Implementation of the nursing process in a health area: models and assessment structures used

PubMed Central

Huitzi-Egilegor, Joseba Xabier; Elorza-Puyadena, Maria Isabel; Urkia-Etxabe, Jose Maria; Asurabarrena-Iraola, Carmen

2014-01-01

OBJECTIVE: to analyze what nursing models and nursing assessment structures have been used in the implementation of the nursing process at the public and private centers in the health area Gipuzkoa (Basque Country). METHOD: a retrospective study was undertaken, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the Henderson model, Carpenito's bifocal structure, Gordon's assessment structure and the Resident Assessment Instrument Nursing Home 2.0 have been used as nursing models and assessment structures to implement the nursing process. At some centers, the selected model or assessment structure has varied over time. CONCLUSION: Henderson's model has been the most used to implement the nursing process. Furthermore, the trend is observed to complement or replace Henderson's model by nursing assessment structures. PMID:25493672

The evolution and development of an instrument to measure essential professional nursing practices.

PubMed

Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia

2014-11-01

Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.

The Effects of a Web-Based Nursing Process Documentation Program on Stress and Anxiety of Nursing Students in South Korea.

PubMed

Lee, Eunjoo; Noh, Hyun Kyung

2016-01-01

To examine the effects of a web-based nursing process documentation system on the stress and anxiety of nursing students during their clinical practice. A quasi-experimental design was employed. The experimental group (n = 110) used a web-based nursing process documentation program for their case reports as part of assignments for a clinical practicum, whereas the control group (n = 106) used traditional paper-based case reports. Stress and anxiety levels were measured with a numeric rating scale before, 2 weeks after, and 4 weeks after using the web-based nursing process documentation program during a clinical practicum. The data were analyzed using descriptive statistics, t tests, chi-square tests, and repeated-measures analyses of variance. Nursing students who used the web-based nursing process documentation program showed significant lower levels of stress and anxiety than the control group. A web-based nursing process documentation program could be used to reduce the stress and anxiety of nursing students during clinical practicum, which ultimately would benefit nursing students by increasing satisfaction with and effectiveness of clinical practicum. © 2015 NANDA International, Inc.

Integrating the fundamentals of care framework in baccalaureate nursing education: An example from a nursing school in Denmark.

PubMed

Voldbjerg, Siri Lygum; Laugesen, Britt; Bahnsen, Iben Bøgh; Jørgensen, Lone; Sørensen, Ingrid Maria; Grønkjaer, Mette; Sørensen, Erik Elgaard

2018-06-01

To describe and discuss the process of integrating the Fundamentals of Care framework in a baccalaureate nursing education at a School of Nursing in Denmark. Nursing education plays an essential role in educating nurses to work within healthcare systems in which a demanding workload on nurses results in fundamental nursing care being left undone. Newly graduated nurses often lack knowledge and skills to meet the challenges of delivering fundamental care in clinical practice. To develop nursing students' understanding of fundamental nursing, the conceptual Fundamentals of Care framework has been integrated in nursing education at a School of Nursing in Denmark. Discursive paper using an adjusted descriptive case study design for describing and discussing the process of integrating the conceptual Fundamentals of Care Framework in nursing education. The process of integrating the Fundamentals of Care framework is illuminated through a description of the context, in which the process occurs including the faculty members, lectures, case-based work and simulation laboratory in nursing education. Based on this description, opportunities such as supporting a holistic approach to an evidence-based integrative patient care and challenges such as scepticism among the faculty are discussed. It is suggested how integration of Fundamentals of Care Framework in lectures, case-based work and simulation laboratory can make fundamental nursing care more explicit in nursing education, support critical thinking and underline the relevance of evidence-based practice. The process relies on a supportive context, a well-informed and engaged faculty, and continuous reflections on how the conceptual framework can be integrated. Integrating the Fundamentals of Care framework can support nursing students' critical thinking and reflection on what fundamental nursing care is and requires and eventually educate nurses in providing evidence-based fundamental nursing care. © 2018 John Wiley & Sons Ltd.

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

PubMed

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

2017-01-01

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

Examining the Relationship Between Nursing Informatics Competency and the Quality of Information Processing.

PubMed

Al-Hawamdih, Sajidah; Ahmad, Muayyad M

2018-03-01

The purpose of this study was to examine nursing informatics competency and the quality of information processing among nurses in Jordan. The study was conducted in a large hospital with 380 registered nurses. The hospital introduced the electronic health record in 2010. The measures used in this study were personal and job characteristics, self-efficacy, Self-Assessment Nursing Informatics Competencies, and Health Information System Monitoring Questionnaire. The convenience sample consisted of 99 nurses who used the electronic health record for at least 3 months. The analysis showed that nine predictors explained 22% of the variance in the quality of information processing, whereas the statistically significant predictors were nursing informatics competency, clinical specialty, and years of nursing experience. There is a need for policies that advocate for every nurse to be educated in nursing informatics and the quality of information processing.

E-documentation as a process management tool for nursing care in hospitals.

PubMed

Rajkovic, Uros; Sustersic, Olga; Rajkovic, Vladislav

2009-01-01

Appropriate documentation plays a key role in process management in nursing care. It includes holistic data management based on patient's data along the clinical path with regard to nursing care. We developed an e-documentation model that follows the process method of work in nursing care. It assesses the patient's status on the basis of Henderson's theoretical model of 14 basic living activities and is aligned with internationally recognized nursing classifications. E-documentation development requires reengineering of existing documentation and facilitates process reengineering. A prototype solution of an e-nursing documentation, already being in testing process at University medical centres in Ljubljana and Maribor, will be described.

Implementation of Nursing Process: An Evaluation of an Inservice Educational Program in an HMO Acute Care Hospital.

ERIC Educational Resources Information Center

Johnson, C. Frances; Hales, Loyde W.

A study examined the effectiveness of the current inservice training process used to teach newly employed nurses at Bess Kaiser Medical Center to transfer nursing process theory to practice. Eighty-two of 102 recently hired registered nurses were included in the audit sample. The newly hired nurses, whose previous experience varied from less than…

Clinical reasoning and its application to nursing: concepts and research studies.

PubMed

Banning, Maggi

2008-05-01

Clinical reasoning may be defined as "the process of applying knowledge and expertise to a clinical situation to develop a solution" [Carr, S., 2004. A framework for understanding clinical reasoning in community nursing. J. Clin. Nursing 13 (7), 850-857]. Several forms of reasoning exist each has its own merits and uses. Reasoning involves the processes of cognition or thinking and metacognition. In nursing, clinical reasoning skills are an expected component of expert and competent practise. Nurse research studies have identified concepts, processes and thinking strategies that might underpin the clinical reasoning used by pre-registration nurses and experienced nurses. Much of the available research on reasoning is based on the use of the think aloud approach. Although this is a useful method, it is dependent on ability to describe and verbalise the reasoning process. More nursing research is needed to explore the clinical reasoning process. Investment in teaching and learning methods is needed to enhance clinical reasoning skills in nurses.

A Nursing Process Methodology.

ERIC Educational Resources Information Center

Ryan-Wenger, Nancy M.

1990-01-01

A nursing methodology developed by the faculty at The Ohio State University teaches nursing students problem-solving techniques applicable to any nursing situation. It also provides faculty and students with a basis for measuring students' progress and ability in applying the nursing process. (Author)

[Clinical decision making and critical thinking in the nursing diagnostic process].

PubMed

Müller-Staub, Maria

2006-10-01

The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".

The Use of the Nursing Process in Spain as Compared to the United States and Canada.

PubMed

Huitzi-Egilegor, Joseba Xabier; Elorza-Puyadena, Maria Isabel; Asurabarrena-Iraola, Carmen

2017-05-18

To analyze the development of the nursing method process in Spain, and compare it with the development in the United States and Canada. This is a narrative review. The teaching of the nursing process in nursing schools started in Spain as from 1977 and that it started being used in professional practice in the 1990's. The development, the difficulties, the nursing models used and its application form are discussed. The development of the nursing process in the United States and Canada started to happen in Spain about 15-20 years later and, today, is a reality. Cross-sectional studies are needed to determine the changes in the development of the nursing process in Spain. © 2017 NANDA International, Inc.

[Role transition and working adaption in new nursing graduates: a qualitative study].

PubMed

Ho, Hsueh-Hua; Liu, Pei-Fen; Hu, Hsiao-Chen; Huang, Su-Fei; Chen, Hsiao-Lien

2010-12-01

The role transition process is full of stresses and challenges for nurses. Between 35-61% nurses leave their job within the first year. Past cross-sectional quantitative studies have not provided deep descriptions of either the dynamic role transition or work adaption processes of new nurses. The purpose of this study was to understand the role transition experience of new nurses as they transitioned into clinical practice during their first three months on the job. A qualitative approach was used. Data were collected through a semi-structured interview from 50 new nurses. Data were analyzed using category-content analysis. Three stages were identified in the new nurse work adaption process over the first three-month period. These included (1) Understanding: New nurse knowledge and skills are insufficient to handle routine work, adapting to the role transition is difficult, feelings of anxiety emerge related to fears of incompetence, communication difficulties must be faced in the handover process, new nurses adopt feelings of attachment to their preceptors, they must work to adopt appropriate attitudes and approaches to nursing practice, and support is sought from family, teachers and friends; (2) Acclimation: Learning to care for patients independently, seeking role models, learning to adapt to night shifts, trying to identify with co-workers, and seeking support from colleagues, preceptors and head nurses; (3) Acceptance: Managing nursing work better in terms of time and organization, feeling gradual acceptance from co-workers, restoring personal enthusiasm for work, starting to consider other, non-work related matters, experiencing and appreciating the support of co-workers and head nurses. CONCLUSIONS/IMPLICATION: New nurses face a critical role transition process through their first three months on the job. Guidance and leadership from experienced nurses and multiple support systems can assist new nurses to acclimate to their role. Research results provide information for educators and administrators to better understand the adaption process of new nurses, and offer a reference for developing future strategies to improve nurse competency in handling their work.

Growing up and role modeling: a theory in Iranian nursing students' education.

PubMed

Mokhtari Nouri, Jamileh; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid

2014-11-16

One of the key strategies in students' learning is being affected by models. Understanding the role-modeling process in education will help to make greater use of this training strategy. The aim of this grounded theory study was to explore Iranian nursing students and instructors' experiences about role modeling process. Data was analyzed by Glaserian's Grounded Theory methodology through semi-structured interviews with 7 faculty members, 2 nursing students; the three focus group discussions with 20 nursing students based on purposive and theoretical sampling was done for explaining role modeling process from four nursing faculties in Tehran. Through basic coding, an effort to comprehensive growth and excellence was made with the basic social process consisting the core category and through selective coding three phases were identified as: realizing and exposure to inadequate human and professional growth, facilitating human and professional growth and evolution. The role modeling process is taking place unconscious, involuntary, dynamic and with positive progressive process in order to facilitate overall growth in nursing student. Accordingly, the design and implementation of the designed model can be used to make this unconscious to conscious, active and voluntarily processes a process to help education administrators of nursing colleges and supra organization to prevent threats to human and professional in nursing students' education and promote nursing students' growth.

["Scholar officials": thoughts on the involvement of professional nurses in the political process].

PubMed

Wang, Hsiu-Hung

2014-08-01

A growing number of nurses are concerned with / participate in public affairs, politics, and policymaking processes. In particular, nursing leaders are actively leveraging their collective power to create interdisciplinary alliances aimed at encouraging the media and government to confront key nursing issues and implement healthcare reform. This article highlights the political participation and policy-making process to address the meaning and essence of politics, politics and nursing, training and strategies of public affairs and political participation, the shift from academia to health policy, and facilitation of important health policies. It is hoped that nurses may appropriately use their status and influence to actively participate in political campaigns and the policymaking process. By using their professional knowledge and skills, nurses may not only protect patient safety and public health but also facilitate nursing professional development and promote the professional image of nursing.

ICU Nurses' Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran.

PubMed

Masoumian Hoseini, S T; Manzari, Z; Khaleghi, I

2015-01-01

Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. To assess ICU nurses' knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses' knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.

Participative leadership in the management process of nightshift nursing.

PubMed

da Costa, Diovane Ghignatti; Dall'Agnol, Clarice Maria

2011-01-01

This is a qualitative, exploratory, descriptive study, aiming to identify the perceptions of nurses regarding the leadership process and to analyze how this process takes place on the nightshift. Data collection was performed through the Focus Groups Technique, with 13 nightshift nurses of a public teaching hospital. Two categories that resulted from the thematic analysis are the focus of this article: the context of nightshift nursing work and leadership from the perception of the nightshift nurses. Teamwork is an important condition to vitalize the participatory perspective of the leadership process, given the necessary relationship of support and integration, above all in the nightshift nursing work. This exercise challenges the nurse in the solidification of a culture that promotes spaces for reflection regarding the work, integrating leadership with a learning process that is constituted through constructive bonds between the workers.

School nurse evaluations: making the process meaningful and motivational.

PubMed

McDaniel, Kathryn H; Overman, Muriel; Guttu, Martha; Engelke, Martha Keehner

2013-02-01

The professional standards of school nursing practice provide a framework to help school nurses focus on their unique mission of promoting health and academic achievement for all students. Without the standards, the nurse's role can become task oriented and limited in scope. By using an evaluation tool that reflects the standards, nurses not only become aware and begin to understand the standards; they also become directly accountable for meeting them. In addition, developing an evaluation process based on the standards of school nurse practice increases the visibility of school nurses and helps school administrators understand the role of the school nurse. This article describes how one school district integrated the scope and standards of school nursing into the job description and performance evaluation of the nurse. The process which is used to complete the evaluation in a manner that is meaningful and motivational to the school nurse is described.

"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.

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

PubMed

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

2017-12-28

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

Patient safety and technology-driven medication - A qualitative study on how graduate nursing students navigate through complex medication administration.

PubMed

Orbæk, Janne; Gaard, Mette; Fabricius, Pia; Lefevre, Rikke S; Møller, Tom

2015-05-01

The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26-38% of in-hospital cases. This points to the need for new ways of educating nursing students in today's medication administration. To explore nursing students' experiences and competences with the technology-driven medication administration process. 16 pre-graduate nursing students were included in two focus group interviews which were recorded, transcribed and analyzed using the systematic horizontal phenomenological-hermeneutic template methodology. The interviews uncovered that understanding the technologies; professionalism and patient safety are three crucial elements in the medication process. The students expressed positivity and confidence in using technology, but were fearful of committing serious medication errors. From the nursing students' perspective, experienced nurses deviate from existing guidelines, leaving them feeling isolated in practical learning situations. Having an unclear nursing role model for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient adherence to the medication process, still remains to be studied. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Woman's participation in the decision process of the pregnancy and puerperal cycle: nursing care integrative review].

PubMed

Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa; Lunardi, Valéria Lerch; dos Santos, Silvana Sidnei

2011-12-01

This is an integrative review that aims to identify the contribution of nursing care for woman's participation in the decision process of the pregnancy and puerperal cycle, as described in Brazilian scientific publications. The scientific productions were retrieved in May, 2010, from the Virtual Library of Health (Biblioteca Virtual em Saúde) database. From the eight articles reviewed, two themes stood out: Contributions of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle; and Limitations of nursing care to the woman's participation in the decision process of the pregnancy and puerperal cycle. The following review supports the production of knowledge in nursing, by identifying a gap in what nurses know and do about this issue, as shown by the lack of nursing researches that concern, specifically, the participation of the woman in the decision process during the pregnancy and puerperal cycle and the possible contributions of nursing care to ensure women of this right.

Growing up and Role Modeling: A Theory in Iranian Nursing Students’ Education

PubMed Central

Nouri, Jamileh Mokhtari; Ebadi, Abbas; Alhani, Fatemeh; Rejeh, Nahid

2015-01-01

One of the key strategies in students’ learning is being affected by models. Understanding the role-modeling process in education will help to make greater use of this training strategy. The aim of this grounded theory study was to explore Iranian nursing students and instructors’ experiences about role modeling process. Data was analyzed by Glaserian’s Grounded Theory methodology through semi-structured interviews with 7 faculty members, 2 nursing students; the three focus group discussions with 20 nursing students based on purposive and theoretical sampling was done for explaining role modeling process from four nursing faculties in Tehran. Through basic coding, an effort to comprehensive growth and excellence was made with the basic social process consisting the core category and through selective coding three phases were identified as: realizing and exposure to inadequate human and professional growth, facilitating human and professional growth and evolution. The role modeling process is taking place unconscious, involuntary, dynamic and with positive progressive process in order to facilitate overall growth in nursing student. Accordingly, the design and implementation of the designed model can be used to make this unconscious to conscious, active and voluntarily processes a process to help education administrators of nursing colleges and supra organization to prevent threats to human and professional in nursing students’ education and promote nursing students’ growth. PMID:25716391

Nurses' and personal care assistants' role in improving the relocation of older people into nursing homes.

PubMed

Ellis, Julie M; Rawson, Helen

2015-07-01

This article presents findings from a study that explored nurses' and personal care assistants' role in improving the relocation of older people into a nursing home. Suggestions for improving the relocation process for older people moving into a nursing home have been the outcomes of studies that have interviewed residents and their families. However, the views of nurses and personal care assistants working in nursing homes have not been previously explored. An exploratory, descriptive qualitative research design. Individual interviews were conducted with 20 care staff (seven registered nurses, five enrolled nurses and eight personal care assistants) employed at four nursing homes. Using thematic analysis, two key themes were identified: 'What it's like for them' - highlighted staffs' awareness of the advantages, disadvantages and meaning of relocation, and focused on staffing and nursing care; other services provided and the environment. The second theme - 'We can make it better', revealed suggestions for improving the relocation process, and included spending time with new residents and the importance of a person-centred approach to care. Care staff have an important role in improving the relocation process of older people into a nursing home, as well as contributing to the discussion on this important clinical topic. Challenging care staff to acknowledge the importance of their role in helping older people settle into a nursing home is a key requirement of nursing practice in aged care. Nursing practice guidelines, with a focus on person-centred care, on how to manage the relocation process for an older person and their family are required for this aspect of nursing home care. Education of staff on relocation policies and procedures is essential to ensure that residents and their families are supported through this process. © 2015 John Wiley & Sons Ltd.

Intuition and nursing practice implications for nurse educators: a review of the literature.

PubMed

Correnti, D

1992-01-01

Intuitive knowledge is an essential component of the art of nursing and of the nursing process. This article provides an analysis and review of the literature on intuition. The author addresses the use of intuition in nursing science, characteristics of intuitive nurses, receptivity of intuitive knowledge, and the importance of expanding nursing's utilization of the intuitive process. Strategies are provided for promoting intuitive skills in continuing education/staff development settings.

An administrative marketing strategy: a different perspective on the nursing process.

PubMed

Beaupre, B A

1988-11-01

Through the methods of the nursing process, nurse administrators were able to sell nursing to nurses. The use of marketing to link the business world with nursing stimulated professional dedication, skill, and responsibility. The program helped to encourage habits of flexibility, ensure continuous learning, acceptance of change, and the opportunity for individuals and institutions to grow and advance. It promoted autonomous, collaborative, and consultative practice. Nurturing the nurse had become a reality.

Tracking the footsteps: a constructivist grounded theory of the clinical reasoning processes that registered nurses use to recognise delirium.

PubMed

El Hussein, Mohamed; Hirst, Sandra

2016-02-01

To construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognise delirium while caring for older adults in acute care settings. Delirium is often under-recognised in acute care settings; this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' clinical reasoning processes in complex situations such as delirium recognition. Seventeen registered nurses working in acute care settings were interviewed. Concurrent data collection and analysis, constant comparative analysis and theoretical sampling were conducted in 2013-2014. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of registered nurse in acute hospital settings. The core category that emerged from data was 'Tracking the footsteps'. This refers to the common clinical reasoning processes that registered nurses in this study used to recognise delirium in older adults in acute care settings. It depicted the process of continuously trying to catch the state of delirium in older adults. Understanding the clinical reasoning processes that contribute to delirium under-recognition provides a strategy by which this problem can be brought to the forefront of awareness and intervention by registered nurses. Registered nurses could draw from the various processes identified in this research to develop their clinical reasoning practice to enhance their effective assessment strategies. Delirium recognition by registered nurses will contribute to quality care to older adults. © 2016 John Wiley & Sons Ltd.

Advanced Practice Nursing Committee on Process Improvement in Trauma: An Innovative Application of the Strong Model.

PubMed

West, Sarah Katherine

2016-01-01

This article aims to summarize the successes and future implications for a nurse practitioner-driven committee on process improvement in trauma. The trauma nurse practitioner is uniquely positioned to recognize the need for clinical process improvement and enact change within the clinical setting. Application of the Strong Model of Advanced Practice proves to actively engage the trauma nurse practitioner in process improvement initiatives. Through enhancing nurse practitioner professional engagement, the committee aims to improve health care delivery to the traumatically injured patient. A retrospective review of the committee's first year reveals trauma nurse practitioner success in the domains of direct comprehensive care, support of systems, education, and leadership. The need for increased trauma nurse practitioner involvement has been identified for the domains of research and publication.

The Role of the Built Environment: How Decentralized Nurse Stations Shape Communication, Patient Care Processes, and Patient Outcomes.

PubMed

Real, Kevin; Bardach, Shoshana H; Bardach, David R

2017-12-01

Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.

Bologna Process and Basic Nursing Education in 21 European Countries.

PubMed

Humar, L; Sansoni, J

2017-01-01

The Bologna Process and the Directives of the European Union have had a profound impact on nursing education in Europe. The aim of this study was to identify the similarities and differences within nursing education framework at entry level in 2014 in European countries. A questionnaire was devised by the researchers and distributed via e-mail to the nursing associations/nursing regulatory bodies of 30 European countries. Data were collected from January to May 2014. Responses were received from 21 European Countries. Results indicated that while a completion of 12 years of general education was a requirement to access nursing education in almost all respondent countries, other admission requirements differed between countries. Nursing courses were offered mostly by Faculties of Nursing and Faculties of Health Sciences (in higher education Institutions) and lecturers and management staff were mainly nurses. The results indicated significant different educational requirements for nurse educators. A foreign language was mandatory in half of the respondent countries. Nursing profession was represented at government level in just over half of the respondent countries, often with a Directorate position. The Bologna Process has helped harmonise initial nursing education in Europe but clear standards for nursing education need to be set up. Therefore, the research about the influence of the Bologna process on the development of the nursing profession should be further encouraged.

Implementing a Process to Measure Return on Investment for Nursing Professional Development.

PubMed

Garrison, Elisabeth; Beverage, Jodie

Return on investment (ROI) is one way to quantify the value that nursing professional development brings to the organization. This article describes a process to begin tracking ROI for nursing professional development. Implementing a process of tracking nursing professional development practitioners' ROI increased awareness of the financial impact and effectiveness of the department.

Process for Mapping Global Health Competencies in Undergraduate and Graduate Nursing Curricula.

PubMed

Dawson, Martha; Gakumo, C Ann; Phillips, Jennan; Wilson, Lynda

2016-01-01

Determining the extent to which existing nursing curricula prepare students to address global health issues is a critical step toward ensuring competence to practice in an increasingly globalized world. This article describes the process used by nursing faculty at a public university in the southern United States to assess the extent to which global health competencies for nurses were being addressed across nursing programs. Steps used and lessons learned throughout this process are discussed.

Shared governance in a clinic system.

PubMed

Meyers, Michelle M; Costanzo, Cindy

2015-01-01

Shared governance in health care empowers nurses to share in the decision-making process, which results in decentralized management and collective accountability. Share governance practices have been present in hospitals since the late 1970s. However, shared governance in ambulatory care clinics has not been well established. The subjects of this quality project included staff and administrative nurses in a clinic system. The stakeholder committee chose what model of shared governance to implement and educated clinic staff. The Index of Professional Nursing Governance measured a shared governance score pre- and postimplementation of the Clinic Nursing Council. The Clinic Nursing Council met bimonthly for 3 months during this project to discuss issues and make decisions related to nursing staff. The Index of Professional Nursing Governance scores indicated traditional governance pre- and postimplementation of the Clinic Nursing Council, which is to be expected. The stakeholder committee was beneficial to the initial implementation process and facilitated staff nurse involvement. Shared governance is an evolutionary process that develops empowered nurses and nurse leaders.

Nurse manager cognitive decision-making amidst stress and work complexity.

PubMed

Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

2013-01-01

  The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

Experiences of the fairness of recruitment from unsuccessful applicants in the field of nursing.

PubMed

Kanerva, Anne; Lammintakanen, Johanna; Kivinen, Tuula

2010-04-01

The purpose of this study was to describe the experiences of unsuccessful applicants for permanent nursing positions with regard to the fairness of the recruitment process. The international shortage of recruits in nursing and the rapidly increasing number of nurses retiring implies new challenges for recruitment. The nurses' experiences of fairness affect the availability of nurses and the attractiveness of the organization. The recruitment process is approached through traditional organizational justice theories. The material was gathered from thematic interviews with 12 nurses who had applied for a permanent nursing position but were not selected. The material was analysed using theory-driven content analysis. The nurses felt differently about the result of the recruitment process. The experience of distributive justice alone was not significant in terms of the general sense of justice, since other dimensions of justice compensated for it. The effect of applicants' experiences of fair treatment in the recruitment process affected their future behaviour positively, negatively or not at all. and implications for nursing management It is crucial to recognize applicants' experiences of the fairness of the recruitment process, because unsuccessful applicants constitute a pool of potential new employees. Furthermore, applicants with different experiences cannot be seen as a homogenous group. For example, internal applicants with negative experiences pose challenges for nursing management with regard to retaining them in the organization.

Implementing a Systematic Process for Consistent Nursing Care in a NICU: A Quality Improvement Project.

PubMed

McCarley, Renay Marie; Dowling, Donna A; Dolansky, Mary A; Bieda, Amy

2018-03-01

The global aim of this quality improvement project was to develop and implement a systematic process to assign and maintain consistent bedside nurses for infants and families. A systematic process based on a primary care nursing model was implemented to assign consistent care for a 48-bed, single-family room NICU. Four PDSA cycles were necessary to obtain agreement from the nursing staff as to the best process for assigning primary nurses. Post-intervention data revealed a 9.5 percent decrease of consistent caregivers for infants in the NICU ≤ 28 days and a 2.3 percent increase of consistent caregivers for infants in the NICU ≥ 29 days. Although these findings did not meet the goal of the specific aim, a systematic process was created to assign bedside nurses to infants. Further PDSAs will be needed to refine the process to reach the aim.

The OSHA standard setting process: role of the occupational health nurse.

PubMed

Klinger, C S; Jones, M L

1994-08-01

1. Occupational health nurses are the health professionals most often involved with the worker who suffers as a result of ineffective or non-existent safety and health standards. 2. Occupational health nurses are familiar with health and safety standards, but may not understand or participate in the rulemaking process used to develop them. 3. Knowing the eight basic steps of rulemaking and actively participating in the process empowers occupational health nurses to influence national policy decisions affecting the safety and health of millions of workers. 4. By actively participating in rulemaking activities, occupational health nurses also improve the quality of occupational health nursing practice and enhance the image of the nursing profession.

Nurses' behaviors and visual scanning patterns may reduce patient identification errors.

PubMed

Marquard, Jenna L; Henneman, Philip L; He, Ze; Jo, Junghee; Fisher, Donald L; Henneman, Elizabeth A

2011-09-01

Patient identification (ID) errors occurring during the medication administration process can be fatal. The aim of this study is to determine whether differences in nurses' behaviors and visual scanning patterns during the medication administration process influence their capacities to identify patient ID errors. Nurse participants (n = 20) administered medications to 3 patients in a simulated clinical setting, with 1 patient having an embedded ID error. Error-identifying nurses tended to complete more process steps in a similar amount of time than non-error-identifying nurses and tended to scan information across artifacts (e.g., ID band, patient chart, medication label) rather than fixating on several pieces of information on a single artifact before fixating on another artifact. Non-error-indentifying nurses tended to increase their durations of off-topic conversations-a type of process interruption-over the course of the trials; the difference between groups was significant in the trial with the embedded ID error. Error-identifying nurses tended to have their most fixations in a row on the patient's chart, whereas non-error-identifying nurses did not tend to have a single artifact on which they consistently fixated. Finally, error-identifying nurses tended to have predictable eye fixation sequences across artifacts, whereas non-error-identifying nurses tended to have seemingly random eye fixation sequences. This finding has implications for nurse training and the design of tools and technologies that support nurses as they complete the medication administration process. (c) 2011 APA, all rights reserved.

Measurement of Quality of Nursing Practice in Congenital Cardiac Care.

PubMed

Connor, Jean Anne; Mott, Sandra; Green, Angela; Larson, Carol; Hickey, Patricia

2016-03-01

The impact of nursing care on patients' outcomes has been demonstrated in adult and pediatric settings. However, limited attention has been given to standardized measurement of pediatric nursing care. A collaborative group, the Consortium for Congenital Cardiac Care Measurement of Nursing Practice, was formed to address this gap. The purpose of this study was to assess the current state of measurement of the quality of pediatric cardiovascular nursing in freestanding children's hospitals across the United States. A qualitative descriptive design was used to assess the state of measurement of nursing care from the perspective of experts in pediatric cardiovascular nursing. Nurse leaders from 20 sites participated in audiotaped phone interviews. The data were analyzed by using conventional content analysis. Each level of data coding was increasingly comprehensive. Guided by Donabedian's quality framework of structure, process, and outcome, 2 encompassing patterns emerged: (1) structure and process of health care delivery and (2) structure and process of evaluation of care. Similarities in the structure of health care delivery included program expansion and subsequent hiring of nurses with a bachelor of science in nursing and experienced nurses to provide safety and optimal outcomes for patients. Programs varied in how they evaluated care in terms of structure, measurement, collection and dissemination of data. External factors and response to internal processes of health care delivery were similar in different programs; evaluation was more varied. Seven opportunities for measurement that address both structure and process of nursing care were identified to be developed as benchmarks. ©2016 American Association of Critical-Care Nurses.

[Nursing care in practice: problems, perspectives, and need for systematization].

PubMed

de Andrade, Joseilze Santos; Vieira, Maria Jésia

2005-01-01

Descriptive and qualitative study carried out to subsidize the implementation process of Nursing systematization in a University Hospital. It was used questionnaires approaching activities, perception on Nursing and customer, knowledge and application of the Nursing process and problems which are consequence of non systemized assistance. Results identified that the nurses activities are based on the technique and on the service administration; that nursing was related to the help of the human beings' basic needs and holism, being the customer defined as the one that needs care; that the majority of nurses knew, in theory, the Nursing process, but did not apply it in practice. The most mentioned problems which were consequence of the non systemized assistance were the following: the quality assistance detriment, the service disorganization and the conflict of roles.

Implementation of Free Text Format Nursing Diagnoses at a University Hospital's Medical Department. Exploring Nurses' and Nursing Students' Experiences on Use and Usefulness. A Qualitative Study

PubMed Central

Frigstad, Sigrun Aasen; Nøst, Torunn Hatlen; André, Beate

2015-01-01

Background. Nursing documentation has long traditions and represents core element of nursing, but the documentation is often criticized of being incomplete. Nursing diagnoses are an important research topic in nursing in terms of quality of nursing assessment, interventions, and outcome in addition to facilitating communication and continuity. Aim. The aim of this study was to explore the nurses' and nursing students' experiences after implementing free text format nursing diagnoses in a medical department. Method. The study design included educational intervention of free text nursing diagnoses. Data was collected through five focus group interviews with 18 nurses and 6 students as informants. The data was analyzed using qualitative content analysis. Results. The informants describe positive experiences concerning free text format nursing diagnoses' use and usefulness; it promotes reflection and discussion and is described as a useful tool in the diagnostic process, though it was challenging to find the diagnosis' appropriate formulation. Conclusion. Our findings indicate a valid usability of free text format nursing diagnoses as it promotes the diagnostic process. The use seems to enhance critical thinking and may serve as valuable preparation towards an implementation of standardized nursing diagnoses. Use and support of key personnel seem valuable in an implementation process. PMID:26075091

Effects of process-oriented group supervision - a comparison of three groups of student nurses.

PubMed

Severinsson, Elisabeth; Johansson, Ingrid; Lindquist, Ingegerd

2014-05-01

To evaluate student nurses' perceptions of the effects of process-oriented group supervision provided during their undergraduate education. Supervision is an important ability and part of a nurse's leadership role. Student nurses need to learn competence in clinical practice. A descriptive-correlational study comparing three groups of student nurses (n = 151) who attended process-oriented group supervision during their education. The effects of process-oriented group supervision were increased awareness of interpersonal, professional and communication skills. There was a moderate relation between the three factors. The strongest correlation was found between the factors professional and communication skills (r = 0.81). The correlations between the factors in group 3, the mandatory group, were identical. By correlating the factors, we concluded that the student nurses' perceptions of the effects of process-oriented group supervision strengthened their professional identity, which may have a bearing on patient safety, nursing leadership and collaboration with the patient, her/his family members and other professionals. There is potential for improving the links between nursing leadership, supervision and patient safety. © 2012 John Wiley & Sons Ltd.

The role of nurses/social workers in using a multidimensional guideline for diagnosis of anxiety and challenging behaviour in people with intellectual disabilities.

PubMed

Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; Teerenstra, Steven; van Achterberg, Theo

2015-07-01

This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline. Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process. This study employed a comparative multiple case study design. Qualitative and quantitative research methods. Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process. Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process. After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours. © 2015 John Wiley & Sons Ltd.

'Struggling to be an insider': a phenomenological design of new nurses' transition.

PubMed

Lee, Huei Ying; Hsu, Min-Tao; Li, Pei-Ling; Sloan, Rebecca S

2013-03-01

To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background.  The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. We adopted a phenomenological design using focus group interviews. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of 'being new'. Interview data were analysed according to Sloan's (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of 'struggling to be an insider'. This phenomenon was characterised by four themes, including (1) 'being new as being weak', (2) 'masking myself', (3) 'internalising the unreasonable' and (4) 'transforming myself to get a position'. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self-oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Recognition of the journey of 'struggling to be an insider' helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in-service training programmes and (4) retain future nurses. © 2012 Blackwell Publishing Ltd.

Analysis of a government policy to address nursing shortage and nursing education quality.

PubMed

Abhicharttibutra, K; Kunaviktikul, W; Turale, S; Wichaikhum, O-A; Srisuphan, W

2017-03-01

A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies. Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality. A qualitative study employing Longest's model to examine policy-making processes. Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data. Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities. Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy. Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand. Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing shortages, and enhance practice and education environments. © 2016 International Council of Nurses.

[Systematization of nursing care in the obstetrical center].

PubMed

dos Santos, Raquel Bezerra; Ramos, Karla da Silva

2012-01-01

This is a descriptive and exploratory study with a quantitative approach, aiming to propose a protocol for the systematization of nursing care to women in the process of giving birth in the Obstetrical Center of a public hospital in Recife, Pernambuco, Brazil. A semi-structured instrument was applied to forty women in the process of giving birth, in order to obtaining the nursing history; from which the nursing diagnoses were identified, having as a basis the International Classification for Nursing Practice (ICNP®), version 1, and their respective results and nursing interventions were established. The protocol consists in two stages: the first one is the nursing consultation, which involves the anamnesis and physical examination; and the second, involves the judicious identification of the nursing diagnoses, which will guide the planning of the nursing care to provide the individualized attention to women in the process of giving birth, using a universal terminology.

Nursing process in mental health: an integrative literature review.

PubMed

Garcia, Ana Paula Rigon Francischetti; Freitas, Maria Isabel Pedreira de; Lamas, José Luiz Tatagiba; Toledo, Vanessa Pellegrino

2017-01-01

to identify evidences from the literature on the application of nursing process in care developed by the nurse in mental health. integrative literature review between 1990 and 2013, in the PubMed, Scopus, CINAHL and LILCACS bases. Descriptors: nursing processes, mental health, nursing care. 19 papers were identified. Limited and partial usage of the nursing process in care established by a therapeutic relationship that respects the patient's individuality. We observe care proposals systematized for patients that present pathological aspects in the limits between the physical and psychical, which might be a response to the influence of the practice based on evidences. it was found an antagonistic movement between care based on the relationship and located in the standardization of diagnoses that respond to physical malaise. A lack of evidence was verified for the usage of the nursing process in mental health, and we point at the necessity for the creation of new possibilities for dialogue between relational and biological perspectives.

[A typology for nursing processes exemplified by the "Nursing Process, Standardization and Quality in the Nursing Care Sector" Project].

PubMed

Güttler, Karen; Lehmann, Almut

2003-06-01

This paper is based on the project "nursing process, standardisation and quality in nursing care" which is funded by the BMBF. This venture aims to develop and constitute a structure for recordation and documentation of nursing processes in terms of a typology and to standardise patients data for an exchange. The typology results from both the outcomes of the actual analysis of 128 patients in hospitals, homes for the elderly and community health care centers and the research on nursing classifications. The contents of the typology has been developed in co-operation with nurses working in such institutions. The structure and transfer of the data set will be realised by an IT media based network. The range of the project is regional, national and international. In this project the Bremen Institute of Industrial Technology and Applied Work Science (BIBA-ATOP) was responsible for the project management and the development of the IT based structure of the typology. The contents of the typology have been developed by the Institute of Applied Nursing Research (iap).

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.

Quality nursing care: a qualitative enquiry.

PubMed

Hogston, R

1995-01-01

In spite of the wealth of literature on quality nursing care, a disparity exists in defining quality. The purpose of this study was an attempt to seek out practising nurses' perceptions of quality nursing care and to present a definition of quality as described by nurses. Eighteen nurses from a large hospital in the south of England were interviewed. Qualitative analysis based on a modified grounded theory approach revealed three categories described as 'structure', 'process' and 'outcome'. This supports previous work on evaluating quality care but postulates that structure, process and outcome could also be used as a mechanism for defining quality. The categories are defined by using the words of the informants in order to explain the essential attributes of quality nursing care. The findings demonstrate how more informants cited quality in terms of process and outcome than structure. It is speculated that the significance of this rests with the fact that nurses have direct control over process and outcome whereas the political and economic climate in which nurses work is beyond their control and decisions over structure lie with their managers.

Nurses' reported thinking during medication administration.

PubMed

Eisenhauer, Laurel A; Hurley, Ann C; Dolan, Nancy

2007-01-01

To document nurses' reported thinking processes during medication administration before and after implementation of point-of-care technology. Semistructured interviews and real-time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US. Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose-time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications. Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the "5 rights."

Identification of potential barriers to nurse-sensitive outcome demonstration.

PubMed

Beckel, Jean; Wolf, Gail; Wilson, Roxanne; Hoolahan, Susan

2013-12-01

The objective of this study was to determine differences in chief nursing officer, Magnet(®) program director, nurse leader, and direct care RN perspectives of potential barriers to demonstration of nurse-sensitive outcomes. The Magnet Recognition Program(®) and other designations are focusing on patient outcomes. No evidence is available addressing barriers to demonstration of nursing outcomes at multiple levels of practice. A Likert scale tool was developed and administered to 526 attendees at the 2012 national Magnet conference. Questions related to available resources, benchmarks, outcome demonstration process understanding, perception of value, and competing priorities. Significant perception differences by role were demonstrated related to available resources, competing priorities, and process understanding supporting demonstration of nurse-sensitive outcomes. No significant differences were identified related to benchmarks or perception of process value to the organization. This study provides new information demonstrating potential barriers to demonstration of nurse-sensitive outcomes differing by role. Opportunity exists to develop systems and processes to reduce perceived barriers among the nursing workforce.

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies.

PubMed

Ivory, Catherine H

2016-07-01

The use of standard terminologies is an essential component for using data to inform practice and conduct research; perinatal nursing data standardization is needed. This study explored whether 76 distinct process elements important for perinatal nursing were present in four American Nurses Association-recognized standard terminologies. The 76 process elements were taken from a valid paper-based perinatal nursing process measurement tool. Using terminology-supported browsers, the elements were manually mapped to the selected terminologies by the researcher. A five-member expert panel validated 100% of the mapping findings. The majority of the process elements (n = 63, 83%) were present in SNOMED-CT, 28% (n = 21) in LOINC, 34% (n = 26) in ICNP, and 15% (n = 11) in CCC. SNOMED-CT and LOINC are terminologies currently recommended for use to facilitate interoperability in the capture of assessment and problem data in certified electronic medical records. Study results suggest that SNOMED-CT and LOINC contain perinatal nursing process elements and are useful standard terminologies to support perinatal nursing practice in electronic health records. Terminology mapping is the first step toward incorporating traditional paper-based tools into electronic systems.

Emotional exhaustion and medication administration work-arounds: the moderating role of nurse satisfaction with medication administration.

PubMed

Halbesleben, Jonathon R B; Rathert, Cheryl; Williams, Eric S

2013-01-01

Burnout is very common and has significant negative outcomes for both nurses and patients. However, this literature has only recently begun to address the processes that explain why health care provider burnout leads to negative patient outcomes. This article extends that literature by examining how satisfaction with work processes impacts the link between nurse burnout and work-arounds. The purpose of this study was to examine the relationships between emotional exhaustion and potentially unsafe work practices (work-arounds) in the context of nursing administration of medication. The data were collected using online survey software and pencil-and-paper surveys returned directly to the researchers. The study was conducted among nurses in 2 acute care hospitals in the Midwestern United States. For one of the samples, data on work-arounds were provided by the nurses' supervisors. For the other sample, data were collected at a 6-month interval. The survey included measures of emotional exhaustion (the Maslach Burnout Inventory), work-arounds, and nurse satisfaction with medication administration processes. We found that exhaustion was associated with greater use of work-arounds of medication administration processes. We also found that when nurses were more satisfied with the medication administration process, exhausted nurses were less likely to engage in work-arounds. The findings suggest that although exhaustion in nurses can lead to potentially unsafe practices, satisfaction with the work process can either exacerbate or reduce the problem.

Deep nursing: a thoughtful, co-created nursing process.

PubMed

Griffiths, Colin

2017-03-30

This article examines some of the challenges in nursing practice experienced by patients and nurses in the UK and Ireland, and considers some of the associated stressors in the system. Nurses must respond to these challenges by crafting their own practice, and the article offers a blueprint for developing personal nursing practice through acceptance, paying detailed attention to patients, taking time with patients and personal reflection. It draws on innovations in learning disability practice to suggest that care should be jointly thought through and co-created by patients and nurses, and that this process of thoughtful engagement constitutes 'deep nursing'.

Advancing nursing theory through theory-guided practice: the emergence of a critical caring perspective.

PubMed

Falk-Rafael, Adeline

2005-01-01

Critical caring is proposed as a hybrid, midrange theory that builds on nursing science and critical feminist theories. As such, it has the potential to root public health nursing practice in an expanded nursing caring science that reincorporates the social justice agenda characteristic of early public health nursing practice but not featured prominently in contemporary nursing theories. Critical caring transforms the carative processes of Watson's theory into 7 carative health-promoting processes that form the "core" of public health nursing practice and reflect the legacy and reality of public health nursing practice.

Nurses' reflections on pain management in a nursing home setting.

PubMed

Clark, Lauren; Fink, Regina; Pennington, Karen; Jones, Katherine

2006-06-01

Achieving optimal and safe pain-management practices in the nursing home setting continues to challenge administrators, nurses, physicians, and other health care providers. Several factors in nursing home settings complicate the conduct of clinical process improvement research. The purpose of this qualitative study was to explore the perceptions of a sample of Colorado nursing home staff who participated in a study to develop and evaluate a multifaceted pain-management intervention. Semistructured interviews were conducted with 103 staff from treatment and control nursing homes, audiotaped, and content analyzed. Staff identified changes in their knowledge and attitudes about pain and their pain-assessment and management practices. Progressive solutions and suggestions for changing practice include establishing an internal pain team and incorporating nursing assistants into the care planning process. Quality improvement strategies can accommodate the special circumstances of nursing home care and build the capacity of the nursing homes to initiate and monitor their own process-improvement programs using a participatory research approach.

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

PubMed

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

2016-01-01

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

Advanced Nursing Process quality: Comparing the International Classification for Nursing Practice (ICNP) with the NANDA-International (NANDA-I) and Nursing Interventions Classification (NIC).

PubMed

Rabelo-Silva, Eneida Rejane; Dantas Cavalcanti, Ana Carla; Ramos Goulart Caldas, Maria Cristina; Lucena, Amália de Fátima; Almeida, Miriam de Abreu; Linch, Graciele Fernanda da Costa; da Silva, Marcos Barragan; Müller-Staub, Maria

2017-02-01

To assess the quality of the advanced nursing process in nursing documentation in two hospitals. Various standardised terminologies are employed by nurses worldwide, whether for teaching, research or patient care. These systems can improve the quality of nursing records, enable care continuity, consistency in written communication and enhance safety for patients and providers alike. Cross-sectional study. A total of 138 records from two facilities (69 records from each facility) were analysed, one using the NANDA-International and Nursing Interventions Classification terminology (Centre 1) and one the International Classification for Nursing Practice (Centre 2), by means of the Quality of Diagnoses, Interventions, and Outcomes instrument. Quality of Diagnoses, Interventions, and Outcomes scores range from 0-58 points. Nursing records were dated 2012-2013 for Centre 1 and 2010-2011 for Centre 2. Centre 1 had a Quality of Diagnoses, Interventions, and Outcomes score of 35·46 (±6·45), whereas Centre 2 had a Quality of Diagnoses, Interventions, and Outcomes score of 31·72 (±4·62) (p < 0·001). Centre 2 had higher scores in the 'Nursing Diagnoses as Process' dimension, whereas in the 'Nursing Diagnoses as Product', 'Nursing Interventions' and 'Nursing Outcomes' dimensions, Centre 1 exhibited superior performance; acceptable reliability values were obtained for both centres, except for the 'Nursing Interventions' domain in Centre 1 and the 'Nursing Diagnoses as Process' and 'Nursing Diagnoses as Product' domains in Centre 2. The quality of nursing documentation was superior at Centre 1, although both facilities demonstrated moderate scores considering the maximum potential score of 58 points. Reliability analyses showed satisfactory results for both standardised terminologies. Nursing leaders should use a validated instrument to investigate the quality of nursing records after implementation of standardised terminologies. © 2016 John Wiley & Sons Ltd.

Analyzing the nursing organizational structure and process from a scheduling perspective.

PubMed

Maenhout, Broos; Vanhoucke, Mario

2013-09-01

The efficient and effective management of nursing personnel is of critical importance in a hospital's environment comprising approximately 25 % of the hospital's operational costs. The nurse organizational structure and the organizational processes highly affect the nurses' working conditions and the provided quality of care. In this paper, we investigate the impact of different nurse organization structures and different organizational processes for a real-life situation in a Belgian university hospital. In order to make accurate nurse staffing decisions, the employed solution methodology incorporates shift scheduling characteristics in order to overcome the deficiencies of the many phase-specific methodologies that are proposed in the academic literature.

Holistic nurses' examinations: past, present, future.

PubMed

Erickson, Helen L

2009-09-01

Social and professional paradigm shifts of the 1990s moved holistic nursing into the mainstream of health care, resulting in the need for national certification of Holistic Nurses. Given the assumptions that certification examinations are based on the knowledge, skills, and abilities prerequisite for competent practice in a given specialty, and that the certification credential tells the public and peers that the certificant has such knowledge, The American Holistic Nurses Association's Leadership Council (AHNA-LC) initiated certification processes in 1994. On the request of AHNA-LC, the American Holistic Nurses' Certification Corporation (AHNCC) assumed these responsibilities in April, 1997. Since then, AHNCC has overseen the revision of the first certification process for holistic nursing prepared at the baccalaureate level and development of a second one designed for holistic nurses prepared in graduate nursing programs. This article describe these developmental processes.

Implementation of nursing conceptual models: observations of a multi-site research team.

PubMed

Shea, H; Rogers, M; Ross, E; Tucker, D; Fitch, M; Smith, I

1989-01-01

The general acceptance by nursing of the nursing process as the methodology of practice enabled nurses to have a common grounding for practice, research and theory development in the 1970s. It has become clear, however, that the nursing process is just that--a process. What is sorely needed is the nursing content for that process and consequently in the past 10 years nursing theorists have further developed their particular conceptual models (CM). Three major teaching hospitals in Toronto have instituted a conceptual model (CM) of nursing as a basis of nursing practice. Mount Sinai Hospital has adopted Roy's adaptation model; Sunnybrook Medical Centre, Kings's goal attainment model; and Toronto General Hospital, Orem's self-care deficit theory model. All of these hospitals are affiliated through a series of cross appointments with the Faculty of Nursing at the University of Toronto. Two community hospitals, Mississauga and Scarborough General, have also adopted Orem's model and are related to the University through educational, community and interest groups. A group of researchers from these hospitals and the University of Toronto have proposed a collaborative project to determine what impact using a conceptual model will make on nursing practice. Discussions among the participants of this research group indicate that there are observations associated with instituting conceptual models that can be identified early in the process of implementation. These observations may be of assistance to others contemplating the implementation of conceptually based practice in their institution.

Taking Root: a grounded theory on evidence-based nursing implementation in China.

PubMed

Cheng, L; Broome, M E; Feng, S; Hu, Y

2018-06-01

Evidence-based nursing is widely recognized as the critical foundation for quality care. To develop a middle-range theory on the process of evidence-based nursing implementation in Chinese context. A grounded theory study using unstructured in-depth individual interviews was conducted with 56 participants who were involved in 24 evidence-based nursing implementation projects in Mainland China from September 2015 to September 2016. A middle-range grounded theory of 'Taking Root' was developed. The theory describes the evidence implementation process consisting of four components (driving forces, process, outcome, sustainment/regression), three approaches (top-down, bottom-up and outside-in), four implementation strategies (patient-centred, nurses at the heart of change, reaching agreement, collaboration) and two patterns (transformational and adaptive implementation). Certain perspectives may have not been captured, as the retrospective nature of the interviewing technique did not allow for 'real-time' assessment of the actual implementation process. The transferability of the findings requires further exploration as few participants with negative experiences were recruited. This is the first study that explored evidence-based implementation process, strategies, approaches and patterns in the Chinese nursing practice context to inform international nursing and health policymaking. The theory of Taking Root described various approaches to evidence implementation and how the implementation can be transformational for the nurses and the setting in which they work. Nursing educators, managers and researchers should work together to improve nurses' readiness for evidence implementation. Healthcare systems need to optimize internal mechanisms and external collaborations to promote nursing practice in line with evidence and achieve clinical outcomes and sustainability. © 2017 International Council of Nurses.

[Organizational socialization in the first three years of nursing profession: strategies to decrease turnover intention].

PubMed

Tomietto, Marco; Rappogliosi, Cristina Maria; Sartori, Riccardo; Battistelli, Adalgisa

2014-01-01

In the first years of nursing profession, new-graduate nurses' turnover intention is a relevant issue due to both the tangible and intangible costs it generates to health care organizations, such as selection and recruitment costs, ward team burden in the onboarding process and the possibility to enhance ward team stability in order to provide an effective and safe nusing care. Organizational socialization is the main factor involved in these dynamics of turnover intention in the first years of nursing profession. This study aims to identify the main factors involved in the organizational socialization process to reduce turnover intention in the first 3 years of nursing profession. 101 new-graduate nurses have been enrolled within the first three years of nursing profession. They have been stratified looking at tenure and years in nursing. Organizational Socialization Inventory scale has been used to assess the onboarding process and 4 items to assess turnover intention. Turnover intention is of 23% in the first year in nursing, and it's over the 26% starting from the second year. The onboarding process explains over the 26% of the variance in turnover intention, and over the 36% in the sub-sample with a stable tenure. Unstable tenured nurses prefer to acquire those competences useful to perform their work, while stable tenure nurses aim to search for professional growth opportunities and integration in the ward-team, in order to reduce turnover intention. Turnover intention is relevant in the first three years of nursing profession. According to the different tenure, different strategies are necessary to plan an effective onboarding process and enhance nursing retention.

[Critical thinking skills in the nursing diagnosis process].

PubMed

Bittencourt, Greicy Kelly Gouveia Dias; Crossetti, Maria da Graça Oliveira

2013-04-01

The aim of this study was to identify the critical thinking skills utilized in the nursing diagnosis process. This was an exploratory descriptive study conducted with seven nursing students on the application of a clinical case to identify critical thinking skills, as well as their justifications in the nursing diagnosis process. Content analysis was performed to evaluate descriptive data. Six participants reported that analysis, scientific and technical knowledge and logical reasoning skills are important in identifying priority nursing diagnoses; clinical experience was cited by five participants, knowledge about the patient and application of standards were mentioned by three participants; Furthermore, discernment and contextual perspective were skills noted by two participants. Based on these results, the use of critical thinking skills related to the steps of the nursing diagnosis process was observed. Therefore, that the application of this process may constitute a strategy that enables the development of critical thinking skills.

[The electronic use of the NANDA-, NOC- and NIC- classifications and implications for nursing practice].

PubMed

Bernhart-Just, Alexandra; Hillewerth, Kathrin; Holzer-Pruss, Christina; Paprotny, Monika; Zimmermann Heinrich, Heidi

2009-12-01

The data model developed on behalf of the Nursing Service Commission of the Canton of Zurich (Pflegedienstkommission des Kantons Zürich) is based on the NANDA nursing diagnoses, the Nursing Outcome Classification, and the Nursing Intervention Classification (NNN Classifications). It also includes integrated functions for cost-centered accounting, service recording, and the Swiss Nursing Minimum Data Set. The data model uses the NNN classifications to map a possible form of the nursing process in the electronic patient health record, where the nurse can choose nursing diagnoses, outcomes, and interventions relevant to the patient situation. The nurses' choice is guided both by the different classifications and their linkages, and the use of specific text components pre-defined for each classification and accessible through the respective linkages. This article describes the developed data model and illustrates its clinical application in a specific patient's situation. Preparatory work required for the implementation of NNN classifications in practical nursing such as content filtering and the creation of linkages between the NNN classifications are described. Against the background of documentation of the nursing process based on the DAPEP(1) data model, possible changes and requirements are deduced. The article provides a contribution to the discussion of a change in documentation of the nursing process by implementing nursing classifications in electronic patient records.

RN Baccalaureate Education: A Process-Product Evaluation, 1979-1983. Final Report.

ERIC Educational Resources Information Center

Jacobsen, Marilyn-Lu W.; Sabritt, David

Processes and outcomes associated with baccalaureate education for registered nurses were studied longitudinally as part of the Sleuthing Nursing Pathways Project. Participants included about 500 registered nurses who entered the Bachelor of Science in Nursing (BSN) programs at the University of Kentucky, the University of Louisville, Northern…

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

PubMed

Whittenburg, Luann; Meetim, Aunchisa

2016-01-01

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

Nursing students' understanding and enactment of resilience: a grounded theory study.

PubMed

Reyes, Andrew Thomas; Andrusyszyn, Mary-Anne; Iwasiw, Carroll; Forchuk, Cheryl; Babenko-Mould, Yolanda

2015-11-01

The aim of this study was to explore nursing students' understanding and enactment of resilience. Stress is considered to be a major factor affecting the health, well-being and academic performance of nursing students. Resilience has been extensively researched as a process that allows individuals to successfully adapt to adversity and develop positive outcomes as a result. However, relatively little is known about the resilience of nursing students. A constructivist, grounded theory qualitative design was used for this study. In-depth individual interviews were conducted with 38 nursing students enrolled in a four-year, integrated baccalaureate nursing degree programme at a university in Ontario, Canada. Face-to-face interviews were conducted from January to April 2012 using a semi-structured interview guide. The basic social process of 'pushing through' emerged as nursing students' understanding and enactment of resilience. Participants employed this process to withstand challenges in their academic lives. This process was comprised of three main phases: 'stepping into', 'staying the course' and 'acknowledging'. 'Pushing through' also included a transient 'disengaging' process where students were temporarily unable to push through their adversities. The process of 'pushing through' was based on a progressive trajectory, which implied that nursing students enacted the process to make progress in their academic lives and to attain goals. Study findings provide important evidence for understanding the phenomenon of resilience as a dynamic, contextual process that can be learnt and developed, rather than a static trait or personality characteristic. © 2015 John Wiley & Sons Ltd.

Clinical intuition in the nursing process and decision-making-A mixed-studies review.

PubMed

Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda

2017-12-01

To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision-making that supports safe patient care, and is a validated component of nursing clinical care expertise. © 2017 John Wiley & Sons Ltd.

The Nurse in the University: A History of University Education for South African Nurses: A Case Study of the University of the Witwatersrand

PubMed Central

Horwitz, Simonne

2011-01-01

This paper charts the history and debates surrounding the introduction of academic, university-based training of nurses in South Africa. This was a process that was drawn out over five decades, beginning in the late 1930s. For nurses, university training was an important part of a process of professionalization; however, for other members of the medical community, nursing was seen as being linked to women's service work. Using the case-study of the University of the Witwatersrand, one of South Africa's premier universities and the place in the country to offer a university-based nursing program, we argue that an historical understanding of the ways in which nursing education was integrated into the university system tells us a great deal about the professionalization of nursing. This paper also recognises, for the first time, the pioneers of this important process. PMID:21994840

Ethical principles of informed consent: exploring nurses' dual role of care provider and researcher.

PubMed

Judkins-Cohn, Tanya M; Kielwasser-Withrow, Kiersten; Owen, Melissa; Ward, Jessica

2014-01-01

This article describes the ethical principles of autonomy, beneficence, and justice within the nurse researcher-participant relationship as these principles relate to the informed consent process for research. Within this process, the nurse is confronted with a dual role. This article describes how nurses, who are in the dual role of care provider and researcher, can apply these ethical principles to their practice in conjunction with the American Nurses Association's code of ethics for nurses. This article also describes, as an element of ethical practice, the importance of using participant-centered quality measures to aid informed decision making of participants in research. In addition, the article provides strategies for improving the informed consent process in nursing research. Finally, case scenarios are discussed, along with the application of ethical principles within the awareness of the dual role of the nurse as care provider and researcher. Copyright 2014, SLACK Incorporated.

[Development and application of a computerized nursing process program for orthopedic surgery inpatients-- NANDA, NOC, and NIC linkages].

PubMed

Kim, Hye-Suk

2005-10-01

The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain (28.4%), Impaired physical mobility (15.6%), Impaired walking (8.7%), Chronic pain (5.5%) and Risk for disuse syndrome (5.0%). The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (95.2%), Comfort level (35.5%) and Pain level (17.7%). The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (71.0%), Splinting (24.2%) and Analgesic administration (17.7%). In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. It is expected that this program will help nurses perform their nursing processes more efficiently.

Leadership in nursing: analysis of the process of choosing the heads.

PubMed

de Moura, Gisela Maria Schebella Souto; de Magalhaes, Ana Maria Müller; Dall'agnol, Clarice Maria; Juchem, Beatriz Cavalcanti; Marona, Daniela dos Santos

2010-01-01

The process of choosing heads can be strategic to achieve desired results in nursing care. This study presents an exploratory and descriptive research that aims to analyze the process of choosing heads for the ward, in the nursing area of a teaching hospital in Porto Alegre. Data was collected from registered nurses, technicians and nursing auxiliaries through a semi-structured interview technique and free choice of words. Three theme categories emerged from content analysis: process of choosing heads, managerial competences of the head-to-be and team articulation. Leadership was the word most frequently associated with the process of choosing heads. The consultation process for the choice of the leader also contributes to the success of the manager, as it makes the team members feel co-responsible for the results achieved and legitimizes the head-to-be in their group.

Mentoring doctoral students for qualitative research: interviews with experienced nursing faculty in Japan.

PubMed

Kayama, Mami; Gregg, Misuzu F; Asahara, Kiyomi; Yamamoto-Mitani, Noriko; Okuma, Keiko; Ohta, Kikuko; Kinoshita, Yasuhito

2013-05-01

This study aimed to describe the process of mentoring doctoral students for qualitative research in Japanese graduate programs in nursing. Nine experienced faculty-seven nurse researchers and two sociologists-were interviewed. Participants were asked about their process of mentoring students for qualitative nursing dissertations. Data analysis was conducted using a qualitative descriptive method. Participants' age ranged from 48 to 60 years. The first theme in the mentoring process is about the individualized, one-on-one mentorship process. The second theme occurs in a group process. The third theme is coordinating mentors and establishing a network to support the evaluation system. The mentoring processes identified in this study will be useful for future faculty development. The study elucidated much room for improvement in doctoral education programs for qualitative research methods in nursing science. Copyright 2013, SLACK Incorporated.

[Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

PubMed

Müller-Staub, Maria; Stuker-Studer, Ursula

2006-10-01

Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.

PubMed

Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong

2016-11-01

As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Advanced Nursing Education: Critical Factors That Influence Diploma and Associate Degree Nurses to Advance.

PubMed

McGhie-Anderson, Rose Lavine

The purpose of this study was to gain an understanding of the social processes associated with the decision of diploma and associate degree nurses to advance academically. Advanced nursing education needs to be pursued along the continuum of the nursing career path. This education process is indispensable to the role of nurses as educator, manager, nurse leader, and researcher who will effect policy changes, assume leadership roles as revolutionary thinkers, and implement paradigmatic shifts. Data were collected from two groups of participants using face-to-face, semistructured interviews. Group 1 consisted of diploma and associate degree nurses; Group 2 consisted of baccalaureate, masters, and doctoral degree nurses who have progressed academically. Emerging from the thick, rich data were core categories of rewarding, motivating, and supporting as critical factors that influence professional advancement. This qualitative study elucidated that professional advancement was the social process that grounds. The emergent theory was the theory of professional advancement.

Nurses' various ways of conceiving their learning process as doctoral students: a phenomenographic study.

PubMed

Arvidsson, Barbro; Franke, Anita

2013-01-01

The aim was to describe variations in how doctoral students conceive their learning process to become researchers in the light of their professional background as nurses. Nursing research is an emerging discipline and the number of nurses who acquire a doctor's degree is increasing. The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Three different description categories emerged: (1) A learning process that provides a synthesis of different parts of the research process aimed at developing preparedness for action within the nursing profession. (2) A learning process where practical problems are integrated with and problematised in relation to scientific theories. (3) A learning process involving the transformation from nurse to researcher. The description categories revealed that the focus was on solving problems that occur in health care and synthesising them by means of research tools. Furthermore, the doctoral students explored different ways of understanding and developing their awareness of the nature of research. Focus was also on the nursing profession and practice and a shift towards the role of a researcher was evident. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

PubMed

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

2014-01-01

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

Exploring selection and recruitment processes for newly qualified nurses: a sequential-explanatory mixed-method study.

PubMed

Newton, Paul; Chandler, Val; Morris-Thomson, Trish; Sayer, Jane; Burke, Linda

2015-01-01

To map current selection and recruitment processes for newly qualified nurses and to explore the advantages and limitations of current selection and recruitment processes. The need to improve current selection and recruitment practices for newly qualified nurses is highlighted in health policy internationally. A cross-sectional, sequential-explanatory mixed-method design with 4 components: (1) Literature review of selection and recruitment of newly qualified nurses; and (2) Literature review of a public sector professions' selection and recruitment processes; (3) Survey mapping existing selection and recruitment processes for newly qualified nurses; and (4) Qualitative study about recruiters' selection and recruitment processes. Literature searches on the selection and recruitment of newly qualified candidates in teaching and nursing (2005-2013) were conducted. Cross-sectional, mixed-method data were collected from thirty-one (n = 31) individuals in health providers in London who had responsibility for the selection and recruitment of newly qualified nurses using a survey instrument. Of these providers who took part, six (n = 6) purposively selected to be interviewed qualitatively. Issues of supply and demand in the workforce, rather than selection and recruitment tools, predominated in the literature reviews. Examples of tools to measure values, attitudes and skills were found in the nursing literature. The mapping exercise found that providers used many selection and recruitment tools, some providers combined tools to streamline process and assure quality of candidates. Most providers had processes which addressed the issue of quality in the selection and recruitment of newly qualified nurses. The 'assessment centre model', which providers were adopting, allowed for multiple levels of assessment and streamlined recruitment. There is a need to validate the efficacy of the selection tools. © 2014 John Wiley & Sons Ltd.

An integrative review of communication between parents and nurses of hospitalized technology-dependent children.

PubMed

Giambra, Barbara K; Stiffler, Deborah; Broome, Marion E

2014-12-01

With advances in health care, the population of children who are technology-dependent is increasing and, therefore, the need for nurses to understand how best to engage in communication with the parents of these children is critical. Shared communication between the parents of hospitalized technology-dependent children and their nurses is essential to provide optimal care for the child. The components and behaviors of the parent-nurse communication process that improve mutual understanding of optimal care for the child had not previously been examined. Among parents of hospitalized technology-dependent children and their nurses, what communication behaviors, components, concepts, or processes improve mutual understanding of optimal care for the child? An integrative review of both qualitative and quantitative studies was conducted. Key words including communication, hospitalized, nurse, parent, pediatric, and technology-dependent were used to search databases such as Cumulative Index to Nursing and Allied Health and Medline for years 2000-2014. The data regarding the process of parent-nurse communication were extracted as they related to the mutual understanding of optimal care for the child. The data were grouped into themes and compared across studies, designs, populations, and settings. Six articles were identified that provided information regarding the processes of shared communication among the parents of hospitalized technology-dependent children and their nurses. Providing clear information, involving parents in care decisions, trust and respect for each other's expertise, caring attitudes, advocacy, and role negotiation were all found to be important factors in shared parent-nurse communication. The results of this integrative review inform our understanding of the parent-nurse communication process. The findings provide nurses with an understanding of strategies to better engage in respectful, engaging, and intentional communication with parents of hospitalized technology-dependent children and improve patient outcomes. © 2014 Sigma Theta Tau International.

78 FR 69539 - Removal of Attestation Process for Facilities Using H-1A Registered Nurses

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-20

... of Attestation Process for Facilities Using H-1A Registered Nurses AGENCY: Employment and Training... registered nurses under the H-1A visa program. These subparts became obsolete after the authorizing statute... nonimmigrant classification exclusively for the temporary admission and employment of registered nurses, which...

Thinking in clinical nursing practice: a study of critical care nurses' thinking applying the think-aloud, protocol analysis method.

PubMed

Han, Kyung-Ja; Kim, Hesook Suzie; Kim, Mae-Ja; Hong, Kyung-Ja; Park, Sungae; Yun, Soon-Nyoung; Song, Misoon; Jung, Yoenyi; Kim, Haewon; Kim, Dong-Oak Debbie; Choi, Heejung; Kim, Kyungae

2007-06-01

The purpose of the paper is to discover the patterns and processes of decision-making in clinical nursing practice. A set of think-aloud data from five critical care nurses during 40 to 50 minutes of caregiving in intensive care units were obtained and analyzed by applying the procedures recommended by Ericsson and Simon for protocol analysis. Four thinking processes before acting were identified to constitute various sorts of thoughts in which the nurses were engaged during patient care: reviewing, validation, consideration, rationalization, and action. In addition, three patterns of sequential streaming of thinking (short, intermediate, long) were identified to reveal various ways the nurses dealt with clinical situations involving nursing tasks and responsibilities. This study specifies the initial categories of thoughts for each of the processes and various patterns with which these processes are sequentially combined, providing insights into the ways nurses think about problems and address their concerns. The findings suggest that the thinking in clinical practice involves more than focused decision-making and reasoning, and needs to be examined from a broader perspective.

Weaning from mechanical ventilation: factors that influence intensive care nurses' decision-making.

PubMed

Tingsvik, Catarina; Johansson, Karin; Mårtensson, Jan

2015-01-01

The aim of the study was to describe the factors that influence intensive care nurses' decision-making when weaning patients from mechanical ventilation. Patients with failing vital function may require respiratory support. Weaning from mechanical ventilation is a process in which the intensive care nurse participates in both planning and implementation. A qualitative approach was used. The data were collected by means of semi-structured interviews with 22 intensive care nurses. The interviews were transcribed and analysed using qualitative content analysis. One theme emerged: 'A complex nursing situation where the patient receives attention and which is influenced by the current care culture'. There was consensus that the overall assessment of the patient made by the intensive care nurse was the main factor that influenced the decision-making process. This assessment was a continuous process consisting of three factors: the patient's perspective as well as her/his physical and mental state. On the other hand, there was a lack of consensus about what other factors influenced the decision-making process. These factors included the care culture constituted by the characteristics of the team, the intensive care nurses' professional skills, personalities and ability to be present. The individual overall assessment of the patient enabled nursing care from a holistic perspective. Furthermore, the weaning process can be more effective and potential suffering reduced by creating awareness of the care culture's impact on the decision-making process. © 2014 British Association of Critical Care Nurses.

Who cares? Offering emotion work as a 'gift' in the nursing labour process.

PubMed

Bolton, S C

2000-09-01

Who cares? Offering emotion work as a 'gift' in the nursing labour process The emotional elements of the nursing labour process are being recognized increasingly. Many commentators stress that nurses' 'emotional labour' is hard and productive work and should be valued in the same way as physical or technical labour. However, the term 'emotional labour' fails to conceptualize the many occasions when nurses not only work hard on their emotions in order to present the detached face of a professional carer, but also to offer authentic caring behaviour to patients in their care. Using qualitative data collected from a group of gynaecology nurses in an English National Health Service (NHS) Trust hospital, this paper argues that nursing work is emotionally complex and may be better understood by utilizing a combination of Hochschild's concepts: emotion work as a 'gift' in addition to 'emotional labour'. The gynaecology nurses in this study describe their work as 'emotionful' and therefore it could be said that this particular group of nurses represent a distinct example. Nevertheless, though it is impossible to generalize from limited data, the research presented in this paper does highlight the emotional complexity of the nursing labour process, expands the current conceptual analysis, and offers a path for future research. The examination further emphasizes the need to understand and value the motivations behind nurses' emotion work and their wish to maintain caring as a central value in professional nursing.

A cross-sectional study to identify organisational processes associated with nurse-reported quality and patient safety

PubMed Central

Tvedt, Christine; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir

2012-01-01

Objectives The purpose of this study was to identify organisational processes and structures that are associated with nurse-reported patient safety and quality of nursing. Design This is an observational cross-sectional study using survey methods. Setting Respondents from 31 Norwegian hospitals with more than 85 beds were included in the survey. Participants All registered nurses working in direct patient care in a position of 20% or more were invited to answer the survey. In this study, 3618 nurses from surgical and medical wards responded (response rate 58.9). Nurses' practice environment was defined as organisational processes and measured by the Nursing Work Index Revised and items from Hospital Survey on Patient Safety Culture. Outcome measures Nurses' assessments of patient safety, quality of nursing, confidence in how their patients manage after discharge and frequency of adverse events were used as outcome measures. Results Quality system, nurse–physician relation, patient safety management and staff adequacy were process measures associated with nurse-reported work-related and patient-related outcomes, but we found no associations with nurse participation, education and career and ward leadership. Most organisational structures were non-significant in the multilevel model except for nurses’ affiliations to medical department and hospital type. Conclusions Organisational structures may have minor impact on how nurses perceive work-related and patient-related outcomes, but the findings in this study indicate that there is a considerable potential to address organisational design in improvement of patient safety and quality of care. PMID:23263021

[The students' page. Notes about patient records and the production and reproduction of knowledge. Written and oral presentations].

PubMed

de Almeida, L B; dos Santos, E S; Alves, D de B

1995-01-01

This paper relates a description about nursing notes in pactients promptuaries in relation to the distribution/reproduction/production process of knowledge in nursing. It was developed on an Intensive Care Unity from a Hospital in the teaching/assistance Sanitary District Barra/Rio Vermelho (Salvador-Bahia). The basic premise is that the nursing personal work superficial and sporadic notes just related to patients. Distribution/ reproduction/production process, that happen in the nursing work process isn't considered by it devaluation or just because, for nursing agents, only information about technical procedures related to patient care, expresses the nursing knowledge and so, must be registered. In order to reach the objective, 30% of the promptuaries of patients discharge from the ICU were studied and the nursing team was interviewed, during the months-november, december 1994. The analysis indicates that the way how the nursing notes are been made, results in hard communication among agents of health area and contributes to disqualify the nursing assistance that is given to patients, besides to limit the advance of the distribution/reproduction/production of knowledge in nursing.

Self-tracking, governmentality, and Nursing and Midwifery Council's (2016) revalidation policy.

PubMed

Lanlehin, Rosemary M

2018-05-01

In April 2016 the Nursing and Midwifery Council (NMC) introduced a new revalidation continuous professional development (CPD) policy. This policy states that revalidation is the responsibility of nurses, and although employers are urged to support the revalidation process, the NMC clearly states that employers have no legal requirement to provide either time or funds for the CPD activities of nurses and midwives (NMC, 2014, 2016; Royal College of Nursing, 2016). The aim of this professional development policy is to ensure that nurses and midwives maintain their professional competency and to promote public safety and confidence in nurses and midwives. A closer look at the process of revalidation suggests that several measures have been introduced to ensure that nurses and midwives conform to the CPD policy, and this paper examines the influence of governmentality and neoliberalism on the NMC's self-tracking revalidation policy. It will be recommended that the responsibility for the revalidation process should be shared by nurses, midwives, and their employers, and that time and money should be allocated for the professional development of nurses and midwives. Copyright © 2018 Elsevier Ltd. All rights reserved.

The development of Canadian nursing: professionalization and proletarianization.

PubMed

Coburn, D

1988-01-01

In this article, the development of nursing in Canada is described in terms of three major time periods: the emergence of lay nursing, including organization and registration, 1870-1930; the move to the hospital, 1930-1950; and unionization and the routinization of health care, 1950 to the present. This development is viewed in the light of the orienting concepts of professionalization, proletarianization, and medical dominance (and gender analysis). This historical trajectory of nursing shows an increasing occupational autonomy but continuing struggles over control of the labor process. Nursing is now using theory, organizational changes in health care, and credentialism to help make nursing "separate from but equal to" medicine and to gain control over the day-to-day work of the nurse. Nursing can thus be viewed as undergoing processes of both professionalization and proletarianization. As nursing seeks to control the labor process, its occupational conflicts are joined to the class struggle of white-collar workers in general. Analysis of nursing indicates the problems involved in sorting out the meaning of concepts that are relevant to occupational or class analysis but which focus on the same empirical phenomenon.

Strengthening the Role of Nurses in Medical Device Development.

PubMed

Castner, Jessica; Sullivan, Suzanne S; Titus, Albert H; Klingman, Karen J

2016-01-01

Medical devices and innovative technology promise to revolutionize health care. Despite the importance of involving nurses in the collaborative medical device development processes, there are few learning opportunities in nursing programs. The purpose of this article is to provide a conceptual guide for nurse educators and researchers to engage nursing expertise in medical device development processes. A review of the literature guided the creation of the "Strengthening the Role of Nurses in Medical Device Development Roadmap" model. The model was used to describe how nurses can be engaged in multidisciplinary design of medical devices. An academic transdisciplinary team piloted the application of the model. The model includes the stages of needs assessment, planned brainstorm, feasibility determination, concept design, and prototype building. A transdisciplinary team case study of improving an asthma home-monitoring devices illustrates effective application of the model. Nurse leaders in the academic setting can effectively use the "Strengthening the Role of Nurses in Medical Device Development Roadmap" to inform their engagement of nurses in early medical device development and innovation processes. Copyright © 2016 Elsevier Inc. All rights reserved.

Nurses' professionalism in Canada: a labor process analysis.

PubMed

Campbell, M L

1992-01-01

This article draws on a body of research conducted by the author over the past ten years on the social organization of nursing work. It explores questions surrounding nurses' contemporary labor process control and its meaning for nurses' professionalization and proletarianization. Both are dynamic processes, changing as public administration of the Canadian health care system changes and as nurses are successful in winning more complete self-regulation. Nurses are currently being articulated more and more securely to dominant ideas of public sector management through textually mediated technologies. Nurses find new upwardly mobile careers and challenging, responsible, and more respected work. However, as the generation of objective information for professional accountability, cost-accounting, and managerial decision-making becomes unified in computerized patient information systems, producing and using such information becomes a central and determining core of everyday nursing work. It organizes nurses into a "managed" practice of patient care, contradictory for them in many ways. Outstanding among these contradictions is a new professionalized standpoint of cost-efficiency that subordinates nurses' traditional interests and grounding of their work in the standpoint of care.

Nursing home nurses' perceptions of emergency transfers from nursing homes to hospital: A review of qualitative studies using systematic methods.

PubMed

O'Neill, Barbara; Parkinson, Lynne; Dwyer, Trudy; Reid-Searl, Kerry

2015-01-01

The aim is to describe nursing home nurses' perceptions around emergency transfers to hospital. Transfers are costly and traumatic for residents, and efforts are underway to avoid hospitalization. Nurses play a key role in transfers, yet their views are underreported. A systematic review of qualitative studies was undertaken, guided by Joanna Briggs Institute methods. From seven reviewed studies, it was clear nursing home nurses are challenged by the complexity of the transfer process and understand their need for appropriate clinical knowledge, skills and resources. Communication is important, yet nurses often use persuasive and targeted communication. Ambiguity, strained relationships and negative perceptions of residents' experiences around hospitalization contribute to conflict and uncertainty. Nurses are more confident when there is a plan. Transferring a resident is a complex process and special skills, knowledge and resources are required, but may be lacking. Efforts to formalize the transfer process and improve communication and collaboration amongst all stakeholders is needed and would be well received. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed

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

2015-01-01

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

Nursing communication in nursing care to mastectomized women: a grounded theory study.

PubMed

de Almeida Araújo, Iliana Maria; da Silva, Raimunda Magalhães; Bonfim, Isabela Melo; Fernandes, Ana Fátima Carvalho

2010-01-01

The goal was to understand the nurse/patient communication process, emphasizing nursing care to mastectomized women. Symbolic Interactionism and Grounded Theory were used to interview eight nurses from a referral institution in cancer treatment, using the guiding question: how do nurses perceive their communication process with mastectomized women? Data analysis allowed for the creation of a central theory: the meaning of communication in nursing care to women, constituted by three distinct but inter-related phenomena: perceiving communication, the relationship nurse/mastectomized woman and rethinking the communication nurse/mastectomized woman. With a view to satisfactory communication, professionals need to get involved and believe that their presence is as important as the performance of technical procedures that relieve situations of stress.

[Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence].

PubMed

Silva, Ítalo Rodolfo; Gomes, Antonio Marcos Tosoli; Valadares, Glaucia Valente; dos Santos, Nereida Lúcia Palko; da Silva, Thiago Privado; Leite, Joséte Luzia

2015-09-01

to understand the perception of nurses on the vulnerabilities to STD/AIDS in light of the process of adolescence. qualitative research conducted with 15 nurses in a centre for the studies of adolescent healthcare of a university hospital in Rio de Janeiro/Brazil. The adopted theoretical and methodological frameworks were the Complexity Theory and the Grounded Theory, respectively. The semi-structured interview was used to collect data from January to August 2012. this research presents the category: Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence, and the subcategories: Risks and uncertainties of the process of adolescence: paths to STD/AIDS; Age-adolescence complex: expanding knowledge from the perception of nurses. once the nurses understand the complexity of adolescence, they create strategies to reduce the vulnerability of adolescents to STD/AIDS. This signals the need to invest in education, assistance and the management of nursing care for adolescents.

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.

Undergraduate nursing students' experience related to their clinical learning environment and factors affecting to their clinical learning process.

PubMed

Arkan, Burcu; Ordin, Yaprak; Yılmaz, Dilek

2018-03-01

Clinical education is an essential part of nursing education. The purpose of this study was to explore nurse students' experiences related to cinical learning environments, factors effecting to clinical learning process. Descriptive qualitative design was used in this study, and data were collected from 2nd class nursing student (n = 14). The study took the form of in-depth interviews between August-October 2015. The qualitative interviews were analyzed by using simple content analysis. Data were analyzed manually. Experiences nurse students are described five themes. The themes of the study are (1) effecting persons to clinical learning, (2) educational atmosphere, (3) students' personal charactering, (4) the impact of education in school, and (5) students' perceptions related to clinical learning. Participants stated that they experienced many difficulties during clinical learning process. All students importantly stated that nurse teacher is very effecting to clinical learning. This study contributes to the literature by providing data on beginner nursing student' experiences about clinical learning process. The data of this present study show to Turkish nursing student is affecting mostly from persons in clinical learning. The data of this present study will guide nurse teacher when they plan to interventions to be performed to support student during clinical learning process. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using Nursing Languages in School Nursing Practice. Second Edition

ERIC Educational Resources Information Center

Denehy, Janice

2010-01-01

The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…

The Evaluation of Teaching the Nursing Process Using Traditional Lecture, Campus Laboratory, Clinical, and the Addition of High Fidelity Human Simulation (HFHS) Unfolding Scenarios

ERIC Educational Resources Information Center

Irwin, Ruth E.

2013-01-01

It is not sufficient to just make changes in a nursing curriculum without a plan to evaluate the impact on program outcomes. This study sought to determine the outcomes of teaching the nursing process to Foundation of Nursing students in an Associate Degree Nursing program using a factorial design study. Four groups of students were taught the…

The transition from student to new registered nurse in professional practice.

PubMed

Thomas, Cynthia M; Bertram, Evelyn; Allen, Roberta L

2012-01-01

This qualitative study presents the transition experience of new registered nurses during the first year of professional practice. Four themes emerged: feelings of frustration and being overwhelmed, preceptors, fear, and the orientation process. The orientation process, quality, competent preceptors, and reducing lateral violence are key strategies to successfully retain new nurses. Nurse educators have a crucial role during nurse orientation, training preceptors, and reducing violent behaviors in the workplace.

Simplifying the writing process for the novice writer.

PubMed

Redmond, Mary Connie

2002-10-01

Nurses take responsibility for reading information to update their professional knowledge and to meet relicensure requirements. However, nurses are less enthusiastic about writing for professional publication. This article explores the reluctance of nurses to write, the reasons why writing for publication is important to the nursing profession, the importance of mentoring to potential writers, and basic information about simplifying the writing process for novice writers. Copyright 2002 by American Society of PeriAnesthesia Nurses.

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

PubMed

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

2015-09-01

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

Experience of nurses in the process of donation of organs and tissues for transplant.

PubMed

de Moraes, Edvaldo Leal; dos Santos, Marcelo José; Merighi, Miriam Aparecida Barbosa; Massarollo, Maria Cristina Komatsu Braga

2014-01-01

to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation. this qualitative study with a social phenomenological approach was conducted through individual interviews with ten nurses of three Organ and Tissue Procurement Services of the city of São Paulo. the experience of the nurses in the donation process was represented by the categories: obstacles experienced in the donation process, and interventions performed. The meaning of the action to maintain the viability of organs and tissues for transplantation was described by the categories: to change paradigms, to humanize the donation process, to expand the donation, and to save lives. knowledge of the experience of the nurses in this process is important for healthcare professionals who work in different realities, indicating strategies to optimize the procurement of organs and tissues for transplantation.

[The ethic dimension of daily tasks in the formation process of nurses].

PubMed

Fernandes, Josicélia Dumêt; Rosa, Darci de Oliveira Santa; Vieira, Therezinha Teixeira; Sadigursky, Dora

2008-06-01

This theoretical article had as its object of study the ethic dimension of the formation process of nurses taking in consideration the National Curricular Directives for Nursing Courses. It was based on the presuppositions of ethics and their relationship with the implementation of changes in the formation process of nurses, using as reference elements of ethical behavior in the formation and attempting to bring the reflection to current times and thus contribute to define a direction to Nursing education. It was concluded that the ethical dimension in the formation of nurses involves values that permeate the relations between the subjects of this process and nature itself. The study points out the need to transform the practices of students and teachers and change the current curriculum framework, highlighting elements that indicate that the concern with ethics when developing the curriculum framework is not limited to how a discipline is taught, but pass through as practices that take place in the education process.

Validation of the process criteria for assessment of a hospital nursing service.

PubMed

Feldman, Liliane Bauer; Cunha, Isabel Cristina Kowal Olm; D'Innocenzo, Maria

2013-01-01

to validate an instrument containing process criteria for assessment of a hospital nursing service based on the National Accreditation Organization program. a descriptive, quantitative methodological study performed in stages. An instrument constructed with 69 process criteria was assessed by 49 nurses from accredited hospitals in 2009, according to a Likert scale, and validated by 16 judges through Delphi rounds in 2010. the original instrument assessed by nurses with 69 process criteria was judged by the degree of importance, and changed to 39 criteria. In the first Delphi round, the 39 criteria reached consensus among the 19 judges, with a medium reliability by Cronbach's alpha. In the second round, 40 converging criteria were validated by 16 judges, with high reliability. The criteria addressed management, costs, teaching, education, indicators, protocols, human resources, communication, among others. the 40 process criteria formed a validated instrument to assess the hospital nursing service which, when measured, can better direct interventions by nurses in reaching and strengthening outcomes.

Barriers to nurse entrepreneurship: a study of the process model of entrepreneurship.

PubMed

Elango, B; Hunter, Gary L; Winchell, Mike

2007-04-01

The potential for nurse entrepreneurship to contribute to the effectiveness of healthcare delivery is well acknowledged, yet it has not been fully realized. Using the process model of entrepreneurship, we attempted to glean information from nursing professionals through focus groups on the barriers to starting a business. Two focus groups were used and expert moderators conducted these exercises. The first focus group included two hospital administrators, a nurse entrepreneur, an ophthalmology entrepreneur, and a dean of the nursing school familiar with nurse entrepreneurship. The second focus group used 20 students in a nurse practitioner program. The study findings indicate nurse practitioners and other nursing professionals do recognize the potential of nurse entrepreneurship. However, several barriers prevent them from exploiting the identified opportunity. While the barriers are significant, we believe they can be overcome with coordinated action by individual nurses, professional associations, and public policy initiatives. Several suggestions are offered to nurses seeking to become nurse entrepreneurs.

[Verbal patient information through nurses--a case of stroke patients].

PubMed

Christmann, Elli; Holle, Regina; Schüssler, Dörte; Beier, Jutta; Dassen, Theo

2004-06-01

The article represents results of a theoretical work in the field of nursing education, with the topic: Verbal Patient Information through Nurses--A Case of Stroke Patients. The literature review and analysis show that there is a shortage in (stroke) patient information generally and a lack of successful concepts and strategies for the verbal (stroke) patient information through nurses in hospitals. The authors have developed a theoretical basis for health information as a nursing intervention and this represents a model of health information as a "communicational teach-and-learn process", which is of general application to all patients. The health information takes place as a separate nursing intervention within a non-public, face-to-face communication situation and in the steps-model of the nursing process. Health information is seen as a learning process for patients and nurses too. We consider learning as information production (constructivism) and information processing (cognitivism). Both processes are influenced by different factors and the illness-situation of patients, personality information content and the environment. For a successful health information output, it is necessary to take care of these aspects and this can be realized through a constructivational understanding of didactics. There is a need for an evaluation study to prove our concept of health information.

The impact of organisational factors on horizontal bullying and turnover intentions in the nursing workplace.

PubMed

Blackstock, Sheila; Harlos, Karen; Macleod, Martha L P; Hardy, Cindy L

2015-11-01

To examine the impact of organisational factors on bullying among peers (i.e. horizontal) and its effect on turnover intentions among Canadian registered nurses (RNs). Bullying among nurses is an international problem. Few studies have examined factors specific to nursing work environments that may increase exposure to bullying. An Australian model of nurse bullying was tested among Canadian registered nurse coworkers using a web-based survey (n = 103). Three factors - misuse of organisational processes/procedures, organisational tolerance and reward of bullying, and informal organisational alliances - were examined as predictors of horizontal bullying, which in turn was examined as a predictor of turnover intentions. The construct validity of model measures was explored. Informal organisational alliances and misuse of organisational processes/procedures predicted increased horizontal bullying that, in turn, predicted increased turnover intentions. Construct validity of model measures was supported. Negative informal alliances and misuse of organisational processes are antecedents to bullying, which adversely affects employment relationship stability. The results suggest that reforming flawed organisational processes that contribute to registered nurses' bullying experiences may help to reduce chronically high turnover. Nurse leaders and managers need to create workplace processes that foster positive networks, fairness and respect through more transparent and accountable practices. © 2014 John Wiley & Sons Ltd.

Judging nursing information on the WWW: a theoretical understanding.

PubMed

Cader, Raffik; Campbell, Steve; Watson, Don

2009-09-01

This paper is a report of a study of the judgement processes nurses use when evaluating World Wide Web information related to nursing practice. The World Wide Web has increased the global accessibility of online health information. However, the variable nature of the quality of World Wide Web information and its perceived level of reliability may lead to misinformation. This makes demands on healthcare professionals, and on nurses in particular, to ensure that health information of reliable quality is selected for use in practice. A grounded theory approach was adopted. Semi-structured interviews and focus groups were used to collect data, between 2004 and 2005, from 20 nurses undertaking a postqualification graduate course at a university and 13 nurses from a local hospital in the United Kingdom. A theoretical framework emerged that gave insight into the judgement process nurses use when evaluating World Wide Web information. Participants broke the judgement process down into specific tasks. In addition, they used tacit, process and propositional knowledge and intuition, quasi-rational cognition and analysis to undertake these tasks. World Wide Web information cues, time available and nurses' critical skills were influencing factors in their judgement process. Addressing the issue of quality and reliability associated with World Wide Web information is a global challenge. This theoretical framework could contribute towards meeting this challenge.

Applying language technology to nursing documents: pros and cons with a focus on ethics.

PubMed

Suominen, Hanna; Lehtikunnas, Tuija; Back, Barbro; Karsten, Helena; Salakoski, Tapio; Salanterä, Sanna

2007-10-01

The present study discusses ethics in building and using applications based on natural language processing in electronic nursing documentation. Specifically, we first focus on the question of how patient confidentiality can be ensured in developing language technology for the nursing documentation domain. Then, we identify and theoretically analyze the ethical outcomes which arise when using natural language processing to support clinical judgement and decision-making. In total, we put forward and justify 10 claims related to ethics in applying language technology to nursing documents. A review of recent scientific articles related to ethics in electronic patient records or in the utilization of large databases was conducted. Then, the results were compared with ethical guidelines for nurses and the Finnish legislation covering health care and processing of personal data. Finally, the practical experiences of the authors in applying the methods of natural language processing to nursing documents were appended. Patient records supplemented with natural language processing capabilities may help nurses give better, more efficient and more individualized care for their patients. In addition, language technology may facilitate patients' possibility to receive truthful information about their health and improve the nature of narratives. Because of these benefits, research about the use of language technology in narratives should be encouraged. In contrast, privacy-sensitive health care documentation brings specific ethical concerns and difficulties to the natural language processing of nursing documents. Therefore, when developing natural language processing tools, patient confidentiality must be ensured. While using the tools, health care personnel should always be responsible for the clinical judgement and decision-making. One should also consider that the use of language technology in nursing narratives may threaten patients' rights by using documentation collected for other purposes. Applying language technology to nursing documents may, on the one hand, contribute to the quality of care, but, on the other hand, threaten patient confidentiality. As an overall conclusion, natural language processing of nursing documents holds the promise of great benefits if the potential risks are taken into consideration.

Nurses' reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud study.

PubMed

Funkesson, Kajsa Helena; Anbäcken, Els-Marie; Ek, Anna-Christina

2007-09-01

Nurses' clinical reasoning is of great importance for the delivery of safe and efficient care. Pressure ulcer prevention allows a variety of aspects within nursing to be viewed. The aim of this study was to describe both the process and the content of nurses' reasoning during care planning at different nursing homes, using pressure ulcer prevention as an example. A qualitative research design was chosen. Seven different nursing homes within one community were included. Eleven registered nurses were interviewed. The methods used were think-aloud technique, protocol analysis and qualitative content analysis. Client simulation illustrating transition was used. The case used for care planning was in three parts covering the transition from hospital until 3 weeks in the nursing home. Most nurses in this study conducted direct and indirect reasoning in a wide range of areas in connection with pressure ulcer prevention. The reasoning focused different parts of the nursing process depending on part of the case. Complex assertations as well as strategies aiming to reduce cognitive strain were rare. Nurses involved in direct nursing care held a broader reasoning than consultant nurses. Both explanations and actions based on older ideas and traditions occurred. Reasoning concerning pressure ulcer prevention while care planning was dominated by routine thinking. Knowing the person over a period of time made a more complex reasoning possible. The nurses' experience, knowledge together with how close to the elderly the nurses work seem to be important factors that affect the content of reasoning.

Quality of Electronic Nursing Records: The Impact of Educational Interventions During a Hospital Accreditation Process.

PubMed

Nomura, Aline Tsuma Gaedke; Pruinelli, Lisiane; da Silva, Marcos Barragan; Lucena, Amália de Fátima; Almeida, Miriam de Abreu

2018-03-01

Hospital accreditation is a strategy for the pursuit of quality of care and safety for patients and professionals. Targeted educational interventions could help support this process. This study aimed to evaluate the quality of electronic nursing records during the hospital accreditation process. A retrospective study comparing 112 nursing records during the hospital accreditation process was conducted. Educational interventions were implemented, and records were evaluated preintervention and postintervention. Mann-Whitney and χ tests were used for data analysis. Results showed that there was a significant improvement in the nursing documentation quality postintervention. When comparing records preintervention and postintervention, results showed a statistically significant difference (P < .001) between the two periods. The comparison between items showed that most scores were significant. Findings indicated that educational interventions performed by nurses led to a positive change that improved nursing documentation and, consequently, better care practices.

Use of critical thinking in the diagnostic process.

PubMed

Lunney, Margaret

2010-01-01

To demonstrate use of critical thinking in the diagnostic process in order to achieve accuracy of nursing diagnoses. The 7 cognitive skills and 10 habits of mind identified as important for nursing in a Delphi study by Scheffer and Rubenfeld are applied to the diagnostic process using a published case study of a woman with heart failure. Taking into account all data from the case study and using the concepts of critical thinking, two high-accuracy nursing diagnoses were selected to guide nursing interventions. Because the specific types of critical thinking needed for accurate diagnosing are not known, nurses should develop all 17 of the cognitive skills and habits of mind so these thinking abilities are available when needed. The 17 critical thinking concepts should be combined with domain knowledge, e.g., nursing diagnoses, to think about thinking, which will improve critical thinking processes.

Diagnostic Reasoning and Cognitive Biases of Nurse Practitioners.

PubMed

Lawson, Thomas N

2018-04-01

Diagnostic reasoning is often used colloquially to describe the process by which nurse practitioners and physicians come to the correct diagnosis, but a rich definition and description of this process has been lacking in the nursing literature. A literature review was conducted with theoretical sampling seeking conceptual insight into diagnostic reasoning. Four common themes emerged: Cognitive Biases and Debiasing Strategies, the Dual Process Theory, Diagnostic Error, and Patient Harm. Relevant cognitive biases are discussed, followed by debiasing strategies and application of the dual process theory to reduce diagnostic error and harm. The accuracy of diagnostic reasoning of nurse practitioners may be improved by incorporating these items into nurse practitioner education and practice. [J Nurs Educ. 2018;57(4):203-208.]. Copyright 2018, SLACK Incorporated.

20 CFR 655.301 - Overview of process.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Nurses § 655.301 Overview of process. This section provides a context for the attestation process, to facilitate understanding by health care facilities that may seek nonimmigrant nurses under H-1A visas. (a... seeking one or more H-1A nurses shall, as the first step, submit an attestation on Form ETA 9029, as...

20 CFR 655.301 - Overview of process.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Nurses § 655.301 Overview of process. This section provides a context for the attestation process, to facilitate understanding by health care facilities that may seek nonimmigrant nurses under H-1A visas. (a... seeking one or more H-1A nurses shall, as the first step, submit an attestation on Form ETA 9029, as...

Emancipatory Nursing Praxis: A Theory of Social Justice in Nursing.

PubMed

Walter, Robin R

Emancipatory nursing praxis (ENP) is a middle-range nursing theory of social justice developed from an international, grounded theory study of the critical factors influencing nurses' perceptions of their role in social justice. The ENPs implementing processes (becoming, awakening, engaging, and transforming) and 2 conditional contexts (relational and reflexive) provide an in-depth understanding of the transformative learning process that determines nurse engagement in social justice. Interpretive findings include the voice of Privilege primarily informed ENP theory, the lack of nursing educational and organizational support in social justice role development, and the advocate role should expand to include the role of an ally.

Creating a culture of shared Governance begins with developing the nurse as scholar.

PubMed

Donohue-Porter, Patricia

2012-01-01

The relationship between shared governance and nursing scholarship is investigated with an emphasis on the connection between stages of scholarly development and nursing action in the evolution of professional practice models. The scholarly image of nursing is described and four critical stages of scholarship (scholarly inquiry, conscious reflection, persistent critique, and intellectual creation) are presented. The development of nursing scholars is described with emphasis on intellectual virtues as described by philosophers and values as described by nursing theorists that are foundational to this process. Shared governance is viewed holistically as a true scholarly process when these elements are in place and are used by nurses.

Socialization of Japanese nursing students.

PubMed

Condon, Eileen; Sharts-Hopko, Nancy

2010-01-01

An important focus of nursing education research is the acquisition of values, behaviors, and attitudes that will influence a nurse's professional role. In this qualitative study, the process of professional socialization among Japanese nursing students was investigated. Interviews with nursing students and faculty members in Tokyo revealed that socialization of nursing students is a multidimensional process, with classroom experiences, clinical practice, and extracurricular elements all having an influence. Six themes emerged from the data: openness to others, communication, team building, reflection, extracurricular networking, and focused education. Although communication and clinical experiences are limited by cultural norms, students become socialized to the nursing profession through various other means.

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

An emancipatory study of contemporary nursing practice.

PubMed

Jacobs, Barbara Bennett; Fontana, Joyce S; Kehoe, Maryanne Hidalgo; Matarese, Colette; Chinn, Peggy L

2005-01-01

Changes in health care facilities have created the necessity for individual nurses to change, eg, change jobs, pursue additional education, become independent entrepreneurs. There is a shortage of nurses that places stress on those who remain to care for an increasing number of persons with too few resources. The purposes of this study were to explore nurses' perceptions of the circumstances of their work lives and to describe the processes by which they can create change in these circumstances. The methodology was an emancipatory design combining tenets of critical inquiry and feminist research. The method used was a dialectical process of reflection and action (praxis). Three diverse groups of nurses met weekly over 6-10 weeks. Using the group process method, each group reflected on, discussed, and analyzed the phenomenon of practicing nursing today. The outcome of an emancipatory study is reflected in the power of the process. The group interaction increased awareness, promoted reflection on the status quo, and energized the groups to derive possible solutions to changing that status quo. It is not the solutions themselves that are as relevant as is the obvious cogency of the process to achieve individual and group emancipation. Six codifications reflected the themes that emerged and 5 processes for exploring untested feasibilities for change were identified. The participants perceived themselves more as subjects in their history than objects to be manipulated, capable of transforming a rather dismal situation of nursing practice into one that was critical, creative, and freer from constraints. The implication of this study is that nurses are encouraged to adopt and adapt this process of group interaction because of its demonstrated credibility to empower and validate the role that nurses have to derive and implement solutions to change their unsatisfactory status quo.

Nurse adoption of continuous patient monitoring on acute post-surgical units: managing technology implementation.

PubMed

Jeskey, Mary; Card, Elizabeth; Nelson, Donna; Mercaldo, Nathaniel D; Sanders, Neal; Higgins, Michael S; Shi, Yaping; Michaels, Damon; Miller, Anne

2011-10-01

To report an exploratory action-research process used during the implementation of continuous patient monitoring in acute post-surgical nursing units. Substantial US Federal funding has been committed to implementing new health care technology, but failure to manage implementation processes may limit successful adoption and the realisation of proposed benefits. Effective approaches for managing barriers to new technology implementation are needed. Continuous patient monitoring was implemented in three of 13 medical/surgical units. An exploratory action-feedback approach, using time-series nurse surveys, was used to identify barriers and develop and evaluate responses. Post-hoc interviews and document analysis were used to describe the change implementation process. Significant differences were identified in night- and dayshift nurses' perceptions of technology benefits. Research nurses' facilitated the change process by evolving 'clinical nurse implementation specialist' expertise. Health information technology (HIT)-related patient outcomes are mediated through nurses' acting on new information but HIT designed for critical care may not transfer to acute care settings. Exploratory action-feedback approaches can assist nurse managers in assessing and mitigating the real-world effects of HIT implementations. It is strongly recommended that nurse managers identify stakeholders and develop comprehensive plans for monitoring the effects of HIT in their units. © 2011 Blackwell Publishing Ltd.

Advancing the Development of the Guidelines for the Nursing of Children, Adolescents, and Families: 2014 Revision: Process, Development, and Dissemination.

PubMed

Betz, Cecily L; Cowell, Julia Muennich; Faulkner, Melissa Spezia; Feeg, Veronica D; Greenberg, Cindy Smith; Krajicek, Marilyn J; Lipman, Terri H; Lobo, Marie L; Nehring, Wendy M; Craft-Rosenberg, Martha; Vessey, Judith A

2016-01-01

This article details the process used to develop the revision of the original Guidelines that resulted in the development of the 2014 Health Care Quality and Outcomes Guidelines for Nursing of Children, Adolescents, and Families. Members of the 2014 Guidelines Revision Task Force conducted an extensive process of revision, which included the input and approval of 16 pediatric and child health nursing and affiliated organizational endorsements. The revised Guidelines were presented to and endorsed by the American Academy of Nursing Board. These Guidelines are designed for use by pediatric and child health nurses who work in a range of health care and community-based settings. The Guidelines are proposed to be used as a framework for nurse-directed services and intervention development and testing, as a model for undergraduate and graduate pediatric and child health nursing program curriculum development, and as the theoretical basis for nursing investigations on the care of children, adolescents, and families. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Critical thinking in clinical nurse education: application of Paul's model of critical thinking.

PubMed

Andrea Sullivan, E

2012-11-01

Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul's Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Application analysis of Nursing Care Systematization according to Horta's Conceptual Model].

PubMed

da Cunha, Sandra Maria Botelho; Barros, Alba Lúcia Botura Leite

2005-01-01

This study has as purpose to analyse the implementation of the Nursing Care Systematization in a private hospital in medical surgical units. Results evidenced that the Horta's Conceptual Model was present only in part of nursing hystory instrument, that the remaining phases of nursing process were not inter-related and that there was a lack of coherence of the prescribed actions in relation to the patient's health condition. From the results of the study it can be concluded that the model used for Nursing Care Systematization is eclectic, not obeying therefore, only to Horta's conceptual model; the totality of the data had not been collected in some phases of the nursing process; there is no correlation of the phases in the majority of analyzed patient records; diagnostic and planning phases do not comprise the phases of the nursing process as proposed by Horta.

NursesforTomorrow: a proactive approach to nursing resource analysis.

PubMed

Bournes, Debra A; Plummer, Carolyn; Miller, Robert; Ferguson-Paré, Mary

2010-03-01

This paper describes the background, development, implementation and utilization of NursesforTomorrow (N4T), a practical and comprehensive nursing human resources analysis method to capture regional, institutional and patient care unit-specific actual and predicted nurse vacancies, nurse staff characteristics and nurse staffing changes. Reports generated from the process include forecasted shortfalls or surpluses of nurses, percentage of novice nurses, occupancy, sick time, overtime, agency use and other metrics. Readers will benefit from a description of the ways in which the data generated from the nursing resource analysis process are utilized at senior leadership, program and unit levels to support proactive hiring and resource allocation decisions and to predict unit-specific recruitment and retention patterns across multiple healthcare organizations and regions.

Nursing informatics, outcomes, and quality improvement.

PubMed

Charters, Kathleen G

2003-08-01

Nursing informatics actively supports nursing by providing standard language systems, databases, decision support, readily accessible research results, and technology assessments. Through normalized datasets spanning an entire enterprise or other large demographic, nursing informatics tools support improvement of healthcare by answering questions about patient outcomes and quality improvement on an enterprise scale, and by providing documentation for business process definition, business process engineering, and strategic planning. Nursing informatics tools provide a way for advanced practice nurses to examine their practice and the effect of their actions on patient outcomes. Analysis of patient outcomes may lead to initiatives for quality improvement. Supported by nursing informatics tools, successful advance practice nurses leverage their quality improvement initiatives against the enterprise strategic plan to gain leadership support and resources.

Measuring End-of-Life Care Processes in Nursing Homes

ERIC Educational Resources Information Center

Temkin-Greener, Helena; Zheng, Nan; Norton, Sally A.; Quill, Timothy; Ladwig, Susan; Veazie, Peter

2009-01-01

Purpose: The objectives of this study were to develop measures of end-of-life (EOL) care processes in nursing homes and to validate the instrument for measuring them. Design and Methods: A survey of directors of nursing was conducted in 608 eligible nursing homes in New York State. Responses were obtained from 313 (51.5% response rate) facilities.…

Problem solving strategies integrated into nursing process to promote clinical problem solving abilities of RN-BSN students.

PubMed

Wang, Jing-Jy; Lo, Chi-Hui Kao; Ku, Ya-Lie

2004-11-01

A set of problem solving strategies integrated into nursing process in nursing core courses (PSNP) was developed for students enrolled in a post-RN baccalaureate nursing program (RN-BSN) in a university in Taiwan. The purpose of this study, therefore, was to evaluate the effectiveness of PSNP on students' clinical problem solving abilities. The one-group post-test design with repeated measures was used. In total 114 nursing students with 47 full-time students and 67 part-time students participated in this study. The nursing core courses were undertaken separately in three semesters. After each semester's learning, students would start their clinical practice, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. The overall score of problem solving indicated that score on the post-test III was significantly better than that on post-test I and II, meaning both full-time and part-time students' clinical problem solving abilities improved at the last semester. In conclusion, problem-solving strategies integrated into nursing process designed for future RN-BSN students are recommendable.

"Theory Becoming Alive": The Learning Transition Process of Newly Graduated Nurses in Canada.

PubMed

Nour, Violet; Williams, Anne M

2018-01-01

Background Newly graduated nurses often encounter a gap between theory and practice in clinical settings. Although this has been the focus of considerable research, little is known about the learning transition process. Purpose The purpose of this study was to explore the experiences of newly graduated nurses in acute healthcare settings within Canada. This study was conducted to gain a greater understanding of the experiences and challenges faced by graduates. Methods Grounded theory method was utilized with a sample of 14 registered nurses who were employed in acute-care settings. Data were collected using in-depth interviews. Constant comparative analysis was used to analyze data. Results Findings revealed a core category, "Theory Becoming Alive," and four supporting categories: Entry into Practice, Immersion, Committing, and Evolving. Theory Becoming Alive described the process of new graduate nurses' clinical learning experiences as well as the challenges that they encountered in clinical settings after graduating. Conclusions This research provides a greater understanding of learning process of new graduate nurses in Canada. It highlights the importance of providing supportive environments to assist new graduate nurses to develop confidence as independent registered nurses in clinical areas. Future research directions as well as supportive educational strategies are described.

[The role adaptation process of the executive director of nursing department].

PubMed

Kang, Sung-Ye; Park, Kwang-Ok; Kim, Jong-Kyung

2010-12-01

The purpose of this study was to identify the role adaptation process experienced by executive directors of nursing department of general hospitals. Data were collected from 9 executive nursing directors though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of role adaptation as an executive nursing director?" Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology. The core category of experience of the process of role adaptation as an executive nursing director was identified as "entering the center with pushing and pulling". The participants used five interactional strategies;'maintaining modest attitudes','inquiring about trends of popular feeling','making each person a faithful follower','collecting & displaying power','leading with initiative'. The consequences of role adaptation in executive nursing directors were'coexisting with others','immersing in one's new role with dedication', and'having capacity for high tolerance'. The types of role adaptations of executive directors in nursing department were friendly type, propulsive type, accommodating type. The results of this study produced useful information for executive nursing directors on designing a self-managerial program to enhance role adaptation based on interactional strategies.

Staff Nurses' Perceptions and Experiences about Structural Empowerment: A Qualitative Phenomenological Study.

PubMed

Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan

2016-01-01

The aim of the study reported in this article was to investigate staff nurses' perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses' involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.

[Nurses' subjectivity production and the decision-making in the process of care].

PubMed

Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa

2013-06-01

This study aimed to understand the relationship between Nurse's production of subjectivity and the decision-making in the process of Nursing care. A qualitative design of research was conducted. The investigation was carried out with twelve nurses who work at the Associação de Caridade Santa Casa do Rio Grande, a hospital located in Rio Grande, RS, Brazil. For data collection, focus group technique was used three meetings were conducted in december 2011. The results were presented in semantic categories: Capitalist System: maintenance of employment bond; Submission System: institutionalized culture and vision of society; Nursing Hierarchical System; and Values System: feeling of guilt and lack of professional recognition. The capitalist system mediates, mainly, the behavior that prevails in the decision-making process in Nursing care.

Meeting the complex needs of the health care team: identification of nurse-team communication practices perceived to enhance patient outcomes.

PubMed

Propp, Kathleen M; Apker, Julie; Zabava Ford, Wendy S; Wallace, Nancy; Serbenski, Michele; Hofmeister, Nancee

2010-01-01

Nurses occupy a central position in today's increasingly collaborative health care teams that place a premium on quality patient care. In this study we examined critical team processes and identified specific nurse-team communication practices that were perceived by team members to enhance patient outcomes. Fifty patient-care team members were interviewed to uncover forms of nurse communication perceived to improve team performance. Using a grounded theory approach and constant comparative analysis, study findings reveal two critical processes nurses contribute to as the most central and consistent members of the health care team: ensuring quality decisions and promoting a synergistic team. Moreover, the findings reveal 15 specific nurse-team communication practices that comprise these processes, and thereby are theorized to improve patient outcomes.

Shared decision making: empowering the bedside nurse.

PubMed

Slack, Stephanie M; Boguslawski, Jean M; Eickhoff, Rachel M; Klein, Kristi A; Pepin, Teresa M; Schrandt, Kevin; Wise, Carrie A; Zylstra, Jody A

2005-12-01

Shared decision making is a process that has empowered specialty nurses at the Mayo Clinic in Rochester, MN, to solve a practice concern. Staff nurses recognized a lack of concise, collated information available that described what nurses need to know when caring for patients receiving chemotherapy. Many aspects of the administration process were knowledge and experience based and not easily retrievable. The Hematology/Oncology/Blood and Marrow Transplant Clinical Practice Committee identified this as a significant practice issue. Ideas were brainstormed regarding how to make the information available to nursing colleagues. The Chemotherapy Yellow Pages is a resource that was developed to facilitate the rapid retrieval of pertinent information for bedside nurses. The content of this article outlines a'model of shared decision making and the processes used to address and resolve the practice concern.

Enhancing critical thinking with case studies and nursing process.

PubMed

Neill, K M; Lachat, M F; Taylor-Panek, S

1997-01-01

Challenged to enhance critical thinking concepts in a sophomore nursing process course, faculty expanded the lecture format to include group explorations of patient case studies. The group format facilitated a higher level of analysis of patient cases and more sophisticated applications of nursing process. This teaching strategy was a positive learning experience for students and faculty.

Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina.

PubMed

Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet

2016-06-01

We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the inclusion of nursing-related standard operating procedures in certification/accreditation standards. © 2016 International Council of Nurses.

I am quitting my job. Specialist nurses in perioperative context and their experiences of the process and reasons to quit their job.

PubMed

Lögde, Ann; Rudolfsson, Gudrun; Broberg, Roma Runesson; Rask-Andersen, Anna; Wålinder, Robert; Arakelian, Erebouni

2018-05-01

The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour. Leaving one's job was described as a process and specialist nurses had thought about it for some time. Two main reasons were described; the head nurse manager's dismissive attitude and treatment of their employees and colleagues' mistreatment and colleagues' diminishing behaviour. Increasing knowledge on the role of the head nurse managers in specialist nurses' decision making for leaving their workplace, and creating a friendly, non-violent workplace, may give the opportunity for them to take action before it is too late.

Does daily nurse staffing match ward workload variability? Three hospitals' experiences.

PubMed

Gabbay, Uri; Bukchin, Michael

2009-01-01

Nurse shortage and rising healthcare resource burdens mean that appropriate workforce use is imperative. This paper aims to evaluate whether daily nursing staffing meets ward workload needs. Nurse attendance and daily nurses' workload capacity in three hospitals were evaluated. Statistical process control was used to evaluate intra-ward nurse workload capacity and day-to-day variations. Statistical process control is a statistics-based method for process monitoring that uses charts with predefined target measure and control limits. Standardization was performed for inter-ward analysis by converting ward-specific crude measures to ward-specific relative measures by dividing observed/expected. Two charts: acceptable and tolerable daily nurse workload intensity, were defined. Appropriate staffing indicators were defined as those exceeding predefined rates within acceptable and tolerable limits (50 percent and 80 percent respectively). A total of 42 percent of the overall days fell within acceptable control limits and 71 percent within tolerable control limits. Appropriate staffing indicators were met in only 33 percent of wards regarding acceptable nurse workload intensity and in only 45 percent of wards regarding tolerable workloads. The study work did not differentiate crude nurse attendance and it did not take into account patient severity since crude bed occupancy was used. Double statistical process control charts and certain staffing indicators were used, which is open to debate. Wards that met appropriate staffing indicators prove the method's feasibility. Wards that did not meet appropriate staffing indicators prove the importance and the need for process evaluations and monitoring. Methods presented for monitoring daily staffing appropriateness are simple to implement either for intra-ward day-to-day variation by using nurse workload capacity statistical process control charts or for inter-ward evaluation using standardized measure of nurse workload intensity. The real challenge will be to develop planning systems and implement corrective interventions such as dynamic and flexible daily staffing, which will face difficulties and barriers. The paper fulfils the need for workforce utilization evaluation. A simple method using available data for daily staffing appropriateness evaluation, which is easy to implement and operate, is presented. The statistical process control method enables intra-ward evaluation, while standardization by converting crude into relative measures enables inter-ward analysis. The staffing indicator definitions enable performance evaluation. This original study uses statistical process control to develop simple standardization methods and applies straightforward statistical tools. This method is not limited to crude measures, rather it uses weighted workload measures such as nursing acuity or weighted nurse level (i.e. grade/band).

Obseving Nurse Interaction With Infusion Pump Technologies

DTIC Science & Technology

2005-01-01

24 Observations of the medication administration process , as described below, were performed to provide data to the FMEA team on nursing practice...involves an FMEA of the medication administration process using the observation data as input into the assessment process .29 One use of the...invaluable to the FMEA team in many ways. First, it allowed for an unbiased and nonjudgmental look at the actual nursing processes in place, as

What do nurses and midwives value about their jobs? Results from a discrete choice experiment.

PubMed

Scott, Anthony; Witt, Julia; Duffield, Christine; Kalb, Guyonne

2015-01-01

To examine nurses' and midwives' preferences for the characteristics of their jobs. A discrete choice experiment of 990 nurses and midwives administered as part of a survey of nurses and midwives in Victoria, Australia. Autonomy, working hours, and processes to deal with violence and bullying were valued most highly. Nurses and midwives would be willing to forgo 19% and 16% of their annual income for adequate autonomy and adequate processes to deal with violence and bullying, compared to poor autonomy and poor processes for violence and bullying. They would need to be paid an additional 24% to increase their working hours by 10% ($73 per hour). Job characteristics that were less important were shift work, nurse to patient ratios, and public or private sector work. Policies to improve retention and job satisfaction of nurses and midwives should initially focus on autonomy, processes to deal with violence and bullying, and reasonable working hours. Further research on the cost-effectiveness of these different policies is needed. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The role of leadership in the implementation of person-centred care using Dementia Care Mapping: a study in three nursing homes.

PubMed

Rokstad, Anne Marie Mork; Vatne, Solfrid; Engedal, Knut; Selbæk, Geir

2015-01-01

The aim of this study was to investigate the role of leadership in the implementation of person-centred care (PCC) in nursing homes using Dementia Care Mapping (DCM). Leadership is important for the implementation of nursing practice. However, the empirical knowledge of positive leadership in processes enhancing person-centred culture of care in nursing homes is limited. The study has a qualitative descriptive design. The DCM method was used in three nursing homes. Eighteen staff members and seven leaders participated in focus-group interviews centring on the role of leadership in facilitating the development process. The different roles of leadership in the three nursing homes, characterized as 'highly professional', 'market orientated' or 'traditional', seemed to influence to what extent the DCM process led to successful implementation of PCC. This study provided useful information about the influence of leadership in the implementation of person-centred care in nursing homes. Leaders should be active role models, expound a clear vision and include and empower all staff in the professional development process. © 2013 John Wiley & Sons Ltd.

The impact of concordant communication in outpatient care planning - nurses' perspective.

PubMed

Olsson, Maivor; Larsson, Lena G; Flensner, Gullvi; Bäck-Pettersson, Siv

2012-09-01

To elucidate registered nurses' experiences of coordinated care planning in outpatient care. Coordinated care planning has been studied from the perspectives of both patients and nurses in inpatient care, but it is deficient in outpatient care. Qualitative content analysis of interviews with 10 registered nurses participating in two focus groups. An overall theme was identified: creating concordant communication in relation to patient and health-care providers. The result is based on four categories and nine subcategories. Nurses need extraordinary communication skills to reach concordance in outpatient care planning. In addition to involving and supporting the patients and next of kin in the decision-making process, the outcome of the nursing process must be understood by colleagues and members of other professions and health-care providers (non-nursing). An effective outpatient care-planning process requires that care managers understand the impact of communicating, transferring information and reaching consensus with other health-care providers, actively supporting employees in the outpatient care-planning process and contributing to the development of common goals and policy documents across organisational boundaries. © 2012 Blackwell Publishing Ltd.

The neuroscience ICU nurse's perceptions about end-of-life care.

PubMed

Calvin, Amy O; Kite-Powell, Dorothy M; Hickey, Joanne V

2007-06-01

The purpose of this qualitative descriptive study was to describe neuroscience intensive care unit (NICU) nurses' perceptions regarding their roles and responsibilities in the decision-making process during the change in intensity of care and end-of-life care for patients. Twelve NICU nurses agreed to a private moderately structured interview. Three major themes summarize the data: (1) providing guidance, (2) being positioned in the middle of the communication process, and (3) feeling the emotions of patients and families. The nurse caring for a patient at the end of life provides guidance from the middle or "hub" of the communication process between family members and physicians. The nurses in this study describe an array of feelings associated with this role. This research adds to the limited body of knowledge concerning critical care nurses' experiences with end-of-life care. Providing guidance and being in the middle of the communication process can be a lonely, challenging, yet rewarding position. Results of this study provide a basis for offering emotional support to NICU nurses who care for patients at the end of life.

ICU Nurses’ Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran

PubMed Central

Masoumian Hoseini, S. T.; Manzari, Z.; Khaleghi, I.

2015-01-01

Background: Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. Objective: To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. Methods: In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. Results: 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Conclusion: Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process. PMID:26306156

Using the Donabedian framework to examine the quality and safety of nursing service innovation.

PubMed

Gardner, Glenn; Gardner, Anne; O'Connell, Jane

2014-01-01

To evaluate the safety and quality of nurse practitioner service using the audit framework of Structure, Process and Outcome. Health service and workforce reform are on the agenda of governments and other service providers seeking to contain healthcare costs whilst providing safe and effective health care to communities. The nurse practitioner service is one health workforce innovation that has been adopted globally to improve timely access to clinical care, but there is scant literature reporting evaluation of the quality of this service innovation. A mixed-methods design within the Donabedian evaluation framework was used. The Donabedian framework was used to evaluate the Structure, Process and Outcome of nurse practitioner service. A range of data collection approaches was used, including stakeholder survey (n = 36), in-depth interviews (11 patients and 13 nurse practitioners) and health records data on service processes. The study identified that adequate and detailed preparation of Structure and Process is essential for the successful implementation of a service innovation. The multidisciplinary team was accepting of the addition of nurse practitioner service, and nurse practitioner clinical care was shown to be effective, satisfactory and safe from the perspective of the clinician stakeholders and patients. This study demonstrated that the Donabedian framework of Structure, Process and Outcome evaluation is a valuable and validated approach to examine the safety and quality of a service innovation. Furthermore, in this study, specific Structure elements were shown to influence the quality of service processes further validating the framework and the interdependence of the Structure, Process and Outcome components. Understanding the Structure and Process requirements for establishing nursing service innovation lays the foundation for safe, effective and patient-centred clinical care. © 2013 John Wiley & Sons Ltd.

Causation and Validation of Nursing Diagnoses: A Middle Range Theory.

PubMed

de Oliveira Lopes, Marcos Venícios; da Silva, Viviane Martins; Herdman, T Heather

2017-01-01

To describe a predictive middle range theory (MRT) that provides a process for validation and incorporation of nursing diagnoses in clinical practice. Literature review. The MRT includes definitions, a pictorial scheme, propositions, causal relationships, and translation to nursing practice. The MRT can be a useful alternative for education, research, and translation of this knowledge into practice. This MRT can assist clinicians in understanding clinical reasoning, based on temporal logic and spectral interaction among elements of nursing classifications. In turn, this understanding will improve the use and accuracy of nursing diagnosis, which is a critical component of the nursing process that forms a basis for nursing practice standards worldwide. © 2015 NANDA International, Inc.

Independent community care gerontological nursing: becoming an entrepreneur.

PubMed

Caffrey, Rosalie A

2005-08-01

Few nurses have the experience of developing an independent practice. This ethnographic study explores the process and challenges of becoming an entrepreneur as described by nurses developing independent practices in community care gerontologic nursing. The process included developing a legal contract, marketing strategies, and reimbursement amounts and strategies. Major barriers to implementing this role identified by the nurses included ignorance and confusion by others about their role, financial issues related to an uncertain income, time management, and legal concerns especially around delegation. These were experienced and dedicated nurses who were also risk-takers and enjoyed the independence of practicing nursing because they believed it was meant to be practiced. Suggestions for research, education, and practice are included.

Collaboration as a process and an outcome: Consumer experiences of collaborating with nurses in care planning in an acute inpatient mental health unit.

PubMed

Reid, Rebecca; Escott, Phil; Isobel, Sophie

2018-04-14

This qualitative study explores inpatient mental health consumer perceptions of how collaborative care planning with mental health nurses impacts personal recovery. Semi-structured interviews were conducted with consumers close to discharge from one unit in Sydney, Australia. The unit had been undertaking a collaborative care planning project which encouraged nurses to use care plan documentation to promote person-centred and goal-focussed interactions and the development of meaningful strategies to aid consumer recovery. The interviews explored consumer understandings of the collaborative care planning process, perceptions of the utility of the care plan document and the process of collaborating with the nurses, and their perception of the impact of collaboration on their recovery. Findings are presented under four organizing themes: the process of collaborating, the purpose of collaborating, the nurse as collaborator and the role of collaboration in wider care and recovery. Consumers highlighted the importance of the process of developing their care plan with a nurse as being as helpful for recovery as the goals and strategies themselves. The findings provide insights into consumers' experiences of care planning in an acute inpatient unit, the components of care that support recovery and highlight specific areas for mental health nursing practice improvement in collaboration. © 2018 Australian College of Mental Health Nurses Inc.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model.

PubMed

Dawber, Chris

2013-04-01

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention

PubMed Central

Lee, Sang-Yi; Kim, Chul-Woung; Kang, Jeong-Hee; Yoon, Tae-Ho; Kim, Cheoul Sin

2014-01-01

Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers’ Union’s educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses’ job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses’ turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses’ job satisfaction. However, the nursing practice environment was not related to nurses’ turnover intention. PMID:25284197

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

PubMed

Schoonover, Heather

The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

Nurses' decision-making process in cases of physical restraint in acute elderly care: a qualitative study.

PubMed

Goethals, S; Dierckx de Casterlé, B; Gastmans, C

2013-05-01

The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented. A thorough understanding of nurses' decision-making process could be useful to understand how nurses reason and make decisions in ethically laden situations. The aims of this study were to explore and describe nurses' decision-making process in cases of physical restraint. We used a qualitative interview design inspired by the Grounded Theory approach. Data analysis was guided by the Qualitative Analysis Guide of Leuven. Twelve hospitals geographically spread throughout the five provinces of Flanders, Belgium. Twenty-one acute geriatric nurses interviewed between October 2009 and April 2011 were purposively and theoretically selected, with the aim of including nurses having a variety of characteristics and experiences concerning decisions on using physical restraint. In cases of physical restraint in acute elderly care, nurses' decision making was never experienced as a fixed decision but rather as a series of decisions. Decision making was mostly reasoned upon and based on rational arguments; however, decisions were also made routinely and intuitively. Some nurses felt very certain about their decisions, while others experienced feelings of uncertainty regarding their decisions. Nurses' decision making is an independent process that requires nurses to obtain a good picture of the patient, to be constantly observant, and to assess and reassess the patient's situation. Coming to thoughtful and individualized decisions requires major commitment and constant critical reflection. Copyright © 2012 Elsevier Ltd. All rights reserved.

Factors affecting and affected by user acceptance of computer-based nursing documentation: results of a two-year study.

PubMed

Ammenwerth, Elske; Mansmann, Ulrich; Iller, Carola; Eichstädter, Ronald

2003-01-01

The documentation of the nursing process is an important but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems such as low quality of documentation are reported. It is unclear whether computer-based documentation systems can reduce these problems and which factors influence their acceptance by users. We introduced a computer-based nursing documentation system on four wards of the University Hospitals of Heidelberg and systematically evaluated its preconditions and its effects in a pretest-posttest intervention study. For the analysis of user acceptance, we concentrated on subjective data drawn from questionnaires and interviews. A questionnaire was developed using items from published questionnaires and items that had to be developed for the special purpose of this study. The quantitative results point to two factors influencing the acceptance of a new computer-based documentation system: the previous acceptance of the nursing process and the previous amount of self-confidence when using computers. On one ward, the diverse acceptance scores heavily declined after the introduction of the nursing documentation system. Explorative qualitative analysis on this ward points to further success factors of computer-based nursing documentation systems. Our results can be used to assist the planning and introduction of computer-based nursing documentation systems. They demonstrate the importance of computer experience and acceptance of the nursing process on a ward but also point to other factors such as the fit between nursing workflow and the functionality of a nursing documentation system.

Seeking Connectivity in Nurses' Work Environments: Advancing Nurse Empowerment Theory.

PubMed

Udod, Sonia

2014-09-01

The purpose of this study was to investigate how staff nurses and their managers exercise power in a hospital setting in order to better understand what fosters or constrains staff nurses' empowerment and to extend nurse empowerment theory. Power is integral to empowerment, and attention to the challenges in nurses' work environment and nurse outcomes by administrators, researchers, and policy-makers has created an imperative to advance a theoretical understanding of power in the nurse-manager relationship. A sample of 26 staff nurses on 3 units of a tertiary hospital in western Canada were observed and interviewed about how the manager affected their ability to do their work. Grounded theory methodology was used. The process of seeking connectivity was the basic social process, indicating that the manager plays a critical role in the work environment and nurses need the manager to share power with them in the provision of safe, quality patient care. Copyright© by Ingram School of Nursing, McGill University.

[Nursing care systematization according to the nurses' view: a methodological approach based on grounded theory].

PubMed

de Medeiros, Ana Lúcia; dos Santos, Sérgio Ribeiro; de Cabral, Rômulo Wanderley Lima

2012-09-01

This study was aimed at understanding, from the nurses' perspective, the experience of going through the Systematization of nursing care (SNC) in an obstetric service unit. We used grounded theory as the theoretical and methodological framework. The subjects of this study consisted of thirteen nurses from a public hospital in the city of João Pessoa, in the state of Paraíba. The data analysis resulted in the following phenomenon. "perceiving SNC as a working method that organizes, directs and improves the quality of care by bringing visibility and providing security for the nursing staff" The nurses expressed the extent of knowledge about the SNC experienced in obstetrics as well as considered the nursing process as a decision-making process, which guides the reasoning of nurses in the planning of nursing care in obstetrics. It was concluded that nurses perceive the SNC as an instrument of theoretical-practical articulation leading to personalized assistance.

Transformational leadership and shared governance: an action study.

PubMed

Bamford-Wade, Anita; Moss, Cheryle

2010-10-01

The present study demonstrates the practical relevance of the concepts of transformational leadership as a Director of Nursing working with structure (shared governance) and active processes, informed by action research, to achieve the incremental breakthroughs associated with culture change in nursing. Responding to the context of a decade of health reforms in a New Zealand tertiary hospital, the leadership challenge, as a Director of Nursing, was to find ways of transforming the nursing workforce. How could nursing evolve from a relatively disempowered position within the organization (impact of the reforms) and reshape to achieve effectiveness within the new organizational culture? Interwoven with transformational leadership are action processes progressively moving forward through cycles of reconnaissance, planning, implementation and evaluation. The principles of shared governance 'partnership', 'equity', 'accountability' and 'ownership' underpin and work synchronically with the active processes in advancing the effectiveness of nursing. It is leadership for and in action. This study is descriptive and exploratory overall, and more specifically it uses reflective practice and self-reporting as methods. The outcomes of transformational leadership are evident in a confident, competent and committed nursing workforce which embraces continuous learning and expresses a professional respect for each other. The practical inter-weaving of the concepts of transformational leadership, shared governance and action processes provide a framework for sustainable change processes both at a unit and organizational level. It is the interplay between the three concepts that generates a process of creative innovation, questioning and challenging existing structures to try and reach a new level of excellence through the participation and valuing of nurses and nursing practice. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

The magnet designation process: a qualitative approach using Donabedian's conceptual framework.

PubMed

Upenieks, Valda V; Abelew, Sheryl

2006-01-01

Twelve nurse leaders and 12 registered nurses from 2 hospitals were interviewed to gain an understanding on the process for preparing for magnet designation. These leaders and nurses provided insight into whether a cultural shift within the organization was occurring while striving for magnet designation and the level of staff nurses' engagement during the process. Donabedian's framework provided the conceptual context for this study. According to Donabedian, stable organizational structures will influence professional nursing processes and result in better outcomes as measured by magnet status. The authors discuss how a magnet culture is achieved when structural factors such as adequate staffing and pay are present before building the processes, as well as the ways certain ingredients such as professional governance councils need to be primed to achieve the desired magnet outcome. However, transforming the culture into a "valued-practice" magnet organization entails a paradigm shift marked by the willingness to share information and the depth and breadth of commitment toward staff engagement in fulfilling the mission of a culture that truly values nursing expertise.

An ontology model for nursing narratives with natural language generation technology.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Jeon, Eunjoo; Lee, Joo Yun; Jo, Soo Jung

2013-01-01

The purpose of this study was to develop an ontology model to generate nursing narratives as natural as human language from the entity-attribute-value triplets of a detailed clinical model using natural language generation technology. The model was based on the types of information and documentation time of the information along the nursing process. The typesof information are data characterizing the patient status, inferences made by the nurse from the patient data, and nursing actions selected by the nurse to change the patient status. This information was linked to the nursing process based on the time of documentation. We describe a case study illustrating the application of this model in an acute-care setting. The proposed model provides a strategy for designing an electronic nursing record system.

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.

A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation.

PubMed

Sand-Jecklin, Kari; Sherman, Jay

2014-10-01

To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report. The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance. Quasi-experimental pre- and postimplementation design. Seven medical-surgical units in a large university hospital implemented a blend of recorded and bedside nursing report. Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors. We found statistically significant improvements postimplementation in four patient survey items specifically impacted by the change to bedside report. Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre- and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented. Several positive outcomes were documented in relation to the implementation of a blended bedside shift report, with few drawbacks. Nurse attitudes about report at the final data collection were more positive than at the initial postimplementation data collection. If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process. © 2014 John Wiley & Sons Ltd.

Affecting culture change and performance improvement in Medicaid nursing homes: the Promote Understanding, Leadership, and Learning (PULL) Program.

PubMed

Eliopoulos, Charlotte

2013-01-01

A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.

Role, perspective and knowledge of Iranian critical care nurses about breaking bad news.

PubMed

Imanipour, Masoomeh; Karim, Zahra; Bahrani, Naser

2016-05-01

Given the issue of caring critically ill patients, nurses are involved in the process of breaking bad news in critical care units, while little research has been conducted on this challenging issue. The purpose of this study was to determine the role, perspective and knowledge of Iranian critical care nurses regarding breaking bad news. This descriptive study was conducted on a sample of 160 nurses working in critical care units of hospitals affiliated to Tehran University of Medical Sciences. Stratified and quota sampling methods were used. The data collection tool was a four-part questionnaire with validity and reliability confirmed via content validity and test-retest, respectively. The study showed that most critical care nurses were involved in breaking bad news, with different roles. The majority of participants (91.2%) had a positive attitude towards involvement of nurses in breaking bad news. In this study, 78.8% of nurses had moderate knowledge about how to break bad news, and only a few had good level of knowledge (16.2%). According to the findings, while critical care nurses took different roles in the process of breaking bad news and they had positive attitude towards participation in this process, yet their knowledge about this process was inadequate. Thus, designing educational programmes to enhance critical care nurses' knowledge and skills in this area seems necessary. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Values-based recruitment in health care.

PubMed

Miller, Sam Louise

2015-01-27

Values-based recruitment is a process being introduced to student selection for nursing courses and appointment to registered nurse posts. This article discusses the process of values-based recruitment and demonstrates why it is important in health care today. It examines the implications of values-based recruitment for candidates applying to nursing courses and to newly qualified nurses applying for their first posts in England. To ensure the best chance of success, candidates should understand the principles and process of values-based recruitment and how to prepare for this type of interview.

The impact of the Bologna process on nursing higher education in Europe: a review.

PubMed

Collins, Shawn; Hewer, Ian

2014-01-01

Changes are occurring in global higher education. Nursing is not exempt from these changes, and must adapt in order to be competitive in a global market. The Bologna process has been integral in the last decade in modernizing European higher education. However, modernization does not occur without challenges. This paper addresses the Bologna process and the challenges it presents to nursing higher education in Europe. To describe the Bologna Process as it relates to European nursing education. Literature review via searches of the following electronic databases: Academic Search Premier, MEDLINE, PubMed, ERIC, and CINAHL. Search criteria included Bologna process, European higher education, nursing education, quality assurance, and ECTS. Twenty-four peer-reviewed articles were included as well as one peer-reviewed presentation, one commission report, and one book. Further investigation is required to address the complexities of the Bologna process and its evolutionary changes as it relates to nursing education in Europe. Change is not always easy, and is often complex, especially as it relates to cross-border education that involves governmental regulation. Bologna-member countries need to adapt to the ever-changing higher education environment or fall behind. Copyright © 2013 Elsevier Ltd. All rights reserved.

Processes in healthcare teams that include nurse practitioners: what do patients and families perceive to be effective?

PubMed

Kilpatrick, Kelley; Jabbour, Mira; Fortin, Chantal

2016-03-01

To explore patient and family perceptions of team effectiveness of teams those include nurse practitioners in acute and primary care. Nurse practitioners provide safe and effective care. Patients are satisfied with the care provided by nurse practitioners. Research examining patient and family perceptions of team effectiveness following the implementation of nurse practitioners in teams is lacking. A descriptive qualitative design was used. We used purposeful sampling to identify participants in four clinical specialties. We collected data from March 2014-January 2015 using semi-structured interviews and demographic questionnaires. Content analysis was used. Descriptive statistics were generated. Participants (n = 49) believed that the teams were more effective after the implementation of a nurse practitioner and this was important to them. They described processes that teams with nurse practitioners used to effectively provide care. These processes included improved communication, involvement in decision-making, cohesion, care coordination, problem-solving, and a focus on the needs of patients and families. Participants highlighted the importance of interpersonal team dynamics. A human approach, trust, being open to discussion, listening to patient and family concerns and respect were particularly valued by participants. Different processes emerged as priorities when data were examined by speciality. However, communication, trust and taking the time to provide care were the most important processes. The study provides new insights into the views of patients and families and micro-level processes in teams with nurse practitioners. The relative importance of each process varied according to the patient's health condition. Patients and providers identified similar team processes. Future research is needed to identify how team processes influence care outcomes. The findings can support patients, clinicians and decision-makers to determine the processes to focus on to promote effective team functioning, and involve patients and families as team members. © 2016 John Wiley & Sons Ltd.

The power of social judgement: struggle and negotiation in the nursing process.

PubMed

Johnson, M; Webb, C

1995-04-01

In this paper we discuss an alternative view of the nursing process as it is experienced by both patients and nurses. The current conception of the nursing process is that it is a benevolent activity which aims to render care more individualized or person-centred. Its rhetoric usually includes notions of mutuality in goal setting, openness and collaboration between patients and nurses. We will suggest that such a view is idealized and has little basis in empirical reality as it is experienced by both nurses and patients. Rather, nurse-patient relations are beset by conflict and struggle, frequently resulting in the acquiescence of patients to the nursing and the medical goals of care. On the basis of an ethnography of a hospital medical ward, we will describe a process of social judgement and set it into a discussion of the social context where an unequal balance of power is integral to provider-recipient relations. Our account will focus upon four categories through which judgemental labelling may be analysed. These are assessing, negotiation, struggling and acquiescing. Of special interest to us are strategies which nurses used to maintain excellent care in the context of negative social judgements, and the place social judgement may play in moral decision-making. We emphasize the strengths which rich qualitative data have in relation to previous survey approaches of this phenomenon, whilst recognising the limitations of so focused a study.

[Structural elements of critical thinking of nurses in emergency care].

PubMed

Crossetti, Maria da Graça Oliveira; Bittencourt, Greicy Kelly Gouveia Dias; Lima, Ana Amélia Antunes; de Góes, Marta Georgina Oliveira; Saurin, Gislaine

2014-09-01

The objective of this study was to analyze the structural elements of critical thinking (CT) of nurses in the clinical decision-making process. This exploratory, qualitative study was conducted with 20 emergency care nurses in three hospitals in southern Brazil. Data were collected from April to June 2009, and a validated clinical case was applied from which nurses listed health problems, prescribed care and listed the structural elements of CT. Content analysis resulted in categories used to determine priority structural elements of CT, namely theoretical foundations and practical relationship to clinical decision making; technical and scientific knowledge and clinical experience, thought processes and clinical decision making: clinical reasoning and basis for clinical judgments of nurses: patient assessment and ethics. It was concluded that thinking critically is a skill that enables implementation of a secure and effective nursing care process.

The contribution of organization theory to nursing health services research.

PubMed

Mick, Stephen S; Mark, Barbara A

2005-01-01

We review nursing and health services research on health care organizations over the period 1950 through 2004 to reveal the contribution of nursing to this field. Notwithstanding this rich tradition and the unique perspective of nursing researchers grounded in patient care production processes, the following gaps in nursing research remain: (1) the lack of theoretical frameworks about organizational factors relating to internal work processes; (2) the need for sophisticated methodologies to guide empirical investigations; (3) the difficulty in understanding how organizations adapt models for patient care delivery in response to market forces; (4) the paucity of attention to the impact of new technologies on the organization of patient care work processes. Given nurses' deep understanding of the inner workings of health care facilities, we hope to see an increasing number of research programs that tackle these deficiencies.

Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process.

PubMed

Salmela, Susanne; Eriksson, Katie; Fagerström, Lisbeth

2012-02-01

This paper is a report of a qualitative study which explored how nurse leaders described and understood their main tasks and roles during a change process. During a database search for literature, no actual research that highlighted the main tasks and roles of nurse leaders during a change process was found. Earlier research has indicated the need for different leadership styles and the importance of strategies and values. In-depth interviews with 17 nurse leaders took place in 2004. A phenomenological-hermeneutical approach was used for data analysis. The findings resulted in a model of leading change in health care that focuses on good patient care and consists of three dimensions: leading relationships, leading processes and leading a culture. In addition to leading relationships and processes, nurse leaders, as role models, greatly impact caring culture and its inherent ethical behaviour, especially about the responsibility for achieving good patient care. Nurse leaders are also instrumental in leading ward culture. Nurse leaders need guidance and knowledge of what is expected of them during a structural change process. They play different roles by directing, guiding, motivating, supporting and communicating without losing their cultural ethos of caring and use various leadership styles to bring about actual change, which, in turn, requires learning so that the thought patterns, values and attitudes of personnel can be changed. © 2011 Blackwell Publishing Ltd.

Patient participation in nursing care: towards a concept clarification from a nurse perspective.

PubMed

Sahlsten, Monika J M; Larsson, Inga E; Sjöström, Björn; Lindencrona, Catharina S C; Plos, Kaety A E

2007-04-01

The aim of this study was to investigate the meanings of the concept of patient participation in nursing care from a nurse perspective. Participation is essential and increases patients' motivation and satisfaction with received care. Studies of patient participation in nursing care are not congruent regarding definition, elements and processes. This lack of clarity is amplified by several terms used; patient/client/consumer involvement or collaboration, partnership and influence. Despite the fact that several nursing theories have emphasized the importance of patient participation, an empirically grounded theory has yet to be published. Seven focus group interviews were held with nurses providing inpatient physical care at five hospitals in West Sweden. The focus groups consisted of Registered Swedish nurses (n = 31) who described the meaning and implementation of patient participation in nursing care. A Grounded Theory approach has been applied to tape-recorded data. Constant comparative analysis was used and saturation was achieved. Mutuality in negotiation emerged as the core category for explaining nurses' perspectives on patient participation in nursing care. It is characterized by four interrelated sub-core categories: interpersonal procedure, therapeutic approach, focus on resources and opportunities for influence. Mutuality in negotiation constitutes the dynamic nurse-patient interaction process. The study clarifies that patient participation can be explained as an interactional process identified as mutuality in negotiation based on four components. The results are important and can be used in nursing practice and education. Application in a clinical context means nursing care organized to include all the components presented. The results can also be used in quality assurance to improve and evaluate patient participation.

Nursing Outcomes Classification implementation projects across the care continuum.

PubMed

Moorhead, S; Clarke, M; Willits, M; Tomsha, K A

1998-06-01

The health care environment in which nurses deliver care is experiencing constant change characterized by decreased lengths of stay in acute care settings, increased use of technology, increasing emphasis on computerized patient records and care planning options, increasing markets dominated by managed care, and an emphasis on outcomes rather than process. These changes dictate that nursing as a profession ensures that the work of nursing is visible in this health care environment and included in the data used to make health policy decisions. This article describes the rich history of a Midwestern hospital's use of standardized nursing languages for the last 25 years. Currently this facility is in the process of implementing the Nursing Outcomes Classification (NOC). Four projects are described that illustrate the ways nurses can use this language with diagnoses from the North American Nursing Diagnoses Association (NANDA) and interventions from the Nursing Interventions Classification (NIC).

Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

PubMed Central

Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

2008-01-01

Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post-acute rehabilitation facilities are highly relevant for rehabilitation nursing. Linking nursing interventions with ICF Core Set categories is a feasible way to analyse nursing. Using the ICF Core Sets to describe goals of nursing interventions both facilitates inter-professional communication and respects patient's needs. The ICF may thus be a useful framework to set nursing intervention goals. PMID:18282288

Finding positives after disaster: Insights from nurses following the 2010-2011 Canterbury, NZ earthquake sequence.

PubMed

Johal, Sarbjit S; Mounsey, Zoe R

2015-11-01

This paper identifies positive aspects of nurse experiences during the Canterbury 2010-2011 earthquake sequence and subsequent recovery process. Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of the longer term recovery process. The interview transcripts were analysed and coded using a grounded theory approach. The data analysis identified that despite the many challenges faced by the nurses during and following the earthquakes they were able to identify positives from their experience. A number of themes were identified that are related to posttraumatic growth, including; improvement in relationships with others, change in perspective/values, changed views of self and acknowledgement of the value of the experience. The research indicates that nurses were able to identify positive aspects of their experiences of the earthquakes and recovery process, suggesting that both positive and negative impacts on wellbeing can co-exist. These insights have value for employers designing support processes following disasters as focusing on positive elements could enhance nurse wellbeing during stressful times. Copyright © 2015 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

Nurses and nurse assistants' experiences with using a design thinking approach to innovation in a nursing home.

PubMed

Eines, Trude Fløystad; Vatne, Solfrid

2018-05-01

The aim of this study was to evaluate nurses' and nurse assistants' experiences with a design thinking approach to innovation used in a nursing home in Norway. A design thinking approach to innovation that focuses on users' needs can be employed to address many of the challenges facing health care providers in a field facing a growing ageing population, complex diseases and financial shortfalls. This study is based on a thematic analysis of four focus group interviews with nurses and nurse assistants (n = 23). In the initial phase of developing the new service model, which included defining staff roles and responsibilities, participating nurses and nurse assistants felt engaged and motivated by the designers' inclusive and creative methods. However, during the new model's testing phase, they were critical of management's lack of involvement in the model`s implementation and therefore became less motivated about the project. The findings of the study highlight the importance of the designers cooperating with management and staff for the duration of the innovation process. Challenging innovation processes require strong managers who engage with designers, patients, staff and volunteers throughout all phases of an innovation process using a design thinking approach. © 2017 John Wiley & Sons Ltd.

Compass and Prerequisite Course Scores as Predictors of Success in Practical Nursing School

ERIC Educational Resources Information Center

Pritchard, Toni L. Early

2010-01-01

The nursing shortage is compounded by nursing student attrition. Schools of nursing have limited enrollment, making the admission process an important factor in resolving the ongoing nursing shortage. The purpose of this study was to identify preadmission criteria that accurately identify applicants to practical/vocational nursing (P/VN) schools…

Delegation. Position Statement. Revised

ERIC Educational Resources Information Center

Board, Connie; Bushmiaer, Margo; Davis-Alldritt, Linda; Fekaris, Nina; Morgitan, Judith; Murphy, M. Kathleen; Yow, Barbara

2010-01-01

It is the position of the National Association of School Nurses (NASN) that the delegation of nursing tasks in the school setting can be a valuable tool for the school nurse, when based on the nursing definition of delegation and in compliance with state nursing regulations and guidance. Delegation in school nursing is a complex process in which…

All for one and one for all: team building and nursing.

PubMed

Ryan, T

1994-05-01

Nursing care provision has become increasingly complex with the growth of health care systems in recent years. This has resulted in a greater emphasis upon the use of team approaches to providing care. This paper explores the nature of teams within nursing and how they can be developed. The membership of nursing teams and the differences between the type of teams is also examined. The process of team building in nursing teams and the way that induction programmes can play a part in this team building process is also discussed.

Oncology Nurse Generalist Competencies: Oncology Nursing Society’s Initiative to Establish Best Practice

PubMed

Gaguski, Michele; George, Kim; Bruce, Susan; Brucker, Edie; Leija, Carol; LeFebvre, Kristine; Thompson Mackey, Heather

2017-09-25

A project team was formulated by the Oncology Nursing Society (ONS) to create evidence-based oncology nurse generalist (ONG) competencies to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses. This article aims to describe the process and the development of ONG competencies. This article describes how the ONG competencies were accomplished, and includes outcomes and suggestions for use in clinical practice. Institutions can use the ONG competencies to assess and develop competency programs, offer unique educational strategies to measure and appraise proficiency, and establish processes to foster a workplace environment committed to mentoring and teaching future oncology nurses. 2017 Oncology Nursing Society

Exploring nurses' reactions to a novel technology to support acute health care delivery.

PubMed

Kent, Bridie; Redley, Bernice; Wickramasinghe, Nilmini; Nguyen, Lemai; Taylor, Nyree J; Moghimi, Hoda; Botti, Mari

2015-08-01

To explore nurses' reactions to new novel technology for acute health care. Past failures of technology developers to deliver products that meet nurses' needs have led to resistance and reluctance in the technology adoption process. Thus, involving nurses in a collaborative process from early conceptualisation serves to inform design reflective upon current clinical practice, facilitating the cementing of 'vision' and expectations of the technology. An exploratory descriptive design to capture nurses' immediate impressions. Four focus groups (52 nurses from medical and surgical wards at two hospitals in Australia; one private and one public). Nursing reactions towards the new technology illustrated a variance in barrier and enabler comments across multiple domains of the Theoretical Domains Framework. Most challenging for nurses were the perceived threat to their clinical skill, and the potential capability of the novel technology to capture their clinical workflow. Enabling reactions included visions that this could help integrate care between departments; help management and support of nursing processes; and coordinating their patients care between clinicians. Nurses' reactions differed across hospital sites, influenced by their experiences of using technology. For example, Site 1 nurses reported wide variability in their distribution of barrier and enabling comments and nurses at Site 2, where technology was prevalent, reported mostly positive responses. This early involvement offered nursing input and facilitated understanding of the potential capabilities of novel technology to support nursing work, particularly the characteristics seen as potentially beneficial (enabling technology) and those conflicting (barrier technology) with the delivery of both safe and effective patient care. Collaborative involvement of nurses from the early conceptualisation of technology development brings benefits that increase the likelihood of successful use of a tool intended to support the delivery of safe and efficient patient care. © 2015 John Wiley & Sons Ltd.

Nurses' role and care practices in decision-making regarding artificial ventilation in late stage pulmonary disease.

PubMed

Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per; Halvorsen, Kristin

2017-11-01

Decisions regarding whether or not to institute mechanical ventilation during the later stages of chronic obstructive pulmonary disease is challenging both ethically, emotionally and medically. Caring for these patients is a multifaceted process where nurses play a crucial role. Research question and design: We have investigated how nurses experienced their own role in decision-making processes regarding mechanical ventilation in later stages of chronic obstructive pulmonary disease and how they consider the patients' role in these processes. We applied a qualitative approach, with six focus-group interviews of nurses (n = 26). Ethical considerations: The Regional Committees for Medical and Health Research Ethics approved the study. Voluntary informed consent was obtained. The nurses found themselves operating within a cure-directed treatment culture wherein they were unable to stand up for the caring values. They perceived their roles and responsibilities in decision-making processes regarding mechanical ventilation to patients as unclear and unsatisfactory. They also experienced inadequate interdisciplinary cooperation. Lack of communication skills, the traditional hierarchical hospital culture together with operating in a medical-orientated treatment culture where caring values is rated as less important might explain the nurses' absence in participation in the decision about mechanical ventilation. To be able to advocate for the patients' and their own right to be included in decision-making processes, nurses need an awareness of their own responsibilities. This requires personal courage, leadership who are capable of organising common interpersonal meetings and willingness on the part of the physicians to include and value the nurses' participation in decision-making processes.

A comparative study on the clinical decision-making processes of nurse practitioners vs. medical doctors using scenarios in a secondary care environment.

PubMed

Thompson, Stephen; Moorley, Calvin; Barratt, Julian

2017-05-01

To investigate the decision-making skills of secondary care nurse practitioners compared with those of medical doctors. A literature review was conducted, searching for articles published from 1990 - 2012. The review found that nurse practitioners are key to the modernization of the National Health Service. Studies have shown that compared with doctors, nurse practitioners can be efficient and cost-effective in consultations. Qualitative research design. The information processing theory and think aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment. This study was conducted from May 2012 - January 2013. The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took 3 minutes longer to complete the scenarios. This study suggests that nurse practitioner consultations are comparable to those of medical doctors in a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes. © 2016 John Wiley & Sons Ltd.

Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project.

PubMed

Garcia, Mayra G; Watt, Jennifer L; Falder-Saeed, Karie; Lewis, Brennan; Patton, Lindsey

Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS. The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process. Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process. Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

Criteria used by nurses to evaluate practice-related information on the World Wide Web.

PubMed

Cader, Raffik; Campbell, Steve; Watson, Don

2003-01-01

Existing criteria used to evaluate information on the World Wide Web often are not related to nursing, especially in relation to clinical and evidence-based practice. Published criteria have been found orientated to the health-consumer, medicine, or general information. In this study, the process by which nurses evaluate practice-related information and the associated evaluative nursing criteria were investigated using a grounded theory approach. In the first stage of this ongoing investigation, semistructured interviews were used to collect data from UK postregistration nursing students. The findings from this initial study provided indications of the process and the criteria for evaluating information on the World Wide Web. Participating students identified intuition as part of the evaluative process. They identified some criteria similar to existing standards, but critically, with additional criteria that are nursing practice related. Because these new criteria are significant for evaluating nursing information, further refinement of these findings is being undertaken through the next stage of the research program.

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.

Using the nursing process to implement a Y2K computer application.

PubMed

Hobbs, C F; Hardinge, T T

2000-01-01

Because of the coming year 2000, the need was assessed to upgrade the order entry system at many hospitals. At Somerset Medical Center, a training team divided the transition into phases and used a modified version of the nursing process to implement the new program. The entire process required fewer than 6 months and was relatively problem-free. This successful transition was aided by the nursing process, training team, and innovative educational techniques.

Nursing in the mirror: unveiling transpersonal leadership in team care.

PubMed

Nunes, Emanuelle Caires Dias Araújo; Muniz, Edla Lobo

2017-02-23

The aim of this paper was to reveal the individual nurse in the leadership process for transpersonal care of the nursing team. This is a descriptive-exploratory and qualitative study grounded in Transpersonal Care provided at the General Hospital in Vitória da Conquista, Bahia, with 10 nurses who coordinated services at the unit in 2013. Data were collected using a mirror and semi-structured interviews subjected to thematic analysis. The following three categories emerged: Leadership in nursing: potentialities and barriers that permeate intersubjectivity; Transpersonal care of the leader with the team; and transpersonal leadership on balance: critical nodes. The final reflections revealed the individual nurse in the leadership process for transpersonal care of the nursing team, and stress the need to provide institutional and educational support that can help develop the servant and transpersonal skills of the leading nurse.

Bottom lines: the influence of government funding on 20th century district nursing practice in Australia.

PubMed

Madsen, Wendy

2009-10-01

To investigate the impact of past government policy and legislation on the practice of district nursing in Australia. Nurses have historically been politically passive and have not engaged in the political processes of policy development. However, legislation can have profound impacts on the daily work of nurses as demonstrated in this paper. Historical analysis. The archival records of six district nursing services in Australia were analysed within the political, social and economic context of the 20th century, with particular focus on the 1950s and 1970s. Two pieces of Federal legislation passed in 1956 and 1973, respectively, had critical effects on the work of district nurses. Both resulted in significant expansion of district nursing in Australia; neither was formulated with input from district nursing services. However, together these acts shifted district nursing from being a voluntary, charity based activity to one that was greatly controlled by government. Greater government funding allowed district nursing to expand beyond the capacity possible when funding was locally based, but with government funding came other restrictions related to accountability processes and expectations regarding services provided, and these had profound effects on nursing practice, including excess workloads to the point of unsafe practice. Nurses need to engage with the political processes associated with government policy formulation and implementation if they are to avoid placing themselves and their clients in vulnerable situations as a result of government decisions.

Qualitative assessment of a blended learning intervention in an undergraduate nursing course.

PubMed

Hsu, Li-Ling

2012-12-01

Nurses are experiencing new ethical issues because of global developments and changes in the healthcare environment. Blended learning is one of the various methods used to deliver meaningful learning experiences. Well-designed, properly administered nursing ethics education is essential for nursing students to visualize the role of professional nurses. However, a literature review shows that only a few existing studies have touched on the subject of nursing student experiences with blended learning in a nursing ethics course. This study examines how undergraduate nursing students respond to a blended learning approach in a nursing ethics course and how blended learning affects the learning process. We used a qualitative research design with in-depth interviews. Participants included 28 female undergraduate nursing students who had completed the nursing ethics course. Each interview lasted 50-100 minutes. The researcher conducted all interviews in 2009. The researcher identified six major themes and 13 subthemes from the data. The six themes included (a) enhancing thinking ability, (b) improving problem-solving skills, (c) reflecting in and on practice, (d) perceiving added workload, (e) encouraging active learning, and (f) identifying the value of nursing. Participants felt that the blended learning experience was a generally positive experience. Most participants appreciated the opportunity to take a more active role in the learning process, think about issues profoundly and critically, and exercise metacognitive powers in the thinking and decision-making process. Study findings may suggest productive ideas for fine-tuning blended learning models.

The practice of nursing research: getting ready for 'ethics' and the matter of character.

PubMed

Sellman, Derek

2016-03-01

Few would argue with the idea that nursing research should be conducted ethically yet obtaining ethical approval is considered by many to have become unnecessarily burdensome. This brief article investigates the idea that there might be a relationship between the level of perceived burdensomeness of the research ethics application process on the one hand and the character of the nurse-researcher on the other. Given that nurses are required to be other-regarding, a nurse who undertakes research primarily for self-regarding reasons would seem to be acting in ways inconsistent with the aims of nursing as set out in nursing codes. It is suggested that the self-regarding nurse-researcher may find the ethics application process more burdensome than the other-regarding nurse-researcher who, it is further suggested, is engaged with nursing research as a practice in the technical sense in which that term has been developed by the philosopher Alasdair MacIntyre. © 2015 John Wiley & Sons Ltd.

Assessing the use of the NANDA-International nursing diagnoses at the Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria.

PubMed

Olaogun, Adenike; Oginni, Monisola; Oyedeji, Tinuke Abimbola; Nnahiwe, Blessing; Olatubi, Idowu

2011-01-01

This study assessed the use of the NANDA-I nursing diagnoses in a Nigerian hospital. A multi-stage sampling method was used to select seven wards and 67 nursing process booklets from the Medical, Surgical, Orthopedic, and Mental Health Units of the hospital. A total of 154 nursing diagnoses were made: 50.7% were made within the first 48 hours of admission, while 35.8% were made on reassessments. The most frequently used nursing diagnoses were self-care deficit, pain, and anxiety. The NANDA-I nursing diagnoses are in use in Nigeria, adding support to the global use of the NANDA-I taxonomy, but findings also suggest a need for an assessment framework informed by nursing. Nurses in Nigeria would benefit from training programs organized by NANDA-I and national institutions to further refine their use of the nursing process. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

Clinical nursing informatics. Developing tools for knowledge workers.

PubMed

Ozbolt, J G; Graves, J R

1993-06-01

Current research in clinical nursing informatics is proceeding along three important dimensions: (1) identifying and defining nursing's language and structuring its data; (2) understanding clinical judgment and how computer-based systems can facilitate and not replace it; and (3) discovering how well-designed systems can transform nursing practice. A number of efforts are underway to find and use language that accurately represents nursing and that can be incorporated into computer-based information systems. These efforts add to understanding nursing problems, interventions, and outcomes, and provide the elements for databases from which nursing's costs and effectiveness can be studied. Research on clinical judgment focuses on how nurses (perhaps with different levels of expertise) assess patient needs, set goals, and plan and deliver care, as well as how computer-based systems can be developed to aid these cognitive processes. Finally, investigators are studying not only how computers can help nurses with the mechanics and logistics of processing information but also and more importantly how access to informatics tools changes nursing care.

Selection of student nurses at Bafokeng Nursing College.

PubMed

Setsoe, G

1992-06-01

Bafokeng Nursing College is a privately owned institution situated at the Impala Mines in Bophuthatswana. It selects and trains student nurses from all parts of Southern Africa in the comprehensive four-year course who at qualifying are free to work for Genmin or anywhere else in the country. The College is affiliated to Medunsa in offering the four-year comprehensive course. Selection is limited because of limited facilities. The old selection process was evaluated in 1985 and the new selection process started functioning in 1986 when the new course was offered for the first time at the College. With the new selection process, the drop-out rate is very low, the pass rate has improved and the quality of nursing care is improving.

Nursing Homes Appeals of Deficiency Citations: The Informal Dispute Resolution Process

PubMed Central

Mukamel, Dana B.; Weimer, David L.; Li, Yue; Bailey, Lauren; Spector, William D.; Harrington, Charlene

2012-01-01

Objective Nursing homes found to be not meeting quality standards are cited for deficiencies. Before 1995, their only recourse was a formal appeal process, which is lengthy and costly. In 1995, the Centers for Medicare & Medicaid Services (CMS) instituted the Informal Dispute Resolution (IDR) process. This study presents for the first time national statistics about the IDR process and an analysis of the factors that influence nursing homes’ decisions to request an IDR. Design Retrospective study including descriptive statistics and multivariate logistic hierarchical models. Setting U.S. nursing homes in 2005 to 2008. Participant 15,916 Medicaid and Medicare certified nursing homes nationally, with 94,188 surveys and 9,388 IDRs. Measures The unit of observation was an annual survey or a complaint survey that generated at least one deficiency. The dependent variable was dichotomous and indicated whether the annual or a complaint survey triggered an IDR request. Independent variables included characteristics of the nursing home, the deficiency, the market, and the state regulatory environment. Results Ten percent of all annual surveys and complaint surveys resulted in IDRs. There was substantial variation across states, which persisted over time. Multivariate results suggest that nursing homes’ decisions to request an IDR depend on their assessment of the probability of success and assessment of the benefits of the submission. Conclusions Nursing homes avail themselves of the IDR process. Their propensity to do so depends on a number of factors, including the state regulatory system and the market environment in which they operate. PMID:22402171

Conducting Nursing Research to Advance and Inform Health Policy.

PubMed

Ellenbecker, Carol Hall; Edward, Jean

2016-11-01

The primary roles of nurse scientists in conducting health policy research are to increase knowledge in the discipline and provide evidence for informing and advancing health policies with the goal of improving the health outcomes of society. Health policy research informs, characterizes, explains, or tests hypotheses by employing a variety of research designs. Health policy research focuses on improving the access to care, the quality and cost of care, and the efficiency with which care is delivered. In this article, we explain how nurses might envision their research in a policy process framework, describe research designs that nurse researchers might use to inform and advance health policies, and provide examples of research conducted by nurse researchers to explicate key concepts in the policy process framework. Health policies are well informed and advanced when nurse researchers have a good understanding of the political process. The policy process framework provides a context for improving the focus and design of research and better explicating the connection between research evidence and policy. Nurses should focus their research on addressing problems of importance that are on the healthcare agenda, work with interdisciplinary teams of researchers, synthesize, and widely disseminate results.

42 CFR 410.76 - Clinical nurse specialists' services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a clinical nurse specialist works with one or more physicians to deliver... collaboration, collaboration is a process in which a clinical nurse specialist has a relationship with one or...

Processes and Strategies for Implementation of Learning Modules in a Nursing Curriculum

ERIC Educational Resources Information Center

Swendsen, Leslee; And Others

1977-01-01

Explains the processes and strategies utilized by the faculty at the University of California, San Francisco, School of Nursing, to implement modularization in the undergraduate nursing program. Presents goals for modularization and discusses problems and constraints encountered during the implementation. Available from: Journal of…

The Effects of Structured Health Policy Education on Connecticut Registered Nurses' Clinical Documentation

ERIC Educational Resources Information Center

Lobo, Rosale Constance

2017-01-01

Registered Nurses use clinical documentation to describe care planning processes, measure quality outcomes, support reimbursement, and defend litigation. The Connecticut Department of Health, guided by federal Conditions of Participation, defines state-level healthcare policy to include required care planning processes. Nurses are educated in care…

Nurses' Behaviors and Visual Scanning Patterns May Reduce Patient Identification Errors

ERIC Educational Resources Information Center

Marquard, Jenna L.; Henneman, Philip L.; He, Ze; Jo, Junghee; Fisher, Donald L.; Henneman, Elizabeth A.

2011-01-01

Patient identification (ID) errors occurring during the medication administration process can be fatal. The aim of this study is to determine whether differences in nurses' behaviors and visual scanning patterns during the medication administration process influence their capacities to identify patient ID errors. Nurse participants (n = 20)…

Nurse Perspectives on the Practical, Emotional, and Professional Impacts of Living and Working in Post-earthquake Canterbury, New Zealand.

PubMed

Johal, Sarbjit S; Mounsey, Zoe; Brannelly, Petula; Johnston, David M

2016-02-01

This report explores nurses' perspectives following the Canterbury (New Zealand) 2010-2011 earthquake sequence and the subsequent recovery process. Problem Little is known about the experiences of health care professionals during a disaster recovery process, and this research generates insights about the challenges faced. Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch (New Zealand) area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of longer term aspects of the recovery process. The interview transcripts were analyzed and coded using a grounded theory approach. The data analysis identified that the nurses had faced a number of challenges and these were characterized as practical, emotional, and professional. While some of the challenges were short-lived in the aftermath of the earthquakes, some were long-lasting due to the extended nature of the recovery process. Dealing with house damage, insurance negotiations, and working in damaged environments had a negative impact on the nurses. The nurses experienced a range of emotions, both negative and positive, after the disaster, though many had needed time to elapse before feeling able to reflect on their experiences. The findings suggest that secondary stressors have a negative impact on the psychosocial recovery process. The nurses recognized that they received support from others and were also required to focus on others. Keeping busy appeared to be the most common coping strategy. This lack of reflection on their experiences may have resulted in delayed emotional responses. Some of the nurses changed their work role, hours, and responsibilities suggesting that working in this environment was having a detrimental impact. The research indicates the challenges faced by nurses in the initial impact of the earthquakes and during the longer term recovery process. There is a need to consider the psychosocial impact of working and living in a post-disaster context and to develop support packages to ensure the health and well-being of nurses in this environment.

Teachers at Heart: A Case Study Exploration of the Role Transition from Clinical Nurse to Community College Adjunct Clinical Nursing Instructor

ERIC Educational Resources Information Center

Wilson, Deborah S.

2017-01-01

The shortage of nursing faculty is limiting the number of students community colleges are able to enroll (National League for Nursing, 2014). The use of adjunct clinical nursing instructors may help lessen the impact of this shortage, while allowing nurses to gain valuable academic experience. An understanding of the process these nurses go…

Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses.

PubMed

Kim, MinYoung; Oh, Seieun

2016-01-01

The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. "Assimilating to the hierarchical culture" emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses' perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members' satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression.

Patient perception of nursing service quality; an applied model of Donabedian's structure-process-outcome approach theory.

PubMed

Kobayashi, Hideyuki; Takemura, Yukie; Kanda, Katsuya

2011-09-01

Nursing is a labour-intensive field, and an extensive amount of latent information exists to aid in evaluating the quality of nursing service, with patients' experiences, the primary focus of such evaluations. To effect further improvement in nursing as well as medical care, Donabedian's structure-process-outcome approach has been applied. To classify and confirm patients' specific experiences with regard to nursing service based on Donabedian's structure-process-outcomes model for improving the quality of nursing care. Items were compiled from existing scales and assigned to structure, process or outcomes in Donabedian's model through discussion among expert nurses and pilot data collection. With regard to comfort, surroundings were classified as structure (e.g. accessibility to nurses, disturbance); with regard to patient-practitioner interaction, patient participation was classified as a process (e.g. expertise and skill, patient decision-making); and with regard to changes in patients, satisfaction was classified as an outcome (e.g. information support, overall satisfaction). Patient inquiry was carried out using the finalized questionnaire at general wards in Japanese hospitals in 2005-2006. Reliability and validity were tested using psychometric methods. Data from 1,810 patients (mean age: 59.7 years; mean length of stay: 23.7 days) were analysed. Internal consistency reliability was supported (α = 0.69-0.96), with factor analysis items of structure aggregated to one factor and overall satisfaction under outcome aggregated to one. The remaining items of outcome and process were distributed together in two factors. Inter-scale correlation (r = 0.442-0.807) supported the construct validity of each structure-process-outcome approach. All structure items were represented as negative-worded examples, as they dealt with basic conditions under Japanese universal health care system, and were regarded as representative related to concepts of dissatisfaction and no dissatisfaction. Patients' experiences with nursing service were confirmed using Donabedian's approach and can therefore be applied to improve quality of nursing practice by practitioners, managers and policy makers. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

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.

[Computers in nursing: development of free software application with care and management].

PubMed

dos Santos, Sérgio Ribeiro

2010-06-01

This study aimed at developing an information system in nursing with the implementation of nursing care and management of the service. The SisEnf--Information System in Nursing--is a free software module that comprises the care of nursing: history, clinical examination and care plan; the management module consists of: service shifts, personnel management, hospital indicators and other elements. The system was implemented at the Medical Clinic of the Lauro Wanderley University Hospital, at Universidade Federal da Paraiba. In view of the need to bring user and developer closer, in addition to the constant change of functional requirements during the interactive process, the method of unified process was used. The SisEnf was developed on a WEB platform and using free software. Hence, the work developed aimed at assisting in the working process of nursing, which will now have the opportunity to incorporate information technology in their work routine.

[Nursing students' perception of the learning process in a hospital setting].

PubMed

Alves, Elcilene Andreíne Terra Durgante; Cogo, Ana Luísa Petersen

2014-03-01

The aim of this study was to identijf how nursing students perceive and experience the learning process during curricular practice in a hospital setting. A qualitative, retrospective, documentary study was developed in an undergraduate nursing course. Data were comprised of 162 posts made by 34 students in the online discussion forum of the Learning Management System Moodle, during the first half of 2011. The following themes emergedfrom t he thematic content analysis: "nursing students' understanding about the professional practice," and "the teaching and learning process in the perspective of nursing students." The study demonstrated that the forum was a place for reporting experiences such as the description of the physical area, performing procedures, perception of nursing care activities, conJlicts with peers, coping with death and learning evaluation. The online discussion forum needs to be used by professors as a space of interaction so as to contribute to professional training.

Design of a Recommendation System for Adding Support in the Treatment of Chronic Patients.

PubMed

Torkar, Simon; Benedik, Peter; Rajkovič, Uroš; Šušteršič, Olga; Rajkovič, Vladislav

2016-01-01

Rapid growth of chronic disease cases around the world is adding pressure on healthcare providers to ensure a structured patent follow-up during chronic disease management process. In response to the increasing demand for better chronic disease management and improved health care efficiency, nursing roles have been specialized or enhanced in the primary health care setting. Nurses become key players in chronic disease management process. Study describes a system to help nurses manage the care process of patient with chronic disease. It supports focusing nurse's attention on those resources/solutions that are likely to be most relevant to their particular situation/problem in nursing domain. System is based on multi-relational property graph representing a flexible modeling construct. Graph allows modeling a nursing ontology and the indices that partition domain into an efficient, searchable space where the solution to a problem is seen as abstractly defined traversals through its vertices and edges.

The evolution of nurse-to-nurse bedside report on a medical-surgical cardiology unit.

PubMed

Caruso, Eva M

2007-02-01

Change of shift report is unique to the nursing profession. During report, nurses transfer critical information to promote patient safety and best practices. Nurse-to-nurse bedside report is described as a strategy that includes the patient in the reporting process and is an innovative alternative to traditional shift report.

Nurse Education and Communities of Practice. Researching Professional Education Research Reports Series.

ERIC Educational Resources Information Center

Burkitt, Ian; Husband, Charles; Mackenzie, Jennifer; Torn, Alison

The processes whereby nurses develop the skills and knowledge required to deliver individualized and holistic care were examined in a 2-year study of nurses in a range of clinical settings and a university department of nursing in England. Members of two research teams of qualified nurses joined various communities of nursing practice as…

Nutrition for Nurses: Nursing 245.

ERIC Educational Resources Information Center

Palermo, Karen R.

A description is presented of "Nutrition for Nurses," a prerequisite course for students anticipating entrance into the junior level of a state university registered nursing program. Introductory material highlights the course focus (i.e., the basics of good nutrition; nutrition through the life cycle; nursing process in nutritional care; and…

The nursing process in crisis-oriented psychiatric home care.

PubMed

Boomsma, J; Dingemans, C A; Dassen, T W

1997-08-01

Crisis-oriented psychiatric home care is a recent development in the Dutch mental health care system. Because of the difference between psychiatric care in the home and in the hospital, an action research project was initiated. This project was directed at the nursing process and the nurses' role and skills in psychiatric home care. The main goal of the project was to describe and to standardize nursing diagnoses and interventions used in crisis-oriented and long-term psychiatric home care. The development of supporting methods of assessment and intervention were also important aspects of this project. In this article a crisis-oriented psychiatric home care programme and the first developmental research activities within this programme are described. To support the nursing process, the development of a nursing record and an assessment-format, based on Gordon's Functional Health Patterns (FHP), took place. By means of content analysis of 61 nursing records, the most frequently stated nursing diagnoses, based upon the North American Nursing Diagnosis Association (NANDA) taxonomy, were identified. The psychiatric diagnostic categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) were also collected. The most common categories found were those of mood disorders and schizophrenia or psychotic disorders. Seventy-five per cent of the nursing diagnoses showed up within four FHP: role-relationship, coping-stress tolerance, self-perception/self-concept and activity-exercise. The nursing diagnosis of 'ineffective individual coping' was stated most frequently. This is not surprising because of the similarities in the definitions of this nursing diagnosis and the concept of 'crisis' to which the psychiatric home care programme is oriented. Further research activities will be focused on standardization of nursing diagnosis and the interventions that nurses undertake in this type of care.

In search of salience: phenomenological analysis of moral distress.

PubMed

Manara, Duilio F; Villa, Giulia; Moranda, Dina

2014-07-01

The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how and when this could be confirmed in situations where the effect of emotions on the nurse's decisional process is undiscovered. To explore the processes through which situations of moral distress are determined for the nurses involved in nursing situations, a phenomenological-hermeneutic analysis of a nurse's report of an experience lived by her as a moral distress situation has been conducted. Nursing emerges as a relational doctrine that requires the nurse to have different degrees of personal involvement, the integration between logical-formal thinking and narrative thinking, the perception of the salience of the given situation also through the interpretation and management of one's own emotions, and the capacity to undergo a process of co-construction of shared meanings that the others might consider adequate for the resolution of her problem. Moral action requires the nurse to think constantly about the important things that are happening in a nursing situation. Commitment towards practical situations is directed to training in order to promote the nurse's reflective ability towards finding salience in nursing situations, but it is also directed to the management of nursing assistance and human resources for the initial impact that this reflexive ability has on patients' and their families' lives and on their need to be heard and assisted. The only case analysed does not allow generalizations. Further research is needed to investigate how feelings generated by emotional acceptance influence ethical decision making and moral distress in nursing situations. © 2014 John Wiley & Sons Ltd.

Decision-making in nursing practice: An integrative literature review.

PubMed

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. © 2017 John Wiley & Sons Ltd.

Holistic Nursing Simulation: A Concept Analysis.

PubMed

Cohen, Bonni S; Boni, Rebecca

2018-03-01

Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

[Narrative Pedagogy in Nursing Education: The Essence of Clinical Nursing Process Recording].

PubMed

Chao, Yu-Mei Y; Chiang, Hsien-Hsien

2017-02-01

Clinical nursing process recording (CNPR) has been shown to be an effective tool for facilitating student-centered teaching and learning in nursing education. Yet, the essence and process of this tool have yet to be sufficiently explored and clarified. To explore the essence of CNPR in the contexts of clinical teaching and learning. Reflective analysis was used as the phenomenological approach to analyze the qualitative data, which were transcribed from the oral responses of the six participants who were attending the Clinical Nursing Education Forum. A total of five sessions of the Clinical Nursing Education Forums were conducted. The content of the Clinical Nursing Education Forums consisted of a series of 12 narrative writings of CNPR that were written by a senior student and read and commented on by the student's clinical instructor. Three groups of the essence and process of clinical teaching and learning were inductively identified as: (a) mobilizing autonomous, self-directed learning behavior from self-writing and re-storying; (b) establishing the student-instructor dialogical relationship from mutual localization; and (c) co-creating a learning environment in education and in clinical practice. When used as an interactive teaching and learning tool, CNPR promotes mutual understanding by re-locating the self in the coexisting roles of student nurse, instructor, and patient in a series of nursing care situations. This re-location facilitates students' self-directed learning, enhances the abilities of asking question, waiting for and accompany with the instructor; and promotes the self-care capabilities of patients.

Supporting the Uptake of Nursing Guidelines: what you really need to know to move nursing guidelines into practice.

PubMed

Matthew-Maich, Nancy; Ploeg, Jenny; Dobbins, Maureen; Jack, Susan

2013-05-01

There is a current push to use best practice guidelines (BPGs) in health care to enhance client care and outcomes. Even though intensive resources have been invested internationally to develop BPGs, a gap in knowledge exists about how to consistently and efficiently move them into practice. Constructivist grounded theory was used to explore the complex processes of a breastfeeding BPG implementation and uptake in three acute care hospitals. Interviews (n = 120) with 112 participants representing clients, nurses, lactation consultants, midwives, physicians, managers, administrators, and nurse educators as well as document and field note analysis informed this study. Data were analyzed using constant comparison and coding steps outlined by Charmaz: initial coding, selective (focused) coding, then theoretical coding. Triangulation of data types and sources were used as well as theoretical sampling. Data were collected from 2009 to 2010. Two sites showed BPG uptake while one did not. Factors present in the uptake sites included, ongoing passionate frontline leaders, the use of multifaceted strategies, and processes that occurred at organizational, leadership, individual and social levels. Particularly noteworthy was the transformation of individual nurses to believing in and using the BPG. Impacts occurred at client, nurse, unit, inter-professional, organizational and system levels. A conceptual framework: Supporting the Uptake of Nursing Guidelines, was developed that reveals essential processes used to facilitate BPG uptake into nursing practice and a process of nurse transformation to believing in and using the BPG. © Sigma Theta Tau International.

User-Centered Design Practices to Redesign a Nursing e-Chart in Line with the Nursing Process.

PubMed

Schachner, María B; Recondo, Francisco J; González, Zulma A; Sommer, Janine A; Stanziola, Enrique; Gassino, Fernando D; Simón, Mariana; López, Gastón E; Benítez, Sonia E

2016-01-01

Regarding the user-centered design (UCD) practices carried out at Hospital Italiano of Buenos Aires, nursing e-chart user interface was redesigned in order to improve records' quality of nursing process based on an adapted Virginia Henderson theoretical model and patient safety standards to fulfil Joint Commission accreditation requirements. UCD practices were applied as standardized and recommended for electronic medical records usability evaluation. Implementation of these practices yielded a series of prototypes in 5 iterative cycles of incremental improvements to achieve goals of usability which were used and perceived as satisfactory by general care nurses. Nurses' involvement allowed balance between their needs and institution requirements.

The Nurse Advocate in End-of-Life Care

PubMed Central

Hebert, Kathy; Moore, Harold; Rooney, Joan

2011-01-01

End-of-life nursing encompasses many aspects of care: pain and symptom management, culturally sensitive practices, assisting patients and their families through the death and dying process, and ethical decisionmaking. Advocacy has been identified as a key core competency for the professional nurse, yet the literature reveals relevant barriers to acquiring this skill. Challenges exist, such as limitations in nursing school curricula on the death and dying process, particularly in multicultural settings; differing policies and practices in healthcare systems; and various interpretations of end-of-life legal language. Patricia Benner's conceptual model of advocacy behaviors in end-of-life nursing provides the framework in which nurses can become effective patient advocates. Developing active listening and effective communication skills can enhance the nurse-patient trust relationship and create a healing environment. PMID:22190882

[Implementation of the nursing process in a patient with hepatic cirrhosis using the standardized terminologies NANDA, NIC and NOC].

PubMed

Vargas, Rosimeire da Silva; França, Fabiana Cláudia de Vasconcelos

2007-01-01

This case study aimed at describing the implementation the implementation of the Nursing Process to a patient with hepatic cirrhosis, and report the difficulties found on the implementation of the assistance. The conceptual model of Horfa was used, NANDA--Nursing Diagnosis, Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) were also applied in care composition. The present study was developed in a public hospital of Distrito Federal, in September 2005, at the Emergency Unit. Among the identified nursing diagnosis was included: acute confusion, constipation and knowledge deficit. Among the pointed difficulties, it was detached: the disinterest of the nursing team and of the pacient, knowledge deficit and unpreparedness of the professionals, lack of human and material resources to deliver the care.

The developmental processes for NANDA International Nursing Diagnoses.

PubMed

Scroggins, Leann M

2008-01-01

This study aims to provide a step-by-step procedural guideline for the development of a nursing diagnosis that meets the necessary criteria for inclusion in the NANDA International and NNN classification systems. The guideline is based on the processes developed by the Diagnosis Development Committee of NANDA International and includes the necessary processes for development of Actual, Wellness, Health Promotion, and Risk nursing diagnoses. Definitions of Actual, Wellness, Health Promotion, and Risk nursing diagnoses along with inclusion criteria and taxonomy rules have been incorporated into the guideline to streamline the development and review processes for submitted diagnoses. A step-by-step procedural guideline will assist the submitter to move efficiently and effectively through the submission process, resulting in increased submissions and enhancement of the NANDA International and NNN classification systems.

Empowerment in School Nursing Practice: A Grounded Theory Approach

ERIC Educational Resources Information Center

Broussard, Lisa

2007-01-01

Professional empowerment is vital to nurses' productivity and job satisfaction. A grounded theory study was conducted to describe the basic social process experienced by school nurses in relation to professional empowerment. Interviews with 10 school nurses led to the development of a situation-specific theory of school nurse empowerment,…

Holistic nursing as a specialty: holistic nursing - scope and standards of practice.

PubMed

Mariano, Carla

2007-06-01

This article describes the Holistic Nursing: Scope and Standards of Practice. It defines holistic nursing, its five core values, and its practice standards. These include holistic philosophy, theory, and ethics; holistic caring process; holistic communication, therapeutic environment, and cultural diversity; holistic education and research; and holistic nurse self-care. Educational preparation for holistic nursing and settings in which holistic nurses practice are also explored.

Developing nursing care plans.

PubMed

Ballantyne, Helen

2016-02-24

This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred.

Model medication management process in Australian nursing homes using business process modeling.

PubMed

Qian, Siyu; Yu, Ping

2013-01-01

One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.

Developing a social media platform for nurses.

PubMed

Jackson, Jennifer; Kennedy, Maggie

2015-11-18

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

Using a nursing balanced scorecard approach to measure and optimize nursing performance.

PubMed

Jeffs, Lianne; Merkley, Jane; Richardson, Sandy; Eli, Jackie; McAllister, Mary

2011-04-01

The authors give an overview of one healthcare organization's experience in developing a nursing strategic plan and nursing balanced scorecard (NBS) using a focused planning process involving strategy mapping. The NBS is being used at this organization to manage the nursing strategic plan by leveraging and improving nursing processes and organizational capabilities as required, based on data and transparent communication of performance results to key stakeholders. Key strategies and insights may help other nurse leaders in developing or refining strategic approaches to measuring nursing performance. Vital to the success of an organization's strategic plan are ongoing endorsement, engagement and visibility of senior leaders. Quality of decisions made depends on the organization's ability to collect data from multiple sources using standardized definitions, mine data and extract them for statistical analysis and effectively present them in a compelling and understandable way to users and decision-makers.

A nursing data base for initial patient assessment.

PubMed

Hartman, D; Knudson, J

1991-01-01

The introduction of nursing diagnoses at Saddleback Memorial Medical Center, Laguna Hills, CA, resulted in the nursing process becoming the basis for the documentation system. However, the medical model or body system remained the organizational structure for nursing data collection and narrative charting. The need for a model that would aid in identification and treatment of illness and not negatively affect the nursing process was the impetus behind the selection of Gordon's functional health patterns as the assessment format. These patterns provide a standard method for data collection and a holistic approach to assessment and diagnosis.

Thinking strategies used by Registered Nurses during emergency department triage.

PubMed

Göransson, Katarina E; Ehnfors, Margareta; Fonteyn, Marsha E; Ehrenberg, Anna

2008-01-01

This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.

Intuition: A Concept Analysis.

PubMed

Chilcote, Deborah R

2017-01-01

The purpose of this article is to conceptually examine intuition; identify the importance of intuition in nursing education, clinical practice, and patient care; encourage acceptance of the use of intuition; and add to the body of nursing knowledge. Nurses often report using intuition when making clinical decisions. Intuition is a rapid, unconscious process based in global knowledge that views the patient holistically while synthesizing information to improve patient outcomes. However, with the advent of evidence-based practice (EBP), the use of intuition has become undervalued in nursing. Walker and Avant's framework was used to analyze intuition. A literature search from 1987 to 2014 was conducted using the following keywords: intuition, intuition and nursing, clinical decision making, clinical decision making and intuition, patient outcomes, EBP, and analytical thinking. The use of intuition is reported by nurses, but is not legitimized within the nursing profession. Defining attributes of intuition are an unconscious, holistic knowledge gathered without using an analytical process and knowledge derived through synthesis, not analysis. Consequences include verification of intuition through an analytical process and translating that knowledge into a course of action. This article supports the use of intuition in nursing by offering clarity to the concept, adds to the nursing knowledge base, encourages a holistic view of the patient during clinical decision making, and encourages nurse educators to promote the use of intuition. © 2016 Wiley Periodicals, Inc.

Defining the paramedic process.

PubMed

Carter, Holly; Thompson, James

2015-01-01

The use of a 'process of care' is well established in several health professions, most evidently within the field of nursing. Now ingrained within methods of care delivery, it offers a logical approach to problem solving and ensures an appropriate delivery of interventions that are specifically suited to the individual patient. Paramedicine is a rapidly advancing profession despite a wide acknowledgement of limited research provisions. This frequently results in the borrowing of evidence from other disciplines. While this has often been useful, there are many concerns relating to the acceptable limit of evidence transcription between professions. To date, there is no formally recognised 'process of care'-defining activity within the pre-hospital arena. With much current focus on the professional classification of paramedic work, it is considered timely to formally define a formula that underpins other professional roles such as nursing. It is hypothesised that defined processes of care, particularly the nursing process, may have features that would readily translate to pre-hospital practice. The literature analysed was obtained through systematic searches of a range of databases, including Ovid MEDLINE, Cumulative Index to Nursing and Allied Health. The results demonstrated that the defined process of care provides nursing with more than just a structure for practice, but also has implications for education, clinical governance and professional standing. The current nursing process does not directly articulate to the complex and often unstructured role of the paramedic; however, it has many principles that offer value to the paramedic in their practice. Expanding the nursing process model to include the stages of Dispatch Considerations, Scene Assessment, First Impressions, Patient History, Physical Examination, Clinical Decision-Making, Interventions, Re-evaluation, Transport Decisions, Handover and Reflection would provide an appropriate model for pre-hospital practices.

A model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.

PubMed

Seekoe, Eunice

2014-04-24

South Africa transformed higher education through the enactment of the Higher Education Act (No. 101 of 1997). The researcher identified the need to develop a model for the mentoring of newly-appointed nurse educators in nursing education institutions in South Africa.  To develop and describe the model for mentoring newly-appointed nurse educators in nursing education institutions in South Africa.  A qualitative and theory-generating design was used (following empirical findings regarding needs analysis) in order to develop the model. The conceptualisation of the framework focused on the context, content, process and the theoretical domains that influenced the model. Ideas from different theories were borrowed from and integrated with the literature and deductive and inductive strategies were applied.  The structure of the model is multidimensional and complex in nature (macro, mesoand micro) based on the philosophy of reflective practice, competency-based practice andcritical learning theories. The assumptions are in relation to stakeholders, context, mentoring, outcome, process and dynamic. The stakeholders are the mentor and mentee within an interactive participatory relationship. The mentoring takes place within the process with a sequence of activities such as relationship building, development, engagement, reflective process and assessment. Capacity building and empowerment are outcomes of mentoring driven by motivation.  The implication for nurse managers is that the model can be used to develop mentoring programmes for newly-appointed nurse educators.

Fundamental Nursing: Process-Oriented Guided-Inquiry Learning (POGIL) Research

ERIC Educational Resources Information Center

Roller, Maureen C.

2015-01-01

Measuring the effect of a Process-Oriented Guided-Inquiry Learning (POGIL) implementation in a fundamental baccalaureate-nursing course is one way to determine its effectiveness. To date, the use of POGIL from a research perspective in fundamental nursing has not been documented in the literature. The purpose of the study was to measure the…

Understanding the Transformation of Compassion in Nurses Who Become Patients

ERIC Educational Resources Information Center

Pucino, Carrie L.

2013-01-01

The purpose of this study was to examine how nurses who become patients learn compassion toward patients in their professional practice, and examine the role of empathy in the process of learning compassion. The process of learning compassion represents a significant change in the way nurses perceive this aspect of practice. Therefore,…

The Process of Coping with Changes: A Study of Learning Experiences for the Aboriginal Nursing Freshmen

ERIC Educational Resources Information Center

Liu, Ruo Lan

2012-01-01

Background: Given the increasing presence of aborigines in Taiwan higher education, especially in nursing institutes, the retention and adaptation of aboriginal students is a critical issue for research. Understanding the adjustment and transformation process of aboriginal nursing freshmen is very important for improving their learning, but very…

Ambiguous meanings of projects as facilitators of sensegiving.

PubMed

Lunkka, Nina; Suhonen, Marjo

2015-10-01

To describe mid-level nurse managers' experiences of sensegiving in the context of hospital projects. Sensegiving is about shaping and affecting how employees see themselves, their work and issues related to their work. It has been little studied in the context of hospital projects from mid-level nurse managers' point of view. Mid-level nurse managers (n = 10) were interviewed about their experiences of projects from the viewpoint of sensegiving during change processes. Data was analysed using discourse analysis. Three repertoires were constructed from the data: the repertoires of regeneration, control and humane. Projects were considered as appropriate ways for sensegiving in hospitals from the viewpoint of mid-level nurse managers. In order to use projects effectively in hospitals as means for change management mid-level nurse managers ought to enhance their role as interpreters during the change process (i.e. strengthen their visioning, talk and dialogue skills). Training on the nature of change as a social and interactive process could deepen mid-level nurse managers' understanding of the change process in the context of hospital projects. © 2014 John Wiley & Sons Ltd.

Using a High-Performance Planning Model to Increase Levels of Functional Effectiveness Within Professional Development.

PubMed

Winter, Peggi

2016-01-01

Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.

Exploring the Perceptions of Core Values of Nursing in Taiwanese Nursing Students at the Baccalaureate Level.

PubMed

Lin, Chun-Chih; Han, Chin-Yen; Pan, I-Ju; Lin, Pi-Li

2016-06-01

The core values of nursing are a standard component of the nursing curriculum in Taiwan. Therefore, these values provide an essential guide for educating and evaluating the learning outcomes of nursing students. Student perceptions of those core values that relate to the process of curricula learning are key to measuring the core values of nursing. This study explores the views on the core values of nursing of baccalaureate-level nursing students at a Taiwanese university. This qualitative study collected data from the reflection reports of 109 students and analyzed these data using thematic content analysis. The results of this study identified that the learning of core values of nursing tends to utilize the latent curriculum rather than the open curriculum. Critical thinking was perceived and experienced by asking "why." General clinical skills and basic biomedical science were categorized collectively as care ability, which relates to the thinking, analysis, and mapping of client health problems. The value of communication and teamwork capability was defined as the sequential process of accepting, interacting, communicating, and collaborating. Caring was defined as contributing empathy with respect to one's self and to others. Ethics was defined as a moral perspective, as respecting others, and as prioritizing the needs of clients. Accountability was defined as a way of observing standards within the role given in a position. Finally, lifelong learning is a process of learning that encourages more aggressive learning. The progress of core values of nursing in this study reflects positive movement and achievement. The participants expressed the perception that the core values of nursing enhance understanding, which enables nursing educators to reframe the nursing curriculum to meet their learning needs. The perceptions of nursing students of core values of nursing may be used as a guide to increase clinical nursing competence in healthcare.

Professional ethics: beyond the clinical competency.

PubMed

Vanaki, Zohreh; Memarian, Robabeh

2009-01-01

Assessment of clinical competency in professional roles especially in crucial situations can improve the nursing profession. This qualitative research was conducted to determine the process of acquiring clinical competency by nurses in its cultural context and within the health care delivery system in Iran. This study, using grounded theory methodology, took place in universities and hospitals in Tehran. Nurses (36) included nurse managers, tutors, practitioners, and members of the Iranian Nursing Organization. Simultaneous data collection and analysis took place using participant semistructured interviews. Three categories emerged: (a) personal characteristics such as philanthropy, strong conscience, being attentive, accepting responsibility, being committed to and respecting self and others; (b) care environment including appropriate management systems, in-service training provision, employment laws, and control mechanisms, suitable and adequate equipment; and (c) provision of productive work practices including love of the profession, critical thinking, nursing knowledge, and professional expertise. Professional ethics has emerged as the core variable that embodies concepts such as commitment, responsibility, and accountability. Professional ethics guarantees clinical competency and leads to the application of specialized knowledge and skill by nurses. The results can be used to form the basis of guiding the process of acquiring clinical competency by nurses using a systematic process.

Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses

PubMed Central

2016-01-01

The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. “Assimilating to the hierarchical culture” emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses’ perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members’ satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression. PMID:27253389

Exploring nursing assistants' roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study.

PubMed

Liu, Justina Y W

2014-05-01

To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.

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.

N²E: Envisioning a process to support transition from nurse to educator.

PubMed

McAllister, Margaret; Oprescu, Florin; Jones, Christian

2014-01-01

Rising health inequities, continuing nursing shortages, and overlooked professional development needs of nurse educators are three important issues facing nursing in Australia. This paper argues for an innovative and proactive strategy that could transform the nurse education workforce into one that is repopulated, reinvigorated and refocused. The problem facing nurse educators, and subsequently affecting nurses' preparation for practice and longevity in the profession, was identified by drawing on findings from the literature, extensive educational experience, and an exploratory study of nurse educators working in universities, colleges and health services. A solution has been devised by drawing together the tenets of critical social theory, transformative learning, communities of practice and social media. Nursing educators, refocused around a social justice agenda, may be the remedy that the Australian Health Care System requires to embark on effective action that can benefit everyone, from the health service staff to our most vulnerable groups in society. This refocusing can be achieved in a structured and strategic process that builds confidence and professional capabilities.

N2E: Envisioning a process to support transition from nurse to educator.

PubMed

McAllister, Margaret; Oprescu, Florin; Jones, Christian

2013-11-21

Abstract Rising health inequities, continuing nursing shortages, and overlooked professional development needs of nurse educators are three important issues facing nursing in Australia. This paper argues for an innovative and proactive strategy that could transform the nurse education workforce into one that is repopulated, reinvigorated and refocused. The problem facing nurse educators, and subsequently affecting nurses' preparation for practice and longevity in the profession, was identified by drawing on findings from the literature, extensive educational experience, and an exploratory study of nurse educators working in universities, colleges and health services. A solution has been devised by drawing together the tenets of critical social theory, transformative learning, communities of practice and social media. Nursing educators, refocused around a social justice agenda, may be the remedy that the Australian Health Care System requires to embark on effective action that can benefit everyone, from the health service staff to our most vulnerable groups in society. This refocusing can be achieved in a structured and strategic process that builds confidence and professional capabilities.

Impact of clinical leadership development on the clinical leader, nursing team and care-giving process: a case study.

PubMed

Dierckx de Casterlé, Bernadette; Willemse, An; Verschueren, Marc; Milisen, Koen

2008-09-01

This study explored the dynamics related to a leadership development programme and their impact on the clinical leader, the nursing team and the care-giving process. While there is a growing conviction about the need to invest in transformational leadership in nursing, further insight into the true complexity of leadership development and, more specifically, how leadership can make a difference in nursing and patient outcomes is essential. A single instrumental case study was conducted in a unit of a large academic hospital where a Clinical Leadership development Project (CLP) was implemented successfully. We used mixed methods with multiple sources of data to capture the complexity of leadership development. Data were collected through individual interviews, focus groups and observation of participants. A purposive sample of 17 participants representing a wide variety of team members has permitted data saturation. The data were categorized and conceptualized and finally organized into a framework describing leadership development on the unit and its impact on the leader, the nursing team and the care-giving process. Leadership development is an ongoing, interactive process between the clinical leader and the co-workers. The head nurse became more effective in areas of self-awareness, communication skills, performance and vision. The nursing team benefited because more effective leadership promoted effective communication, greater responsibility, empowerment and job clarity. Improved clinical leadership seemed also to influence patient-centred communication, continuity of care and interdisciplinary collaboration. The results of the study give more insight into the processes underlying the leader's progress towards attaining a transformational leadership style and its impact on the team members. The impact of leadership on the care-giving process, however, remains difficult to describe. The interactive nature of leadership development makes CLP a challenge for the leader as well for the team members. Through its impact on the leader and the nursing team, CLP is a valuable instrument for improving work environments of nurses, contributing positively to patient-centred care.

Competence evaluation processes for nursing students abroad: Findings from an international case study.

PubMed

Tommasini, Cristina; Dobrowolska, Beata; Zarzycka, Danuta; Bacatum, Claudia; Bruun, Anne Marie Gran; Korsath, Dag; Roel, Siv; Jansen, Mette Bro; Milling, Tine; Deschamps, Anne; Mantzoukas, Stefanos; Mantzouka, Christine; Palese, Alvisa

2017-04-01

Assessing clinical competence in nursing students abroad is a challenge, and requires both methods and instruments capable of capturing the multidimensional nature of the clinical competences acquired. The aim of the study was to compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. A case study design was adopted in 2015. A purposeful sample of eight nursing programmes located in seven countries (Belgium, Denmark, Greece, Norway, Poland, Portugal and Italy) were approached. Tools as instruments for evaluating competences developed in clinical training by international nursing students, and written procedures aimed at guiding the evaluation process, were scrutinised through a content analysis method. All clinical competence evaluation procedures and instruments used in the nursing programmes involved were provided in English. A final evaluation of the competences was expected by all nursing programmes at the end of the clinical placement, while only four provided an intermediate evaluation. Great variability emerged in the tools, with between five and 88 items included. Through content analysis, 196 items emerged, classified into 12 different core competence categories, the majority were categorised as 'Technical skills' (=60), 'Self-learning and critical thinking' (=27) and 'Nursing care process' (=25) competences. Little emphasis was given in the tools to competences involving 'Self-adaptation', 'Inter-professional skills', 'Clinical documentation', 'Managing nursing care', 'Patient communication', and 'Theory and practice integration'. Institutions signing Bilateral Agreements should agree upon the competences expected from students during their clinical education abroad. The tools used in the process, as well as the role expected by the student, should also be agreed upon. Intercultural competences should be further addressed in the process of evaluation, in addition to adaptation to different settings. There is also a need to establish those competences achievable or not in the host country, aiming at increasing transparency in learning expectations and evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

The attitudes, role & knowledge of mental health nurses towards euthanasia because of unbearable mental suffering in Belgium: a pilot study.

PubMed

Demedts, Dennis; Roelands, Marc; Libbrecht, Julien; Bilsen, Johan

2018-05-26

Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. A cross-sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n=133) as a pilot study. Self-administered questionnaires were provided to mental health nurses. Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare management, education and policy. A form of systematic cooperation between nurses, physicians and patients can contribute to the utmost careful decision-making process needed in these cases. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Final assessment of nursing students in clinical practice: Perspectives of nursing teachers, students and mentors.

PubMed

Helminen, Kristiina; Johnson, Martin; Isoaho, Hannu; Turunen, Hannele; Tossavainen, Kerttu

2017-12-01

To describe the phenomenon of final assessment of the clinical practice of nursing students and to examine whether there were differences in assessments by the students and their teachers and mentors. Final assessment of students in clinical practice during their education has great importance for ensuring that enough high-quality nursing students are trained, as assessment tasks affect what the nursing student learns during the clinical practice. This study used descriptive, cross-sectional design. The population of this study comprised nursing students (n = 276) and their teachers (n = 108) in five universities of applied sciences in Finland as well as mentors (n = 225) who came from five partner hospitals. A questionnaire developed for this study contained questions about background variables as well as structured questions scored on a four-point scale, which also allowed the respondents to provide additional comments. When comparing the results related to nursing teachers' presence in the final assessment situation, it was found that teachers and mentors evaluated this as being carried out more often than nursing students suggested. Nursing students noted that fair and consistent assessment is carried out more often than nursing teachers thought. Mentors and teachers said that honest and direct criteria-based final assessment was carried out more often than nursing students evaluated. Nursing students and mentors need support from educational institutions and from nursing teachers in order to ensure the completion of a relevant assessment process. The findings of this study highlight an awareness of final assessment process. It is desirable to have a common understanding, for example, of how the assessment should be managed and what the assessment criteria are, as this will ensure a good quality process. © 2017 John Wiley & Sons Ltd.

Nursing Process. Nursing: Basic Needs I. Nursing: Basic Needs II. Nursing through the Life Span. Entry into Professional Nursing. A Basic Course Outline (College Freshmen) for Nursing. A Four Year "2+2" Articulated Curriculum for the Occupation of Nursing.

ERIC Educational Resources Information Center

Maddox, Gaylon; And Others

This course outline provides materials for third-year courses in a "2+2" curriculum for the occupation of registered nurse. It is part of a planned and articulated 4-year curriculum that spans the junior and senior years of high school and the freshman and sophomore years of the postsecondary institution. Introductory materials include:…

Genetic discoveries and nursing implications for complex disease prevention and management.

PubMed

Frazier, Lorraine; Meininger, Janet; Halsey Lea, Dale; Boerwinkle, Eric

2004-01-01

The purpose of this article is to examine the management of patients with complex diseases, in light of recent genetic discoveries, and to explore how these genetic discoveries will impact nursing practice and nursing research. The nursing science processes discussed are not comprehensive of all nursing practice but, instead, are concentrated in areas where genetics will have the greatest influence. Advances in genetic science will revolutionize our approach to patients and to health care in the prevention, diagnosis, and treatment of disease, raising many issues for nursing research and practice. As the scope of genetics expands to encompass multifactorial disease processes, a continuing reexamination of the knowledge base is required for nursing practice, with incorporation of genetic knowledge into the repertoire of every nurse, and with advanced knowledge for nurses who select specialty roles in the genetics area. This article explores the impact of this revolution on nursing science and practice as well as the opportunities for nursing science and practice to participate fully in this revolution. Because of the high proportion of the population at risk for complex diseases and because nurses are occupied every day in the prevention, assessment, treatment, and therapeutic intervention of patients with such diseases in practice and research, there is great opportunity for nurses to improve health care through the application (nursing practice) and discovery (nursing research) of genetic knowledge.

Understanding the process of patient satisfaction with nurse-led chronic disease management in general practice.

PubMed

Mahomed, Rosemary; St John, Winsome; Patterson, Elizabeth

2012-11-01

  To investigate the process of patient satisfaction with nurse-led chronic disease management in Australian general practice.   Nurses working in the primary care context of general practice, referred to as practice nurses, are expanding their role in chronic disease management; this is relatively new to Australia. Therefore, determining patient satisfaction with this trend is pragmatically and ethically important. However, the concept of patient satisfaction is not well understood particularly in relation to care provided by practice nurses.   A grounded theory study underpinned by a relativist ontological position and a relativist epistemology.   Grounded theory was used to develop a theory from data collected through in-depth interviews with 38 participants between November 2007-April 2009. Participants were drawn from a larger project that trialled a practice nurse-led, collaborative model of chronic disease management in three Australian general practices. Theoretical sampling, data collection, and analysis were conducted concurrently consistent with grounded theory methods.   Patients undergo a cyclical process of Navigating Care involving three stages, Determining Care Needs, Forming Relationship, and Having Confidence. The latter two processes are inter-related and a feedback loop from them informs subsequent cycles of Determining Care Needs. If any of these steps fails to develop adequately, patients are likely to opt out of nurse-led care.   Navigating Care explains how and why time, communication, continuity, and trust in general practitioners and nurses are important to patient satisfaction. It can be used in identifying suitable patients for practice nurse-led care and to inform the practice and organization of practice nurse-led care to enhance patient satisfaction. © 2012 Blackwell Publishing Ltd.

Mentoring in Associate Degree Nursing: A Mixed-Methods Study for Student Success

ERIC Educational Resources Information Center

Fishman, Darlene C.

2013-01-01

For over a decade, the nursing profession has increased enrollments and established new education programs in response to the national nursing shortage. The profession has focused on increasing the numbers of new graduate nurses prepared to replace the nation's aging nursing workforce. Considering the expense of this educational process with close…

A feminist perspective on nursing education.

PubMed

Hedin, B A; Donovan, J

1989-01-01

Models of nursing education that mirror the human, caring side of nursing that we expect students to put into practice in the clinical arena are needed in the classroom. In that interest, the authors explore the relationship between feminism and nursing education and outline the characteristics of a nursing education process based on feminist principles and values.

Nurse case management: negotiating care together within a developing relationship.

PubMed

Yamashita, Mineko; Forchuk, Cheryl; Mound, Bronwyn

2005-01-01

TOPIC/PROBLEM: The purpose of this study was to explicate the process of nurse case management involving clients afflicted with chronic mental illness. Grounded theory was the method of choice. Interviews were conducted with nurses in inpatient, transitional, and community settings in four cities in southern Ontario, Canada. Negotiating care together within a developing relationship emerged as the basic social process. "Building a trusting relationship" was identified as the foundation of case management. Salient differences were found between the three settings, yet the basic social process was consistent across settings. This underscores the therapeutic relationship as the basis for nurse psychiatric case management.

A unique collaborative nursing evidence-based practice initiative using the Iowa model: a clinical nurse specialist, a health science librarian, and a staff nurse's success story.

PubMed

Krom, Zachary R; Batten, Janene; Bautista, Cynthia

2010-01-01

The purpose of this article was to share how the collaboration of a clinical nurse specialist (CNS), a health science librarian, and a staff nurse can heighten staff nurses' awareness of the evidence-based practice (EBP) process. The staff nurse is expected to incorporate EBP into daily patient care. This expectation is fueled by the guidelines established by professional, accrediting, and regulatory bodies. Barriers to incorporating EBP into practice have been well documented in the literature. A CNS, a health science librarian, and a staff nurse collaborated to develop an EBP educational program for staff nurses. The staff nurse provides the real-time practice issues, the CNS gives extensive knowledge of translating research into practice, and the health science librarian is an expert at retrieving the information from the literature. The resulting collaboration at this academic medical center has increased staff nurse exposure to and knowledge about EBP principles and techniques. The collaborative relationship among the CNS, health science librarian, and staff nurse effectively addresses a variety of barriers to EBP. This successful collaborative approach can be utilized by other medical centers seeking to educate staff nurses about the EBP process.

[Nursing care in fluorescein angiography].

PubMed

Santos-Blanco, Feliciano

2008-01-01

Fluoresceinic angiography of the ocular fundus is a diagnostic technique to study retinal and choroidal circulation. This technique consists of parenteral administration of 500 mg of sodium fluorescein 10% and photographing the fluorescence in the eye vessels. Although this substance is fairly safe, it may also produce mild, moderate or severe local and/or general adverse reactions. The nursing process is routinely used in hospital units but not always in outpatient clinics, even through the use of invasive procedures with intravenous medication administration is common. Therefore, nurses, as those reponsible for intravenous administration, should use the nursing process to guarantee the quality of care required by the patient. To do this, we describe an individualized care plan based on evaluation by Marjorie Gordon's functional health patterns, NANDA's nursing diagnoses Taxonomy II, Nursing Outcomes Classification (NOC), Nursing Interventions Classifications (NIC) and potential complications of the procedure.

Philosophy and nursing.

PubMed

Griffin, A P

1980-05-01

It is claimed that philosophy has a distinctive contribution to make to the education of nurses and their teachers, as well as to the development of nursing theory and research. After a brief characterization of philosophy and philosophy of education, stressing its relationship with thinking processes, and the development of personal values, the above claim is supported in the body of the article by discussion of four central concerns in nursing. First the concept of caring where cognitive, moral and attitudinal aspects are examined and secondly, the importance of gaining a moral and political consciousness of assumptions underlying a nurse's work. Thirdly, a discussion of some ethical and other implications in adopting a systems approach to the nursing process. Finally an anlysis of nursing theory and research which draws attention to the value of non-empirical work, and reiterates criticisms of the objectives approach as a research tool.

The process, logistics and challenges of implementing clinical supervision in a generalist tertiary referral hospital.

PubMed

Brunero, Scott; Lamont, Scott

2012-03-01

Clinical supervision (CS) has been identified within nursing as a process for improving clinical practice and reducing the emotional burden of nursing practice. Little is known about its implementation across large tertiary referral hospitals. The purpose of this study is to evaluate the implementation of clinical supervision across several different nursing specialities at a teaching hospital in Sydney, Australia. Using a model of nursing implementation science, a process was developed at the study site that facilitated the development, implementation and evaluation of the project. After a 6-month study period, the CS groups were postevaluated using a survey tool developed for the project. A total of nine CS groups were in operation over the 6-month study period. A predominant focus within the sessions was one of the collegial support and developing standards of practice. The process was able to achieve wide hospital-based support for the role of CS from the senior nurse executives to junior nurses. Whilst there was overall positive support for the CS groups, logistical and resource challenges remain, in the effective roll out of CS to large numbers of nurses. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

A Grounded theory study of the intention of nurses to leave the profession 1

PubMed Central

Alilu, Leyla; Zamanzadeh, Vahid; Valizadeh, Leila; Habibzadeh, Hosein; Gillespie, Mark

2017-01-01

ABSTRACT Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them. PMID:28591301

Empowering nurses to handle the guideline implementation process: identification of implementation competencies.

PubMed

Holleman, Gerda; van Tol, Marjo; Schoonhoven, Lisette; Mintjes-de Groot, Joke; van Achterberg, Theo

2014-01-01

Employing nurses as opinion leaders to implement guidelines may be a promising implementation activity. Until now, insight into necessary competencies of nurse opinion leaders is lacking. We studied and supported aspiring nurse opinion leaders, using a training program based on social influence and implementation theory. Twenty-one competencies were identified, of which the most important were cooperating, communicating, delegating, giving feedback, networking, and information processing. Understanding and addressing these competencies may support the implementation of evidence-based guidelines.

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.

Fears for literacy and numeracy as new nurses fail basic tests.

PubMed

Learner, Sue

2006-08-16

The Nursing and Midwifery Council (NMC) has voiced concern over nurses' poor levels of English and maths after a third of newly qualified nurses failed a basic test set by a hospital as part of anew selection process.

Research in Nursing Education: Yesterday--Today--Tomorrow.

ERIC Educational Resources Information Center

Reilly, Dorothy E.

1990-01-01

Discusses the development of research in nursing education from Florence Nightingale as statistician to the effects of doctor-nurse relations to the acceleration produced by various wars to the special nurses who make research a natural process for the profession. (Author/JOW)

Northern nursing practice in a primary health care setting.

PubMed

Vukic, Adele; Keddy, Barbara

2002-12-01

This paper explicates the nature of outpost nursing work, and/or the day-to-day realities of northern nursing practice in a primary health care setting in Canada. The study was carried out to systematically explore the work of nurses in an indigenous setting. Institutional ethnography, pioneered by Dorothy Smith was the methodology used to guide this research. The theoretical perspective of this methodology does not seek causes or links but intends to explicate visible practices. It is intended to explicate the social organization of specific discourses that inform work processes of nurses working in remote indigenous communities. The data originated from various sources including spending 2 weeks in a northern remote community shadowing experienced nurses, taking field notes and audio taping interviews with these nurses. One of the two researchers was a northern practice nurse for many years and has had taught in an outpost nursing programme. As part of the process, texts were obtained from the site as data to be incorporated in the analysis. The lived experiences have added to the analytical understanding of the work of nurses in remote areas. Data uncovered documentary practices inherent to the work setting which were then analysed along with the transcribed interviews and field notes derived from the on-site visit. Identifying disjuncture in the discourse of northern nursing and the lived experience of the nurses in this study was central to the research process. The results indicated that the social organization of northern community nursing work required a broad generalist knowledge base for decision making to work effectively within this primary health care setting. The nurse as 'other' and the invisibility of nurses' work of building a trusting relationship with the community is not reflected in the discourse of northern nursing. Trust cannot be quantified or measured yet it is fundamental to working effectively with the community. The nurses in this study saw building trust to promote health and well-being in communities as very important, yet very difficult to achieve. The difficulty in part stems from the constraining, structural, administrative, historical, cultural and political contextual realities that have shaped northern community nursing.

Implementing two nurse practitioner models of service at an Australian male prison: A quality assurance study.

PubMed

Wong, Ides; Wright, Eryn; Santomauro, Damian; How, Raquel; Leary, Christopher; Harris, Meredith

2018-01-01

To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service. The study was guided by Donabedian's structure, processes and outcomes framework. Routinely collected information included surveys of staff attitudes to the implementation of the nurse practitioner models (n = 21 staff), consultation records describing clinical processes and time use (n = 289 consultations), and a patient satisfaction survey (n = 29 patients). Data were analysed descriptively and compared to external benchmarks where available. Over the two-month period, the nurse practitioners provided 289 consultations to 208 prisoners. The presenting problems treated indicated that most referrals were appropriate. A significant proportion of consultations involved medication review and management. Both nurse practitioners spent more than half of their time on individual patient-related care. Overall, multidisciplinary team staff agreed that the nurse practitioner services were necessary, safe, met patient need and reduced treatment delays. Findings suggest that the implementation of nurse practitioners into Australian correctional facilities is acceptable and feasible and has the potential to improve prisoners' access to health services. Structural factors (e.g., room availability and limited access to prisoners) may have reduced the efficiency of the nurse practitioners' clinical processes and service implementation. Results suggest that nurse practitioner models can be successfully integrated into a prison setting and could provide a nursing career pathway. © 2017 John Wiley & Sons Ltd.

Critical Thinking Outcomes of Computer-Assisted Instruction versus Written Nursing Process.

ERIC Educational Resources Information Center

Saucier, Bonnie L.; Stevens, Kathleen R.; Williams, Gail B.

2000-01-01

Nursing students (n=43) who used clinical case studies via computer-assisted instruction (CAI) were compared with 37 who used the written nursing process (WNP). California Critical Thinking Skills Test results did not show significant increases in critical thinking. The WNP method was more time consuming; the CAI group was more satisfied. Use of…

The Process of Teaching and Learning about Reflection: Research Insights from Professional Nurse Education

ERIC Educational Resources Information Center

Bulman, Chris; Lathlean, Judith; Gobbi, Mary

2014-01-01

The study aimed to investigate the process of reflection in professional nurse education and the part it played in a teaching and learning context. The research focused on the social construction of reflection within a post-registration, palliative care programme, accessed by nurses, in the United Kingdom (UK). Through an interpretive ethnographic…

[Inverse innovation models in the nurse clinic of a Urology Department].

PubMed

Gamarra, Manuela; López, Maria C; Luján, Marcos; Mora, Jose Ramón

2015-01-01

In the urology clinics there is an important volume of limited-complexity pathology that consumes an important part of resources. Delegating some tasks of this type to Nurses may imply a competitive advantage in economic terms without decrease in the quality of the care given to patients and their level of satisfaction. This is an example of the concept of inverse innovation. In this work we try to make public our experience in the management by nursing staff of features of the urology consultation traditionally reserved to physicians, as well as the design of the related processes. We developed the most frequent processes competence of the nursing staff in the unit: 1) Care of ambulatory urological surgery pathology; 2) Urologic ultrasound; 3) Traditional urologic nurse consultation. During 2013 the nursing staff performed 423 ambulatory urologic surgery pathology clinic visits, 931 urologic ultrasounds and 1019 varied actions corresponding to traditional urological nurse work.We developed stabilization formularies and flow diagrams of the aforementioned processes. We performed a quantification of the amount of money saved in comparison with the costs generated if a nurse or a physician was employed. Such saving was 2,78 and 4,00 Euros in the ambulatory urological surgery pathology and urologic ultrasound, respectively. Total savings in both processes was 4900 Euros. Implication of urological nursing staff in certain care tasks traditionally reserved to the physician is possible without increase in quality defects, obtaining an advantage in terms of economic cost and flexibility in staff organization thanks to the expansion of the competence array.

Neonatal Intensive Care Nursing Curriculum Challenges based on Context, Input, Process, and Product Evaluation Model: A Qualitative Study.

PubMed

Ashghali-Farahani, Mansoureh; Ghaffari, Fatemeh; Hoseini-Esfidarjani, Sara-Sadat; Hadian, Zahra; Qomi, Robabeh; Dargahi, Helen

2018-01-01

Weakness of curriculum development in nursing education results in lack of professional skills in graduates. This study was done on master's students in nursing to evaluate challenges of neonatal intensive care nursing curriculum based on context, input, process, and product (CIPP) evaluation model. This study was conducted with qualitative approach, which was completed according to the CIPP evaluation model. The study was conducted from May 2014 to April 2015. The research community included neonatal intensive care nursing master's students, the graduates, faculty members, neonatologists, nurses working in neonatal intensive care unit (NICU), and mothers of infants who were hospitalized in such wards. Purposeful sampling was applied. The data analysis showed that there were two main categories: "inappropriate infrastructure" and "unknown duties," which influenced the context formation of NICU master's curriculum. The input was formed by five categories, including "biomedical approach," "incomprehensive curriculum," "lack of professional NICU nursing mentors," "inappropriate admission process of NICU students," and "lack of NICU skill labs." Three categories were extracted in the process, including "more emphasize on theoretical education," "the overlap of credits with each other and the inconsistency among the mentors," and "ineffective assessment." Finally, five categories were extracted in the product, including "preferring routine work instead of professional job," "tendency to leave the job," "clinical incompetency of graduates," "the conflict between graduates and nursing staff expectations," and "dissatisfaction of graduates." Some changes are needed in NICU master's curriculum by considering the nursing experts' comments and evaluating the consequences of such program by them.

[Threats to Identity: A Grounded Theory Approach on Student Nurses' Experience of Incivility during Clinical Placement].

PubMed

Kang, Jiyeon; Jeong, Yeon Jin; Kong, Kyoung Ran

2018-02-01

This qualitative study aimed to explore the experience of incivility among nursing students. Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments. © 2018 Korean Society of Nursing Science.

Nursing education in Poland - The past and new development perspectives.

PubMed

Ślusarska, Barbara; Zarzycka, Danuta; Dobrowolska, Beata; Marcinowicz, Ludmiła; Nowicki, Grzegorz

2018-05-25

Professional nursing education in Poland began in 1911 in Kraków. Since then, the nursing education system has continued to change. From the establishment of the first professional nursing school, Poland experienced partition, war and the German occupation, short-lived independence, the Soviet regime and the regaining of its freedom, as well as the development of democracy processes. All of these events impacted on nurses' education. The current state of nursing training is determined by the requirements of the Council of the European Communities. Today, the challenge for nursing education in Poland is the permanent process of the country's education system's adjustment to the European Higher Education Area to ensure the quality of education and to support the mobility of students and academic teachers. Additionally, new competencies pertaining to nurse prescribing, which have been in force in Poland since 2016, will cause new changes to the under- and postgraduate programmes of nursing education. The aim of this study is to present the development of nursing education in Poland in the context of socio-political changes in the country and from the perspective of current nursing challenges worldwide. Copyright © 2018. Published by Elsevier Ltd.

Due Process Rights of Nursing Students in Case of Misconduct.

ERIC Educational Resources Information Center

Osinski, Kay

2003-01-01

Explains the concepts of academic misconduct, due process rights, and the implicit contract between students and the university. Discusses ways to incorporate due process in nursing school course catalogs, course requirements, evaluation methods, and grievance procedures. (SK)

The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students.

PubMed

Taylor, Christine; Angel, Liz; Nyanga, Lucy; Dickson, Cathy

2017-10-01

To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy. Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements. The project used a descriptive approach within a quality implementation framework. The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications. A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given. There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements. Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning clinical placement procurement, and assisting in decision-making and developing strategies and processes for practice. © 2016 John Wiley & Sons Ltd.

Oncology Nurse Generalist Competencies: Oncology Nursing Society's Initiative to Establish Best Practice.

PubMed

Gaguski, Michele E; George, Kim; Bruce, Susan D; Brucker, Edie; Leija, Carol; LeFebvre, Kristine B; Mackey, Heather

2017-12-01

A project team was formulated to create evidence-based oncology nurse generalist competencies (ONGCs) to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses.
. This article aims to describe the process and the development of ONGCs. 
. This article explains how the ONGCs were accomplished, and includes outcomes and suggestions for use in clinical practice. 
. Institutions can use the ONGCs to assess and develop competency programs, offer educational strategies to measure proficiency, and establish processes to foster a workplace committed to mentoring and teaching future oncology nurses.

[International Classification of Public Health Nursing Practices - CIPESC®: a pedagogical tool for epidemiological studies].

PubMed

Nichiata, Lúcia Yasuko Izumi; Padoveze, Maria Clara; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins; Costa, Angela Aparecida; Takahashi, Renata Ferreira; Bertolozzi, Maria Rita; de Araújo, Núbia Virgínia D'Ávila Limeira; Pereira, Erica Gomes; Dias, Vânia Ferreira Gomes; Cubas, Marcia Regina

2012-06-01

The CIPESC® is a tool that informs the work of nurses in Public Health and assists in prioritizing their care in practice, management and research. It is also a powerful pedagogical instrument for the qualification of nurses within the Brazilian healthcare system. In the teaching of infectious diseases, using the CIPESC® assists in analyzing the interventions by encouraging clinical and epidemiological thinking regarding the health-illness process. With the purpose in mind of developing resources for teaching undergraduate nursing students and encouraging reflection regarding the process of nursing work, this article presents an experimental application of CIPESC®, using meningococcal meningitis as an example.

Evolving safety practices in the setting of modern complex operating room: role of nurses.

PubMed

Niu, L; Li, H Y; Tang, W; Gong, S; Zhang, L J

2017-01-01

Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher. Although, utmost priority is placed on insuring patient safety and well-being, they are also expected to participate in professional organization, continuing medical education programs and participating in research activities. A Surgical Patient Safety Checklist formulated by the World Health Organization serves as a major guideline to all activities in OR, and peri-operative nurses are key personnel in its implementation. Communication among the various players of a procedure in OR is key to successful patient outcome, and peri-operative nurses have a central role in making it happen. Setting up of OR in military conflict zones or places that suffering a widespread natural disaster poses a unique challenge to nursing. This review discusses all aspects of peri-operative nursing and suggests points of improvement in patient care.

Use of Balanced Indicators as a Management Tool in Nursing.

PubMed

Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

2015-01-01

To develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. A single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. We identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

[Information technology and hospital care: reflection on the meaning of the work].

PubMed

Fonseca, Cláudia Maria Barboza Machado; dos Santos, Mônica Loureiro

2007-01-01

The purpose of this paper is to present the experience of nurses since the introduction of information technology in hospital work processes. It analyzes the meaning of information technology within the subjectivity and perception of healthcare in nursing work in a general hospital. As a theoretical background, it takes studies of work psychodynamics/psychopathology, referred to healthcare work processes and their repercussions on worker health. This qualitative inquiry strives to understand the significance of this subject in nursing routines. The field research was based on semi-structured interviews and non-systematic observation of some nursing activities, noting some resistance to change among the nurses, with difficulties in organizing the work and introducing them to new ways of handling their tasks. Faced by a machine, they feel trapped and isolated. This leads to the conclusion that the implementation of information technology interferes significantly in the work processes of the nurses participating in this study, and may adversely affect their health in the future.

[Cost of nursing turnover in a Teaching Hospital].

PubMed

Ruiz, Paula Buck de Oliveira; Perroca, Marcia Galan; Jericó, Marli de Carvalho

2016-02-01

To map the sub processes related to turnover of nursing staff and to investigate and measure the nursing turnover cost. This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology. The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%). The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.

Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis.

PubMed

Hernández-Marrero, Pablo; Fradique, Emília; Pereira, Sandra Martins

2018-01-01

Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations" (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses' current end-of-life care practices. Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described. All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients' preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses' involvement and practices in end-of-life decision-making.

Nursing care of patients during the dying process: a painful professional and human function.

PubMed

Lopera Betancur, Martha Adiela

2015-01-01

This work sought to describe the care functions of nurses with patients during the dying process. This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. Patient care during dying processes transcends the limits of the nurse' professional functions to become a human obligation.

Research environments that promote integrity.

PubMed

Jeffers, Brenda Recchia; Whittemore, Robin

2005-01-01

The body of empirical knowledge about research integrity and the factors that promote research integrity in nursing research environments remains small. To propose an internal control model as an innovative framework for the design and structure of nursing research environments that promote integrity. An internal control model is adapted to illustrate its use for conceptualizing and designing research environments that promote integrity. The internal control model integrates both the organizational elements necessary to promote research integrity and the processes needed to assess research environments. The model provides five interrelated process components within which any number of research integrity variables and processes may be used and studied: internal control environment, risk assessment, internal control activities, monitoring, and information and communication. The components of the proposed research integrity internal control model proposed comprise an integrated conceptualization of the processes that provide reasonable assurance that research integrity will be promoted within the nursing research environment. Schools of nursing can use the model to design, implement, and evaluate systems that promote research integrity. The model process components need further exploration to substantiate the use of the model in nursing research environments.

Evaluating and improving a model of nursing care delivery: a process of partnership.

PubMed

Hall, Catherine; McCutcheon, Helen; Deuter, Kate; Matricciani, Lisa

2012-01-01

Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Researchers conducted non-participant observations (n = 9) of two hours duration across the 24 h period. Focus groups (n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008-2009. Two main problem areas were identified as impeding the nurses' ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.

Registered nurses' clinical reasoning in home healthcare clinical practice: A think-aloud study with protocol analysis.

PubMed

Johnsen, Hege Mari; Slettebø, Åshild; Fossum, Mariann

2016-05-01

The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. An exploratory qualitative think-aloud design with protocol analysis was used. Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. A purposeful sample of eight registered nurses with one year of experience. Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nurses' views on their involvement in euthanasia: a qualitative study in Flanders (Belgium)

PubMed Central

de Casterlé, B Dierckx; Verpoort, C; De Bal, N; Gastmans, C

2006-01-01

Background Although nurses worldwide are confronted with euthanasia requests from patients, the views of palliative care nurses on their involvement in euthanasia remain unclear. Objectives In depth exploration of the views of palliative care nurses on their involvement in the entire care process surrounding euthanasia. Design A qualitative Grounded Theory strategy was used. Setting and participants In anticipation of new Belgian legislation on euthanasia, we conducted semistructured interviews with 12 nurses working in a palliative care setting in the province of Vlaams‐Brabant (Belgium). Results Palliative care nurses believed unanimously that they have an important role in the process of caring for a patient who requests euthanasia, a role that is not limited to assisting the physician when he is administering life terminating drugs. Nurses' involvement starts when the patient requests euthanasia and ends with supporting the patient's relatives and healthcare colleagues after the potential life terminating act. Nurses stressed the importance of having an open mind and of using palliative techniques, also offering a contextual understanding of the patient's request in the decision making process. Concerning the actual act of performing euthanasia, palliative care nurses saw their role primarily as assisting the patient, the patient's family, and the physician by being present, even if they could not reconcile themselves with actually performing euthanasia. Conclusions Based on their professional nursing expertise and unique relationship with the patient, nurses participating as full members of the interdisciplinary expert team are in a key position to provide valuable care to patients requesting euthanasia. PMID:16574869

Establishing the competences of clinical reasoning for nursing students in Taiwan: From the nurse educators' perspectives.

PubMed

Huang, Hui-Man; Huang, Chu-Yu; Lee-Hsieh, Jane; Cheng, Su-Fen

2018-07-01

Clinical reasoning is an essential core competence for nurses. Maintaining quality of care and safety of patients results from cultivation of student's clinical reasoning competency. However, the concept of clinical reasoning in nursing students is complex and its meaning and process needs further clarification. The objectives were to explore the meaning of clinical reasoning competency in Taiwanese nursing students and to operationalize the concept in order to structure a framework illustrating the process of clinical reasoning. Thirteen seasoned nursing experts who had more than ten years of experience in nursing education or clinical practice participated in the interviews. The interviews were conducted in settings that the participants perceived as convenient, quiet and free of disturbance. Semi-structured interviews were conducted. The interviews were audio-recorded and field notes were taken. The data were analyzed using Waltz et al.'s (2010) method of content analysis. The data revealed four domains and 11 competency indicators. The four domains include: awareness of clinical cues, confirmation of clinical problems, determination and implementation of actions, and evaluation and self-reflection. Each domain comprises of 2-4 indicators of clinical reasoning competency. In addition, this study established a framework for cultivation of clinical reasoning competency in nursing students. The indicators of clinical reasoning competency in nursing students are interwoven, interactive and interdependent to form a dynamic process. The findings of this study may facilitate evaluation of nursing students' clinical reasoning competency and development of instruments to assess clinical reasoning in nursing students. Copyright © 2018 Elsevier Ltd. All rights reserved.

Nurse practitioner integration: Qualitative experiences of the change management process.

PubMed

Lowe, Grainne; Plummer, Virginia; Boyd, Leanne

2018-04-30

The aim of this qualitative research was to explore perceptions of organisational change related to the integration of nurse practitioners from key nursing stakeholders. The ongoing delivery of effective and efficient patient services is reliant upon the development and sustainability of nurse practitioner roles. Examination of the factors contributing to the underutilization of nurse practitioner roles is crucial to inform future management policies. A change management theory is used to reveal the complexity involved. Qualitative interviews were undertaken using a purposive sampling strategy of key stakeholders. Thematic analysis was undertaken and key themes were correlated to the theoretical framework. The results confirm the benefits of nurse practitioner roles, but suggest organisational structures and embedded professional cultures present barriers to full role optimization. Complicated policy processes are creating barriers to the integration of nurse practitioner roles. The findings increase understanding of the links between strategic planning, human resource management, professional and organisational cultures, governance and politics in change management. Effective leadership drives the change process through the ability to align key components necessary for success. Sustainability of nurse practitioners relies on recognition of their full potential in the health care team. The results of this study highlight the importance of management and leadership in the promotion of advanced nursing skills and experience to better meet patient outcomes. The findings reinforce the potential of nurse practitioners to deliver patient centred, timely and efficient health care. © 2018 John Wiley & Sons Ltd.

Thinking Like a Nurse and Perceived Readiness for Professional Practice: A Mixed Methods Study

ERIC Educational Resources Information Center

Bowdoin, Carol

2014-01-01

Thinking like a nurse (TLN) has been identified as a core competency of professional nursing practice. The term embraces the full context of the daily metacognitive process nurses use to provide competent nursing care and was theorized in this study to have four attributes: critical thinking, clinical judgment, moral reasoning, and professional…

Recognizing and responding to uncertainty: a grounded theory of nurses' uncertainty.

PubMed

Cranley, Lisa A; Doran, Diane M; Tourangeau, Ann E; Kushniruk, Andre; Nagle, Lynn

2012-08-01

There has been little research to date exploring nurses' uncertainty in their practice. Understanding nurses' uncertainty is important because it has potential implications for how care is delivered. The purpose of this study is to develop a substantive theory to explain how staff nurses experience and respond to uncertainty in their practice. Between 2006 and 2008, a grounded theory study was conducted that included in-depth semi-structured interviews. Fourteen staff nurses working in adult medical-surgical intensive care units at two teaching hospitals in Ontario, Canada, participated in the study. The theory recognizing and responding to uncertainty characterizes the processes through which nurses' uncertainty manifested and how it was managed. Recognizing uncertainty involved the processes of assessing, reflecting, questioning, and/or being unable to predict aspects of the patient situation. Nurses' responses to uncertainty highlighted the cognitive-affective strategies used to manage uncertainty. Study findings highlight the importance of acknowledging uncertainty and having collegial support to manage uncertainty. The theory adds to our understanding the processes involved in recognizing uncertainty, strategies and outcomes of managing uncertainty, and influencing factors. Tailored nursing education programs should be developed to assist nurses in developing skills in articulating and managing their uncertainty. Further research is needed to extend, test and refine the theory of recognizing and responding to uncertainty to develop strategies for managing uncertainty. This theory advances the nursing perspective of uncertainty in clinical practice. The theory is relevant to nurses who are faced with uncertainty and complex clinical decisions, to managers who support nurses in their clinical decision-making, and to researchers who investigate ways to improve decision-making and care delivery. ©2012 Sigma Theta Tau International.

Nursing process decision support system for urology ward.

PubMed

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

2013-07-01

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

The dimensions of nursing surveillance: a concept analysis.

PubMed

Kelly, Lesly; Vincent, Deborah

2011-03-01

This paper is a report of an analysis of the concept of nursing surveillance. Nursing surveillance, a primary function of acute care nurses, is critical to patient safety and outcomes. Although it has been associated with patient outcomes and organizational context of care, little knowledge has been generated about the conceptual and operational process of surveillance. A search using the CINAHL, Medline and PubMed databases was used to compile an international data set of 18 papers and 4 book chapters published from 1985 to 2009. Rodger's evolutionary concept analysis techniques were used to analyse surveillance in a systems framework. This method focused the search to nursing surveillance (as opposed to other medical uses of the term) and used a theoretical framework to guide the analysis. The examination of the literature clarifies the multifaceted nature of nursing surveillance in the acute care setting. Surveillance involves purposeful and ongoing acquisition, interpretation and synthesis of patient data for clinical decision-making. Behavioural activities and multiple cognitive processes are used in surveillance in order for the nurse to make decisions for patient safety and health maintenance. A systems approach to the analysis also demonstrates how organizational characteristics and contextual factors influence the process in the acute care environment. This conceptual analysis describes the nature of the surveillance process and clarifies the concept for effective communication and future use in health services research. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

Evaluation of the quality of the teaching-learning process in undergraduate courses in Nursing.

PubMed

González-Chordá, Víctor Manuel; Maciá-Soler, María Loreto

2015-01-01

to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing. prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis. nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p<0.05). There are statistically significant differences depending on the hospital and clinical practices unit (p<0.05). the analysis of the evaluation tools used in the article "Nursing Care in Welfare Processes" of the analyzed university undergraduate course enabled the detection of the areas for improvement in the teachinglearning process. The challenge of education in nursing is to reach the best clinical research and educational results, in order to provide improvements to the quality of education and health care.

The Vanderbilt Professional Nursing Practice Program, part 3: managing an advancement process.

PubMed

Steaban, Robin; Fudge, Mitzie; Leutgens, Wendy; Wells, Nancy

2003-11-01

Consistency of performance standards across multiple clinical settings is an essential component of a credible advancement system. Our advancement process incorporates a central committee, composed of nurses from all clinical settings within the institution, to ensure consistency of performance in inpatient, outpatient, and procedural settings. An analysis of nurses advanced during the first 18 months of the program indicates that performance standards are applicable to nurses in all clinical settings. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program underway at Vanderbilt University Medical Center. Part 2 described the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the program's inception. The purpose of this article is to review the advancement process, review the roles of those involved in the process, and to describe outcomes and lessons learned.

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Reconciling professional identity: A grounded theory of nurse academics' role modelling for undergraduate students.

PubMed

Baldwin, A; Mills, J; Birks, M; Budden, L

2017-12-01

Role modelling by experienced nurses, including nurse academics, is a key factor in the process of preparing undergraduate nursing students for practice, and may contribute to longevity in the workforce. A grounded theory study was undertaken to investigate the phenomenon of nurse academics' role modelling for undergraduate students. The study sought to answer the research question: how do nurse academics role model positive professional behaviours for undergraduate students? The aims of this study were to: theorise a process of nurse academic role modelling for undergraduate students; describe the elements that support positive role modelling by nurse academics; and explain the factors that influence the implementation of academic role modelling. The study sample included five second year nursing students and sixteen nurse academics from Australia and the United Kingdom. Data was collected from observation, focus groups and individual interviews. This study found that in order for nurse academics to role model professional behaviours for nursing students, they must reconcile their own professional identity. This paper introduces the theory of reconciling professional identity and discusses the three categories that comprise the theory, creating a context for learning, creating a context for authentic rehearsal and mirroring identity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Being at peace as an important factor in acquiring teaching competency by Iranian nurse teachers: a qualitative study.

PubMed

Emamzadeh Ghasemi, Hormat Sadat; Rafii, Forough; Farahani, Mansoureh A; Mohammadi, Nooreddin

2014-02-24

It is imperative to understand the factor that influence teaching competency. Therefore, it is necessary to study those that have an impact on the process of acquiring teaching competency. Competent nurse teachers have an important role in the achievement of nursing students and improving the quality of nursing education. However, few researches have focused specifically on the process of acquiring teaching competency in nurse teachers and its related factors. This study as a part of more extensive research aims to explore the factors influencing acquisition of teaching competency by Iranian nurse teachers. Grounded theory was chosen as the method. Eleven teachers from three nursing schools in Tehran were recruited. Data was generated by semi structured interviews during May 2011 to March 2013 and was analyzed through using constant comparison. Three main categories were emerged including "individual characteristics" (spirituality, professional interest, ethical conducts, knowledge expansion and reflective practice), "organizational factors" (management of educational systems, solidarity culture, student characteristics) and "socio-cultural factors" (social situations, and public definition of nursing). Nurse teachers who deal peacefully with the nursing profession and colleagues are responsible and committed to acquiring teaching competency. A suitable organization in nursing educational systems that is structured and ordered also encourages a peaceful approach by nurse teachers.

Being at Peace as an Important Factor in Acquiring Teaching Competency by Iranian Nurse Teachers: A Qualitative Study

PubMed Central

ghasemi, Hormat Sadat Emamzadeh; Rafii, Forough; Farahani, Mansoureh A.; Mohammadi, Nooreddin

2014-01-01

It is imperative to understand the factor that influence teaching competency. Therefore, it is necessary to study those that have an impact on the process of acquiring teaching competency. Competent nurse teachers have an important role in the achievement of nursing students and improving the quality of nursing education. However, few researches have focused specifically on the process of acquiring teaching competency in nurse teachers and its related factors. This study as a part of more extensive research aims to explore the factors influencing acquisition of teaching competency by Iranian nurse teachers. Grounded theory was chosen as the method. Eleven teachers from three nursing schools in Tehran were recruited. Data was generated by semi structured interviews during May 2011 to March 2013 and was analyzed through using constant comparison. Three main categories were emerged including “individual characteristics” (spirituality, professional interest, ethical conducts, knowledge expansion and reflective practice), “organizational factors” (management of educational systems, solidarity culture, student characteristics) and “socio-cultural factors” (social situations, and public definition of nursing). Nurse teachers who deal peacefully with the nursing profession and colleagues are responsible and committed to acquiring teaching competency. A suitable organization in nursing educational systems that is structured and ordered also encourages a peaceful approach by nurse teachers. PMID:24762353

Marketing in nursing organizations.

PubMed

Chambers, S B

1989-05-01

The purpose of chapter 3 is to provide a conceptual framework for understanding marketing. Although it is often considered to be, marketing is not really a new activity for nursing organizations. What is perhaps new to most nursing organizations is the conduct of marketing activities as a series of interrelated events that are part of a strategic marketing process. The increasingly volatile nursing environment requires a comprehensive approach to marketing. This chapter presents definitions of marketing, the marketing mix, the characteristics of nonprofit marketing, the relationship of strategic planning and strategic marketing, portfolio analysis, and a detailed description of the strategic marketing process. While this chapter focuses on marketing concepts, essential components, and presentation of the strategic marketing process, chapter 4 presents specific methods and techniques for implementing the strategic marketing process.

Emancipated minors: health policy and implications for nursing.

PubMed

Lane, Susan H; Kohlenberg, Eileen

2012-10-01

Emancipation is a process that offers adolescents a solution to serve in the role of an adult in circumstances that warrant the need for more autonomy. The process and definitions of emancipation are often ambiguous for adolescents, nurses, and other health care providers that provide services for these individuals. Emancipation can be additionally perplexing with the lack of overarching federal guidelines and the fragmented definitions among various states. Nursing has a significant and legal role in providing care for emancipated minors and a more global duty to advocate for adolescents in situations that necessitate emancipation. This article explores the emancipation process, the laws of each state that govern emancipation, the facilitators and barriers, and the role of nursing in the emancipation process. Copyright © 2012 Elsevier Inc. All rights reserved.

Cognitive Continuum Theory in nursing decision-making.

PubMed

Cader, Raffik; Campbell, Steve; Watson, Don

2005-02-01

The purpose of this paper is to analyse and evaluate Cognitive Continuum Theory and to provide evidence for its relevance to nurses' decision-making. It is critical that theories used in nursing are evaluated to provide an understanding of their aims, concepts and usefulness. With the advent of evidence-based care, theories on decision-making have acquired increased significance. The criteria identified by Fawcett's framework has been used to analyse and evaluate Hammond's Cognitive Continuum Theory. Findings. There is empirical evidence to support many of the concepts and propositions of Cognitive Continuum Theory. The theory has been applied to the decision-making process of many professionals, including medical practitioners and nurses. Existing evidence suggests that Cognitive Continuum Theory can provide the framework to explain decision-making in nursing. Cognitive Continuum Theory has the potential to make major contributions towards understanding the decision-making process of nurses in the clinical environment. Knowledge of the theory in nursing practice has become crucial.

Optimizing nursing care delivery systems in the Army: back to basics with care teams and peer feedback.

PubMed

Prue-Owens, Kathy; Watkins, Miko; Wolgast, Kelly A

2011-01-01

The Patient CaringTouch System emerged from a comprehensive assessment and gap analysis of clinical nursing capabilities in the Army. The Patient CaringTouch System now provides the framework and set of standards by which we drive excellence in quality nursing care for our patients and excellence in quality of life for our nurses in Army Medicine. As part of this enterprise transformation, we placed particular emphasis on the delivery of nursing care at the bedside as well as the integration of a formal professional peer feedback process in support of individual nurse practice enhancement. The Warrior Care Imperative Action Team was chartered to define and establish the standards for care teams in the clinical settings and the process by which we established formal peer feedback for our professional nurses. This back-to-basics approach is a cornerstone of the Patient CaringTouch System implementation and sustainment.

Mission possible: twenty-five years of university and college collaboration in baccalaureate nursing education.

PubMed

Zawaduk, Cheryl; Duncan, Susan; Mahara, M Star; Tate, Betty; Callaghan, Doris; McCullough, Deborah; Chapman, Marilyn; Van Neste-Kenny, Jocelyne

2014-10-01

In Canada, nurse educators from five postsecondary institutions in the province of British Columbia established a collaborative nursing education initiative in 1989, with a vision to transform RN college diploma programs to baccalaureate degree programs. The principles, processes, and structures that served to develop and sustain this nursing education initiative are briefly reviewed. Curriculum, scholarship, and education legislation serve as platforms to critically explore a 25-year history (1989-2014) of successes, challenges, and transitions within this unique nursing education collaboration. The importance of curriculum development as faculty development, program evaluation as an adjunct to pedagogical scholarship, diversity of cross-institutional mandates, political interplay in nursing education, collegiality, and courageous leadership are highlighted. Nurse educators seeking to create successful collaborations must draw upon well-defined principles and organizational structures and processes to guide pedagogical practices and inquiry while remaining mindful of and engaged in professional and societal developments. Copyright 2014, SLACK Incorporated.

[TREATMENT OF ATTENTION DEFICIT AND HYPERACTIVITY DISORDER (ADHD): NURSING IMPLICATIONS].

PubMed

Luna Delgado, Laura; Moriones Jiménez, Olalla

2014-09-01

This review aims to know the role of the nurse in ADHD treatment, identifying the most appropriate therapeutic options between nursing interventions and pharmacological treatment. In ADHD, the role of the nurse is to respond family needs about the effectiveness of medication, behavior modification treatment and other alternatives. There are family interventions of psychoeducation that assist the child in the recovery process. Through the education for health, the nurse should promote the combination of behavioral therapy and pharmacological as the only one able to improve child's quality of life. Nurses have a privileged role due to its experience in education for health; this contributes to being a competent agent that provides families essential information about the disease treatment. Spanish schools are lacking a figure that represent health as a relevant subject in the vital process, hence the need of the school nurse.

Information science for the future: an innovative nursing informatics curriculum.

PubMed

Travis, L; Flatley Brennan, P

1998-04-01

Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.

Feminist pedagogy: a framework for nursing education?

PubMed

Hezekiah, J

1993-02-01

This article describes the feminist pedagogical strategies used in a nursing course in the post-RN Bachelor of Science in Nursing (BScN) program, Aga Khan University, Karachi, Pakistan. A variety of concepts that have direct relevance for nurses were discussed within small groups. These settings provided the venue for an examination of the issues that nurses, as primarily female, face in a patriarchal Muslim society and an androcentric health care system. Emphasis is on the process used in terms of feminist pedagogical practices and its relationship to feminist theory and critical pedagogy. The five process goals suggested by Schniedewind (1983) formed the basis for an exploration of this relationship through an analysis of the content and practices used in the course. It is demonstrated that the teaching practices advocated by feminist pedagogy hold much promise for nursing education to empower nurses and to make an impact on the health care system.

Fitting Square Pegs into round Holes: Doing Qualitative Nursing Research in a Quantitative World.

PubMed

Newton, Lorelei; Kimpson, Sally

2014-09-01

The authors, as doctoral candidates and registered nurses, took on a qualitative research project investigating nursing practice in a research-intensive organization. Their aims were to explore and describe how nurses in the ambulatory care setting assist patients and families, including how nursing practice was carried out, constraints to practice, and the influence of the interprofessional milieu. Their first finding, in part because of the qualitative research design used, concerned the potential impact of the organizational ethics review process on the project. The authors discuss how the language, definition of risk, and notion of informed consent articulated in the organizational review process influenced both the research timeline and (potentially) the study itself. While not dismissing the value of ethics review, they explore the tension of overlaying generic criteria for quantitative research, specifically randomized controlled trials, on nursing research from other traditions. Copyright© by Ingram School of Nursing, McGill University.

The cognitive style of nursing students: educational implications for teaching and learning.

PubMed

Noble, Kim A; Miller, Susan M; Heckman, James

2008-06-01

As cognitive and kinesthetic demands on nursing students increase, so does the need for optimal learning environments. Witkin's empirically supported measure of field dependent/independent cognitive style assesses the manner in which students perceive and process information and classifies them along a continuum of field dependence to field independence. Witkin's Groups Embedded Figures Test (GEFT) was administered to 876 students enrolled in 10 health care programs. Statistically significant differences in the GEFT mean scores of students enrolled in the different programs were discovered. The effect size was moderate. Undergraduate nursing students scored higher on the GEFT than did graduate or RN-to-BSN nursing students. However, nursing students were classified as more field dependent than students in other health-related disciplines. Due to their cognitive processing requirements, field-dependent nursing students may be at risk for academic failure. Therefore, instructional strategies tailored to students' needs should be incorporated into the nursing curriculum.

Nursing Informatics Training in Undergraduate Nursing Programs in Peru.

PubMed

Condor, Daniel F; Sanchez Alvarez, Katherine; Bidman, Austin A

2018-01-01

Nursing informatics training has been progressively developing as a field in Latin America, each country with diverse approaches to its implementation. In Peru, this process has not yet taken place, so it is necessary to determine how universities are performing in this regard. We conducted a search to describe if universities provide training in computer nursing or similar. There are 72 universities offering professional nursing training, with only 24% of these providing any specific course in nursing informatics. Training undergraduates in nursing informatics improves the skillset of licensed nurses.

Competency Based Refresher Nurse Curriculum.

ERIC Educational Resources Information Center

Lombardo, Mary C.

This competency-based course is designed to update the skills and knowledge of inactive nurses desiring to return to active practice. Focus of the course is on organizing and managing patient care using the nursing process; performing nursing procedures, including medication administration; and reintegrating oneself into the professional…

A task force model for statewide change in nursing education: building quality and safety.

PubMed

Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

2013-01-01

The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.

Dusting off the looking-glass: A historical analysis of the development of a nursing identity in Chile.

PubMed

Ayala, Ricardo A; Núñez, E Rocío

2017-07-01

Histories of nursing that disregard their linkage to broader historical movements often lead to historically detached versions of nursing identity that omit the perspective of their sources and the ideas of their time. Drawing on materials retrieved through a multilayered research strategy comprising internal and external sources, this article examines the development of a nursing identity in Chile during the period starting in the 1950s through the early 2000s. We analysed the sociopolitical contexts in which the nursing profession grew, the changing direction of its role and how the nursing identity transformed itself. Through the use of historical sources and oral testimonies, we aim to give a nuanced account of how the history of public health and that of the country more broadly changed the object of identification of nurses, creating only relatively recently a sense of nursing community. Processes of identification, fragmentation and integration are highlighted, which challenge usual notions of history as a linear process. © 2017 John Wiley & Sons Ltd.

Magnet status and registered nurse views of the work environment and nursing as a career.

PubMed

Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert

2007-05-01

To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.

Magnet status and registered nurse views of the work environment and nursing as a career.

PubMed

Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert

2009-01-01

To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.

A magnet nursing service approach to nursing's role in quality improvement.

PubMed

Bolton, Linda Burnes; Goodenough, Anne

2003-01-01

The heightened focus on quality and the rise of health care consumerism are manifestations of numerous interrelated dynamics, especially including the aging of the "baby boomers" and greater prevalence of chronic conditions, the explosion of biomedical scientific knowledge and technology, changes in prevailing methods of health care financing, a recent prolonged period of economic prosperity, widespread concerns about patient safety, return of disproportionate health care cost, and the democratization of medical knowledge consequent to widespread use of the Internet. Quality improvement in nursing was first introduced by Florence Nightingale during the Crimean War. Today, nursing quality continues to look at process, but has evolved to an emphasis on patient care outcomes. This article discusses nursing quality structure, processes, and outcomes at a large, teaching, tertiary medical center in Los Angeles, California. The medical center is one of two designated magnet nursing services in California. Nursing's role in achieving clinical and service quality for patients, communities, and staff are essential characteristics of magnet-designated nursing service organizations.

Similarity and accuracy of mental models formed during nursing handovers: A concept mapping approach.

PubMed

Drach-Zahavy, Anat; Broyer, Chaya; Dagan, Efrat

2017-09-01

Shared mental models are crucial for constructing mutual understanding of the patient's condition during a clinical handover. Yet, scant research, if any, has empirically explored mental models of the parties involved in a clinical handover. This study aimed to examine the similarities among mental models of incoming and outgoing nurses, and to test their accuracy by comparing them with mental models of expert nurses. A cross-sectional study, exploring nurses' mental models via the concept mapping technique. 40 clinical handovers. Data were collected via concept mapping of the incoming, outgoing, and expert nurses' mental models (total of 120 concept maps). Similarity and accuracy for concepts and associations indexes were calculated to compare the different maps. About one fifth of the concepts emerged in both outgoing and incoming nurses' concept maps (concept similarity=23%±10.6). Concept accuracy indexes were 35%±18.8 for incoming and 62%±19.6 for outgoing nurses' maps. Although incoming nurses absorbed fewer number of concepts and associations (23% and 12%, respectively), they partially closed the gap (35% and 22%, respectively) relative to expert nurses' maps. The correlations between concept similarities, and incoming as well as outgoing nurses' concept accuracy, were significant (r=0.43, p<0.01; r=0.68 p<0.01, respectively). Finally, in 90% of the maps, outgoing nurses added information concerning the processes enacted during the shift, beyond the expert nurses' gold standard. Two seemingly contradicting processes in the handover were identified. "Information loss", captured by the low similarity indexes among the mental models of incoming and outgoing nurses; and "information restoration", based on accuracy measures indexes among the mental models of the incoming nurses. Based on mental model theory, we propose possible explanations for these processes and derive implications for how to improve a clinical handover. Copyright © 2017 Elsevier Ltd. All rights reserved.

Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators.

PubMed

Jones, Carolynn Thomas; Hastings, Clare; Wilson, Lynda Law

2015-01-01

There has been limited research to document differences in roles between nurses and non-nurses who assume clinical research coordination and management roles. Several authors have suggested that there is no acknowledged guidance for the licensure requirements for research study coordinators and that some non-nurse research coordinators may be assuming roles that are outside of their legal scopes of practice. There is a need for further research on issues related to the delegation of clinical research activities to non-nurses. This study used nominal group process focus groups to identify perceptions of experienced research nurse managers at an academic health science center in the Southern United States about the clinical research activities that are being performed by non-nurse clinical research coordinators without supervision that they believed should only be performed by a nurse or under the supervision of a nurse. A total of 13 research nurse managers volunteered to be contacted about the study. Of those, 8 participated in two separate nominal group process focus group sessions. The group members initially identified 22 activities that they felt should only be performed by a nurse or under the direct supervision of a nurse. After discussion and clarification of results, activities were combined into 12 categories of clinical research activities that participants believed should only be performed by a nurse or under the direct supervision of a nurse. Copyright © 2015 Elsevier Inc. All rights reserved.

[To represent needs of nursing care using nursing diagnoses: potentials and restrictions of the NANDA classification and ICNP].

PubMed

Schilder, Michael

2005-03-01

Nursing diagnoses represent individual reactions to existing or potential changes in one's state of health. They are result of a diagnostic process, which is part of the dynamic nursing care process in its whole. Thus, as a basis of nursing interventions diagnoses have to be proved continuously. The classification of the North American Nursing Diagnosis Association (NANDA) as well as the International Classification for Nursing Practice (ICNP) can be account to the international well-known classifications of nursing diagnoses. Comparing their structures, some fundamental differences between both classifications become obvious. While the NANDA classification represents a systematic structured body of nursing knowledge with regard to human health reactions patterns, the ICNP reflects a more comprehensive part of the nursing reality, since it also contains nursing interventions and outcomes. Until the latest changes by establishing the taxonomy II, NANDA diagnoses have primarily focused deficits. But in contrast to the diagnoses of the ICNP they also comprise etiological factors. To prove the applicability of both classifications to nursing practice, they have been applied to a case study of a female resident living in a nursing home. The results of analysis show that because of their different structures the NANDA classification and ICNP have their own possibilities and limitations in covering the resident's individual needs of nursing care. These characteristic potentials and restrictions have to be taken into account when one of the classification systems is going to be implemented into nursing practice.

Letting go: How newly graduated registered nurses in Western Canada decide to exit the nursing profession.

PubMed

Chachula, Kathryn M; Myrick, Florence; Yonge, Olive

2015-07-01

The Canadian Nurses Association (CNA) estimates a nursing shortage in Canada will rise to 60,000 registered nurses by 2022. Further compounding this crisis is the approximate 14-61% of new nursing graduates who will change nursing roles or exit the profession. To explore the factors and basic psychosocial process involved in the decisions of newly graduated registered nurses in Western Canada who permanently exit the nursing profession within five years. Data was collected through unstructured and semi-structured interviews using the Glaserian grounded theory method. Participants were found to be in a process of letting go of nursing that commenced as students and continued as they entered practice as registered nurses. Four major themes were identified. 1) Navigating constraints of the healthcare system and workplace: participants encountered difficulties adjusting to shiftwork and workload. 2) Negotiating social relationships, hierarchies, and troublesome behaviors; specifically hierarchal and horizontal violence. 3) Facing fears, traumas and challenges. 4) Weighing competing rewards and tensions which resulted in leaving the nursing profession. Students and subsequently new nursing graduates require a variety of supports to establish a nursing identity and remain in the profession. These supports include a manageable workload; meaningful orientation; interprofessional teamwork; and engagement within transformational and authentic leadership constructs. New nurses require a sense of being welcomed, valued, respected and accepted into the workplace environment, as well as constructive feedback, emotional support and debriefing to face workplace challenges. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medication room madness: calming the chaos.

PubMed

Conrad, Carole; Fields, Willa; McNamara, Tracey; Cone, Maryann; Atkins, Patricia

2010-01-01

Nurses work in stressful environments, encountering interruptions and distractions at almost every turn. The aim of this medication safety project was to improve the physical design and organizational layout of the medication room, reduce nurse interruptions and distractions, and create a standard medication process for enhanced patient safety and efficiency. This successful change improved the medication administration process, decreased medication errors, and enhanced nursing satisfaction.

Empowering Oncology Nurses to Lead Change Through a Shared Governance Project.

PubMed

Gordon, Jeanine N

2016-11-01

Nurses at the bed- or chairside are knowledgeable about clinical and operational concerns that need improvement and, consequently, are in the best position to generate and evaluate practical options and potential solutions to improve efficacy and care processes. Implementation of a shared governance model is effective in engaging staff nurses to make meaningful and sustainable change in patient care processes.

Faculty-Student Caring Interaction in Nursing Education: An Integrative Review

PubMed Central

Salehian, Maryam; Heydari, Abbas; Aghebati, Nahid; Karimi Moonaghi, Hossein

2017-01-01

Introduction: Faculty- student caring relationship in nursing education has been offered as enhancing students’ learning experiences to care , desire to care for others and self-actu­alization. This review therefore was carried out to analyze faculty-student caring interactions in nursing education. Methods: This concept analysis of caring in the nursing education was conducted based on Broom methodology of integrative review. The literature was consisted of two books from two known theorists, and 47 relevant articles. They retrieved from English data bases including MEDLINE, CINAHL, ERIC, SCOPUS, and SID, with based on the keywords of caring and "nursing education", during the period 2005-2014. Results: Caring in nursing education refers to faculty-student interaction based on ethical and human values. The development of values and moral principles in education, flexibility in educational processes, application of objective patterns in learning, and dynamism in educational processes are identified as caring concept attributes in teaching-learning process. This requires environmental support, constant human relationship, and knowing. Internalization of values, achieving self-esteem, peace, and towards human evolution were the main achievements of the concept of caring in nursing education. Conclusion: The details obtained from the dimensions of "caring" concept in this study could be utilized by nursing education researchers and designers in order to develop content and structure for educational programs. PMID:28971076

Faculty-Student Caring Interaction in Nursing Education: An Integrative Review.

PubMed

Salehian, Maryam; Heydari, Abbas; Aghebati, Nahid; Karimi Moonaghi, Hossein

2017-09-01

Introduction: Faculty- student caring relationship in nursing education has been offered as enhancing students' learning experiences to care , desire to care for others and self-actu-alization. This review therefore was carried out to analyze faculty-student caring interactions in nursing education. Methods: This concept analysis of caring in the nursing education was conducted based on Broom methodology of integrative review. The literature was consisted of two books from two known theorists, and 47 relevant articles. They retrieved from English data bases including MEDLINE, CINAHL, ERIC, SCOPUS, and SID, with based on the keywords of caring and "nursing education", during the period 2005-2014. Results: Caring in nursing education refers to faculty-student interaction based on ethical and human values. The development of values and moral principles in education, flexibility in educational processes, application of objective patterns in learning, and dynamism in educational processes are identified as caring concept attributes in teaching-learning process. This requires environmental support, constant human relationship, and knowing. Internalization of values, achieving self-esteem, peace, and towards human evolution were the main achievements of the concept of caring in nursing education. Conclusion: The details obtained from the dimensions of "caring" concept in this study could be utilized by nursing education researchers and designers in order to develop content and structure for educational programs.

Assessment of bachelor's theses in a nursing degree with a rubrics system: Development and validation study.

PubMed

González-Chordá, Víctor M; Mena-Tudela, Desirée; Salas-Medina, Pablo; Cervera-Gasch, Agueda; Orts-Cortés, Isabel; Maciá-Soler, Loreto

2016-02-01

Writing a bachelor thesis (BT) is the last step to obtain a nursing degree. In order to perform an effective assessment of a nursing BT, certain reliable and valid tools are required. To develop and validate a 3-rubric system (drafting process, dissertation, and viva) to assess final year nursing students' BT. A multi-disciplinary study of content validity and psychometric properties. The study was carried out between December 2014 and July 2015. Nursing Degree at Universitat Jaume I. Spain. Eleven experts (9 nursing professors and 2 education professors from 6 different universities) took part in the development and content validity stages. Fifty-two theses presented during the 2014-2015 academic year were included by consecutive sampling of cases in order to study the psychometric properties. First, a group of experts was created to validate the content of the assessment system based on three rubrics (drafting process, dissertation, and viva). Subsequently, a reliability and validity study of the rubrics was carried out on the 52 theses presented during the 2014-2015 academic year. The BT drafting process rubric has 8 criteria (S-CVI=0.93; α=0.837; ICC=0.614), the dissertation rubric has 7 criteria (S-CVI=0.9; α=0.893; ICC=0.74), and the viva rubric has 4 criteria (S-CVI=0.86; α=8.16; ICC=0.895). A nursing BT assessment system based on three rubrics (drafting process, dissertation, and viva) has been validated. This system may be transferred to other nursing degrees or degrees from other academic areas. It is necessary to continue with the validation process taking into account factors that may affect the results obtained. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Gods, daemons and banshees on the journey to the magic scroll: the use of myth as a framework for reflective practice in nurse education.

PubMed

Morgan, S

1996-04-01

This paper reports the use of a mythic journey scenario within a student nurse groupwork session. This approach was introduced as a means to facilitate personal and interpersonal sharing and self-knowledge. These processes are held as important for the development of critical reflective process as a cornerstone of contemporary nursing practice. The use of myth invoked a coherent and supportive student environment within which previously reticent students appeared confident enough to contribute and explore their educational experience in nursing. The mythic allegoric process also identified some poignant themes and enemies, common across the student body. Monsters no less!

The Role of the School Nurse in the Special Education Process: Part 2: Eligibility Determination and the Individualized Education Program.

PubMed

Shannon, Robin Adair; Yonkaitis, Catherine Falusi

2017-07-01

This is the second of two articles outlining the professional school nurse's role in the special education process for students with disabilities. The Individuals with Disabilities in Education Improvement Act of 2004 mandates the special education process: identification, full and individual evaluation, eligibility determination, and development of the individual education program (IEP), including special education placement. Part 1 focused on the importance of the school nurse's role in student identification, response to intervention, and the full and individual evaluation. Part 2 highlights the school nurse's vital and unique contribution to the subsequent special education steps of eligibility determination, IEP development, and special education services placement and minutes.

Toward decolonizing nursing: the colonization of nursing and strategies for increasing the counter-narrative.

PubMed

McGibbon, Elizabeth; Mulaudzi, Fhumulani M; Didham, Paula; Barton, Sylvia; Sochan, Ann

2014-09-01

Although there are notable exceptions, examination of nursing's participation in colonizing processes and practices has not taken hold in nursing's consciousness or political agenda. Critical analyses, based on the examination of politics and power of the structural determinants of health, continue to be marginalized in the profession. The goals of this discussion article are to underscore the urgent need to further articulate postcolonial theory in nursing and to contribute to nursing knowledge about paths to work toward decolonizing the profession. The authors begin with a description of unifying themes in postcolonial theory, with an emphasis on colonized subjectivities and imperialism; the application of a critical social science perspective, including postcolonial feminist theory; and the project of working toward decolonization. Processes involved in the colonization of nursing are described in detail, including colonization of nursing's intellectual development and the white privilege and racism that sustain colonizing thinking and action in nursing. The authors conclude with strategies to increase the counter-narrative to continued colonization, with a focus on critical social justice, human rights and the structural determinants of health. © 2013 John Wiley & Sons Ltd.

Competence of newly qualified registered nurses from a nursing college.

PubMed

Morolong, B G; Chabeli, M M

2005-05-01

The South African education and training system, through its policy of outcomes-based education and training, has made competency a national priority. In compliance to this national requirement of producing competent learners, the South African Nursing Council (1999 B) require that the beginner professional nurse practitioners and midwives have the necessary knowledge, skills, attitudes and values which will enable them to render efficient professional service. The health care system also demands competent nurse practitioners to ensure quality in health care. In the light of competency being a national priority and a statutory demand, the research question that emerges is, how competent are the newly qualified registered nurses from a specific nursing college in clinical nursing education? A quantitative, non-experimental contextual design was used to evaluate the competence of newly qualified registered nurses from a specific nursing college. The study was conducted in two phases. The first phase dealt with the development of an instrument together with its manual through the conceptualisation process. The second phase focused on the evaluation of the competency of newly qualified nurses using the instrument based on the steps of the nursing process. A pilot study was conducted to test the feasibility of the items of the instrument. During the evaluation phase, a sample of twenty-six newly qualified nurses was selected by simple random sampling from a target population of thirty-six newly qualified registered nurses. However, six participants withdrew from the study. Data was collected in two general hospitals where the newly qualified registered nurses were working. Observation and questioning were used as data collection techniques in accordance with the developed instrument. Measures were taken to ensure internal validity and reliability of the results. To protect the rights of the participants, the researcher adhered to DENOSA'S (1998:2.2.1) ethical standards of research. A descriptive statistical method of data analysis was used in this study. Findings revealed that newly qualified registered nurses were not competent. The highest score obtained was 51% and the lowest score was 22% with an average score of 34.05%. The results concerning the implementation of the phases of the nursing process indicated that participants were fairly competent in terms of knowledge, skills, attitudes and values of assessment. Participants had very little knowledge of nursing diagnosis and were not competent on the skills of diagnosis. Participants lacked basic knowledge, skills, attitudes and values of the nursing process. They lacked critical thinking skills in their approach to providing quality patient care. The recommendations of the study relate to improving the system of clinical accompaniment, reviewing the clinical facilities where learners are allocated, reviewing the implementation of the curriculum, the methods of teaching and the quality assurance mechanisms that are in place. Further research is recommended on competence of newly qualified registered nurses at other nursing colleges or similar context.

Using clinical nurses as preceptors to teach leadership and management to senior nursing students: a qualitative descriptive study.

PubMed

Lillibridge, Jennifer

2007-01-01

The preceptor model of clinical education uses nurses to fulfill the role of 'teacher' in a one-on-one relationship with students. The current nursing shortage, however, places increased demands on nurses and threatens their continuation in this role. The purpose of this qualitative descriptive study was to gain a better understanding of the nurse preceptor's experience. Five themes evolved during data analysis: (1) making it worthwhile for the nurse, (2) making a difference, (3) engaging in the process, (4) "I love being a preceptor, but..., and (5) accepting the role, taking responsibility. Making it worthwhile for the nurse included how nurses saw personal and professional rewards and benefits in precepting. Making a difference described how nurses felt they made a difference in student learning. Engaging in the process described how nurses created learning opportunities for students by being a good role model and protecting students from negative experiences. "I love being a preceptor, but..." identified aspects of the precepting role that were difficult. Accepting the role, taking responsibility identified the different people involved in the complex precepting experience; the preceptor, nursing faculty, students, and the nurse manager that all had to work together if students were to have a good experience. Findings can be used to develop better support for preceptors as well as more structured and consistent orientation to the role.

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Bedside nurse involvement in end-of-life decision making: a brief review of the literature.

PubMed

Erickson, Jodi

2013-01-01

Bedside nurses in the critical care setting deal with death on a regular basis. Historically, end-of-life decision making has been addressed by physicians with the family and patient, yet nurses may be a better resource for families during the decision-making process. The purpose of this article was to provide a brief review of literature surrounding end-of-life decision making. As patient advocates, nurses should be more actively involved with facilitating the end-of-life decision-making process for critically ill patients and their families.

IEP, IHP, and Section 504 Primer for New School Nurses.

PubMed

Galemore, Cynthia A; Sheetz, Anne H

2015-03-01

Three types of documents and their frequently used acronyms play a vital role in ensuring that students with disabilities have the planning, services, and accommodations necessary to facilitate attendance and success in the school setting. Federal and state laws, as well as state nurse practice acts, govern the process and eligibility of students for these services. School nurses play a vital role in these processes, and new school nurses benefit from a comparison of the terms along with a historical explanation of the acronyms. © 2015 The Author(s).

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.

A National Informatics Agenda for Nursing Education and Practice. Report to the Secretary of the Department of Health & Human Services.

ERIC Educational Resources Information Center

National Advisory Council on Nurse Education and Practice, Rockville, MD.

Nursing informatics is a specialty whose activities center around information management and processing for the nursing profession. The Division of Nursing of the U.S. Department of Health and Human Services and the National Advisory Council on Nurse Education and Practice (NACNEP) recognized a need to identify initiatives that would more…

Nurse Educators' Perceptions about the Culture of Nursing and How They Bring Students into That Culture: A Focused Ethnography

ERIC Educational Resources Information Center

Strouse, Susan M.

2012-01-01

Purpose: The purpose of this study was to discover nurse educators' perceptions about the culture of nursing and how they bring students into that culture. Background: Although the extant literature addresses the process of socialization to the profession, literature exploring socialization as enculturation is scant. Nurse educators'…

Knowledge Elicitation and Techniques of Representing Nurse Practitioner Knowledge Use: Establishing Capability and Social Integration within Busy Nursing Contexts.

ERIC Educational Resources Information Center

Fessey, Christine

The progression of qualified surgical nurses toward capable proficiency was examined in an ethnographic study during which 25 nurses, including 4 who transferred to other wards, were observed to determine whether social mediation affects the process of proficiency development. The nurses were observed for 18 months. Data were also gathered through…

Final Report of Nursing Transition: A Process to Facilitate Career Mobility, July 1, 1980-June 30, 1981.

ERIC Educational Resources Information Center

Brookdale Community Coll., Lincroft, NJ.

A program was developed to facilitate the transition of Licensed Practical Nurses (LPNs) into a program to become registered nurses (RNs) and acquire an associate degree in allied health at Brookdale Community College (New Jersey). A committee of four nursing faculty compared the curriculum of an exemplary practical nursing program with…

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.

The pursuit of excellence and innovation in service user involvement in nurse education programmes: report from a travel scholarship.

PubMed

Terry, Julia M

2013-05-01

The involvement of service users and carers in nurse education is increasing, with the new standards for pre-registration nurse education in the UK, which require nurse education providers to demonstrate how they are involving users and carers in the planning, delivery, teaching and evaluation of nursing curricula (Nursing and Midwifery Council, 2010). A travel scholarship provided the opportunity to explore best practice in this area, focussing on identifying support systems and processes that enable user involvement. The scholarship was undertaken in the UK and Ireland during a 4 week study tour between June and July 2011, during which I visited 15 universities, and met with nurse education staff, users and carers involved in nurse education programmes. Prerequisite processes, the spectrum and variety of involvement activities, quality assurance and evaluation; and sustainability of user involvement in nurse education are reported in this paper. Service users and carers are an under-utilised resource, and as experts by experience have much to offer students and staff by increased involvement in nurse education programmes. The importance of values, enthusiasm and relationships, the cornerstones that strengthen user involvement; often sustain such partnerships. Copyright © 2012 Elsevier Ltd. All rights reserved.

Change champions at the grassroots level: practice innovation using team process.

PubMed

Scott, J; Rantz, M

1994-01-01

A nursing administrative group recognized the critical value of staff participation in the formulation of a restructuring project and guidance throughout the project. Using a team approach, a task force of three staff nurses, two assistant nurse managers, a nurse clinician, a nursing practice specialist, and a representative from nursing administration came together. They were given responsibility for researching and setting the course for restructuring change. A unit-based team including a unit secretary, a nursing attendant, licensed practical nurse (LPN), and six staff nurses was formed from volunteers from the 40-bed medicine unit to develop that unit's plan for restructuring. The unit-based team analyzed patient care needs and staff member roles. They created a new patient care technician role as well as a nurse care coordinator role. The role of the LPN was envisioned as providing technical support. Staffing mix was also determined by the unit-based team. Both the task force and the unit-based team continue to evaluate, troubleshoot, and take every opportunity to sell their vision to solidify it further as the foundation for the future of patient care services at the hospital. The process will soon move forward to a large surgical unit.

Challenges of safe medication practice in paediatric care--a nursing perspective.

PubMed

Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph

2013-05-01

To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

Integrating nurse researchers in clinical practice - a challenging, but necessary task for nurse leaders.

PubMed

Hølge-Hazelton, Bibi; Kjerholt, Mette; Berthelsen, Connie Bøttcher; Thomsen, Thora Grothe

2016-05-01

To create awareness among nurse leaders, of what they may need to consider, when integrating nurse researchers as advanced nurse practitioners (ANP) at PhD-level among their staff. In a time of transition nurse leaders may be challenged by the change towards evidence-based clinical nursing, including integrating nurse researchers in ANP positions. A collective case study including three ANPs took place at a large regional hospital in Denmark. The cases were first analysed by focusing on the generic features, functions and skills of ANPs, and second by focusing on the approaches to evidence-based practice seen in the cases. Regardless of same position, formal level of research expertise and overall responsibility, different approaches related to each ANPs professional profile, interest, academic ambitions and personality were seen. Nurse leaders must ensure a process where the content and expectations of the particular role are mutually clarified and adjusted to the individual ANP and to the specific context, in order to create a harmonious match. In order to clarify expectations regarding the inclusion of nurse researchers as ANPs at PhD level, the paper provides firm recommendations that may guide the process. © 2015 John Wiley & Sons Ltd.

[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.

Neonatal Intensive Care Nursing Curriculum Challenges based on Context, Input, Process, and Product Evaluation Model: A Qualitative Study

PubMed Central

Ashghali-Farahani, Mansoureh; Ghaffari, Fatemeh; Hoseini-Esfidarjani, Sara-Sadat; Hadian, Zahra; Qomi, Robabeh; Dargahi, Helen

2018-01-01

Background: Weakness of curriculum development in nursing education results in lack of professional skills in graduates. This study was done on master's students in nursing to evaluate challenges of neonatal intensive care nursing curriculum based on context, input, process, and product (CIPP) evaluation model. Materials and Methods: This study was conducted with qualitative approach, which was completed according to the CIPP evaluation model. The study was conducted from May 2014 to April 2015. The research community included neonatal intensive care nursing master's students, the graduates, faculty members, neonatologists, nurses working in neonatal intensive care unit (NICU), and mothers of infants who were hospitalized in such wards. Purposeful sampling was applied. Results: The data analysis showed that there were two main categories: “inappropriate infrastructure” and “unknown duties,” which influenced the context formation of NICU master's curriculum. The input was formed by five categories, including “biomedical approach,” “incomprehensive curriculum,” “lack of professional NICU nursing mentors,” “inappropriate admission process of NICU students,” and “lack of NICU skill labs.” Three categories were extracted in the process, including “more emphasize on theoretical education,” “the overlap of credits with each other and the inconsistency among the mentors,” and “ineffective assessment.” Finally, five categories were extracted in the product, including “preferring routine work instead of professional job,” “tendency to leave the job,” “clinical incompetency of graduates,” “the conflict between graduates and nursing staff expectations,” and “dissatisfaction of graduates.” Conclusions: Some changes are needed in NICU master's curriculum by considering the nursing experts' comments and evaluating the consequences of such program by them. PMID:29628958

A 10-year retrospective study of teaching nursing diagnosis to baccalaureate students in Italy.

PubMed

Palese, Alvisa; De Silvestre, Daniele; Valoppi, Graziella; Tomietto, Marco

2009-01-01

The aim of this 10-year retrospective study was to evaluate the impact of teaching nursing process to students at different levels of baccalaureate education, using the North American Nursing Diagnosis Association International (NANDA-I) Taxonomy. Nursing care plans written between 1996 and 2006 by 3,784 students who had completed a baccalaureate course in nursing process at a university in northern Italy were evaluated. At least three of the four steps of the nursing process were included in the evaluation: assessing, planning, intervening, and evaluating. An average of 6.3 (range 0-31; +/-3.9; median 6) problems were identified in each care plan. Of these, 5.1 (range 0-29; +/-3.06; median 5) were related to nursing diagnoses concerning either an actual problem or the risk of developing a problem; the remaining 1.2 (range 0-20; +/-1.9; median 0) diagnoses were concerned either with collaborative problems or with potential complications. The students demonstrated significant improvement in accurately identifying 75 diagnostic titles from the NANDA-I Taxonomy as they progressed through their first, second, and third years of baccalaureate study. These findings suggest that the ability to use the NANDA-I Taxonomy accurately is acquired over time. Thus, the theory and practice of using nursing process should be introduced in a formal course during the first year of baccalaureate nursing education and should be reinforced throughout the remaining courses. Students can then progressively improve their knowledge, critical thinking abilities, and use of the NANDA-I Taxonomy during their second and third years of study. Teaching strategies to reinforce students' learning are recommended.

[Decision-making processes in nursing and activities at the end of life in intensive care–An international comparative study].

PubMed

Kohlen, Helen; McCarthy, Joan; Szylit Buosso, Regina; Gallagher, Ann; Andrews, Tom

2015-12-01

Intensive care units (ICUs) are traditionally settings that offer high technologically advanced treatment for those who are in critical situations due to an illness or accident. Questions regarding the withdrawal and withholding as well as the ending of life sustaining treatment are related to ethical dilemmas. Nurses’ decision-making processes and nursing activities in different countries are scarcely studied. Which end-of-life decision-making processes and activities that are performed by nurses can be identified and described? The objective is the identification of a nursing terrain regarding decision-making and activities in patient end-of-life care on the intensive care unit. Semi-structured interviews were conducted with 51 experienced nurses in university or hospital premises: 10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine. The study used grounded theory to inform data collection and analysis. The finding of the study is the identification of a dynamic process in which activities with a focus on cure shift to activities with a focus on end-of-life care. The core category that emerged was ’negotiated reorienting’: The shift of activities implies negotiations between nurses and physicians, relatives as well as with oneself. Moreover the process is characterized by a constant re-orientation that is induced by changing patient data and the realisation of the whole situation. Nurses’ core practices are ’consensus seeking’ and ’emotional holding’ (sub-categories). In all countries a nursing terrain of activities in end-of-life care could be identified and described. However, it is unclear whether nursing activities connected to relatives of the patient are dominant in such a way that relations to dying patients and respect for their autonomy are put into the background. A field study could give answers to this question possible.

Using continuous process improvement methodology to standardize nursing handoff communication.

PubMed

Klee, Kristi; Latta, Linda; Davis-Kirsch, Sallie; Pecchia, Maria

2012-04-01

The purpose of this article was to describe the use of continuous performance improvement (CPI) methodology to standardize nurse shift-to-shift handoff communication. The goals of the process were to standardize the content and process of shift handoff, improve patient safety, increase patient and family involvement in the handoff process, and decrease end-of-shift overtime. This article will describe process changes made over a 4-year period as result of application of the plan-do-check-act procedure, which is an integral part of the CPI methodology, and discuss further work needed to continue to refine this critical nursing care process. Copyright © 2012 Elsevier Inc. All rights reserved.

What Is Nursing Home Quality and How Is It Measured?

PubMed Central

Castle, Nicholas G.; Ferguson, Jamie C.

2010-01-01

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is used to frame the discussion. Current quality indicators and quality initiatives are discussed, including those included in the Facility Quality Indicator Profile Report, Nursing Home Compare, deficiency citations included as part of Medicare/Medicaid certification, and the Advancing Excellence Campaign. Results: Current quality indicators are presented as a mix of structural, process, and outcome measures, each of which has noted advantages and disadvantages. We speculate on steps that need to be taken in the future to address and potentially improve the quality of care provided by nursing homes, including report cards, pay for performance, market-based incentives, and policy developments in the certification process. Areas for future research are identified throughout the review. Implications: We conclude that improvements in nursing home quality have likely occurred, but improvements are still needed. PMID:20631035

Complaints against nurses: a reflection of 'the new managerialism' and consumerism in health care?

PubMed

Beardwood, B; Walters, V; Eyles, J; French, S

1999-02-01

This paper discusses the effects of restructuring on nursing as a profession through an examination of the issue of complaints in Ontario. It argues that new managerialist techniques and associated changes in the nature of work are reducing the autonomy of nurses and making it difficult for them to meet the standards of their profession. Simultaneously, the Ontario government has increased the power of the public in the disciplinary process and the College of Nurses of Ontario is encouraging patients to register their complaints. The growth of consumerism in health care, coupled with the disciplinary process, individualizes complaints and deemphasizes their relationship to restructuring. Moreover, in response to the increasing number of complaints - complaints which more often come from the public - nursing organizations have encouraged the legalization of the disciplinary process, thus fostering the individualization of the issues.

The Nursing Diagnosis Disturbed Thought Processes: An Integrative Review.

PubMed

Escalada-Hermández, Paula; Marín-Fernández, Blanca

2017-09-08

To analyze and synthetize the existing scientific literature in relation to the nursing diagnosis disturbed thought processes (DTPs) (00130). An integrative review was developed, identifying relevant papers through a search of international and Spanish databases and the examination of key manuals. Theoretical papers propose modifications for the nursing diagnosis DTPs. Most of the research papers offer data about its frequency in different clinical settings. There exists an interest in the nursing diagnosis DTPs. However, the available evidence is not very extensive and further work is necessary in order to refine this nursing diagnosis. The re-inclusion of DTPs in the NANDA-I classification will specially contribute to increment its utility in mental healthcare. © 2017 NANDA International, Inc.

The Vanderbilt Professional Nursing Practice Program: part 1: Growing and supporting professional nursing practice.

PubMed

Robinson, Karen; Eck, Carol; Keck, Becky; Wells, Nancy

2003-09-01

Professional practice programs are designed to attract, retain, and reward nurses. This three-part series will describe Vanderbilt's performance-based career advancement system, the Vanderbilt Professional Nursing Practice Program (VPNPP). Part 1 outlines the overall program's foundation, philosophical background, and basic structure. The VPNPP is built upon Benner's work, distinguishing among four levels of practice: novice, competent, proficient, and expert. Work by many in the organization identified the expected behaviors for nurses at each level, which were then used to develop clear process evaluation criteria. Part 2 will examine the performance measurement and evaluation system created to support the program. The process of advancing within the program will be described in part 3.

Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned.

PubMed

Knight, Kaye M; Kenny, Amanda; Endacott, Ruth

2015-04-09

Due to large geographical distances, the telephone is central to enabling rural Australian communities to access care from their local health service. While there is a history of rural nurses providing care via the telephone, it has been a highly controversial practice that is not routinely documented and little is known about how the practice is governed. The lack of knowledge regarding governance extends to the role of Directors of Nursing as clinical leaders charged with the responsibility of ensuring practice safety, quality, regulation and risk management. The purpose of this study was to identify clinical governance processes related to managing telephone presentations, and to explore Directors of Nursing perceptions of processes and clinical practices related to the management of telephone presentations to health services in rural Victoria, Australia. Qualitative documentary analysis and semi structured interviews were used in the study to examine the content of health service policies and explore the perceptions of Directors of Nursing in eight rural health services regarding policy content and enactment when people telephone rural health services for care. Participants were purposively selected for their knowledge and leadership role in governance processes and clinical practice. Data from the interviews were analysed using framework analysis. The process of analysis resulted in the identification of five themes. The majority of policies reviewed provided little guidance for managing telephone presentations. The Directors of Nursing perceived policy content and enactment to be largely inadequate. When organisational structures failed to provide appropriate governance for the context, the Directors of Nursing engaged in protective mechanisms to support rural nurses who manage telephone presentations. Rural Directors of Nursing employed intuitive behaviours to protect rural nurses practicing within a clinical governance context that is inadequate for the complexities of the environment. Protective mechanisms provided indicators of clinical leadership and governance effectiveness, which may assist rural nurse leaders to strengthen quality and safe care by unlocking the potential of intuitive behaviours. Kanter's theory of structural power provides a way of conceptualising these protective mechanisms, illustrating how rural nurse leaders enact power.

Creating a nursing strategic planning framework based on evidence.

PubMed

Shoemaker, Lorie K; Fischer, Brenda

2011-03-01

This article describes an evidence-informed strategic planning process and framework used by a Magnet-recognized public health system in California. This article includes (1) an overview of the organization and its strategic planning process, (2) the structure created within nursing for collaborative strategic planning and decision making, (3) the strategic planning framework developed based on the organization's balanced scorecard domains and the new Magnet model, and (4) the process undertaken to develop the nursing strategic priorities. Outcomes associated with the structure, process, and key initiatives are discussed throughout the article. Copyright © 2011 Elsevier Inc. All rights reserved.

Nurse-led action research project for expanding nurses' role in patient education in Iran: Process, structure, and outcomes.

PubMed

Khorasani, Parvaneh; Rassouli, Maryam; Parvizy, Soroor; Zagheri-Tafreshi, Mansoureh; Nasr-Esfahani, Mahmood

2015-01-01

Patient education is among the lowest met need of patients in Iran; therefore, expansion of that role can result in greater professional accountability. This study aimed to explain the practical science of the process, structure, and outcomes of a nurse-led action research project to expand the nurses' role in patient education in Iran. This study was part of a participatory action research. Daily communications and monthly joint meetings were held from January 2012 to February 2014 for planning and management. These were based on the research protocol, and the conceptual framework included the Mobilizing for Action through Planning and Partnerships process by means of Leadership for Change skills. Data were produced and gathered through participant observations. Administrative data included project records, official documents, artifacts, news, and reports, which were analyzed through qualitative content analysis. A participatory project was established with three groups of participants organized from both academic and clinical fields. These consisted of a "core research support team," "two steering committees," and community representatives of clients and professionals as "feedback groups." A seven-stage process, named the "Nurse Educators: Al-Zahra Role Expansion Action Research" (NEAREAR) process, resulted from the project, in which strategic issues were gradually developed and implemented through 32 action plans and quality improvement cycles of action research. Audits and supervision evaluations showed meaningful changes in capacity building components. A nurse-led ad hoc structure with academic-clinical partnerships and strategic management process was suggested as a possible practical model for expanding nurses' educational role in similar contexts. Implications and practical science introduced in this action research could also be applicable for top managers and health system policy makers in a wider range of practice.

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

PubMed

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

2016-01-01

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

Why board of nursing disciplinary actions do not always yield the expected results.

PubMed

Raper, James Luther; Hudspeth, Randall

2008-01-01

One of the ways boards of nursing serve to protect the public health, safety, and welfare is by removing from practice those nurses who fail to meet recognized standards of care or otherwise pose a public threat. Self-reporting and discovery through criminal background checks and reports from the court system or other regulatory bodies represent only small numbers of those disciplined. Most complaints investigated by a board are reported by nursing administrators, either chief nursing officers or nurse managers. Frequently, the reporting nurses provide the board with information from their own investigation that identifies the problem and the cause and includes supporting evidence. Based on their own independent investigation, the reporting nurses often assume that the outcome of board action is a foregone conclusion. Without understanding all of the ramifications of disciplinary processes and the requirements to protect the rights of the nurse that are guaranteed under the US Constitution, the final outcome decision can be totally different than anticipated and thus disappointing to the reporting nurse administrator. They could perceive the decision as wrong, nonsupportive, and discounting the efforts made by the reporting nurse. This unhappiness with the outcome causes vulnerability in the major reporting source to a board, namely, the relationship between the board and the nurse administrator. An initial step in mitigating this vulnerability is a better understanding by nursing administrators of the legal procedures that guide disciplinary processes and boards providing timely feedback to reporting nurses on the disposition of cases.

Evaluating teaching effectiveness in nursing education: an Iranian perspective.

PubMed

Salsali, Mahvash

2005-07-27

The main objective of this study was to determine the perceptions of Iranian nurse educators and students regarding the evaluation of teaching effectiveness in university-based programs. An exploratory descriptive design was employed. 143 nurse educators in nursing faculties from the three universities in Tehran, 40 undergraduate, and 30 graduate students from Tehran University composed the study sample. In addition, deans from the three nursing faculties were interviewed. A researcher-developed questionnaire was used to determine the perceptions of both faculty and students about evaluating the teaching effectiveness of nurse educators, and an interview guide was employed to elicit the views of deans of faculties of nursing regarding evaluation policies and procedures. Data were analyzed using parametric and nonparametric statistics to identify similarities and differences in perceptions within the Iranian nurse educator group and the student group, and between these two groups of respondents. While faculty evaluation has always been a major part of university based nursing programs, faculty evaluation must be approached more analytically, objectively, and comprehensively to ensure that all nursing educators receive the fairest treatment possible and that the teaching-learning process is enhanced. Educators and students stressed that systematic and continuous evaluation as well as staff development should be the primary goals for the faculty evaluation process. The ultimate goals is the improvement of teaching by nurse educators.

Effects of ward rotation on subsequent transition processes of Japanese clinical nurses.

PubMed

Fujino, Mitsuku; Nojima, Yoshiko

2005-03-01

The purpose of this study was to examine the experience of Japanese clinical nurses undertaking a ward rotation in a general hospital, and its effects on subsequent processes relating to: (i) perception of ward rotation; (ii) reactions to the ward transition process; and (iii) outcomes of ward rotation. In-depth interviews were conducted with 21 Japanese clinical nurses who had an average of 8.8 years (SD = 5.50) clinical experience. Findings indicated that participants experienced role overload, role incongruity and/or role underload, role overqualification, or role ambiguity in the new environment. These role stresses created critical emotional distress during the transition process. The high desire for career development facilitated the transition process, while lack of preparation inhibited the transition process. To facilitate smooth transition, well-prepared and structured supports based on reliable interpersonal relationships are necessary. The findings offer significant cues for effective ward rotation programs. The implication for nursing administrators is that appropriate ward rotations enhance confidence and promote effective role development in the new clinical setting.

Aligning Career with Faith: Reflective Practice for Christian Nurse Educators.

PubMed

McKnight, Heather

Christian nurses are challenged by the process of incorporating faith and Christianity into their career. Nurse educators are particularly challenged to embed Christian principles into the tenure and promotion journey. Developing a God-inspired plan takes time and patience. Prayer, reflective practice, evaluation, decisions, and follow-through are areas that can be incorporated to infuse faith throughout the tenure and promotion process.

Oncology Nursing Education: Nursing Students' Commitment of "Presence" with the Dying Patient and the Family.

ERIC Educational Resources Information Center

Walsh, Sandra M.; Hogan, Nancy S.

2003-01-01

Following a chaplain's lecture on the end of life, nursing students wrote reaction papers on appropriate ways to support dying patients and their families. Six processes emerged, including the core concept of the nurse's presence at the bedside. (Contains 23 references.) (SK)

42 CFR 424.20 - Requirements for posthospital SNF care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... knowledge of the case; or (2) A nurse practitioner or clinical nurse specialist, neither of whom has a... physician. For purposes of this section— (i) Collaboration means a process whereby a nurse practitioner or clinical nurse specialist works with a doctor of medicine or osteopathy to deliver health care services...

The Stress Sources of Nursing Students

ERIC Educational Resources Information Center

Oner Altiok, Hatice; Ustun, Besti

2013-01-01

Overall, nursing training is a stressful process. Especially when second year nursing students are evaluated within the professional socialization theory, they are stated to be affected by these sources of stress more negatively. This research was carried out in order to determine the stress sources of second year nursing students. 15 nursing…

The Essentials of Baccalaureate Education for Professional Nursing Practice.

ERIC Educational Resources Information Center

American Association of Colleges of Nursing, Washington, DC.

This report presents recommendations of an American Association of Colleges of Nursing (AACN) task force which revised existing guidelines for nursing education. An introduction provides background information and notes major trends in health care and nursing. Also provided is a summary of the revision process which included two invitational…

Occupational Health Content in Baccalaureate Nursing Education.

ERIC Educational Resources Information Center

Keller, Marjorie J.; May, W. Theodore

A 4-year project was conducted at the University of Tennessee College of Nursing to identify occupational health nursing content essential in baccalaureate education for professional nursing. In the process of determining content, a review of relevant literature was made, and a theoretical framework was developed which consisted of an integration…

Nursing Principles & Skills. Teacher Edition.

ERIC Educational Resources Information Center

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

This curriculum guide contains 14 units for a course on nursing principles and skills needed by practical nurses. The 14 units of instruction cover the following: (1) using medical terminology; (2) practicing safety procedures; (3) using the nursing process for care planning; (4) using infection control techniques; (5) preparing a patient…

Beliefs Held by Associate Degree Nursing Students about Role Models.

ERIC Educational Resources Information Center

Bellinger, Kathleen; And Others

1985-01-01

Reports on a study of the professional socialization of associate degree nursing (ADN) students. Reviews previous research on the process of nursing socialization. Presents study findings based on responses from 1,877 nursing students in 20 ADN programs, focusing on students' characteristics and ideal and actual role models. (DMM)

Nursing student stories on learning how to think like a nurse.

PubMed

Di Vito-Thomas, Pam

2005-01-01

The ability to think critically, improve clinical systems, and decrease errors in clinical judgments are ever the vision of nursing practice. The author describes the thinking processes of nursing students as they make clinical judgments and the most important teaching/learning strategies that help develop their clinical judgment.

Facilitating Trust Engenderment in Secondary School Nurse Interactions with Students

ERIC Educational Resources Information Center

Summach, Anne H. J.

2011-01-01

School nurses are involved in a complex framework of interactions with students, other professionals, parents, and administrators. Trust between nurse and student is critical for interaction effectiveness. The goal of this study was to understand through phenomenology the process of engendering trust in school nurse-high school student…

Advancing nursing scholarship: the Mozambique model

PubMed Central

Bruce, Judith C.; Dippenaar, Joan; Schmollgruber, Shelley; Mphuthi, David D.; Huiskamp, Agnes

2017-01-01

ABSTRACT Background: Despite the importance of Human Resources for Health for the development and functioning of health systems worldwide, many countries continue to be plagued by poor health systems and a lack of adequate health care. Health systems failures may be attributed to both quantitative and qualitative nursing shortages including the lack of advanced skills to lead health initiatives, to conduct research and to educate other nurses. The response by development partners is usually framed around the production of skilled nurses through the processes of up-skilling and scaling-up. The outcome is expanded practice but with scant attention to the professional advancement of nurses. Objectives: In this paper we present a two-phased capacity development model that adopted professionalization strategies to advance nursing scholarship and consequent postgraduate specialization of the first cohort of nurses in Mozambique. The main objectives were to: develop and implement a clinical course work master’s degree in nursing; and ensure sustainability by capacitating the host institution to continue with the master’s programme following graduation. Methods: Rigorous processes for project discussions, negotiations and monitoring were necessary amid limited resources and a challenging political climate. Forging in-country partnerships, sustaining alliances and government investment are thus key to the success of the Mozambique model. Outcomes: Notwithstanding some difficulties, the process unfolded over a five-year period, graduating the first cohort of 11 senior nurses with a master’s degree, specializing either in critical care and trauma nursing, or maternal and neonatal health. Conclusions: Bridging the skills gap between generalist and specialist nurses is essential for them to manage complex and high acuity cases and to reverse associated morbidity and mortality. We conclude that this model serves as a professionalization strategy to advance nurses’ scholarship of clinical practice, research and teaching. PMID:28771092

Ethical dimensions of paediatric nursing: A rapid evidence assessment.

PubMed

Bagnasco, Annamaria; Cadorin, Lucia; Barisone, Michela; Bressan, Valentina; Iemmi, Marina; Prandi, Marzia; Timmins, Fiona; Watson, Roger; Sasso, Loredana

2018-02-01

Paediatric nurses often face complex situations requiring decisions that sometimes clash with their own values and beliefs, or with the needs of the children they care for and their families. Paediatric nurses often use new technology that changes the way they provide care, but also reduces their direct interaction with the child. This may generate ethical issues, which nurses should be able to address in the full respect of the child. Research question and objectives: The purpose of this review is to describe the main ethical dimensions of paediatric nursing. Our research question was, 'What are the most common ethical dimensions and competences related to paediatric nursing?' A rapid evidence assessment. According to the principles of the rapid evidence assessment, we searched the PubMed, SCOPUS and CINAHL databases for papers published between January 2001 and March 2015. These papers were then independently read by two researchers and analysed according to the inclusion criteria. Ethical considerations: Since this was a rapid evidence assessment, no approval from the ethics committee was required. Ten papers met our inclusion criteria. Ethical issues in paediatric nursing were grouped into three areas: (a) ethical issues in paediatric care, (b) social responsibility and (c) decision-making process. Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses' perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan.

Identifying critical thinking indicators and critical thinker attributes in nursing practice.

PubMed

Chao, Shu-Yuan; Liu, Hsing-Yuan; Wu, Ming-Chang; Clark, Mary Jo; Tan, Jung-Ying

2013-09-01

Critical thinking is an essential skill in the nursing process. Although several studies have evaluated the critical thinking skills of nurses, there is limited information related to the indicators of critical thinking or evaluation of critical thinking in the context of the nursing process. This study investigated the potential indicators of critical thinking and the attributes of critical thinkers in clinical nursing practice. Knowledge of these indicators can aid the development of tools to assess nursing students' critical thinking skills. The study was conducted between September 2009 and August 2010. In phase 1, a literature review and four focus groups were conducted to identify the indicators of critical thinking in the context of nursing and the attributes of critical thinkers. In phase 2, 30 nursing professionals participated in a modified Delphi research survey to establish consensus and the appropriateness of each indicator and attribute identified in phase 1. We identified 37 indicators of critical thinking and 10 attributes of critical thinkers. The indicators were categorized into five subscales within the context of the nursing process toreflect nursing clinical practice: assessment, 16 indicators of ability to apply professional knowledge and skills to analyze and interpret patient problems; diagnosis, five indicators of ability to propose preliminary suppositions; planning, five indicators of ability to develop problem-solving strategies; implementation, five indicators of ability to implement planning; and evaluation, six indicators of ability to self-assess and reflect. The study operationalized critical thinking into a practical indicator suitable for nursing contexts in which critical thinking is required for clinical problem solving. Identified indicators and attributes can assist clinical instructors to evaluate student critical thought skills and development-related teaching strategies.

Accreditation of Continuing Education: The Critical Elements.

ERIC Educational Resources Information Center

DeSilets, Lynore D.

1998-01-01

Reviews the history of accreditation in nursing continuing education, describes the system and process, and identifies institutional characteristics needed before beginning the process. Uses the American Nurses Center Commission on Accreditation model. (Author/SK)

Teaching Feminist Group Process within a Nursing Curriculum.

ERIC Educational Resources Information Center

Banister, Elizabeth; Schreiber, Rita

1999-01-01

Describes feminist group processes (praxis, empowerment, awareness, consensus, evolution) taught to nursing students through experiential learning activities. Explains changes in learner and teacher behavior and challenges that were encountered and overcome. (SK)

Modeling efficiency at the process level: an examination of the care planning process in nursing homes.

PubMed

Lee, Robert H; Bott, Marjorie J; Gajewski, Byron; Taunton, Roma Lee

2009-02-01

To examine the efficiency of the care planning process in nursing homes. We collected detailed primary data about the care planning process for a stratified random sample of 107 nursing homes from Kansas and Missouri. We used these data to calculate the average direct cost per care plan and used data on selected deficiencies from the Online Survey Certification and Reporting System to measure the quality of care planning. We then analyzed the efficiency of the assessment process using corrected ordinary least squares (COLS) and data envelopment analysis (DEA). Both approaches suggested that there was considerable inefficiency in the care planning process. The average COLS score was 0.43; the average DEA score was 0.48. The correlation between the two sets of scores was quite high, and there was no indication that lower costs resulted in lower quality. For-profit facilities were significantly more efficient than not-for-profit facilities. Multiple studies of nursing homes have found evidence of inefficiency, but virtually all have had measurement problems that raise questions about the results. This analysis, which focuses on a process with much simpler measurement issues, finds evidence of inefficiency that is largely consistent with earlier studies. Making nursing homes more efficient merits closer attention as a strategy for improving care. Increasing efficiency by adopting well-designed, reliable processes can simultaneously reduce costs and improve quality.

Facilitating problem-based learning among undergraduate nursing students: A qualitative systematic review.

PubMed

Wosinski, Jacqueline; Belcher, Anne E; Dürrenberger, Yvan; Allin, Anne-Claude; Stormacq, Coraline; Gerson, Linda

2018-01-01

The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL. a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted. Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists. Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis. 51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice. The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Experiences of nursing students and educators during the co-construction of clinical nursing leadership learning activities: A qualitative research and development study.

PubMed

Ha, Laurence; Pepin, Jacinthe

2017-08-01

Student voice posits that students' unique perspectives on teaching and learning can be used in conjunction with those of educators to create meaningful educational activities. The study aimed to describe nursing students' and educators' experiences during the co-construction of educational activities involving clinical nursing leadership. Qualitative research and development model. The study was conducted at a French-Canadian nursing faculty that provides a 3-year undergraduate program. Five undergraduate nursing students, four nursing educators, and the principal investigator formed the co-construction team. Data collected included all documents (written and audio) related to the co-construction process: three 2-hour team meetings, PI's fieldnotes and a focus group discussion that occurred once the co-construction process was completed. Thematic analysis was performed guided by Paillé and Muchielli's (2010) method. Data analysis revealed two interrelated themes: (1) unique, purposeful collaboration and (2) change that makes a difference. A space described as safe, without hierarchy and that included the "right" people helped the team achieve their objective of creating new educational activities on clinical nursing leadership. The two new learning activities developed by the team were perceived as useful for future nursing students. At the individual level, team members appreciated how co-construction helped them understand teaching and learning from new perspectives. A structured, efficient co-construction process contributed to positive changes in the nursing program and participants. Additional research is required to enhance understanding of the factors that facilitate and hinder student-educator collaboration outside the classroom. Copyright © 2017 Elsevier Ltd. All rights reserved.

Striving for best practice: standardising New Zealand nursing procedures, 1930-1960.

PubMed

Wood, Pamela J; Nelson, Katherine

2013-11-01

To identify how nurses in the past determined best practice, using the context of New Zealand, 1930-1960. In the current context of evidence-based practice, nurses strive to provide the best care, based on clinical research. We cannot assume that nurses in the past, prior to the evidence-based practice movement, did not also have a deliberate process for pursuing best practice. Discovering historical approaches to determining best practice will enrich our understanding of how nurses' current efforts are part of a continuing commitment to ensuring quality care. Historical research. The records of the Nursing Education Committee of the New Zealand Registered Nurses' Association, 1940-1959, and the 309 issues of New Zealand's nursing journal, Kai Tiaki, 1930-1960, were analysed to identify the profession's approach to ensuring best practice. This approach was then interpreted within the international context, particularly Canada and the USA. For nearly 30 years, nurse leaders collaborated in undertaking national surveys of training hospitals requesting information on different nursing practices. They subsequently distributed instructions for a range of procedures and other aspects of nursing care to standardise practice. Standardising nursing care was an effective way to ensure quality nursing at a time when hospital care was delivered mostly by nurses in training. The reasons for and timing of standardisation of nursing care in New Zealand differed from the international move towards standardisation, particularly in the USA. Historically, nurses also pursued best practice, based on standardising nursing procedures. Examining the antecedents of the present evidence-based approach to care reminds us that the process and reasons for determining best practice change through time. As knowledge and practice continually change, current confident assertions of best practice should and will continue to be challenged in future. © 2013 John Wiley & Sons Ltd.

Military to civilian nurse: Personal and professional reconstruction.

PubMed

Elliott, Brenda; Chargualaf, Katie A; Patterson, Barbara

2017-05-01

To examine and describe the transition process of military nurses from military nursing practice to civilian nursing practice. A second aim was to identify challenges and facilitators to this transition. Serving in the military, and embodying its values, can have a major impact on a person's worldview. These individuals serve not only as nurses but also as part of a larger military culture with a mission to protect. The decision to separate from the military and transition into the civilian workforce carries many challenges capable of influencing nurses' personal and professional identities. Qualitative descriptive. Semi-structured interviews of 10 nurse veterans were conducted in 2015-2016. Data were collected until saturation was reached. The transition includes four major phases from military to civilian nurse: Separating from Military Life, Conflict and Chaos, Shifting Sands and Personal and Professional Reconstruction. Duration and progress through each phase varied slightly for individual nurses. Both work-role and personal identity transition occur when a nurse leaves the military and enters civilian practice. Military and civilian organisations, in both the USA and other countries, can implement supports to aid these nurses during this personal and professional change. Recommendations from the study group are provided. The global nursing profession, as well as healthcare organisations that employ nurse veterans, has a commitment and obligation to understand the transition process of nurses who practise within the scope of military nursing and later in civilian nursing environments so that they may be supported and used to the extent of their prior experience. Lessons learned and advice from this group of nurses may positively aid others in their transition experience. © 2016 John Wiley & Sons Ltd.

Troubling distinctions: a semiotics of the nursing/technology relationship.

PubMed

Sandelowski, M

1999-09-01

I consider the discursive practices that have served conceptually and ontologically to trouble the boundaries between nursing and technology: between nurse/human/subject and machine/non-human/object. Nursing and technology have been semiotically related largely by two processes: (a) by the metaphor that depicts nursing as technology and (b) by opposition, or as not like and even in conflict with technology. Less frequently but no less significantly, nursing and technology have been semiotically linked (c) by the metaphor that depicts technology as nursing and (d) by metonymy, or by word or picture juxtapositions of nursing with technology. The troubling distinctions between nursing and technology suggest yet another reason why the construction of difference continues to elude nursing.

Nursing's ways of knowing and dual process theories of cognition.

PubMed

Paley, John; Cheyne, Helen; Dalgleish, Len; Duncan, Edward A S; Niven, Catherine A

2007-12-01

This paper is a comparison of nursing's patterns of knowing with the systems identified by cognitive science, and evaluates claims about the equal-status relation between scientific and non-scientific knowledge. Ever since Carper's seminal paper in 1978, it has been taken for granted in the nursing literature that there are ways of knowing, or patterns of knowing, that are not scientific. This idea has recently been used to argue that the concept of evidence, typically associated with evidence-based practice, is inappropriately restricted because it is identified exclusively with scientific research. The paper reviews literature in psychology which appears to draw a comparable distinction between rule-based, analytical cognitive processes and other forms of cognitive processing which are unconscious, holistic and intuitive. There is a convincing parallel between the 'patterns of knowing' distinction in nursing and the 'cognitive processing' distinction in psychology. However, there is an important difference in the way the relation between different forms of knowing (or cognitive processing) is depicted. In nursing, it is argued that the different patterns of knowing have equal status and weight. In cognitive science, it is suggested that the rule-based, analytical form of cognition has a supervisory and corrective function with respect to the other forms. Scientific reasoning and evidence-based knowledge have epistemological priority over the other forms of nursing knowledge. The implications of this claim for healthcare practice are briefly indicated.

[Problem solving abilities of nursing students: the experience of the bachelor degree course in nursing at the University of Udine].

PubMed

Bulfone, Giampiera; Galletti, Caterina; Vellone, Ercole; Zanini, Antonietta; Quattrin, Rosanna

2008-01-01

The process nurses adopt to solve the patients' problems is known as "Problem Solving" in the literature. Problem Solving Abilities include Diagnostic Reasoning, Prognostic Judgment and Decision Making. Nursing students apply the Problem Solving to the Nursing Process that is the mental and operative approach that nurses use to plan the nursing care. The purpose of the present study is to examine if there is a positive relationship between the number of Educational Tutorial Strategies (Briefing, Debriefing and Discussion according to the Objective Structured Clinical Examination Methodology) used for nursing students and their learning of Problem Solving Abilities (Diagnostic Reasoning, Prognostic Judgment and Decision Making). The study design was retrospective, descriptive and comparative. The Problem Solving Instrument, specifically developed for this study and proved for its reliability and validity, was used to collect the data from a sample of 106 nursing care plans elaborated by the second-year students of the Bachelor Degree in Nursing of the University of Udine. Nursing care plans were elaborated during three times consecutively, after students had participated in different Educational Tutorial Strategies. Results showed that the more the students took part in a higher number of Educational Tutorial Strategies the more they significantly increased their Problem Solving Abilities. The results demonstrate that it is important to use Educational Tutorial Strategies in the nursing education to teach skills.

Caring: the socialisation of pre-registration student nurses: a longitudinal qualitative descriptive study.

PubMed

Mackintosh, Carolyn

2006-11-01

This study explores the impact of the process of socialisation on pre-registration student nurses views about care, and their personal ability to cope with becoming a nurse. It aims to identify the effect time has on participants attitudes and views of care and becoming a nurse, during pre-registration nurse training, by using a descriptive longitudinal qualitative design. Data collection took place within the School of Health or on student's clinical placement areas, using a random sample of 16 pre-registration student nurses obtained from a convenience sample of 52 volunteers. Participants were involved in two semi-structured in depth interviews, the first 6-9 months after entering nurse training and the second 6-9 months prior to completion. Interviews were tape recorded, transcribed verbatim and analysed using Morse and Field's (1996) four stages of analysis. Identified changes between data collection stages suggest socialisation results in a loss of idealism about care within nursing, as well as the identification of negative aspects of care. Loss of care is linked to increased abilities to cope with the nursing role, although this is not uniform and some participants clearly discriminate and reject negative exposures. In conclusion this study identifies an under recognised dichotomy between the caring ethos of professional nursing and the professional socialisation processes student nurses are subject to, which directly mitigate against the individual nurses abilities to care.

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.

Health disparities, social injustice, and the culture of nursing.

PubMed

Giddings, Lynne S

2005-01-01

Nurses are well positioned to challenge institutionalized social injustices that lead to health disparities. The aim of this cross-cultural study was to collect stories of difference and fairness within nursing. The study used a life history methodology informed by feminist theory and critical social theory. Life story interviews were conducted with 26 women nurses of varying racial, cultural, sexual identity, and specialty backgrounds in the United States (n = 13) and Aotearoa New Zealand (n = 13). Participants reported having some understanding of social justice issues. They were asked to reflect on their experience of difference and fairness in their lives and specifically within nursing. Their stories were analyzed using a life history immersion method. Nursing remains attached to the ideological construction of the "White good nurse." Taken-for-granted ideals privilege those who fit in and marginalize those who do not. The nurses experienced discrimination and unfairness, survived by living in two worlds, learned to live in contradiction, and worked surreptitiously for social justice. For nurses to contribute to changing the systems and structures that maintain health disparities, the privilege of not seeing difference and the processes of mainstream violence that support the construction of the "White good nurse" must be challenged. Nurses need skills to deconstruct the marginalizing social processes that sustain inequalities in nursing and healthcare. These hidden realities--racism, sexism, heterosexism, and other forms of discrimination--will then be made visible and open to challenge.

Achieving Excellence Through Contemporary and Relevant Psychiatric-Mental Health Nursing Standards of Practice.

PubMed

McInnis-Perry, Gloria; Greene, Ann; Mina, Elaine Santa

2015-09-01

Standards of practice (SOPs) comprise competency statements, which are grounded in current knowledge and research, and provide foundations for performance that support professional accountability. The nursing profession, and specifically the psychiatric-mental health specialty of nursing practice in Canada, develops and revises practice standards regularly. The current article describes the collaborative, evidence-informed journey of the Canadian Federation of Mental Health Nurses during its fourth revision of the Canadian Psychiatric-Mental Health Nursing SOPs. An intraprofessional team of psychiatric-mental health nurses from the clinical, academic, research, and policy areas developed and nurtured collaborative processes that emphasize collegial and authentic relationships. Effective communication and a respectful learning environment supported the process for all members of the team. The current article provides recommendations for other professional organizations considering developing and/or revising SOPs. Copyright 2015, SLACK Incorporated.

[Essential data set's archetypes for nursing care of endometriosis patients].

PubMed

Spigolon, Dandara Novakowski; Moro, Claudia Maria Cabral

2012-12-01

This study aimed to develop an Essential Data Set for Nursing Care of Patients with Endometriosis (CDEEPE), represented by archetypes. An exploratory applied research with specialists' participation that was carried out at Heath Informatics Laboratory of PUCPR, between February and November of 2010. It was divided in two stages: CDEEPE construction and evaluation including Nursing Process phases and Basic Human Needs, and archetypes development based on this data set. CDEEPE was evaluated by doctors and nurses with 95.9% of consensus and containing 51 data items. The archetype "Perception of Organs and Senses" was created to represents this data set. This study allowed identifying important information for nursing practices contributing to computerization and application of nursing process during care. The CDEEPE was the basis for archetype creation, that will make possible structured, organized, efficient, interoperable, and semantics records.

Understanding Influence within the Context of Nursing: Development of the Adams Influence Model Using Practice, Research, and Theory.

PubMed

Adams, Jeffrey M; Natarajan, Sudha

2016-01-01

Acquiring influence, and knowing how to use it, is a required competency for nurse leaders, yet the concept of influence and how it works is not well described in the nursing literature. In this article, the authors examine what is known about influence and present an influence model specific to nurse leaders. The Adams Influence Model was developed through an iterative process and is based on a comprehensive review of the influence literature, expert commentary, multiple pilot studies, evaluation of nursing theories, and validation by an external data source. Rather than defining "how to" influence, the model serves as a guide for personal reflection, helping nurse leaders understand and reflect on the influence process and factors, tactics, and strategies they can use when seeking to influence others.

[Gender mainstreaming and nursing].

PubMed

Wang, Hsiu-Hung

2011-12-01

Gender mainstreaming is one of the most important strategies in promoting global gender equality. The Taiwan government launched policies on gender mainstreaming and gender impact assessment in 2007 in response to strong public and academic advocacy work. With rising awareness of gender issues, nursing professionals in Taiwan should keep pace with global trends and become actively involved in advancing gender-mainstreaming policies. This article shows that nursing professionals should prepare themselves by cultivating gender competence, understanding gender-related regulations, recognizing the importance of gender impact assessment implementation, integrating gender issues into nursing education, conducting gender-related research and participating in decision-making processes that promote gender mainstreaming. Nursing professionals should enhance their knowledge and understanding of gender mainstreaming-related issues and get involved in the gender-related decision-making process in order to enhance gender awareness and women's health and further the professional development of nurses.

A framework to support preceptors' evaluation and development of new nurses' clinical judgment.

PubMed

Nielsen, Ann; Lasater, Kathie; Stock, Mary

2016-07-01

In today's complex, fast-paced world of hospital nursing, new graduate nurses do not have well-developed clinical judgment skills. Nurse preceptors are charged with bridging the gap between new graduates' learning in school and their autonomous practice as RNs. In one large, urban medical center in the U.S., a clinical judgment model and rubric were used as a framework for a new evaluation and orientation process. Preceptors of new graduate nurses who had used the former and new processes described their experiences using the framework. The findings indicated that having a structured framework provided objective ways to evaluate and help develop new graduate nurses' clinical judgment. It is hypothesized that academic clinical supervisors may find such a framework useful to prepare students for transition to practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Patient safety competencies in undergraduate nursing students: a rapid evidence assessment.

PubMed

Bianchi, Monica; Bressan, Valentina; Cadorin, Lucia; Pagnucci, Nicola; Tolotti, Angela; Valcarenghi, Dario; Watson, Roger; Bagnasco, Annamaria; Sasso, Loredana

2016-12-01

To identify patient safety competencies, and determine the clinical learning environments that facilitate the development of patient safety competencies in nursing students. Patient safety in nursing education is of key importance for health professional environments, settings and care systems. To be effective, safe nursing practice requires a good integration between increasing knowledge and the different clinical practice settings. Nurse educators have the responsibility to develop effective learning processes and ensure patient safety. Rapid Evidence Assessment. MEDLINE, CINAHL, SCOPUS and ERIC were searched, yielding 500 citations published between 1 January 2004-30 September 2014. Following the Rapid Evidence Assessment process, 17 studies were included in this review. Hawker's (2002) quality assessment tool was used to assess the quality of the selected studies. Undergraduate nursing students need to develop competencies to ensure patient safety. The quality of the pedagogical atmosphere in the clinical setting has an important impact on the students' overall level of competence. Active student engagement in clinical processes stimulates their critical reasoning, improves interpersonal communication and facilitates adequate supervision and feedback. Few studies describe the nursing students' patient safety competencies and exactly what they need to learn. In addition, studies describe only briefly which clinical learning environments facilitate the development of patient safety competencies in nursing students. Further research is needed to identify additional pedagogical strategies and the specific characteristics of the clinical learning environments that encourage the development of nursing students' patient safety competencies. © 2016 John Wiley & Sons Ltd.

The issue of life: Aristotle in nursing perspective.

PubMed

Elstad, Ingunn; Torjuul, Kirsti

2009-10-01

This paper explores the issue of life and its relevance to nursing, through Aristotle's philosophy and an Aristotelian interpretation of Nightingale's Notes on Nursing. Life as process and becoming has ontological status in Aristotle's philosophy and this dynamism is particularly relevant for nursing. The paper presents aspects of Aristotle's philosophy of life: his account of life as inherent powers of the individual, his analysis of change and time, and his understanding of sickness and health as qualitative states of living beings. It is shown how the Greek medical-philosophical tradition, continued by Galenic medicine and hygiene into modern time, influenced Nightingale's nursing. Individuals' life-maintaining metabolic relations to their surroundings are investigated through Aristotle and modern philosophy of biology and through Nightingale's nursing emphasis on the patient's relation to her or his immediate surroundings. It is argued that Nightingale's concern is really the processes of individual life, which in sickness necessitate temporally continuous nursing observation. Humans' radical dependency on their surroundings is actualized as interpersonal interdependency. The paper argues that the end of nursing care, the telos for which sake it is practised, is inherent in the individual course of the patients' life. When life processes are affected by sickness, infirmity, medical interventions or mental suffering, individuals need competent help to live - and to live as well as possible. It is suggested that the special responsibility of nursing is to facilitate, relieve and protect individual life continuously during such times.

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

PubMed

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

2017-02-01

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

Rationalisation of nursing education in Limpopo province : nurse educators' perspectives.

PubMed

Makhuvha, T R; Davhana-Maselesele, M; Netshandama, V O

2007-12-01

Nursing education institutions are facing a challenge of realigning its functioning according to the changes that are taking place within the country. The intention of the government post apartheid was to correct the imbalances which were brought about by the apartheid government and the following regulations and policies influenced the change in nursing education, that is, Reconstruction and Development Programme (RDP), White Paper on Higher Education (WPHE), and the National Qualification Framework (NQF) (South Africa, 1995:6). In 1996 the government introduced the first democratic constitution of the Republic of South Africa (RSA) according toAct 108 of 1996. In the light of those increasing changes in nursing education, led by political change, the experiences of nurse educators is a critical issue facing nursing campuses. The purpose of this study was two-fold; namely: to explore and describe the experiences of nurse educators with regard to the rationalisation of nursing education and to use information obtained to describe guidelines for the effective rationalisation of a nursing college in the Limpopo Province. A qualitative, exploratory, descriptive and contextual research design was used. Qualitative interviews were conducted with nurse educators who worked in nursing colleges before and after 1994. Measures to ensure trustworthiness were applied and ethical issues were adhered to throughout the research process. Data was analysed following Tesch's method (Creswell 1994:154-155). The research established that nurse educators experienced dissatisfaction in several areas relating to the rationalization of nursing education. Support was also expected from bureaucracy at higher level. This study developed guidelines to policy makers and nurse educators to ensure effective rationalisation process.

Conflict engagement: collaborative processes.

PubMed

Gerardi, Debra

2015-05-01

This article is one in a series on conflict. It is part of an ongoing series on leadership coordinated by the American Organization of Nurse Executives (AONE; www.aone.org), highlighting topics of interest to nurse managers and emerging nurse leaders. The AONE provides leadership, professional development, advocacy, and research to advance nursing practice and patient care, promote nursing leadership excellence, and shape public policy for health care.

The Application of Learning Styles to Computer Assisted Instruction in Nursing Education

DTIC Science & Technology

1991-01-01

nursing profession is to integrate computer technology into the learning process at all levels of nursing education . In order to successfully accomplish... learning styles. * Computer technology needs to be integrated into nursing education , research and practice. * * An evaluation tool needs to be...Computer-assisted video instruction Learning Styles and CAI 71 References Aiken, E. (1990). Continuing nursing education in computer technology : A regional

Nursing staff work patterns in a residential aged care home: a time-motion study.

PubMed

Qian, Siyu; Yu, Ping; Hailey, David

2016-11-01

Objective Residential aged care services are challenged by an increasing number of residents and a shortage of nursing staff. Developing strategies to overcome this challenge requires an understanding of nursing staff work patterns. The aim of the present study was to investigate the work processes followed by nursing staff and how nursing time is allocated in a residential aged care home. Methods An observational time-motion study was conducted at two aged care units for 12 morning shifts. Seven nurses were observed, one per shift. Results In all, there were 91h of observation. The results showed that there was a common work process followed by all nurse participants. Medication administration, documentation and verbal communication were the most time-consuming activities and were conducted most frequently. No significant difference between the two units was found in any category of activities. The average duration of most activities was less than 1min. There was no difference in time utilisation between the endorsed enrolled nurses and the personal carers in providing nursing care. Conclusion Medication administration, documentation and verbal communication were the major tasks in morning shifts in a residential aged care home. Future research can investigate how verbal communication supports nursing care. What is known about the topic? The aging population will substantially increase the demand for residential aged care services. There is a lack of research on nurses' work patterns in residential aged care homes. What does this paper add? The present study provides a comprehensive understanding of nurses' work patterns in a residential aged care home. There is a common work process followed by nurses in providing nursing care. Medication administration, verbal communication and documentation are the most time-consuming activities and they are frequently conducted in the same period of time. Wound care, physical review and documentation on desktop computers are arranged flexibly by the nurses. What are the implications for practitioners? When developing a task reallocation strategy to improve work efficiency, effort can be put into tasks that can be arranged more flexibly.

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

PubMed

Buchan, James; Ball, Jane

2011-01-01

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

Use of Balanced Indicators as a Management Tool in Nursing1

PubMed Central

Fugaça, Neidamar Pedrini Arias; Cubas, Marcia Regina; Carvalho, Deborah Ribeiro

2015-01-01

Objective: to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. Method: a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. Results: we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Conclusion: although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators. PMID:26625995

Technology and medication errors: impact in nursing homes.

PubMed

Baril, Chantal; Gascon, Viviane; St-Pierre, Liette; Lagacé, Denis

2014-01-01

The purpose of this paper is to study a medication distribution technology's (MDT) impact on medication errors reported in public nursing homes in Québec Province. The work was carried out in six nursing homes (800 patients). Medication error data were collected from nursing staff through a voluntary reporting process before and after MDT was implemented. The errors were analysed using: totals errors; medication error type; severity and patient consequences. A statistical analysis verified whether there was a significant difference between the variables before and after introducing MDT. The results show that the MDT detected medication errors. The authors' analysis also indicates that errors are detected more rapidly resulting in less severe consequences for patients. MDT is a step towards safer and more efficient medication processes. Our findings should convince healthcare administrators to implement technology such as electronic prescriber or bar code medication administration systems to improve medication processes and to provide better healthcare to patients. Few studies have been carried out in long-term healthcare facilities such as nursing homes. The authors' study extends what is known about MDT's impact on medication errors in nursing homes.

Migrant nurses in Brazil: demographic characteristics, migration flow and relationship with the training process

PubMed Central

Silva, Kênia Lara; de Sena, Roseni Rosângela; Tavares, Tatiana Silva; Belga, Stephanie Marques Moura Franco; Maas, Lucas Wan Der

2016-01-01

Objective to analyze the migration of nurses in Brazil, describe the demographic characteristics of migrant nurses, the main migration flows, and establish relationships with the training process. Method a descriptive, exploratory study, based on 2010 Census data. The data were analyzed using descriptive statistics. Result there were 355,383 nurses in Brazil in 2010. Of these, 36,479 (10.3%) reported having moved compared to the year 2005: 18,073 (5.1%) for intrastate migration, 17,525 (4.8%) interstate migration, and 871 (0.2%) international migration. Females (86.3%), Caucasians (65.2%), and unmarried (48.3%) nurses prevailed in the population, without considerable variation between groups according to migration situation. The findings indicate that the migration flows are driven by the training process for states that concentrate a greater number of courses and positions in undergraduate and graduate studies, and the motivation of employment opportunity in regions of economic expansion in the country. Conclusion it is necessary to deepen the discussion on the movement of nurses in Brazil, their motivations, and international migration. PMID:27027681

Lessons learned from the implementation of a bedside handoff model.

PubMed

Hagman, Jan; Oman, Kathleen; Kleiner, Catherine; Johnson, Elizabeth; Nordhagen, Jamie

2013-06-01

At the University of Colorado Hospital, nurse-to-nurse shift reports traditionally occurred in a conference room setting and consisted of nurse-to-nurse verbal communication. Evidence supports moving this information exchange to the patient bedside. This model of report improves clinical effectiveness, patient safety, nurse efficiency, and staff satisfaction. Bedside reporting empowers patients and families to ask questions and contribute to their plan of care and increases patient satisfaction. This article describes the process of implementing and evaluating a model of nurse-to-nurse bedside handoff report.

Seeing beyond monitors-Critical care nurses' multiple skills in patient observation: Descriptive qualitative study.

PubMed

Alastalo, Mika; Salminen, Leena; Lakanmaa, Riitta-Liisa; Leino-Kilpi, Helena

2017-10-01

The aim of this study was to provide a comprehensive description of multiple skills in patient observation in critical care nursing. Data from semi-structured interviews were analysed using thematic analysis. Experienced critical care nurses (n=20) from three intensive care units in two university hospitals in Finland. Patient observation skills consist of: information gaining skills, information processing skills, decision-making skills and co-operation skills. The first three skills are integrated in the patient observation process, in which gaining information is a prerequisite for processing information that precedes making decisions. Co-operation has a special role as it occurs throughout the process. This study provided a comprehensive description of patient observation skills related to the three-phased patient observation process. The findings contribute to clarifying this part of the competence. The description of patient observation skills may be applied in both clinical practice and education as it may serve as a framework for orientation, ensuring clinical skills and designing learning environments. Based on this study, patient observation skills can be recommended to be included in critical care nursing education, orientation and as a part of critical care nurses' competence evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Career Cartography: From Stories to Science and Scholarship.

PubMed

Wilson, Deleise S; Rosemberg, Marie-Anne S; Visovatti, Moira; Munro-Kramer, Michelle L; Feetham, Suzanne

2017-05-01

To present four case scenarios reflecting the process of research career development using career cartography. Career cartography is a novel approach that enables nurses, from all clinical and academic settings, to actively engage in a process that maximizes their clinical, teaching, research, and policy contributions that can improve patient outcomes and the health of the public. Four early-career nurse researchers applied the career cartography framework to describe their iterative process of research career development. They report the development process of each of the components of career cartography, including destination statement, career map, and policy statement. Despite diverse research interests and career mapping approaches, common experiences emerged from the four nurse researchers. Common lessons learned throughout the career cartography process include: (a) have a supportive mentorship team, (b) start early and reflect regularly, (c) be brief and to the point, (d) keep it simple and avoid jargon, (e) be open to change, (f) make time, and (g) focus on the overall career destination. These four case scenarios support the need for nurse researchers to develop their individual career cartography. Regardless of their background, career cartography can help nurse researchers articulate their meaningful contributions to science, policy, and health of the public. © 2017 Sigma Theta Tau International.

The evolution of a doctor of nursing practice capstone process: programmatic revisions to improve the quality of student projects.

PubMed

Nelson, Joan M; Cook, Paul F; Raterink, Ginger

2013-01-01

The past several years have seen explosive growth in the number of doctor of nursing practice (DNP) degree programs offered by colleges of nursing in the United States. Through a process of trial and error since 2005, the faculty at the University of Colorado, College of Nursing, have revised the course structure and procedures related to the DNP capstone project to improve the quality and usefulness of these student projects. Efforts have focused on educating and involving all nursing faculty in the DNP capstone process, distinguishing between competencies for our PhD and DNP projects, clearly aligning the DNP capstone project with quality improvement methods rather than with research, working with our campus institutional review board to clarify regulatory review requirements for quality improvement studies, developing a review committee to oversee DNP students' projects, and structuring our sequential course requirements to encourage students' professional presentations and publications. Our current capstone process reflects 7 years of iterative work, which we summarize in this article in hopes that it will help institutions currently in the process of developing a DNP program. Copyright © 2013 Elsevier Inc. All rights reserved.

A model of adaptation of overseas nurses: exploring the experiences of Japanese nurses working in Australia.

PubMed

Kishi, Yuka; Inoue, Kumiyo; Crookes, Patrick; Shorten, Allison

2014-04-01

The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. A qualitative study. Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Analysis of qualitative open-ended questions revealed the participants' adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.

Contextual Factors for Establishing Nursing Regulation in Iran: A Qualitative Content Analysis

PubMed Central

Nejatian, Ahmad; Joulaei, Hassan

2018-01-01

ABSTRACT Background: Professional regulation is one of the strategies of the governments which protect the public’s right. Nursing practice is not an exception; hence, it is regulated to protect the public against nursing services’ adverse effects. Although modern nursing in Iran started from 100 years ago, documents show that there was no regulation mechanism for nursing in Iran till 2016. Hence, this study was conducted to illuminate the contextual factors affecting the nursing regulation process in Iran. Methods: To explore the contextual elements of late establishment of nursing registration as an important part of nursing regulation, we applied directed qualitative content analysis. For this purpose, all the historical events and related materials including articles published in scientific journals, gray literature, statements, news articles, and interviews in the period of 2006-2016 were reviewed and analyzed by expert panel and categorized in predetermined groups. Results: Pooled analysis data showed four contributing elements that affected the emerging nursing regulation in Iran. These elements include 1) cultural determinants, 2) structural determinants, 3) situational determinants, and 4) international or exogenous determinants. Conclusion: Nursing regulation is an important health policy issue in Iran which needs to be facilitated by contextual factors. These factors are complicated and country-specific. Political willingness should be accompanied by nursing association willingness to establish and improve nursing regulation. Other researches are recommended to explore actors and process and content of nursing regulation policy in Iran. PMID:29607341

Introduction and development of NCP using ICNP in Pakistan.

PubMed

Rukanuddin, R J

2005-12-01

Traditionally, nursing care has been described as performing nursing tasks and often focused on nurses carrying out doctors' orders. In many countries of the world, including Pakistan, nurses do not document care in a standardized manner. Because of this limitation many health administrators, policy makers, and consumers make inadequate assumptions about nursing work, often regarding nurses as any other 'health care technician' who can be easily replaced by more economical health care workers. To overcome this problem, standardized documentation is being introduced into the Aga Khan University School of Nursing and hospital, Aga Khan Health Services, Public Health School in Karachi, and government colleges of nursing, using the International Classification for Nursing Practice (ICNP). The purpose of this paper is to highlight the process of introducing and developing standardized nursing care plans (NCP) using ICNP in Pakistan. The process for introducing ICNP consists of four components, including administrative planning, development, teaching and training, and testing. Subsets of the ICNP for (i) maternity: antenatal, postnatal and natal care; and (ii) cardiology were developed using standardized NCPs. The subsets were developed by nurse experts and introduced at the testing sites. The testing will be conducted as a pilot project. Findings from the pilot will be used to continue and expand standardized nursing documentation using the ICNP across Pakistan. Through this project, nurses, midwives and lady health visitors (midwives, vaccinator and health educators) will test standardization of documentation and begin to evaluate efficiency and effectiveness of clinical practice.

Strengths-Based Nursing: A Process for Implementing a Philosophy Into Practice.

PubMed

Gottlieb, Laurie N; Gottlieb, Bruce

2017-08-01

Strengths-Based Nursing (SBN) is both a philosophy and value-driven approach that can guide clinicians, educators, manager/leaders, and researchers. SBN is rooted in principles of person/family centered care, empowerment, relational care, and innate health and healing. SBN is family nursing yet not all family nursing models are strengths-based. The challenge is how to translate a philosophy to change practice. In this article, we describe a process of implementation that has organically evolved of a multi-layered and multi-pronged approach that involves patients and families, clinicians, educators, leaders, managers, and researchers as well as key stakeholders including union leaders, opinion leaders, and policy makers from both nursing and other disciplines. There are two phases to the implementation process, namely, Phase 1: pre-commitment/pre-adoption and Phase 2: adoption. Each phase consists of distinct steps with accompanying strategies. These phases occur both sequentially and concurrently. Facilitating factors that enable the implementation process include values which align, readiness to accept SBN, curiosity-courage-commitment on the part of early adopters, a critical mass of early adopters, and making SBN approach both relevant and context specific.

Evaluation of the quality of the teaching-learning process in undergraduate courses in Nursing 1

PubMed Central

González-Chordá, Víctor Manuel; Maciá-Soler, María Loreto

2015-01-01

Abstract Objective: to identify aspects of improvement of the quality of the teaching-learning process through the analysis of tools that evaluated the acquisition of skills by undergraduate students of Nursing. Method: prospective longitudinal study conducted in a population of 60 secondyear Nursing students based on registration data, from which quality indicators that evaluate the acquisition of skills were obtained, with descriptive and inferential analysis. Results: nine items were identified and nine learning activities included in the assessment tools that did not reach the established quality indicators (p<0.05). There are statistically significant differences depending on the hospital and clinical practices unit (p<0.05). Conclusion: the analysis of the evaluation tools used in the article "Nursing Care in Welfare Processes" of the analyzed university undergraduate course enabled the detection of the areas for improvement in the teachinglearning process. The challenge of education in nursing is to reach the best clinical research and educational results, in order to provide improvements to the quality of education and health care. PMID:26444173

Teaching concept analysis to graduate nursing students.

PubMed

Schiller, Catharine J

2018-04-01

To provide guidance to educators who use the Wilson (1963) concept analysis method, as modified by Walker and Avant (2011), in their graduate nursing curriculum BACKGROUND: While graduate nursing curricula often include a concept analysis assignment, there is a paucity of literature to assist educators in guiding students through this challenging process. This article details one way for educators to assist graduate nursing students in learning how to undertake each step of the Wilson (1963) concept analysis method, as modified by Walker and Avant (2011). Wilson (1963) concept analysis method, as modified by Walker and Avant (2011). Using examples, this article walks the reader through the Walker and Avant (2011) concept analysis process and addresses those issues commonly encountered by educators during this process. This article presented one way of walking students through a Walker and Avant (2011) concept analysis. Having clear information about the steps involved in developing a concept analysis will make it easier for educators to incorporate it into their graduate nursing curriculum and to effectively guide students on their journey through this process. © 2018 Wiley Periodicals, Inc.

Redesigning a risk-management process for tracking injuries.

PubMed

Wenzel, G R

1998-01-01

The changing responsibilities of registered nurses are challenging even the most dedicated professionals. To survive within her newly-defined roles, one nurse used a total quality improvement model to understand, analyze, and improve a medical center's system for tracking inpatient injuries. This process led to the drafting of an original software design that implemented a nursing informatics tracking system. It has resulted in significant savings of time and money and has far surpassed the accuracy, efficiency, and scope of the previous method. This article presents an overview of the design process.

Concept formation: a supportive process for early career nurses.

PubMed

Thornley, Tracey; West, Sandra

2010-09-01

Individuals come to understand abstract constructs such as that of the 'expert' through the formation of concepts. Time and repeated opportunity for observation to support the generalisation and abstraction of the developing concept are essential if the concept is to form successfully. Development of an effective concept of the 'expert nurse' is critical for early career nurses who are attempting to integrate theory, values and beliefs as they develop their clinical practice. This study explores the use of a concept development framework in a grounded theory study of the 'expert nurse'. Qualitative. Using grounded theory methods for data collection and analysis, semi-structured interviews were conducted with registered nurses. The participants were asked to describe their concept of the 'expert nurse' and to discuss their experience of developing this. Participants reported forming their concept of the 'expert nurse', after multiple opportunities to engage with nurses identified as 'expert'. This identification did not necessarily relate to the designated position of the 'expert nurse' or assigned mentors. When the early career nurse does not successfully form a concept of the 'expert nurse', difficulties in personal and professional development including skill/knowledge development may arise. To underpin development of their clinical practice effectively, early career nurses need to be provided with opportunities that facilitate the purposive formation of their own concept of the 'expert nurse'. Formation of this concept is not well supported by the common practice of assigning mentors. Early career nurses must be provided with the time and the opportunity to individually develop and refine their concept of the 'expert nurse'. To achieve this, strategies including providing opportunities to engage with expert nurses and discussion of the process of concept formation and its place in underpinning personal judgments may be of assistance. © 2010 Blackwell Publishing Ltd.

[The process of demedicalization of women's health care in nursing education].

PubMed

Vargens, Octávio Muniz da Costa; Progianti, Jane Márcia

2004-03-01

This objective of this study is to present the pedagogic strategies adopted by the Rio de Janeiro State University Nursing School (UERJ--Brazil) for the demedicalization of care in nursing education in women's health. It presents the context of teaching in this area of knowledge. It also presents, from the perspective of concepts by Pierre Bourdieu, three spheres of students' and teachers' performance in this process.

[Assessment of a software application tool for managing nursing care processes in the period 2005-2010].

PubMed

Medina-Valverde, M José; Rodríguez-Borrego, M Aurora; Luque-Alcaraz, Olga; de la Torre-Barbero, M José; Parra-Perea, Julia; Moros-Molina, M del Pilar

2012-01-01

To identify problems and critical points in the software application. Assessment of the implementation of the software tool "Azahar" used to manage nursing care processes. The monitored population consisted of nurses who were users of the tool, at the Hospital and those who benefited from it in Primary Care. Each group was selected randomly and the number was determined by data saturation. A qualitative approach was employed using in-depth interviews and group discussion as data collection techniques. The nurses considered that the most beneficial and useful application of the tool was the initial assessment and the continuity of care release forms, as well as the recording of all data on the nursing process to ensure quality. The disadvantages and weaknesses identified were associated with the continuous variability in their daily care. The nurses related an increase in workload with the impossibility of entering the records into the computer, making paper records, thus duplicating the recording process. Likewise, they consider that the operating system of the software should be improved in terms of simplicity and functionality. The simplicity of the tool and the adjustment of workloads would favour its use and as a result, continuity of care. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Evaluation of nurse engagement in evidence-based practice.

PubMed

Davidson, Judy E; Brown, Caroline

2014-01-01

The purpose of this project was to explore nurses' willingness to question and change practice. Nurses were invited to report practice improvement opportunities, and participants were supported through the process of a practice change. The project leader engaged to the extent desired by the participant. Meetings proceeded until the participant no longer wished to continue, progress was blocked, or practice was changed. Evaluation of the evidence-based practice change process occurred. Fifteen nurses reported 23 practice improvement opportunities. The majority (12 of 15) preferred to have the project leader review the evidence. Fourteen projects changed practice; 4 were presented at conferences. Multiple barriers were identified throughout the process and included loss of momentum, the proposed change involved other disciplines, and low level or controversial evidence. Practice issues were linked to quality metrics, cost of care, patient satisfaction, regulatory compliance, and patient safety. Active engagement by nurse leaders was needed for a practice change to occur. Participants identified important problems previously unknown to hospital administrators. The majority of nurses preferred involvement in practice change based on clinical problem solving when supported by others to provide literature review and manage the process through committees. Recommendations include supporting a culture that encourages employees to report practice improvement opportunities and provide resources to assist in navigating the identified practice change.

What Is Nursing Home Quality and How Is It Measured?

ERIC Educational Resources Information Center

Castle, Nicholas G.; Ferguson, Jamie C.

2010-01-01

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO)…

Grounding our practice in nursing professional development.

PubMed

Dickerson, Pamela S

2014-07-01

The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice. Copyright 2014, SLACK Incorporated.

North Dakota Statewide Nursing Study, Phase III. Final Report and Recommendations.

ERIC Educational Resources Information Center

Clark, Neil; Smith, David

The process, outcomes, and recommendations resulting from a project to develop a statewide nursing resource planning system are examined. Phase 1 of the project investigated nursing manpower demands for 1984 and 1986, while phase 2 studied the current scope of nursing practice. In addition to summarizing the findings of these investigations,…

Nursing Effort and Quality of Care for Nursing Home Residents

ERIC Educational Resources Information Center

Arling, Greg; Kane, Robert L.; Mueller, Christine; Bershadsky, Julie; Degenholtz, Howard B.

2007-01-01

Purpose: The purpose of this study was to determine the relationship between nursing home staffing level, care received by individual residents, and resident quality-related care processes and functional outcomes. Design and Methods: Nurses recorded resident care time for 5,314 residents on 156 units in 105 facilities in four states (Colorado,…

Investigating the effect of nurse-team communication on nurse turnover: relationships among communication processes, identification, and intent to leave.

PubMed

Apker, Julie; Propp, Kathleen M; Ford, Wendy S Zabava

2009-03-01

Enhanced team communication may strengthen nurses' attachment to their organizations and teams and improve nurse retention. This study examines the relationships among nurse-team communication, identification (organizational and team), and intent to leave. Hospital nurses (N = 201) completed surveys measuring 3 nurse-team communication processes: promoting team synergy, ensuring quality decisions, and individualizing communication. Hierarchical regression analyses revealed that promoting team synergy was a significant predictor of intent to leave, whereas ensuring quality decisions and individualizing communication did not account for significant additional variance in intent to leave. Separate analyses showed that the relationship between promoting team synergy and intent to leave was partially mediated by team identification or by organizational identification. Further analyses were conducted on the 7 communication practices for promoting team synergy. Mentoring emerged as the only significant predictor of intent to leave; however, its relationship to intent to leave was fully mediated by organizational identification or partially mediated by team identification. Pragmatic suggestions are offered to improve nurse identification and reduce turnover.

Critical thinking: the development of an essential skill for nursing students.

PubMed

Papathanasiou, Ioanna V; Kleisiaris, Christos F; Fradelos, Evangelos C; Kakou, Katerina; Kourkouta, Lambrini

2014-08-01

Critical thinking is defined as the mental process of actively and skillfully perception, analysis, synthesis and evaluation of collected information through observation, experience and communication that leads to a decision for action. In nursing education there is frequent reference to critical thinking and to the significance that it has in daily clinical nursing practice. Nursing clinical instructors know that students face difficulties in making decisions related to clinical practice. The main critical thinking skills in which nursing students should be exercised during their studies are critical analysis, introductory and concluding justification, valid conclusion, distinguish of facts and opinions, evaluation the credibility of information sources, clarification of concepts and recognition of conditions. Specific behaviors are essentials for enhancing critical thinking. Nursing students in order to learn and apply critical thinking should develop independence of thought, fairness, perspicacity in personal and social level, humility, spiritual courage, integrity, perseverance, self-confidence, interest for research and curiosity. Critical thinking is an essential process for the safe, efficient and skillful nursing practice. The nursing education programs should adopt attitudes that promote critical thinking and mobilize the skills of critical reasoning.

A purposeful Yet Nonimposing Approach: How Japanese Home Care Nurses Establish Relationships With Older Clients and Their Families.

PubMed

Iwasaki, Takako; Yamamoto-Mitani, Noriko; Sato, Kana; Yumoto, Yoshie; Noguchi-Watanabe, Maiko; Ogata, Yasuko

2017-11-01

Relationship development is crucial to nursing practice with families. However, little is known about the process of building relationships with multiple family members in home care settings and in various cultures. The objective of this study was to explore the experiences of home care nurses about how they established relationships with older clients and their families in Japan. Grounded theory was used to guide the research. Twenty-three expert home care nurses participated in semistructured interviews concerning their family nursing practice. The establishment of relationships with clients/family members was based on a purposeful yet nonimposing approach composed of four aspects: keeping a mindful distance from the family, not being a threat to family life, being a comfortable neighbor, and gaining trust as a competent nurse. Through a purposeful nonimposing approach, Japanese home care nurses promoted and nurtured nurse-family relationships and became involved in the life of the family. These findings provide a useful foundation to guide practice with families and grow knowledge about the process of establishing relationships with multiple family members in home settings.

Engaging clinical nurses in quality and performance improvement activities.

PubMed

Albanese, Madeline P; Evans, Dietra A; Schantz, Cathy A; Bowen, Margaret; Disbot, Maureen; Moffa, Joseph S; Piesieski, Patricia; Polomano, Rosemary C

2010-01-01

Nursing performance measures are an integral part of quality initiatives in acute care; however, organizations face numerous challenges in developing infrastructures to support quality improvement processes and timely dissemination of outcomes data. At the Hospital of the University of Pennsylvania, a Magnet-designated organization, extensive work has been conducted to incorporate nursing-related outcomes in the organization's quality plan and to integrate roles for clinical nurses into the Department of Nursing and organization's core performance-based programs. Content and strategies that promote active involvement of nurses and prepare them to be competent and confident stakeholders in quality initiatives are presented. Engaging clinical nurses in the work of quality and performance improvement is essential to achieving excellence in clinical care. It is important to have structures and processes in place to bring meaningful data to the bedside; however, it is equally important to incorporate outcomes into practice. When nurses are educated about performance and quality measures, are engaged in identifying outcomes and collecting meaningful data, are active participants in disseminating quality reports, and are able to recognize the value of these activities, data become one with practice.

Critical Thinking: The Development of an Essential Skill for Nursing Students

PubMed Central

Papathanasiou, Ioanna V.; Kleisiaris, Christos F.; Fradelos, Evangelos C.; Kakou, Katerina; Kourkouta, Lambrini

2014-01-01

Critical thinking is defined as the mental process of actively and skillfully perception, analysis, synthesis and evaluation of collected information through observation, experience and communication that leads to a decision for action. In nursing education there is frequent reference to critical thinking and to the significance that it has in daily clinical nursing practice. Nursing clinical instructors know that students face difficulties in making decisions related to clinical practice. The main critical thinking skills in which nursing students should be exercised during their studies are critical analysis, introductory and concluding justification, valid conclusion, distinguish of facts and opinions, evaluation the credibility of information sources, clarification of concepts and recognition of conditions. Specific behaviors are essentials for enhancing critical thinking. Nursing students in order to learn and apply critical thinking should develop independence of thought, fairness, perspicacity in personal and social level, humility, spiritual courage, integrity, perseverance, self-confidence, interest for research and curiosity. Critical thinking is an essential process for the safe, efficient and skillful nursing practice. The nursing education programs should adopt attitudes that promote critical thinking and mobilize the skills of critical reasoning. PMID:25395733

Light at the end of the tunnel: a vision for an empowered nursing profession across the continuum of care.

PubMed

Dingel-Stewart, Sylvia; LaCoste, Janice

2004-01-01

Lacking political stewardship, healthcare in America is shaped primarily by rapidly changing market forces seeking to stem the tide of rising healthcare costs. However, nursing's voice in this process is fragmented and unfocused. Staff nurses' focus and commitment are to quality care rendered at the bedside and in interactions with the patient. With this narrow focus, staff nurses are paralyzed by the constant change and unable to move to a broader, more integrative view of healthcare-one that encompasses quality care, policymaking, and healthcare finance. Using the theory of transformative learning, nurse administrators and managers can influence nurses' frames of reference and expand their view to be more inclusive. Nurses who are successful in this transformation process will emerge with a new view of self-visible and empowered. These newly transformed nurses see themselves more as healthcare engineers than as technicians coordinating care across the continuum, and creating fluid working relationships to prevent the dis-continuum of care of patients falling through the cracks of the current healthcare system.

Democratization of health care: challenge for nursing.

PubMed

Watts, R J

1990-01-01

One of the key foundational principles of primary health care is community involvement. The implementation of meaningful community involvement requires democratic institutions and processes within the health care system. In this context the meaning of substantive democracy and the implications of this concept for the health care system are briefly discussed. The relationship between the purpose, values, and foundational concepts of democracy and those of nursing is examined in greater detail. Based on the congruency between these, the role of nursing in generating and enhancing democratic processes within the health care system is discussed and a model of nursing practice proposed.

Clinical judgments about endotracheal suctioning: what cues do expert pediatric critical care nurses consider?

PubMed

Thomas, Margot; Fothergill-Bourbonnais, Frances

2005-12-01

Making accurate and timely judgments based on multiple ways of knowing is an essential skill in critical care nursing practice. Studies have proposed that positive patient outcomes are linked to expert judgments in a variety of critical care situations; however, little is known about clinical judgments related to specific critical care nursing interventions. This article presents a qualitative nursing research study which examined the cues that expert pediatric critical care nurses used in making clinical judgments about suctioning intubated and ventilated, critically ill children. The participants' words and actions attest that the 'sensing' and 'thinking' of the process of cue use, are interwoven with, and integral to, the 'doing,' which is the process of skilled performance.

The experiences of family members in the nursing home to hospital transfer decision.

PubMed

Abrahamson, Kathleen; Bernard, Brittany; Magnabosco, Lara; Nazir, Arif; Unroe, Kathleen T

2016-11-15

The objective of this study was to better understand the experiences of family members in the nursing home to hospital transfer decision making process. Semi-structured interviews were conducted with 20 family members who had recently been involved in a nursing home to hospital transfer decision. Family members perceived themselves to play an advocacy role in their resident's care and interview themes clustered within three over-arching categories: Family perception of the nursing home's capacity to provide medical care: Resident and family choices; and issues at 'hand-off' and the hospital. Multiple sub-themes were also identified. Findings from this study contribute to knowledge surrounding the nursing home transfer decision by illuminating the experiences of family members in the transfer decision process.

Becoming a psychiatric/mental health nurse in the UK: a qualitative study exploring processes of identity formation.

PubMed

Hurley, John; Lakeman, Richard

2011-01-01

Identity studies are well established across the social science literature with mental health nursing beginning to offer evidenced insights into what may, or may not, constitute key identity performances. For mental health nursing these performances remain contested, both from within the profession and from international contexts that favour generic constructions of mental health. This paper offers findings from a qualitative study that focused upon the process of how mental health nursing identity development is influenced, rather than what that identity may or may not be. These findings highlight that mental health nurses (MHNs) not only form their identity around service user centred education and training, but that many also use the education as a means to leave the profession. Through highlighting the impact of informal education (i.e., through work), formal education, and training upon the formation of mental health nursing identity, nurses are potentially alerted to the importance of clinically focussed mental health being prominent within curricula, rewarding mental health nursing skills specialisation, and the importance of the role of the service user in mental health nurse education and, hence, identity formation.

Nurse managers and the sandwich support model.

PubMed

Chisengantambu, Christine; Robinson, Guy M; Evans, Nina

2018-03-01

To explore the interplay between the work of nurse managers and the support they receive and provide. Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the "sandwich support model," to promote effective functioning and desirable patient outcomes via support "from above" and "from below." The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. © 2017 John Wiley & Sons Ltd.

Creating tomorrow's leaders today: the Emerging Nurse Leaders Program of the Texas Nurses Association.

PubMed

Sportsman, Susan; Wieck, Lynn; Yoder-Wise, Patricia S; Light, Kathleen M; Jordan, Clair

2010-06-01

The Texas Nurses Association initiated an Emerging Nurse Leaders Program as an approach to engaging new nurses in the leadership of the professional association. This article explains the program's origin, the commitment of the Texas Nurses Association to this process, the implementation of the plan, and the discussions that launched a new way of connecting leaders across generations. Further, it is an approach that any professional organization can use to encourage the involvement of new leaders.

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.

Migrant Nurses and Federal Caregiver Programs in Canada: Migration and Health Human Resources Paradox.

PubMed

Salami, Bukola

2016-06-01

Despite the links between health human resources policy, immigration policy, and education policy, silos persist in the policy-making process that complicate the professional integration of internationally educated nurses in Canada. Drawing on the literature on nurse migration to Canada through the Live-in Caregiver Program, this paper sheds light on the contradictions between immigration and health human resources policy and their effect on the integration of internationally educated nurses in Canada. The analysis reveals a series of paradoxes within and across immigration and health human resources policy that affect the process of professional integration of this group of health professionals into the nursing workforce in Canada. I will further link the discussion to the recently implemented Caregiver Program, which provides a unique pathway for healthcare workers, including nurses, to migrate to Canada. Given recent introduction of the Canadian Caregiver Program, major policy implications include the need to bridge the gap between health human resources policy and immigration policy to ensure the maximum integration of migrant nurses in Canada.

The diffusion of innovation in nursing regulatory policy: removing a barrier to medication administration training for child care providers.

PubMed

Torre, Carolyn T; Crowley, Angela A

2011-08-01

Safe medication administration is an essential component of high-quality child care. Its achievement in New Jersey was impeded by a controversy over whether teaching child care providers medication administration involves registered nurses in the process of nursing delegation. Through the theoretical framework of the Diffusion of Innovation, this paper examines how the interpretation of regulatory policy related to nursing practice in New Jersey was adjusted by the Board of Nursing following a similar interpretation of regulatory policy by the Board of Nursing in Connecticut. This adjustment enabled New Jersey nurses to continue medication administration training for child care providers. National data supporting the need for training child care providers in medication administration is presented, the Diffusion of Innovation paradigm is described; the Connecticut case and the New Jersey dilemma are discussed; the diffusion process between the two states is analyzed and an assessment of the need for further change is made.

The Productive Ward program™: a longitudinal multilevel study of nurse perceived practice environment, burnout, and nurse-reported quality of care and job outcomes.

PubMed

Van Bogaert, Peter; Van heusden, Danny; Somers, Annemie; Tegenbos, Muriel; Wouters, Kristien; Van der Straeten, Johnny; Van Aken, Paul; Havens, Donna Sullivan

2014-09-01

The objective of this study was to investigate the impact of The Productive Ward-Releasing Time to Care™ program implemented in a hospital transformation process on nurse perception related to practice environment, burnout, quality of care, and job outcomes. To address the continuously evolving complex challenges of patient care, high-performance nursing care is necessary. A longitudinal survey design was used to conduct a study in a 600-bed acute care university hospital with 3 measurement periods: T0: base line in 2006, T1 in 2011, and T2 in 2013. As part of the hospital transformation process, the productive ward program was introduced between T1 and T2. Relevant impact on nurse-physician relations, nurse management, hospital management-organizational support, nurse-reported quality of care, and job outcomes were identified. Hospital strategies and policies should be aligned with daily practices so that engaged and committed staff can promote excellent outcomes.

The American College of Nurse-Midwives' dream becomes reality: The Division of Accreditation.

PubMed

Carrington, Betty Watts; Burst, Helen Varney

2005-01-01

Recognized continuously by the US Department of Education since 1982 as a specialized accrediting agency, the American College of Nurse-Midwives' Division of Accreditation (DOA) accredits not only nurse-midwifery education programs at the postbaccalaureate or higher academic level as certificate and graduate programs for registered nurses (RNs), but also precertification programs for professional midwives from other countries who are licensed as RNs in the United States. The DOA also accredits midwifery education programs for non-nurses at the postbaccalaureate or higher academic level as certificate and graduate programs, and precertification programs for professional midwives from other countries. The accreditation process is a voluntary activity involving both nurse-midwifery and/or midwifery education programs and the DOA. Present plans include another expansion of recognition: to become an institutional accreditation agency for independent and proprietary schools and to continue as a programmatic accrediting agency. Since its inception, the accreditation process has been viewed as a positive development in nurse-midwifery education.

Stories and Music for Adolescent/Young Adult Resilience During Transplant Partnerships: Strategies to Support Academic-Clinical Nurse Collaborations in Behavioral Intervention Studies.

PubMed

Hendricks-Ferguson, Verna L; Barnes, Yvonne J; Cherven, Brooke; Stegenga, Kristin; Roll, Lona; Docherty, Sharon L; Haase, Joan E

Evidence-based nursing is in the forefront of healthcare delivery systems. Federal and state agencies, academic institutions, and healthcare delivery systems recognize the importance of nursing research. This article describes the mechanisms that facilitate nursing partnerships yielding high-level research outcomes in a clinical setting. A phase-II multicenter behavioral intervention study with pediatric stem cell transplant patients was the context of this academic/clinical research partnership. Strategies to develop and maintain this partnership involved a thorough understanding of each nurse's focus and barriers. A variety of communication plans and training events maximized preexisting professional networks. Academic/clinical nurses' discussions identified barriers to the research process, the most significant being role conflict. Communication and validation of benefits to each individual and institution facilitated the research process during challenging times. Establishing strong academic/clinical partnerships should lead to evidence-based research outcomes for the nursing profession, healthcare delivery systems, and patients and families.

Manual for monitoring the quality of nursing home care records.

PubMed

Barbosa, Silvia Freitas; Tronchin, Daisy Maria Rizatto

2015-01-01

to build and validate an instrument aimed at monitoring the quality of nursing records in the Home Care Program (HCP) of a university hospital. methodological study involving the elaboration of a manual, whose content was later submitted to six experts for validation, reaching a ≥ 80% consensus. The data collection process was carried out in 2012 by means of a questionnaire comprised of the following issues: nursing evolution, nursing diagnosis, and nursing prescription, and standards for the nursing team recommended by the Regional Nursing Council of São Paulo and by the assessed institution. Manual items were judged according to the following variables: relevance, pertinence, clarity and simplicity. of the 39 propositions, 100% achieved ≥ 80% agreement in the relevance, pertinence and clarity variables; 92.3% in the simplicity variable. Sleep/rest, Mobility and Check-out variables did not reach a favorable minimum consensus in the prescribed activities and were improved following suggestions from the experts. we believe that the instrument will enable the improvement of the HCP's work process.

Nursing professionalism: An evolutionary concept analysis

PubMed Central

Ghadirian, Fataneh; Salsali, Mahvash; Cheraghi, Mohammad Ali

2014-01-01

Background: Professionalism is an important feature of the professional jobs. Dynamic nature and the various interpretations of this term lead to multiple definitions of this concept. The aim of this paper is to identify the core attributes of the nursing professionalism. Materials and Methods: We followed Rodgers’ evolutionary method of concept analysis. Texts published in scientific databases about nursing professionalism between 1980 and 2011 were assessed. After applying the selection criteria, the final sample consisting of 4 books and 213 articles was selected, examined, and analyzed in depth. Two experts checked the process of analysis and monitored and reviewed them. Results: The analysis showed that nursing professionalism is determined by three attributes of cognitive, attitudinal, and psychomotor. In addition, the most important antecedents concepts were demographic, experiential, educational, environmental, and attitudinal factors. Conclusion: Nursing professionalism is an inevitable, complex, varied, and dynamic process. In this study, the importance, scope, and concept of professionalism in nursing, the concept of a beginning for further research and development, and expanding the nursing knowledge are explained and clarified. PMID:24554953

An evaluation of the process and initial impact of disseminating a nursing e-thesis.

PubMed

Macduff, Colin

2009-05-01

This paper is a report of a study conducted to evaluate product, process and outcome aspects of the dissemination of a nursing PhD thesis via an open-access electronic institutional repository. Despite the growth of university institutional repositories which make theses easily accessible via the world wide web, nursing has been very slow to evaluate related processes and outcomes. Drawing on Stake's evaluation research methods, a case study design was adopted. The case is described using a four-phase structure within which key aspects of process and impact are reflexively analysed. In the conceptualization/re-conceptualization phase, fundamental questions about the purpose, format and imagined readership for a published nursing PhD were considered. In the preparation phase, seven key practical processes were identified that are likely to be relevant to most e-theses. In the dissemination phase email invitations were primarily used to invite engagement. The evaluation phase involved quantitative indicators of initial impact, such as page viewing and download statistics and qualitative feedback on processes and product. Analysis of process and impact elements of e-thesis dissemination is likely to have more than intrinsic value. The advent of e-theses housed in web-based institutional repositories has the potential to transform thesis access and use. It also offers potential to transform the nature and scope of thesis production and dissemination. Nursing scholars can exploit and evaluate such opportunities.

Characteristics of nurses and hospital work environments that foster satisfaction and clinical expertise.

PubMed

Foley, Barbara Jo; Kee, Carolyn C; Minick, Ptlene; Harvey, Susan S; Jennings, Bonnie M

2002-05-01

The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals. Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities. A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables. Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment. This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.

Practices for caring in nursing: Brazilian research groups.

PubMed

Erdmann, A L; de Andrade, S R; de Mello, A L Ferreira; Klock, P; do Nascimento, K C; Koerich, M Santos; Backes, D Stein

2011-09-01

The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distributed in sample groups, were interviewed. The core phenomenon 'research groups of administration and management in nursing: arrangements and interactions in the system of caring in nursing' was derived from the categories: conceptual bases and contexts of the research groups; experiencing interactions in the research groups; functionality of the research groups; and outputs of the research groups. The research groups are integrated in the system of caring in nursing. The activities of the Brazilian administration and management in nursing research groups are process oriented and in a process of constant renovation, socially relevant, operate in a complex scenario and contribute to the advancement of the organizations of the system of caring in nursing through strengthening the connection among academia, service and community. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

[Modification of nursing practice through reflection: participatory action research].

PubMed

Delgado Hito, P; Sola Prado, A; Mirabete Rodríguez, I; Torrents Ros, R; Blasco Afonso, M; Barrero Pedraza, R; Catalá Gil, N; Mateos Dávila, A; Quinteiro Canedo, M

2001-01-01

Technology and complex techniques are inevitably playing an increasing role in intensive care units. They continue to characterize nursing care and in some cases dehumanize it. The general aim of this study was to stimulate reflection on nursing care. The study was based on the participation of the investigators with the goal of producing changes in nursing practice. Qualitative methodology in the form of participatory action research and the Kemmis and McTaggart method were used. Data were collected through systematic observation, seven group meetings and document analysis. Eight nurses took part in the study. The meetings were recorded and transcribed verbatim into a computer. This process and the meaning of the verbatim transcription (codification/categorization process and document synthesis cards) were analyzed. The results of this study enabled exploration of the change in nursing practice and showed that the reflection in action method stimulates changes in practice. The new way of conceiving nursing action has increased nursing care quality and its humanization since it shows greater respect for the patient, provides families with closer contact and greater support, improves coordination of nursing care acts and increases collaboration among professionals.In conclusion, participatory action research is a valid and appropriate method that nurses can use to modify their daily practice.

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

PubMed

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

2015-09-01

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

A successful online mentoring program for nurses.

PubMed

O'Keefe, Trish; Forrester, David Anthony Tony

2009-01-01

This article describes the successful implementation of An Online Mentoring Program for Nurses at a Magnet-designated acute care medical center, Morristown Memorial Hospital (MMH/Atlantic Health). A comprehensive approach to incorporating mentor-protégée teams into professional nurse role development has been demonstrated to (1) improve nurse employee satisfaction, retention, and recruitment outcomes; (2) change the ways nurses and others perceive nurses; (3) augment support by managers and coworkers; and (4) improve patient care outcomes. Nurses are partnered in mentor-protégée relationships and continually engage one another by evaluating the protégée's unique contributions and identifying specific strategic actions to move the protégée toward accomplishing their professional objectives. Building an online mentor-protégée collaboration: (1) maximizing potential, (2) identifying the protégée's unique contributions, and (3) strategic planning. The online mentoring process is a success and has delivered measurable results that have benefited the nurse participants and contributed to our institution's culture of nursing engagement. The online mentoring process has potential to benefit nurses and their organizations by (1) providing real-time communication, (2) facilitating strategic thinking, (3) monitoring progress, (4) "going green," and (5) improving organizational knowledge.

Relationships between duration of practice, educational level, and perception of barriers to implement evidence-based practice among critical care nurses.

PubMed

Phillips, Carswella

2015-12-01

Globally, a greater emphasis has been placed on the delivery of safe, patient-centered, evidence-based nursing care. As point-of-care providers, critical care nurses play a key role in ensuring that patients receive the safest, most effective treatment available. In order to deliver scientific-based care, critical care nurses must stay abreast of the current trends, as well as engage in the evidence-based practice process. This study aimed to describe research activities, to identify barriers to implement evidence-based practice and to explore professional factors related to the use of evidence-based practice among critical care nurses at three teaching hospitals in south-eastern United States. A survey design and convenience sampling method was used. A sample of 30 critical care staff nurses participated in the study. A 61-item online questionnaire composed of a demographic survey - BARRIERS scale - and Evidence-Based Practice Questionnaire was used. Simple descriptive statistics, Pearson's product moment correlations, and independent-sample t test procedures were used to analyze the data. Critical care nurses' reported positive attitudes, but viewed knowledge and use of evidence-based practice less favorably. These results may indicate that having a positive attitude towards evidence-based practice does not necessarily translate to knowledge and use of the evidence-based practice process in clinical practice. An unwillingness to change and time constraints were identified as the top barriers to use evidence-based practice in this study. Perceptions of barriers to use evidence-based practice were higher in those critical care nurses who had less practical experience and educational preparation. The results suggest that critical care nurses possess the foundation to engage in the evidence-based practice process; however, their knowledge, practice, and attitudes just need to be cultivated and strengthened. Understanding the nurses' professional factors, current use and barriers to implement evidence-based practice is an essential step to ensuring competency and value for engaging in the evidence-based practice process. The results of this study support the need for future research to address barriers that impact critical care nurses' ability to deliver state-of-the-science care.

The dimensions of nursing surveillance: a concept analysis

PubMed Central

Kelly, Lesly; Vincent, Deborah

2011-01-01

Aim This paper is a report of an analysis of the concept of nursing surveillance. Background Nursing surveillance, a primary function of acute care nurses, is critical to patient safety and outcomes. Although it has been associated with patient outcomes and organizational context of care, little knowledge has been generated about the conceptual and operational process of surveillance. Data sources A search using the CINAHL, Medline and PubMed databases was used to compile an international data set of 18 papers and 4 book chapters published from 1985 to 2009. Review methods Rodger’s evolutionary concept analysis techniques were used to analyse surveillance in a systems framework. This method focused the search to nursing surveillance (as opposed to other medical uses of the term) and used a theoretical framework to guide the analysis. Results The examination of the literature clarifies the multifaceted nature of nursing surveillance in the acute care setting. Surveillance involves purposeful and ongoing acquisition, interpretation and synthesis of patient data for clinical decision- making. Behavioural activities and multiple cognitive processes are used in surveillance in order for the nurse to make decisions for patient safety and health maintenance. A systems approach to the analysis also demonstrates how organizational characteristics and contextual factors influence the process in the acute care environment. Conclusion This conceptual analysis describes the nature of the surveillance process and clarifies the concept for effective communication and future use in health services research. PMID:21129007

Aspects that facilitate or interfere in the communication process between nursing professionals and patients in critical state.

PubMed

Achury Saldaña, Diana Marcela; Pinilla Alarcón, Maribel; Alvarado Romero, Herly

2015-01-01

To describe aspects facilitating or interfering in the communication process between nursing professionals and patients in critical state. Descriptive study conducted during the second semester of 2013, with the participation of 112 nurses who work in Intensive Care Units of Bogotá (Colombia). To gather the information, the researchers designed a survey. A total of 91.6% of the nursing professionals considers communication important with patients and their families; 75.9% seeks to provide, during the care interventions, physical care and communicate per shift from two to four times with the patient and from one to two times with the family; 50% states feeling afraid to communicate; only 53.7% integrate their emotions in the patient's physical care. Regarding the elements of communication developed during their graduate formation, 42.8% received tools of therapeutic communication during their undergraduate studies and only 33.0% during graduate studies. It is worth to indicate that 80.36% of the Intensive Care Units, where the nursing professionals work, privilege interventions aimed at satisfying physiological needs. The communication process between nurses and patients in critical state is limited by restrictive institutional policies and by the nurse' scarce academic formation. The need exists to start a process of change in relation to models of professional practice deeply rooted in physical care of critical patients to establish models that, during physical care, are centered on communication and the patient-family-professional relationship.

The pedagogical ebb and flow of human patient simulation: empowering through a process of fading support.

PubMed

Parker, Brian Corey; Myrick, Florence

2012-07-01

The use of the high-fidelity human patient simulator (HPS)-based clinical scenario in undergraduate nursing education is a powerful learning tool, well suited to modern nursing students' preference for immersive construction of knowledge through the provision of contextually rich reality-based practice and social discourse. The purpose of this study was to explore the social-psychological processes that occur within HPS-based clinical scenarios. Grounded theory method was used to study students and faculty sampled from a Western Canadian baccalaureate nursing program. The process of leveled coding generated a substantive theory that has the potential to enable educators to empower students through the use of fading support, a twofold process composed of adaptive scaffolding and dynamic assessment that challenges students to realistically self-regulate and transform their frame of reference for nursing practice, while limiting the threats that traditional HPS-based curriculum can impose. Copyright 2012, SLACK Incorporated.

Entry-to-practice public health nursing competencies: A Delphi method and knowledge translation strategy.

PubMed

Schofield, Ruth; Chircop, Andrea; Baker, Cynthia; Dietrich Leurer, Marie; Duncan, Susan; Wotton, Donalda

2018-06-01

Sustaining and strengthening nurses 'contributions to public and population health in the 21st century depends in part on nursing education. Clearly articulated entry-to-practice competencies will contribute to the capacity of undergraduate nursing education programs to prepare graduates to promote local, national and global population health. The Canadian Association of Schools of Nursing created the Public Health Task Force to develop consensus on core, national entry-to-practice competencies in public health nursing for undergraduate nursing students and to support these competencies with corresponding online teaching strategies. Delphi approach. Nurses with public health experience in education and practice, and representatives from other public health professional organizations across Canada. The three-phased competency development included: 1) an environmental scan; 2) an iterative process to draft competencies; and 3) a modified Delphi process to confirm the final competency framework using face to face consultations and a survey. The knowledge translation strategy involved soliciting submissions of teaching strategies for peer-review and subsequent inclusion in an interactive online resource. 242 public health educators and practitioners participated in the consensus consultation. The final document outlined five competency statements with 19 accompanying indicators. A total of 123 teaching strategies were submitted for the online resource, of which 50 were accepted as exemplary teaching strategies. This competency development process can provide guidance for the development of competencies in other countries, thus strengthening public health nursing education globally. The decision to intentionally level the competencies to entry-to-practice, as opposed to an advanced level, enhanced their application to undergraduate nursing education. The development of the additional inventory of teaching strategies created a sustainable innovative resource for public health nursing educators and practitioners world-wide to support the adoption of entry-to-practice public health nursing competencies. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Impacts of structuring nursing records: a systematic review.

PubMed

Saranto, Kaija; Kinnunen, Ulla-Mari; Kivekäs, Eija; Lappalainen, Anna-Mari; Liljamo, Pia; Rajalahti, Elina; Hyppönen, Hannele

2014-12-01

The study aims to describe the impacts of different data structuring methods used in nursing records or care plans. This systematic review examines what kinds of structuring methods have been evaluated and the effects of data structures on healthcare input, processes and outcomes in previous studies. Retrieval from 15 databases yielded 143 papers. Based on Population (Participants), Intervention, Comparators, Outcomes elements and exclusion and inclusion criteria, the search produced 61 studies. A data extraction tool and analysis for empirical articles were used to classify the data referring to the study aim. Thirty-eight studies were included in the final analysis. The study design most often used was a single measurement without any control. The studies were conducted mostly in secondary or tertiary care in institutional care contexts. The standards used in documentation were nursing classifications or the nursing process model in clinical use. The use of standardised nursing language (SNL) increased descriptions of nursing interventions and outcomes supporting daily care, and improving patient safety and information reuse. The nursing process model and classifications are used internationally as nursing data structures in nursing records and care plans. The use of SNL revealed various positive impacts. Unexpected outcomes were most often related to lack of resources. Indexing of SNL studies has not been consistent. That might cause bias in database retrieval, and important articles may be lacking. The study design of the studies analysed varied widely. Further, the time frame of papers was quite long, causing confusion in descriptions of nursing data structures. The value of SNL is proven by its support of daily workflow, delivery of nursing care and data reuse. This facilitates continuity of care, thus contributing to patient safety. Nurses need more education and managerial support in order to be able to benefit from SNL. © 2013 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

Improvement in self-reported confidence in nurses' professional skills in the emergency department.

PubMed

Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari

2013-03-05

The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses' education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services.

Understanding personal narratives: an approach to practice.

PubMed

Gaydos, H Lea

2005-02-01

This paper explores the need for and nature of personal narratives and their relevance to nursing practice. It proposes that the co-creative aesthetic process can be used to understand and co-create personal narratives through an emphasis on self-defining memories and metaphor. Many authors in nursing and other human sciences have recognized the need for and importance of personal narrative, its relationship to aesthetic knowing and its value in qualitative research and in practice. The role of memory and metaphor in the creation of meaning in personal narratives, however, has not been sufficiently explored in nursing literature. The nature of personal narrative is explored, focusing on the way meaning is created from self-defining memories using metaphor. Then, the importance of personal narratives in nursing practice is considered, followed by discussion about how meaning in personal narratives may be co-created between clients and nurses using an aesthetic process developed by the author. The co-creative aesthetic process is an example of nursing as art and can be used to co-create personal narratives in practice. The experience of co-creating a self story with a nurse can be healing, as the self story is heard by a caring person, memories are understood in new ways, and the self story is both confirmed and recreated.

The effects of RN staffing hours on nursing home quality: a two-stage model.

PubMed

Lee, Hyang Yuol; Blegen, Mary A; Harrington, Charlene

2014-03-01

Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss). We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States - Colorado. Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences. Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators. The study finding shows the importance of understanding the role of 'nurse staffing' under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. Copyright © 2013 Elsevier Ltd. All rights reserved.

NMC defends disciplinary record as ex-mid staffs director leaves register.

PubMed

Keogh, Kat

2014-02-05

The Nursing and Midwifery Council has defended its disciplinary process after moving to have Stafford Hospital's former chief nurse struck from the nursing register, just two months after she was given a caution.

Ambiguity in knowledge transfer: The role of theory-practice gap.

PubMed

Cheraghi, Mohammad Ali; Salsali, Mahvash; Safari, Mahmoud

2010-01-01

In spite of much literature written about the theory-practice gap in the international nursing journals, there is evidence that indicates this subject has not been probed comprehensively since nursing education was transferred to universities in Iran. In the recent years, the public and the government have criticized Iranian nurses because of poor quality of patient care. Although this subject has been lamented by some researchers, there is no comprehensive work on how this gap resulted. In the process of a larger study on "nursing knowledge translation to practice", of one PhD thesis, this process was explored. Using grounded theory analysis, indepth interviews were undertaken with a purposive sample of 29 nurses, with different levels of experience, from the school of nursing in Tehran University of Medical Sciences in 2006 from January to August. Data were analyzed using the constant comparative method. Three main themes emerging from this study included clinical behavior structure, paradoxical knowledge and practice, and divergent nursing organization. It seems that nursing education with some praxis and paradoxes in the realm of nursing knowledge and practice, along with divergent organizational structure have decreased nurses' ability in applying their professional knowledge and skills in order to bridge the gap between theory and practice. Moreover, in spite of increased academic input into nursing education, clinical behaviors of both education and practice settings was perceived as "traditional routine-based".

[Integration of the nursing process in the electronic health record in an university hospital].

PubMed

Guadarrama-Ortega, D; Delgado-Sánchez, P; Martínez-Piedrola, M; López-Poves, E M; Acevedo-García, M; Noguera-Quijada, C; Camacho-Pastor, J L

To describe the process of implementation of Individualized Care Plan in the Electronic Health Record and its impact on the University Hospital Alcorcón Foundation. Working groups of staff nurses who analyzed activities usually performed to create a catalog of diagnoses, outcomes and interventions. A group of referents that refined the catalog to make it manageable was created. A training plan, nursing assessment forms and the Nursing Discharge Report were designed. In February 2016 the new methodology was implemented in inpatient units of adults. Between 74.86 and 88.18% of the patients underwent a care plan with the new methodology. Between 69.41 and 76.25% of patients are discharged with a Nursing Discharge Report accordance with regulations. An increase of 24.1% of patients with Nursing Discharge Report after implantation is observed (P=.000; RR: 1.46; 95% CI 1.36-1.56). A total of 116 nurses has been trained. In the study conditions, the use of nursing taxonomies has generated thinking skills and allowed nurses to issue judgments, ensure quality of care, and implementing interventions with a planned results. The nursing taxonomy and care plan in the Electronic Health Record have increased interprofessional communication to improve continuity of care through improved Nursing Discharge Report. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

PubMed

Stab, Nicole; Hacker, Winfried

2018-05-01

The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.

Collaborative learning using nursing student dyads in the clinical setting.

PubMed

Austria, Mary Jean; Baraki, Katie; Doig, Alexa K

2013-05-04

Formal pairing of student nurses to work collaboratively on one patient assignment is a strategy for improving the quality and efficiency of clinical instruction while better utilizing the limited resources at clinical agencies. The aim of this qualitative study was to explore the student nurse and patient experiences of collaborative learning when peer dyads are used in clinical nursing education. Interviews were conducted with 11 students and 9 patients. Students described the process of collaborative learning as information sharing, cross-checking when making clinical decisions, and group processing when assessing the outcomes of nursing interventions. Positive outcomes reported by students and patients included reduced student anxiety, increased confidence and task efficiency. Students' primary concern was reduced opportunity to perform hands-on skills which had to be negotiated within each dyad. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction such as collaborative learning using student peer dyads.

E-nursing documentation as a tool for quality assurance.

PubMed

Rajkovic, Vladislav; Sustersic, Olga; Rajkovic, Uros

2006-01-01

The article presents the results of a project with which we describe the reengineering of nursing documentation. Documentation in nursing is an efficient tool for ensuring quality health care and consequently quality patient treatment along the whole clinical path. We have taken into account the nursing process and patient treatment based on Henderson theoretical model of nursing that consists of 14 basic living activities. The model of new documentation enables tracing, transparency, selectivity, monitoring and analyses. All these factors lead to improvements of a health system as well as to improved safety of patients and members of nursing teams. Thus the documentation was developed for three health care segments: secondary and tertiary level, dispensaries and community health care. The new quality introduced to the documentation process by information and communication technology is presented by a database model and a software prototype for managing documentation.

Stress in telephone helpline nurses is associated with failures of concentration, attention and memory, and with more conservative referral decisions.

PubMed

Allan, Julia L; Farquharson, Barbara; Johnston, Derek W; Jones, Martyn C; Choudhary, Carolyn J; Johnston, Marie

2014-05-01

Nurses working for telephone-based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information-processing errors. Nurses who experienced more frequent cognitive failures at work made more conservative decisions, tending to refer patients on to other health professionals more often than other nurses. As stress is associated with cognitive performance decrements in telephone nursing, stress-reduction interventions could improve the quality and safety of care that callers to medical helplines receive. © 2013 The British Psychological Society.

[Systematization of nursing care: viewing care as interactive, complementary and multi-professional].

PubMed

do Nascimento, Keyla Cristiane; Backes, Dirce Stein; Koerich, Magda Santos; Erdmann, Alacoque Lorenzini

2008-12-01

This study is the result of an extended project, named: The systematization of nursing care in the perspective of complex thinking. The objective of this qualitative study is to better comprehend the meaning of the systematization of nursing care among healthcare professionals. The Data-Based Theory was used as a methodological reference. Data were collected by interviewing three sample groups, in a total of fifteen healthcare professionals. Data codification and analysis led us to the central theme: Viewing the Systematization of Nursing Care (SNC) as an Interactive and Complex Phenomenon. This theme is complemented by two phenomena. In this article, we discuss the phenomenon: Verifying the necessity of on interactive, complementary, and multi-professional process. The Systematization of Nursing Care is part of a process that has been developing over time by nurses committed to improve the care given to the patient, since they view the necessity for interactive, complementary, and multi-professional care.

Workplace Challenges: The Impact of Personal Beliefs and the Birth Environment.

PubMed

Adams, Ellise D

This article reviews 2 workplace challenges faced by the perinatal nurse: the impact of personal beliefs and issues within the birth environment. It also explores how these challenges inform the birth practices of the perinatal nurse. The methods employed for this review are focus groups and a concept analysis. Two focus groups (n = 14) and a concept analysis based on a process defined by Walker and Avant provided a set of birth practices performed by the perinatal nurse who facilitates normal birth. Assertiveness was identified as a primary attribute of the perinatal nurse and several suggestions are identified as empirical referents or methods of measuring the abstract concepts, to identify the workplace challenges of the perinatal nurse. Development of effective processes, designed to overcome the many challenges facing the perinatal nurse, will assist in improving perinatal care for women and newborns.

Assertiveness process of Iranian nurse leaders: a grounded theory study.

PubMed

Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim

2009-06-01

The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.

Establishing a program of global initiatives for nursing education.

PubMed

Kulage, Kristine M; Hickey, Kathleen T; Honig, Judy C; Johnson, Mary P; Larson, Elaine L

2014-07-01

In the global nursing community, schools of nursing are increasingly developing initiatives and networks across national boundaries. This article describes the process undertaken at a school of nursing to determine its global health priorities and develop a program of global initiatives for nursing education. A series of meetings were held to determine faculty global activities and gauge interest in designing a 5-year strategic plan for the program. A volunteer Strategic Planning Work-group was convened to formalize a mission, vision, and strategic plan for the program, which were presented to, refined by, and vetted by an advisory board and the faculty at large. We recommend this process to schools committed to developing or expanding a program dedicated to global initiatives and a global perspective in educational planning. Involving stakeholders, building on current strengths, and aligning with mission and vision are essential elements for developing a meaningful program of global initiatives for nursing education. Copyright 2014, SLACK Incorporated.

Nurse educators and decision making: a female perspective.

PubMed

Valentine, P E

1992-01-01

Quality of work life issues are major concerns of nurses today. Decision making is one such issue. This article is part of a larger case study of a Canadian hospital school of nursing that asked whether women nurse educators bring unique orientations to the workplace that have relevance for the administration of nursing organizations. The process of decision making, a small part of the larger study, is discussed in this article. The results suggested that women nurse educators used a cooperative, collaborative, highly participatory style of decision making that resulted in decisions based on consensus. The implications this female style of decision making has for nurses and nurse administrators is discussed.

[The development and impacts of professional nursing in senior care and senior business management: the perspective of a U.S.-based nurse entrepreneur].

PubMed

Chang, Theresa

2008-10-01

The three main parts of this article include (1) the process of transition from a clinical nurse to a nurse entrepreneur, (2) senior care business management and social responsibility and (3) the development of senior care business in the future as well as the chances for nursing development. The article analyzes the development of gerontology nursing careers in the United States and Taiwan and the role professional nurses can play in ageing societies. A prospective plan for collaboration between gerontology nurses and long-term care health professionals in the United States and Taiwan concludes the article.

[Case report: coordination of the care provided to patients with breast cancer].

PubMed

Peinado-Barraso, M del Carmen; Cabrerizo-Cordero, M del Rosario; Granados-Matute, Ana Eva; Contreras-Fariñas, Raquel

2008-01-01

In Spain, cancer is the leading cause of death in absolute terms. Statistically, the most frequent type of cancer in women in developed countries is breast cancer, which is becoming the leading cause of death from cancer among women. The breast cancer is statistically the most frequent in women and it is getting the first reason of death by cancer between the feminine population, in most of developed countries. This health problem is usually associated with psychological dependency, which can be aggravated in elderly patients without adequate family support. TThe nursing process is the most commonly used tool to establish interaction among the nurse, the patient and the family. Through this interaction, the nurse can identify the patient's health objectives and energy limitations, as well as the resources available to obtain optimal health status. The nursing process is a systematic method for providing efficient humanistic care aimed at achieving expected outcomes. In the case presented herein, we employed Marjory Gordon's Functional Patterns and the taxonomies of the North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC). The nursing diagnoses detected were fear, anxiety, self-care deficit, impaired mobility, risk of low self-esteem, ineffective coping, and potential complications (pain and infection). The care session is one of the main interventions to improve the effectiveness of the care provided. During this session, methodological adjustments of the nursing process are analyzed, with special attention paid to the appropriateness of the interventions, the possible alternatives and encouragement of reflective practice Essential elements to improve quality of life in these elderly oncology patients are the role of nursing through the care provided and coordination among professionals in different disciplines and healthcare levels.

Understanding sustained domestic violence identification in maternal and child health nurse care: process evaluation from a 2-year follow-up of the MOVE trial.

PubMed

Hooker, Leesa; Small, Rhonda; Taft, Angela

2016-03-01

To investigate factors contributing to the sustained domestic violence screening and support practices of Maternal and Child Health nurses 2 years after a randomized controlled trial. Domestic violence screening by healthcare professionals has been implemented in many primary care settings. Barriers to screening exist and screening rates remain low. Evidence for longer term integration of nurse screening is minimal. Trial outcomes showed sustained safety planning behaviours by intervention group nurses. Process evaluation in 2-year follow-up of a cluster randomized controlled trial. Evaluation included a repeat online nurse survey and 14 interviews (July-September 2013). Survey analysis included comparison of proportionate group difference between arms and between trial baseline and 2 year follow-up surveys. Framework analysis was used to assess qualitative data. Normalization Process Theory informed evaluation design and interpretation of results. Survey response was 77% (n = 123/160). Sustainability of nurse identification of domestic violence appeared to be due to greater nurse discussion and domestic violence disclosure by women, facilitated by use of a maternal health and well-being checklist. Over time, intervention group nurses used the maternal checklist more at specific maternal health visits and found the checklist the most helpful resource assisting their domestic violence work. Nurses' spoke of a degree of 'normalization' to domestic violence screening that will need constant investment to maintain. Sustainable domestic violence screening and support outcomes can be achieved in an environment of comprehensive, nurse designed and theory driven implementation. Continuing training, discussion and monitoring of domestic violence work is needed to retain sustainable practices. © 2015 John Wiley & Sons Ltd.

High school students' perceptions of nursing as a career choice.

PubMed

Kohler, P A; Edwards, T A

1990-01-01

Declining enrollments in nursing programs, coupled with the current shortage of practicing registered nurses, prompted this investigation of 306 high school students' beliefs about nurses and nursing. The study also identifies potential numbers of future nursing students from high school populations and their primary source of information about nursing. Using an investigator questionnaire, subjects responded to statements about educational requirements for registered nurses along with their working conditions, earning power, and social status. Findings reveal a projected continuing shortage of nurses based on the very small percentage of subjects even considering nursing as a career. Additional findings show that whereas some perceptions about nursing seem congruent with those of nurses themselves, other beliefs held by high school students are not consistent with the realities of professional nursing today. Results of this study can be used by nurse recruiters to correct misconceptions about nursing and to help high school students perceive the profession in a more positive way. Expanding the informational sources about nursing can facilitate the recruitment process.

Competency frameworks for advanced practice nursing: a literature review.

PubMed

Sastre-Fullana, P; De Pedro-Gómez, J E; Bennasar-Veny, M; Serrano-Gallardo, P; Morales-Asencio, J M

2014-12-01

This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes. © 2014 International Council of Nurses.

Essential elements of the nursing practice environment in nursing homes: Psychometric evaluation.

PubMed

de Brouwer, Brigitte Johanna Maria; Kaljouw, Marian J; Schoonhoven, Lisette; van Achterberg, Theo

2017-06-01

To develop and psychometrically test the Essentials of Magnetism II in nursing homes. Increasing numbers and complex needs of older people in nursing homes strain the nursing workforce. Fewer adequately trained staff and increased care complexity raise concerns about declining quality. Nurses' practice environment has been reported to affect quality of care and productivity. The Essentials of Magnetism II © measures processes and relationships of practice environments that contribute to productivity and quality of care and can therefore be useful in identifying processes requiring change to pursue excellent practice environments. However, this instrument was not explicitly evaluated for its use in nursing home settings so far. In a preparatory phase, a cross-sectional survey study focused on face validity of the essentials of magnetism in nursing homes. A second cross-sectional survey design was then used to further test the instrument's validity and reliability. Psychometric testing included evaluation of content and construct validity, and reliability. Nurses (N = 456) working at 44 units of three nursing homes were included. Respondent acceptance, relevance and clarity were adequate. Five of the eight subscales and 54 of the 58 items did meet preset psychometric criteria. All essentials of magnetism are considered relevant for nursing homes. The subscales Adequacy of Staffing, Clinically Competent Peers, Patient Centered Culture, Autonomy and Nurse Manager Support can be used in nursing homes without problems. The other subscales cannot be directly applied to this setting. The valid subscales of the Essentials of Magnetism II instrument can be used to design excellent nursing practice environments that support nurses' delivery of care. Before using the entire instrument, however, the other subscales have to be improved. © 2016 John Wiley & Sons Ltd.

Changing nurses' dis-empowering relationship patterns.

PubMed

Daiski, Isolde

2004-10-01

Nurses' inter- and intra-disciplinary relationships are frequently interpreted as oppressed group behaviours, contributing to their relatively dis-empowered status. In the context of restructuring in health care, this study examined the views of hospital staff nurses about their relationships with nursing colleagues and other health care professionals and their ideas for change. The aim of this paper is to report a study to add the views of staff nurses to the discourse on restructuring and to make visible the processes that contribute to their marginalization. The study was descriptive and exploratory. Staff nurses from various hospitals in a large Canadian city were selected by theoretical sampling. Twenty volunteer staff nurses were interviewed between 1998 and 1999, using broad, open-ended questions and prompts to explore nurses' various relationships in the health care system. This approach allowed for multiple responses and expansions of ideas, without losing focus. The interviews were audio-taped and later transcribed. Thematic analysis was carried out. Many participants were aware of inter-disciplinary hierarchies, particularly between nurses and physicians. Many also showed insights into their own intra-disciplinary hierarchies and mutual non-supportiveness. Both types of relationships were found to be inextricably linked, sustaining nurses' oppression through dis-empowering discourses. Nurses expressed many ideas about how to promote mutually supportive relationships. Change for the better needs to come from within the nursing profession. To develop effective strategies, bedside nurses have to be included in decision-making processes affecting them and their practice, about which they are the experts. Mutual respect, awareness-raising through education, development of caring nursing communities, mentorship and non-hierarchical leadership are key to stopping dis-empowering discourses and practices amongst nurses.

From bedside to classroom: the nurse educator transition model.

PubMed

Schoening, Anne M

2013-01-01

The purpose of this qualitative study was to generate a theoretical model that describes the social process that occurs during the role transition from nurse to nurse educator. Recruitment and retention of qualified nurse educators is essential in order to remedy the current staff nurse and faculty shortage in the United States, yet nursing schools face many challenges in this area. This grounded theory study utilized purposive, theoretical sampling to identify 20 nurse educators teaching in baccalaureate nursing programs in the Midwest. The Nurse Educator Transition (NET) model was created from these data.This model identifies four phases in the role transition from nurse to nurse educator: a) the Anticipatory/Expectation Phase, b) the Disorientation Phase, c) the Information-Seeking Phase, and d) the Identity Formation Phase. Recommendations include integrating formal pedagogical education into nursing graduate programs and creating evidence-based orientation and mentoring programs for novice nurse faculty.

Learning by playing: A cross-sectional descriptive study of nursing students' experiences of learning clinical reasoning.

PubMed

Koivisto, Jaana-Maija; Multisilta, Jari; Niemi, Hannele; Katajisto, Jouko; Eriksson, Elina

2016-10-01

Clinical reasoning is viewed as a problem-solving activity; in games, players solve problems. To provide excellent patient care, nursing students must gain competence in clinical reasoning. Utilising gaming elements and virtual simulations may enhance learning of clinical reasoning. To investigate nursing students' experiences of learning clinical reasoning process by playing a 3D simulation game. Cross-sectional descriptive study. Thirteen gaming sessions at two universities of applied sciences in Finland. The prototype of the simulation game used in this study was single-player in format. The game mechanics were built around the clinical reasoning process. Nursing students from the surgical nursing course of autumn 2014 (N=166). Data were collected by means of an online questionnaire. In terms of the clinical reasoning process, students learned how to take action and collect information but were less successful in learning to establish goals for patient care or to evaluate the effectiveness of interventions. Learning of the different phases of clinical reasoning process was strongly positively correlated. The students described that they learned mainly to apply theoretical knowledge while playing. The results show that those who played digital games daily or occasionally felt that they learned clinical reasoning by playing the game more than those who did not play at all. Nursing students' experiences of learning the clinical reasoning process by playing a 3D simulation game showed that such games can be used successfully for learning. To ensure that students follow a systematic approach, the game mechanics need to be built around the clinical reasoning process. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pediatric Nurses' Perceptions of Medication Safety and Medication Error: A Mixed Methods Study.

PubMed

Alomari, Albara; Wilson, Val; Solman, Annette; Bajorek, Beata; Tinsley, Patricia

2018-06-01

This study aims to outline the current workplace culture of medication practice in a pediatric medical ward. The objective is to explore the perceptions of nurses in a pediatric clinical setting as to why medication administration errors occur. As nurses have a central role in the medication process, it is essential to explore nurses' perceptions of the factors influencing the medication process. Without this understanding, it is difficult to develop effective prevention strategies aimed at reducing medication administration errors. Previous studies were limited to exploring a single and specific aspect of medication safety. The methods used in these studies were limited to survey designs which may lead to incomplete or inadequate information being provided. This study is phase 1 on an action research project. Data collection included a direct observation of nurses during medication preparation and administration, audit based on the medication policy, and guidelines and focus groups with nursing staff. A thematic analysis was undertaken by each author independently to analyze the observation notes and focus group transcripts. Simple descriptive statistics were used to analyze the audit data. The study was conducted in a specialized pediatric medical ward. Four key themes were identified from the combined quantitative and qualitative data: (1) understanding medication errors, (2) the busy-ness of nurses, (3) the physical environment, and (4) compliance with medication policy and practice guidelines. Workload, frequent interruptions to process, poor physical environment design, lack of preparation space, and impractical medication policies are identified as barriers to safe medication practice. Overcoming these barriers requires organizations to review medication process policies and engage nurses more in medication safety research and in designing clinical guidelines for their own practice.

Caregivers' experience of the decision-making process for placing a person with dementia into a nursing home: comparing caregivers from Chinese ethnic minority with those from English-speaking backgrounds.

PubMed

Caldwell, Lauren; Low, Lee-Fay; Brodaty, Henry

2014-03-01

The experience of care transitions for people with dementia from ethnic minority groups has been poorly researched. Few studies have examined the decision to put someone on a waiting list for a nursing home and then actually accept a place. Many nursing homes have long waiting lists, but sometimes offers of a place are declined. Our aims were to investigate the decision-making process for placing a person with dementia on a waiting list for a nursing home, why offers of a place are accepted or declined, and the influence of cultural factors, comparing caregivers from Chinese and English-speaking backgrounds. Semi-structured interviews with 27 caregivers of people with dementia on waiting lists or living in nursing homes (20 Chinese background and seven English-speaking background) were conducted, with thematic analysis of factors affecting caregivers' decision-making. Caregivers were at different stages of decision-making when they applied for a waiting list - some were ready for placement, others applied "just in case," and for some there was no waiting time because of an urgent need for placement. Caregivers' decisions were influenced by their emotions and expectations of nursing homes. The decision-making process was similar for both cultural groups, but Chinese caregivers spoke more about their sense of duty, the need for a Chinese specific facility, and declining a place because of family disagreement. Understanding cultural issues, including stereotypes and concerns about nursing homes, and providing better information about admission processes may help caregivers by allaying their anxiety about nursing home placement.

These terrifying three words: A qualitative, mixed methods study of students' and mentors' understandings of 'fitness to practise'.

PubMed

Haycock-Stuart, Elaine; MacLaren, Jessica; McLachlan, Alison; James, Christine

2016-08-01

There is little empirical published research pertaining to fitness to practise and pre-registration nursing students. Much of the existing fitness to practise literature focuses on medical students and there is a preponderance of literature reviews and descriptive or discursive papers. The multicentre study aimed to explore students' and mentor's understandings of fitness to practise processes in pre-registration nursing programmes. A qualitative study in the interpretive paradigm with interpretive analysis involving 6 focus groups and 4 face-to-face interviews with nursing students and mentors. Eleven Higher Education Institutions providing pre-registration nursing education in the UK. Data were collected January 2014-March 2015 following ethical approval. Purposive sampling was used to recruit mentors and nursing (but not midwifery) students from pre-registration nursing programmes at different stages of educational preparation. Qualitatively driven semi-structured focus groups (n=6) and interviews (n=4) were conducted with a total of 35 participants (17 pre-registration nursing students and 18 nursing mentors). Three themes identified from the student and mentor data are considered: Conceptualising Fitness to Practise; Good Health and Character; and Fear and Anxiety Surrounding Fitness to Practise Processes. Uncertainty about understandings of fitness to practise contributed to a pervasive fear among students and reluctance among mentors to raise concerns about a student's fitness to practise. Both students and mentors expressed considerable anxiety and engaged in catastrophic thinking about fitness to practise processes. Higher Education Institutes should reinforce to students that they are fit to practise the majority of the time and reduce the negative emotional loading of fitness to practise processes and highlight learning opportunities. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Investigating nurse practitioners in the private sector: a theoretically informed research protocol.

PubMed

Adams, Margaret; Gardner, Glenn; Yates, Patsy

2017-06-01

To report a study protocol and the theoretical framework normalisation process theory that informs this protocol for a case study investigation of private sector nurse practitioners. Most research evaluating nurse practitioner service is focused on public, mainly acute care environments where nurse practitioner service is well established with strong structures for governance and sustainability. Conversely, there is lack of clarity in governance for emerging models in the private sector. In a climate of healthcare reform, nurse practitioner service is extending beyond the familiar public health sector. Further research is required to inform knowledge of the practice, operational framework and governance of new nurse practitioner models. The proposed research will use a multiple exploratory case study design to examine private sector nurse practitioner service. Data collection includes interviews, surveys and audits. A sequential mixed method approach to analysis of each case will be conducted. Findings from within-case analysis will lead to a meta-synthesis across all four cases to gain a holistic understanding of the cases under study, private sector nurse practitioner service. Normalisation process theory will be used to guide the research process, specifically coding and analysis of data using theory constructs and the relevant components associated with those constructs. This article provides a blueprint for the research and describes a theoretical framework, normalisation process theory in terms of its flexibility as an analytical framework. Consistent with the goals of best research practice, this study protocol will inform the research community in the field of primary health care about emerging research in this field. Publishing a study protocol ensures researcher fidelity to the analysis plan and supports research collaboration across teams. © 2016 John Wiley & Sons Ltd.