health care: a control group receiving standard home health care (13 families); a web group receiving home health care supplemented with the use of a web application (12 families); a video group with home health care supplemented with video conferencing using Skype (9 families). Families and nursing staff answered questionnaires about the usefulness of ICT. In addition, semi-structured interviews were conducted with 16 families. All the parents in the web group found the web application easy to use. 83% of the families thought it was good to have access to their child's data through the application. All the families in the video group found Skype easy to use and were satisfied with the video calls. 88% of the families thought that video calls were better than ordinary phone calls. 33% of the families in the web group and 75% of those in the video group thought the need for home visits was decreased by the web application or Skype. 50% of the families in the web group and 100% of those in the video group thought the web application or the video calls had helped them feel more confident in caring for their child. Most of the nurses were motivated to use ICT but some were reluctant and avoided using the web application and video conferencing. The families were satisfied with both the web application and video conferencing. The families readily embraced the use of ICT, whereas motivating some of the nurses to accept and use ICT was a major challenge.

[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.

Strengthening healthcare delivery in Haiti through nursing continuing education.

PubMed

Clark, M; Julmisse, M; Marcelin, N; Merry, L; Tuck, J; Gagnon, A J

2015-03-01

The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings. A case study is presented from the Hôpital Universitaire de Mirebalais in Mirebalais, Haiti of a new nursing continuing education programme called the Beyond Expert Program. The case study highlights eight key dimensions of nursing continuing education in low-resource settings: (1) involving local stakeholders in planning process, (2) targeting programme to nurse participant level and area of care, (3) basing course content on local context, (4) including diverse range of nursing topics, (5) using participatory teaching methods, (6) addressing resource constraints in time and scheduling, (7) evaluating and monitoring outcomes, and (8) establishing partnerships. The case study provides guidance for others wishing to develop programmes in similar settings. Creating a nursing continuing education programme in a low-resource setting is possible when there is commitment and engagement for nursing continuing education at all levels of the organization. Our report suggests a need for policy-makers in resource-limited settings to make greater investments in nursing continuing education as a focus of human resources for health, as it is an important strategy for promoting nurse retention, building the knowledge and skill of the existing nursing workforce, and raising the image of nursing in low-resource settings. © 2015 International Council of Nurses.

Adult cardiothoracic transplant nursing: an ISHLT consensus document on the current adult nursing practice in heart and lung transplantation.

PubMed

Coleman, Bernice; Blumenthal, Nancy; Currey, Judy; Dobbels, Fabienne; Velleca, Angela; Grady, Kathleen L; Kugler, Christiane; Murks, Catherine; Ohler, Linda; Sumbi, Christine; Luu, Minh; Dark, John; Kobashigawa, Jon; White-Williams, Connie

2015-02-01

The role of nurses in cardiothoracic transplantation has evolved over the last 25 years. Transplant nurses work in a variety of roles in collaboration with multidisciplinary teams to manage complex pre- and post-transplantation issues. There is lack of clarity and consistency regarding required qualifications to practice transplant nursing, delineation of roles and adequate levels of staffing. A consensus conference with workgroup sessions, consisting of 77 nurse participants with clinical experience in cardiothoracic transplantation, was arranged. This was followed by subsequent discussion with the ISHLT Nursing, Health Science and Allied Health Council. Evidence and expert opinions regarding key issues were reviewed. A modified nominal group technique was used to reach consensus. Consensus reached included: (1) a minimum of 2 years nursing experience is required for transplant coordinators, nurse managers or advanced practice nurses; (2) a baccalaureate in nursing is the minimum education level required for a transplant coordinator; (3) transplant coordinator-specific certification is recommended; (4) nurse practitioners, clinical nurse specialists and nurse managers should hold at least a master's degree; and (5) strategies to retain transplant nurses include engaging donor call teams, mentoring programs, having flexible hours and offering career advancement support. Future research should focus on the relationships between staffing levels, nurse education and patient outcomes. Delineation of roles and guidelines for education, certification, licensure and staffing levels of transplant nurses are needed to support all nurses working at the fullest extent of their education and licensure. This consensus document provides such recommendations and draws attention to areas for future research. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Nursing in Ghana: A Search for Florence Nightingale in an African City.

PubMed

Adu-Gyamfi, Samuel; Brenya, Edward

2016-01-01

Nursing in Ghana is a crucial subject that permeates almost every issue in the society especially the field of hospital care. To a large extent, the frontiers of nursing have expanded since the time of Florence Nightingale. Globally some studies have been done to study nursing icons like her. The values in nursing practice however continue to preoccupy our minds. The need to accentuate the gains made by historical figures in nursing in present times as well as the nature of interactions between practitioners and patients continues to be of paramount concern to many across the globe and Ghana in particular. This study does an analysis of existing literature on Florence Nightingale and the nature of nursing in Ghana from the colonial times. Additionally, it analyzes responses concerning the activities of nurses and their interactions with patients in Kumasi. The varied information has been thematically pieced together to make inferences that are of great interest to nursing practitioners, policy makers, administrators, and educators among others. The findings to the study suggest among other things that the challenges faced by the nursing institution in modern times are similar to those of the earlier period. The study calls for the emulation of the positive ideas of Florence Nightingale to promote the interest of patients, a core objective championed by a revered nurse.

Nursing in Ghana: A Search for Florence Nightingale in an African City

PubMed Central

Adu-Gyamfi, Samuel; Brenya, Edward

2016-01-01

Nursing in Ghana is a crucial subject that permeates almost every issue in the society especially the field of hospital care. To a large extent, the frontiers of nursing have expanded since the time of Florence Nightingale. Globally some studies have been done to study nursing icons like her. The values in nursing practice however continue to preoccupy our minds. The need to accentuate the gains made by historical figures in nursing in present times as well as the nature of interactions between practitioners and patients continues to be of paramount concern to many across the globe and Ghana in particular. This study does an analysis of existing literature on Florence Nightingale and the nature of nursing in Ghana from the colonial times. Additionally, it analyzes responses concerning the activities of nurses and their interactions with patients in Kumasi. The varied information has been thematically pieced together to make inferences that are of great interest to nursing practitioners, policy makers, administrators, and educators among others. The findings to the study suggest among other things that the challenges faced by the nursing institution in modern times are similar to those of the earlier period. The study calls for the emulation of the positive ideas of Florence Nightingale to promote the interest of patients, a core objective championed by a revered nurse. PMID:27382644

[A development and evaluation of nursing KMS using QFD in outpatient departments].

PubMed

Lee, Han Na; Yun, Eun Kyoung

2014-02-01

This study was done to develop and implement the Nursing KMS (knowledge management system) in order to improve knowledge sharing and creation among clinical nurses in outpatient departments. This study was a methodological research using the 'System Development Life Cycle': consisting of planning, analyzing, design, implementation, and evaluation. Quality Function Deployment (QFD) was applied to establish nurse requirements and to identify important design requirements. Participants were 32 nurses and for evaluation data were collected pre and post intervention at K Hospital in Seoul, a tertiary hospital with over 1,000 beds. The Nursing KMS was built using a Linux-based operating system, Oracle DBMS, and Java 1.6 web programming tools. The system was implemented as a sub-system of the hospital information system. There was statistically significant differences in the sharing of knowledge but creating of knowledge was no statistically meaningful difference observed. In terms of satisfaction with the system, system efficiency ranked first followed by system convenience, information suitability and information usefulness. The results indicate that the use of Nursing KMS increases nurses' knowledge sharing and can contribute to increased quality of nursing knowledge and provide more opportunities for nurses to gain expertise from knowledge shared among nurses.

Helping parents cope with crying babies: decision-making and interaction at NHS Direct.

PubMed

Smith, Suzanne

2010-02-01

This paper is a report of a study of how nurses at a national telephone triage centre in England (NHS Direct) make different use of the algorithms and organizational protocols to make decisions and give advice to parents with crying babies, how their clinical knowledge and experience influences these decisions, and the techniques used to enhance parental coping ability. Parents of persistently crying babies state that they need to be listened to, understood, believed and reassured to help them cope. Nurses at NHS Direct use their clinical judgement in decision-making, and see the software as a guide that can be both valuable and problematic. The study design was influenced by grounded theory and incorporated discourse and thematic analysis. It had two phases involving data collection and analysis over the period 2002-2006. A theoretical sample of 11 calls was analysed and later a focus group of six nurses at the same site. NHS Direct nurses used the 'crying baby' algorithm in various ways, influenced by their experience and confidence to use the algorithm to support their clinical knowledge. Its medical elements were regarded as safe but its non-medical elements, including questions about the likelihood of shaking a child, were treated differently. Nurses were reluctant to deviate from the algorithm when dealing with child-focused calls. However, this reluctance did not apply when they were prompted to ask the caller if they felt that they were reaching a point where they might shake their baby, or when prompted to give related advice.

Cost-Benefit Analysis of a Support Program for Nursing Staff.

PubMed

Moran, Dane; Wu, Albert W; Connors, Cheryl; Chappidi, Meera R; Sreedhara, Sushama K; Selter, Jessica H; Padula, William V

2017-04-27

A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit. A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital. Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program. The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

Coaching Model + Clinical Playbook = Transformative Learning.

PubMed

Fletcher, Katherine A; Meyer, Mary

2016-01-01

Health care employers demand that workers be skilled in clinical reasoning, able to work within complex interprofessional teams to provide safe, quality patient-centered care in a complex evolving system. To this end, there have been calls for radical transformation of nursing education including the development of a baccalaureate generalist nurse. Based on recommendations from the American Association of Colleges of Nursing, faculty concluded that clinical education must change moving beyond direct patient care by applying the concepts associated with designer, manager, and coordinator of care and being a member of a profession. To accomplish this, the faculty utilized a system of focused learning assignments (FLAs) that present transformative learning opportunities that expose students to "disorienting dilemmas," alternative perspectives, and repeated opportunities to reflect and challenge their own beliefs. The FLAs collected in a "Playbook" were scaffolded to build the student's competencies over the course of the clinical experience. The FLAs were centered on the 6 Quality and Safety Education for Nurses competencies, with 2 additional concepts of professionalism and systems-based practice. The FLAs were competency-based exercises that students performed when not assigned to direct patient care or had free clinical time. Each FLA had a lesson plan that allowed the student and faculty member to see the competency addressed by the lesson, resources, time on task, student instructions, guide for reflection, grading rubric, and recommendations for clinical instructor. The major advantages of the model included (a) consistent implementation of structured learning experiences by a diverse teaching staff using a coaching model of instruction; (b) more systematic approach to present learning activities that build upon each other; (c) increased time for faculty to interact with students providing direct patient care; (d) guaranteed capture of selected transformative learning experiences; (e) increased student reflection to promote transformative learning; and (f) provided avenues for timely feedback to students. Copyright © 2016 Elsevier Inc. All rights reserved.

A multi-data source surveillance system to detect a bioterrorism attack during the G8 Summit in Scotland.

PubMed

Meyer, N; McMenamin, J; Robertson, C; Donaghy, M; Allardice, G; Cooper, D

2008-07-01

In 18 weeks, Health Protection Scotland (HPS) deployed a syndromic surveillance system to early-detect natural or intentional disease outbreaks during the G8 Summit 2005 at Gleneagles, Scotland. The system integrated clinical and non-clinical datasets. Clinical datasets included Accident & Emergency (A&E) syndromes, and General Practice (GPs) codes grouped into syndromes. Non-clinical data included telephone calls to a nurse helpline, laboratory test orders, and hotel staff absenteeism. A cumulative sum-based detection algorithm and a log-linear regression model identified signals in the data. The system had a fax-based track for real-time identification of unusual presentations. Ninety-five signals were triggered by the detection algorithms and four forms were faxed to HPS. Thirteen signals were investigated. The system successfully complemented a traditional surveillance system in identifying a small cluster of gastroenteritis among the police force and triggered interventions to prevent further cases.

Quantitative method of medication system interface evaluation.

PubMed

Pingenot, Alleene Anne; Shanteau, James; Pingenot, James D F

2007-01-01

The objective of this study was to develop a quantitative method of evaluating the user interface for medication system software. A detailed task analysis provided a description of user goals and essential activity. A structural fault analysis was used to develop a detailed description of the system interface. Nurses experienced with use of the system under evaluation provided estimates of failure rates for each point in this simplified fault tree. Means of estimated failure rates provided quantitative data for fault analysis. Authors note that, although failures of steps in the program were frequent, participants reported numerous methods of working around these failures so that overall system failure was rare. However, frequent process failure can affect the time required for processing medications, making a system inefficient. This method of interface analysis, called Software Efficiency Evaluation and Fault Identification Method, provides quantitative information with which prototypes can be compared and problems within an interface identified.

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.

A review of the literature regarding stress among nursing students during their clinical education.

PubMed

Alzayyat, A; Al-Gamal, E

2014-09-01

There has been increased attention in the literature about stress among nursing students. It has been evident that clinical education is the most stressful experience for nursing students. The aim of this paper was to critically review studies related to degrees of stress and the type of stressors that can be found among undergraduate nursing students during their clinical education. The search strategy involved the utilization of the following databases: MEDLINE (Medical Literature on-Line), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO (Psychology Information) and PubMed. Keywords were stress, undergraduate nursing students, clinical practice. The review included those studies published between 2002 and 2013, conducted in any country as long as reported in English, and including a focus on the clinical practice experience of nursing students. Thirteen studies met the eligibility criteria. Four themes were identified: initial clinical experience, comparison between different academic years, cross-cultural comparison, and eustress aspects of clinical experience. This review expands current knowledge in the area of stress in clinical settings and calls for further research. Nursing teachers should utilize the findings of this review to direct their students during clinical practice. Moreover, hospital administrators need to promote policies to promote a training environment where students are supported and inspired. © 2014 International Council of Nurses.

Engaging Nursing Voice and Presence During the Federal Election Campaign 2015.

PubMed

Whyte, Nora B; Duncan, Susan M

2016-01-01

During the Canadian federal election in 2015, we conducted a systematic inquiry into the methods and messages developed by national nursing organizations to communicate their policy platforms and their strategies for member and public engagement. Throughout the campaign and in the post-election period, the nursing organizations presented an outward-looking view to improve health and healthcare for Canadians. We observed ways in which they adopted a nursing lens on the issues by showcasing background research, by drawing on relevant nursing knowledge and by communicating clear policy messages based on nursing expertise. The organizations and their members were effective in using social media as a primary tool for reaching out to the candidates, the public and the opinion leaders. The increasing engagement of nursing students in political action is noted as a promising sign for the future impact of the profession. Although the nursing presence was visible in this election, healthcare did not become a strong issue for the public and the political parties. We include a section on post-election uptake of issues raised during the campaign. We conclude with a call for a policy research agenda that deepens our knowledge of political advocacy with a view to identifying how patterns of engagement are defining nursing's collective influence and contributions to health equity.

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.

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.

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 systems and total nurse records demonstrated uncertain or equivocal results. We found some limited evidence of effects on practice attributable to changes in record systems. It is clear from the literature that it is possible to set up the randomised trials or other quasi-experimental designs needed to produce evidence for practice. Qualitative nursing research to explore the relationship between practice and information use could be used as a precursor to the design and testing of nursing information systems.

Florence Nightingale and Irish nursing.

PubMed

McDonald, Lynn

2014-09-01

To challenge statements made about 'Careful Nursing' as a 'distinctive system' of nursing established by the Irish Sisters of Mercy, prior to Florence Nightingale, and which is said to have influenced her. Numerous publications have appeared claiming the emergence of a 'distinctive system' of nursing as 'Ireland's legacy to nursing', which, it is claimed, influenced Nightingale's system. One paper argues that the Irish system has its philosophical roots in Thomist philosophy. Several papers argue the ongoing relevance of the Irish system, not Nightingale's, for contemporary nursing theory and practice. Nightingale's influence on and legacy to Irish nursing are not acknowledged. A Discursive paper. Archival and published sources were used to compare the nursing systems of Florence Nightingale and the Irish Sisters of Mercy, with particular attention to nursing during the Crimean War. Claims were challenged of a 'distinctive system' of nursing established by the Irish Sisters of Mercy in the early nineteenth century, and of its stated influence on the nursing system of Florence Nightingale. The contention of great medical satisfaction with the 'distinctive' system is refuted with data showing that the death rate at the Koulali Hospital, where the Irish sisters nursed, was the highest of all the British war hospitals during the Crimean War. Profound differences between the two systems are outlined. Claims for a 'distinctive' Irish system of nursing fail for lack of evidence. Nightingale's principles and methods, as they evolved over the first decade of her school's work, remain central to nursing theory and practice. Nightingale's insistence on respect for patients and high ethical standards remains relevant to practice no less so as specific practices change with advances in medical knowledge and practice. © 2014 John Wiley & Sons Ltd.

The construction of men who are nurses as gay.

PubMed

Harding, Thomas

2007-12-01

This paper is a report of a study to examine the construction of the stereotype of male nurses as gay, and to describe how this discourse impacts on a group of New Zealand male nurses. A discourse stereotyping male nurses as gay is accompanied by one which privileges hegemonic masculinity and marginalizes homosexuality. This social constructionist study drew on data collected from existing texts on men, nursing and masculinity and interviews with 18 New Zealand men conducted in 2003-2004. Discourse analysis, informed by masculinity theory and queer theory, was used to analyse the data. Despite the participants' beliefs that the majority of male nurses are heterosexual, the stereotype persists. A paradox emerged between the 'homosexual' general nurse and the 'heterosexual' psychiatric nurse. The stigma associated with homosexuality exposes male nurses to homophobia in the workplace. The heterosexual men employed strategies to avoid the presumption of homosexuality; these included: avoiding contact with gay colleagues and overt expression of their heterosexuality. There is a paradox between widespread calls for men to participate more in caring and discourses which stereotype male nurses as gay and conflate homosexuality and sexual predation. These stigmatizing discourses create a barrier to caring and, aligned with the presence of homophobia in the workplace, deter men's entry into the profession and may be important issues with respect to their retention. Nurse educators must ensure that nurses are able to resist collusion with stigmatizing discourses that marginalize men (and women) in the profession through the perpetration of gender and sexual stereotypes.

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.

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.

[Quality, an ethical dimension in nursing care].

PubMed

Svandra, Philippe

2018-04-01

Care cannot simply be summed up as a standardised practice. It constitutes an ethical obligation which drives us to respond actively to the call for help from a person suffering and in need. A real call to action, this practice, both relational and technical, strives to care about others, first and foremost in terms of their ability to be in the world. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Apply creative thinking of decision support in electrical nursing record.

PubMed

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

2006-01-01

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

Women's reasons for attrition from a nurse home visiting program.

PubMed

Holland, Margaret L; Christensen, Julie J; Shone, Laura P; Kearney, Margaret H; Kitzman, Harriet J

2014-01-01

To describe mothers' reasons for leaving a home visiting program early. Qualitative descriptive study using semistructured interviews of mothers who dropped out of the Nurse-Family Partnership (NFP) and two focus groups with nurses and nurse supervisors at an NFP site. A New York State site of a NFP home visitation program for low-income new mothers designed to improve the physical and emotional care of children. Participants included 21 mothers, 8 nurses, and 3 nurse-supervisors. Semistructured interviews and focus groups were used to collect data, which were analyzed using content analysis. The program was not perceived to fit a mother's needs when she was overwhelmed with other responsibilities, the nurse did not meet her expectations, the content was not of interest, or the mother did not desire visits after the infant was born. Nurses and mothers described the need for mothers to have organizational and communication skills, such as keeping track of appointments, calling to reschedule, articulating needs, and asking for assistance. Disruptive external influences included nurse turnover and unstable living situations, including frequent moves and crowded housing. Each of these types of barriers had potential to interact with the others, creating complex combinations of challenges to retention. NFP retention might be improved by reframing program relevance to individual mothers and increasing maternal organizational and communication skill development. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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.

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 care planning. A controlled before-and-after study of two paper nursing record systems showed improvement in meeting documentation standards. No evidence was found of effects on practice attributable to changes in record systems. Although there is a paucity of studies of sufficient methodological rigour to yield reliable results in this area, it is clear from the literature that it is possible to set up randomised trials or other quasi-experimental designs needed to produce evidence for practice. The research undertaken so far may have suffered both from methodological problems and faulty hypotheses.

Distress experienced by nurses in response to the challenging behaviour of residents - evidence from German nursing homes.

PubMed

Schmidt, Sascha G; Dichter, Martin N; Palm, Rebecca; Hasselhorn, Hans Martin

2012-11-01

The aim of this research is to investigate the degree of distress experienced by nurses in response to the challenging behaviour of nursing home residents (residents' challenging behaviour) and their impact on nurses individual resources (general health, burnout and work ability). Because of the increasing and ageing population of nursing home residents, professional nursing care faces several challenges. One highly prevalent issue among nursing home residents is the so-called 'challenging behaviour'. However, to date, 'challenging behaviour' has not yet been recognised as an occupational stressor, and the extent of the impact of 'challenging behaviour' on nurses' well-being and functioning is not well understood. Cross-sectional study. Self-report questionnaire data collected from 731 registered nurses and nursing aides in 56 German nursing homes were used in a secondary data analysis. The level of residents' challenging behaviour-related distress that nurses experienced was assessed using a scale consisting of nine questions. Validated instruments were used for the assessment of individual resources. The mean score for residents' challenging behaviour-related distress was 41·3 (SD 21·2). Twenty-seven per cent of all nurses reported over 50 residents' challenging behaviour. Residents' challenging behaviour had a significant impact on all three measures of individual resources. Specifically, nurses exposed to frequent residents' challenging behaviour reported a significantly lower quality of general health, reduced workability and high burnout levels. Our findings indicate that residents' challenging behaviour-related distress is a significant work place stressor for nurses in nursing homes with a clear impact on general health, the risk of burnout and work ability. Our findings suggest that residents' challenging behaviour is a stressor for nurses in nursing homes. Further scientific and practical attention is necessary from the point of view of working conditions for nurses. The development of preventive concepts for nursing staff and residents is recommended. © 2012 Blackwell Publishing Ltd.

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.

Implementation of a closed-loop reporting system for critical values and clinical communication in compliance with goals of the joint commission.

PubMed

Parl, Fritz F; O'Leary, Mandy F; Kaiser, Allen B; Paulett, John M; Statnikova, Kristina; Shultz, Edward K

2010-03-01

Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission's 2008 National Patient Safety Goals. A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an electronic ALERTS system that reports critical values via the laboratory and hospital information systems to alphanumeric pagers of clinicians and ensures failsafe notification, instant documentation, automatic tracking, escalation, and reporting of critical value alerts. A method for automated acknowledgment of message receipt was incorporated into the system design. The ALERTS system has been applied to inpatients and eliminated approximately 9000 phone calls a year made by medical technologists. Although a small number of phone calls were still made as a result of pages not acknowledged by clinicians within 10 min, they were made by telephone operators, who either contacted the same physician who was initially paged by the automated system or identified and contacted alternate physicians or the patient's nurse. Overall, documentation of physician acknowledgment of receipt in the electronic medical record increased to 95% of critical values over 9 months, while the median time decreased to <3 min. We improved laboratory efficiency and physician communication by developing an electronic system for reporting of critical values that is in compliance with The Joint Commission's goals.

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

Developing Global Nurse Influencers.

PubMed

Spies, Lori A

2016-01-01

How can universities create engaged citizens and global leaders? Each year, a select group of advanced practice nursing students at Baylor University Louise Herrington School of Nursing travel to Africa for a month-long clinical mission experience. Students work alongside local and missionary healthcare providers in a comprehensive Christian outreach to the community at a high-volume clinic. Creating rich learning experiences in a global setting in significant and sustainable ways is difficult, but intentionally focusing on what we are called to do and who we serve provides ballast for faculty and students. The success of the trip in preparing students to be global influencers is evident by the work graduates elect to do around the world, following graduation.

[Brazilian nursing and the democratization of health: notes on the National Policy of Popular Education in Health].

PubMed

David, Helena Maria Scherlowski Leal; Bonetti, Osvaldo Peralta; da Silva, Maria Rocineide Ferreira

2012-01-01

This essay discusses the role of Brazilian nursing as a socially committed practice, in the political and pedagogic plan. The concepts of popular participation, representative and participatory democracy, and education in health are recovered, enlightened by the recent history of the constitution of social network of practices and reflections called Popular Education and Health. The construction process and the ethical-political principles of a National Policy of Popular Education in Health are presented, discussing the participation of nursing in the changes of educational practices, in spaces of political representation and formulation of public policies, with a perspective of achieving a fair and equal social order.

Global migration and health: ecofeminist perspectives.

PubMed

McGuire, S

1998-12-01

Global migration is occurring at an unprecedented rate. The phenomenon of migration is complex and poorly understood by most people in countries who host immigrants. People migrate for numerous reasons related to social, economic, political, cultural, and physical environmental conditions formed by historical antecedents. Migrating people, especially vulnerable women and children, are exposed to numerous health hazards, a situation calling for a response from nursing. To respond effectively nursing needs knowledge development of global migration and health that includes the precursors to migration in addition to the postmigration experience where nurses encounter immigrants. Ecofeminist perspectives allowing for reflection on historical determinants and interlocking socioeconomic, political, and environmental conditions are used as a prism to examine global migration and health.

The Courage to Care-An innovative arts-based event to engage students and the local community to reflect on Australian nurses' roles in the First World War and after.

PubMed

McAllister, Margaret; Davis, Susan; Brien, Donna Lee; Rogers, Irene; Flanagan, Wendy; Howie, Virginia; Dargusch, Jo

2016-12-01

There is a large body of work that documents the history of the nursing profession and the experiences of nurses during significant historical eras such as the First World War. Yet learning about nursing history is commonly a tiny, or absent, component in the undergraduate nursing curriculum. This paper discusses an innovative project that had multiple aims. A primary aim was to engage nursing students and educators in a project that valued nursing history by integrating it into an event to celebrate International Nurses Day. As the paper will explain, other aims were in organising the event so that it capitalised on particular creative arts strengths within the faculty, offering cross-disciplinary connections, engagement and appreciation. A Readers' Theatre event, involving academics and students in nursing, creative arts and education, was conceived, developed and performed for the community. The theme was the experiences of First World War nurses and how they encapsulated values important to nursing today - the 6 Cs - which guide high standards of nursing. The 6 Cs are care, compassion, competence, communication, courage and commitment. We called the Readers' Theatre "The Courage to Care", and this involved a 4month process of script development, event planning and a performance. This process and outcomes were evaluated, prompting a reflection on the strengths and challenges of working in this creative way to engage a wide group of stakeholders to advance the profession of nursing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Emotional and informational support for families during their child's illness.

PubMed

Sarajärvi, A; Haapamäki, M L; Paavilainen, E

2006-09-01

To describe and compare the support provided by nursing staff to families during their child's illness from the viewpoint of families and nurses. A survey method was used. Data were collected by questionnaires planned for families and staff separately. The study population consisted of families who visited paediatric outpatient clinics, families with hospitalized children (n = 344) and the paediatric nursing staff (n = 60). Almost half of the families had received adequate emotional and informational support from the nursing staff for their physical and psychological reactions. One-fifth of the families reported that they had not been supported at all during the child's hospitalization. According to families and nurses, the support was provided in the forms of discussion, listening and giving time. Families' and nurses' suggestions for development of support were related to the time resources of the staff, to the flow of information, to more client-centred attitudes, to being appreciated and listened to and to home care guidance. However, the pervasiveness of this problem in the international literature suggests that deeper consideration of possible underlying reasons for this phenomenon is called for.

The state of the science of emotional intelligence related to nursing leadership: an integrative review.

PubMed

Akerjordet, Kristin; Severinsson, Elisabeth

2010-05-01

To explore the state of the science of emotional intelligence (EI) related to nursing leadership and its critiques. The phenomenon of EI has emerged as a potential new construct of importance for nursing leadership that enhances educational, organizational, staff and patient outcomes. Nevertheless, important questions and critical reflections related to exaggerated claims, conceptualizations and measurements exist. A literature search was conducted using international databases covering the period January 1999 to December 2009. A manual search of relevant journals and significant references increased the data. Critical reflection seems to be associated with the unsubstantiated predictive validity of EI in the area of nursing leadership. In addition, important moral issues are called into question. It is important to possess in-depth knowledge of EI and its scientific critique when integrating the concept into nursing research, education and practical settings. More attention to the nature of emotion in EI is necessary. Implications for nursing leadership The dynamics of EI should be explored in the context of both the surrounding environment and individual differences, as the latter can be adaptive in some settings but harmful in others.

["Scrap" as an element of communication in nursing].

PubMed

Esperidião, E; Medeiros Teixeira, M E; Rodrigues Stacciarini, J M

1996-04-01

Based on the understanding that students and nursing professionals demonstrate difficulties in being a "person" in the profession, we developed a descriptive and exploratory study with a qualitative approach. Then, we offered during the "Iind" II Nursing Congress in the city of Goiania a work-shop called "LEARNING ABOUT NURSE'S ENTITY". Among various processes of work-groups; the "Scrap" was used as a kind of communication. It was a resource utilized in certain dynamics, being the object of our study that has the following goals: to identify the representation of nurse's "entity", to verify the interaction process "man-scrap" during the realization of the work and to verify if the object is represented as it really is. We have seen that there are particularities in the representation of nurse's entity. Regarding "man-scrap" interaction it had the followed sequence: finding strange the material and the proposal of work, manipulating and identifying objects, "scrap" selection and concretion of the job. With respect to the objects, we perceived a clear preference to the ones related to the profession. Finally, we suggest that other studies about the "scrap" communication element, must be developed.

Achieving 80% BSN by 2020: Lessons Learned From Kentucky's Registered Nurses.

PubMed

Warshawsky, Nora E; Brandford, Arica; Barnum, Nancy; Westneat, Susan

2015-09-01

The aim of this study was to understand the educational status and plans of Kentucky's RN workforce in advancing nursing educational levels. The Institute of Medicine called for 80% of nurses to hold a minimum of a BSN by 2020. Nurse leaders from practice, academe, and the community need evidence to guide the development of effective strategies. An electronic survey was administered to Kentucky's RNs. This descriptive analysis was based on 1363 usable responses. Only 40% of Kentucky's RNs held at least a BSN. Another 17% were enrolled in a nursing degree program; half of those enrolled were pursuing a BSN. Of those not enrolled in a degree program, 61.5% reported no plans to return to school. The top barriers were lack of perceived benefit, financial concerns, family obligations, and planned retirement. The top motivating factor was career advancement. The gap between the current reality and the goal is wide. Nurse leaders will need to develop creative strategies that strengthen motivating factors and reduce barriers to accelerate movement toward increasing BSN rates.

WOC practice in cyberspace: legal and ethical issues.

PubMed

Hoyman, K

2001-07-01

WOC nurses have the opportunity to extend their practice geographically by using electronic media, also called telehealth or "practicing in cyberspace." Currently, laws and regulations affecting this aspect of practice are in rapid flux. In addition, practicing electronically makes the ethical issues of choice, privacy, and confidentiality more acute. This article describes the current status of relevant legislation, discusses relevant ethical issues, and provides guidelines for WOC nurses who are considering the use of e-mail and video conferencing within their practice.

PubMed

2004-09-01

Drink drive: emergency care alcohol liaison nurse at Selly Oak Hospital, Birmingham, Sarah Needham has secured funding from University Hospital Birmingham NHS Trust to set up a nine-month alcohol liaison pilot project. Ms Needham, whose work won her the Tyco Healthcare UK and RCN A&E Nursing Association award in 2000, is due to speak on the topic next month at a conference in Birmingham on tackling alcohol abuse. For details of the conference on October 11, call 0121 765 4222 or email castle.comm@which.net.

Caught between a rock and a hard place: An intrinsic single case study of nurse researchers' experiences of the presence of a nursing research culture in clinical practice.

PubMed

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2018-04-01

To explore how nurse researchers in clinical positions experience the presence of a nursing research culture in clinical practice. Higher demands in the hospitals for increasing the quality of patient care engender a higher demand for the skills of health professionals and evidence-based practice. However, the utilisation of nursing research in clinical practice is still limited. Intrinsic single case study design underlined by a constructivist perspective. Data were produced through a focus group interview with seven nurse researchers employed in clinical practice in two university hospitals in Zealand, Denmark, to capture the intrinsic aspects of the concept of nursing research culture in the context of clinical practice. A thematic analysis was conducted based on Braun and Clarke's theoretical guideline. "Caught between a rock and a hard place" was constructed as the main theme describing how nurse researchers in clinical positions experience the presence of a nursing research culture in clinical practice. The main theme was supported by three subthemes: Minimal academic tradition affects nursing research; Minimal recognition from physicians affects nursing research; and Moving towards a research culture. The nurse researchers in this study did not experience the presence of a nursing research culture in clinical practice, however; they called for more attention on removing barriers against research utilisation, promotion of applied research and interdisciplinary research collaboration, and passionate management support. The results of this case study show the pressure which nurse researchers employed in clinical practice are exposed to, and give examples on how to accommodate the further development of a nursing research culture in clinical practice. © 2017 John Wiley & Sons Ltd.