Smith, Mary Jane; Liehr, Patricia
Stories are a fundamental dimension of human experience and nursing practice. Story theory describes a narrative happening that occurs through intentional nurse-person dialogue. Seven inquiry phases are associated with story theory, including gathering the story, reconstructing the story, connecting it to the literature, naming the complicating health challenge, describing the story plot, identifying movement toward resolving, and gathering additional stories. This article describes the use of story theory to advance nursing practice scholarship in both academic and everyday nursing practice.
Gillette, V A
The perioperative nursing role has evolved from that of task-oriented specialists to patient-centered professionals. The concept of caring is significant to perioperative nurses and is manifested by the many caring behaviors perioperative nurses demonstrate toward surgical patients. This article describes how the element of caring is an essential function of perioperative nursing and relates the perioperative nursing role to the work of three nursing theorists (le, Florence Nightingale; Virginia Henderson, RN, AM; Carol L. Montgomery, RN, PhD).
Brady, Margaret A.
A description is provided of "Theories for Extended Pediatric Nursing Practice," a required course for pediatric and family nurse practitioner students in a California state university program. The course description presents information on the curricular placement of the course, prerequisites, in-class time allotments, and the focus of the course…
Georges, Jane M
Situated in a critical-feminist perspective, this article describes a pedagogical approach to linking nursing theory and practice. The inclusion of the critical humanities is emphasized in creating an environment in which this linkage can be reified for learners. Implications for the future of nursing theory and its links to practice in the context of current political realities in academia are considered.
Swartz, Martha K
In academic centers of nursing, faculty or academic practice has become more widespread and integrated into the expectations and criteria for appointment and promotion. Yet, the concept of academic practice is not fully embraced among all schools of nursing. Numerous models of academic nursing practice have evolved and vary widely according to the clinical site, the roles of the practitioners, and the systems for generating revenue. Although most models are related to the mission statements of the schools of nursing, few seem to be based on a distinct philosophy of practice. In this article, a consideration of critical theory that provides a framework for practice-based nursing education is presented. By applying the philosophical underpinnings and assumptions of practice that are guided by critical theory, educators may begin to better identify the values of academic nursing practice and incorporate this activity more fully into the educational environment.
Covell, Christine L; Sidani, Souraya
Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. Studies that have investigated the relationship between nursing knowledge and outcomes have been plagued with conceptual and methodological issues. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. The nursing intellectual capital theory was developed to assist with this area of inquiry. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. In this article, we review the nursing intellectual capital theory and discuss its implications for research and practice. We explain why the theory shows promise for guiding research on quality work environments and how it may assist with administrative decision-making related to nursing human resource management and continuing professional development.
Brennan, P F; Anthony, M K
Nursing Practice Models (NPMs) represent the structural and contextual features that exist within any group practice of nursing. Currently, measurement of NPMs relies on costly and nonreproducible global judgments by experts. Quantitative measurement techniques are needed to provide a useful evaluation of nursing practice. Guided by Multi-Attribute Utility theory (MAU theory), an expert panel identified 24 factors representative of N PMs. The factors became elements in a computational index that, when summed, assigns a score to a given nursing unit reflecting the extent to which that unit's nursing practice model achieves the nursing professional ideal. Initial validation of the index and its elements consisted of comparing assessments of 40 nursing units generated by the index with a global evaluation provided by each of the expert panelists who proposed the model factors. Pearson correlations between the index-generated scores and the global assigned scores provided evidence supporting the preliminary validation of the index.
Professional empowerment is vital to nurses' productivity and job satisfaction. A grounded theory study was conducted to describe the basic social process experienced by school nurses in relation to professional empowerment. Interviews with 10 school nurses led to the development of a situation-specific theory of school nurse empowerment, Making a Difference: The Role of the School Nurse in the Health of Children in Schools. This theory was derived from four theoretical constructs: (a) enlisting support, (b) getting through the day, (c) maintaining control over practice, and (d) adjusting to challenges. Interviews revealed that knowing at the end of each school day that they made a difference in the health of children resulted in feelings of empowerment. Participants cited various areas in which their sense of empowerment was limited, including salaries and workload. Despite these issues, they believed they had a positive impact on the health of children, leading to job satisfaction and feelings of value.
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,…
Nagington, Maurice G
Judith Butler is one of the most influential late 20th and early 21st century philosophers in regard to left wing politics, as well as an active campaigner for social justice within the United States and worldwide. Her academic work has been foundational to the academic discipline of queer theory and has been extensively critiqued and applied across a hugely wide range of disciplines. In addition, Butler's work itself is extensive covering topics such as gender, sexuality, race, literary theory, and warfare. This article can only serve as a taster for the potential application of her work in relation to nursing, which is in its infancy. This introduction covers three of the potentially most productive themes in Butler's work, namely power, performativity, and ethics. Each of these themes are critically explored in turn, sometimes in relation to their actual application in nursing literature, but also in relation to their potential for producing novel critiques of nursing practice. Suggestions are made about how Butler's work can develop nursing research and practice. The article concludes with a short summary of Butler's key works as well as suggested reading for people interested in examining how her theories have been applied across different academic settings.
Forchuk, C; Dorsay, J P
Nursing theories which have evolved from mental health--psychiatric nursing have focused on the individual nurse-client relationship. Other nursing theories generally focus on the individual as client. Therefore, nurses working with families may have difficulty in applying these frameworks to their practice. Nursing theories need to be expanded to include families, groups and communities more explicitly. The well established theory of Hildegard Peplau, which previous studies have found to be the theory most frequently used by psychiatric nurses, and the family systems nursing theory of Wright and Leahey share a complementary focus. Both theories form part of the interpersonal paradigm of nursing; both view nursing from an interactional perspective, rather than focusing on individuals. Use of a combined theoretical approach offers several advantages. The approach explicitly considers both the individual and the family. The combination provides grounding for family work in an articulated nursing theory.
Landers, M G
The increasingly complex requirements of today's nursing practitioners, have been accompanied by demands on nurse educators to look at new ways to facilitate learning in the clinical area (Camiah 1996). In recent years nursing education has undergone a period of major change in many countries through integrating with universities. While nurse educators are striving to respond to changes in education the dichotomy between the theoretical input taught in the classroom and what is practised or experienced on the wards remains a problem (Ashworth & Longmate 1993, Ferguson & Jinks 1994). Dale (1994) postulates that theory provides the basis for understanding the reality of nursing, it would seem reasonable, therefore, to assume that the content studied in the classroom correlates with what the student experiences on the ward. It should also follow that if a gap exists between theory and practice, efforts should be taken for its reduction (Rafferty et al. 1996). According to MacNeil (1997) many initiatives have been introduced in an effort to bridge the theory-practice gap and these have focused around the role of the nurse teacher. These changes in education are redefining the role of the nurse teacher, therefore, the part that they currently play and will play in the future needs to be carefully considered (Phillips et al. 1996b). The aim of this paper is to provide an overview of the literature on the theory-practice divide in nursing. First, some of the reasons cited for its existence will be explored. Second, suggested ways of bridging the divide will be considered focusing on the role of the nurse teacher.
McCarthy, Cindy T; Aquino-Russell, Catherine
This column illuminates nursing practice through two unique theoretical perspectives: Peplau's theory of interpersonal relations and Parse's theory of humanbecoming. Processes of each practice method will be explicated as each is related to a practice scenario. The key differences between Peplau's and Parse's practice methodologies are identified. Nursing is a unique, evolving, everchanging profession for which theory can be used as a guide for practice. This column demonstrates two of these unique theories. Whether through health promotion or quality of life from the person's perspective, theory provides meaning in nursing practice and in everyday life.
Fairchild, Roseanne Moody
In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.
Hoare, Karen J; Mills, Jane; Francis, Karen
Practice nursing in New Zealand is not well described in the literature. One survey illustrated that most of the New Zealand practice nurses sampled did not know of the country's two premier evidence-based health websites. A recent review compared general practice in the UK, New Zealand and Australia and found that whereas there had been significant developments in empowering the practice nurse workforce to run nurse-led clinics in the UK, New Zealand and Australia lagged behind. The aim of this reported constructivist grounded theory study was to investigate practice nurses' use of information. Conducted in Auckland, New Zealand, data were collected through ethnographic techniques in one general practice between September 2009 and January 2010 to enhance theoretical sensitivity to the area of information use. Subsequently, six experienced practice nurses (one twice after moving jobs) and five new graduate nurses from five different general practices were interviewed, using open-ended questions, between January 2010 and August 2011. Concurrent data collection and analysis occurred throughout the study period. The use of memos, the constant comparative method, data categorisation and finally, data abstraction resulted in the final theory of reciprocal role modelling. Experienced practice nurses role modelled clinical skills to new graduate nurses. Unexpectedly, new graduate nurses were unconscious experts at sourcing information and role modelled this skill to experienced practice nurses. Once this attribute was acknowledged by the experienced practice nurse, mutual learning occurred that enabled both groups of nurses to become better practitioners. Graduate nurses of the millennial generation were identified as a resource for experienced practice nurses who belong to the baby boomer generation and generation X.
Dyess, Susan; Boykin, Anne; Rigg, Connie
Theory-based nursing practice positively influences many outcomes in healthcare organizations. As a response to limited human and economic resources, a college of nursing and a for-profit healthcare organization worked in partnership to develop a project that focused on developing and demonstrating the value of a dedicated education unit grounded in caring theory. The authors describe the development of the project, initial outcomes, and the relevance to nursing administration.
Allan, Helen T
This paper illustrates the role of psychodynamic small group work in integrating theory and practice for nursing students. Psychodynamic work with individual patients and small staff groups is established in some areas of medical and nursing practice although not widely used in general nursing. Clinical material which was brought to two group supervision sessions by student nurses on clinical placement is presented in this paper and discussed using a psychodynamic perspective. A critical review of psychodynamic small group work and a position paper is presented in this paper to argue that using a psychodynamic approach in nurse education may address the theory-practice gap for student nurses by allowing them to reflect on the emotional issues arising in clinical placements. The paper illustrates how supervision can assist students to integrate theory and practice. It is suggested that reflecting on feelings in small group work with student nurses with a tutor or supervisor who works psychodynamically may help students integrate their theoretical and practical learning. Understanding the theory-practice gap from a psychodynamic perspective may help nurse tutors in their personal tutor work to integrate theoretical and practical learning for students and thereby support students in providing good quality care for their patients.
Perry, Donna J
This paper proposes that the philosophy of Bernard Lonergan can provide insight into the challenge of integrating nursing theory, research and practice. The author discusses Lonergan's work in regard to reflective understanding, authenticity and the human person as a subject of consciously developing unity. This is followed by a discussion of two key elements in Lonergan's work that relate to nursing: the subject-object challenge of nursing inquiry and common sense vs. scientific knowledge. The author suggests that integration of nursing theory, science and practice may be achieved through self-transcendence.
Numerous policy bodies have identified the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards. Although there is growing evidence of improved care environment and patient safety and quality outcomes after redesigning care delivery microsystems to integrate CNL practice, significant variation in CNL implementation has been noted across reports, making it difficult to causally link CNL practice to reported outcomes. This variability reflects the overall absence in the literature of a well-defined CNL theoretical framework to help guide standardized application in practice. To address this knowledge gap, an interpretive synthesis with a grounded theory analysis of CNL narratives was conducted to develop a theoretical model for CNL practice. The model clarifies CNL practice domains and proposes mechanisms by which CNL-integrated care delivery microsystems improve health care quality. The model highlights the need for a systematic approach to CNL implementation including a well-thought out strategy for care delivery redesign; a consistent, competency-based CNL workflow; and sustained macro-to-micro system leadership support. CNL practice can be considered an effective approach to organizing nursing care that maximizes the scope of nursing to influence the ways care is delivered by all professions within a clinical microsystem.
This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contributing theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consultation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.
Scully, Natashia Josephine
Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the "theory-practice gap". This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses--given their novice, rule governed status--who find themselves in the midst of the theory-practice void. This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in relation to student anxiety levels, nurse education (specifically the roles of the classroom teacher and clinical educators), teaching methods and the responsibility of the student to become accountable for their own education. I intend to communicate how my personal situation was dealt with and evaluate that experience in relation to current nursing literature. Ultimately, this discussion will demonstrate the value of reflection underpinning the development of competency in nursing and its role in bridging the theory-practice gap.
Jones, Terry L.
Topic Nursing time has relevance for those who produce it, those who receive it and those who must pay for it. Though the term nursing time may be commonly used, a common understanding of the concept within the fields of nursing and healthcare administration is lacking. Purpose The purposes of this paper are to explore the concept of nursing time and to identify implications for theory development, clinical and administrative practice, and research. Discussion Both physical and psychological forms of time are viewed as fundamental to our experience of time as social beings. Nursing time has significant intrinsic and instrumental value in nursing and healthcare. A holistic approach incorporating the physical, psychological, and sociological aspects and dimensions of nursing time is advocated. Conclusions Multiple strategies to enhance the patient experience of nursing time are warranted and should address how much time nurses spend with patients as well as how they spend that time. Patterns of overlapping and competing time structures for nurses should be identified and evaluated for their effect on physical time available for patient care and the psychological experiences of time by nurses and patients. PMID:20690994
Barker, P; Jackson, S; Stevenson, C
Contemporary developments in health care have encouraged a review of the professional status of psychiatric nursing. However, little study has been made, to date, of the discrete 'need' for psychiatric nursing within a multidisciplinary service. Employing an adapted grounded theory methodology, substantive theory was developed concerning the expressed need for psychiatric nursing, by patients, their carers and mental health professionals, based on six sites from England, Eire and Northern Ireland. The study found some consensus across both recipients and providers of mental health care, that the essential feature of nursing (the core category) involved a complex of relationships: 'knowing you--knowing me'. Within that complex, nurses either elected, or were required, to move--or 'toggle'--between three discrete domains of relating: the Ordinary Me (OM); the Pseudo-ordinary or Engineered Me (POEM); and the Professional Me (PM). Four internal dimensions involving the nurses' depth of knowing, power, use of time and use of translation, distinguished these domains. The emergent theory is discussed within the context of the emergent growth in user (consumer) influence and health care technology.
Scheel, Merry Elisabeth; Pedersen, Birthe D; Rosenkrands, Vibeke
Nursing is often described from the point of view of either the natural or the human sciences. In contrast to this, the value foundation in Interactional nursing practice is understood from the point of view of the natural sciences as well as that of the human and social sciences. This article presents many-faceted practice-theory of nursing, which is situated in the dynamic field between these three sciences. The focus of the theory is on interaction and practice resulting in a caring practice. Here practice is based on Taylor's and MacIntyre's interpretation of this concept. Action in nursing is based on Habermas' three varied modes of action seen in the light of an understanding of the world as a system world and a life world. Nursing as an interactional practice-theory is presented with examples of interpretative nursing science, seen in the ethical action-oriented, socio-cultural framework of Taylor and Habermas. It is concluded that phenomenologic and socio-cultural research into caring practice as well as an in-depth, comprehensive interpretation of nursing practice are both highly suited to forming the fundamental theoretical framework in nursing, here seen as an interpretative nursing science. Finally, a comparison is drawn between Interactional nursing practice and Benner's theory of nursing practice.
Campbell, Gene, Comp.; Simpson, Bruce, Comp.
These written domain referenced tests (DRTs) for the area of allied health occupations/practical nursing test cognitive abilities or knowledge of theory. Introductory materials describe domain referenced testing and test development. Each multiple choice test includes a domain statement, describing the behavior and content of the domain, and a…
Ivarsson, Bodil; Nilsson, Gunilla
The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.
The definitions and meaning qualified nurses employed in an acute NHS hospital setting in the UK gave to health education and health promotion practice and how these fitted established language and theory were investigated qualitatively. These concepts, and the concomitant frameworks and models of practice, have been the subject of considerable debate in the literature. While unresolved both in general and in nursing, a degree of theoretical convergence was established in the 1990s [Bunton, R., Macdonald, G., 1992. Health promotion: disciplines and diversity. Routledge, London; Maben, J.M., Macleod Clark, J. 1995. Health promotion: a concept analysis. Journal of Advanced Nursing 22, 1158-165] helped by The Ottawa Charter [WHO, 1986. Ottawa Charter for Health Promotion. http://www.who.int/hpr/archive/docs/ottawa.html]. For many of the participants in this study however, the meanings given to these concepts and the predominant use of health education were inconsistent with much of the language of the wider debate and this has potential implications for nurse education. For, if the findings are considered transferable then there is a need to develop education strategies and curricula that articulate the ideological foundations of policy and practice and to use mainstream terminology to assist nurses both to understand and contribute to the contemporary health promotion debate.
Arizona State Dept. of Education, Phoenix.
Part of a health occupations program, these instructional units consist of materials for use by those who are studying to become practical nurses. Unit 16 deals with basic concepts in the nursing of the aged, in community health, and in the legal responsibilities of the practical nurse. Covered next are nursing care procedures for adults with the…
Lewis, Krystina B; Stacey, Dawn; Squires, Janet E; Carroll, Sandra
Patient engagement in collaboration with health professionals is essential to deliver quality health care. A shared decision-making (SDM) approach requires that patients are involved in decisions regarding their health. SDM is expanding from the patient-physician dyad to incorporate an interprofessional perspective. Conceptual models can be used to better understand theoretical underpinnings for application in clinical practice. The aim of this article was to conduct a theory analysis of conceptual models using an interprofessional approach to SDM and discuss each model's relevance to nursing practice. Walker and Avant's theory analysis approach was used. Three conceptual models were eligible. For all models, the decision-making process was considered iterative. The development process was described for 1 model. All models were logical, parsimonious, and generalizable. One was supported by empirical testing. No model described how partnerships are enacted to achieve interprofessional SDM. Also, there was limited articulation as to how nurses' roles and contributions differ from other team members. This theory analysis highlights the need for a model that explains how partnerships among interprofessional team members are enacted to better understand the operationalization of interprofessional SDM. Implications for nursing practice at all system levels are offered and supported by the 3 models.
Booth, Richard G; Andrusyszyn, Mary-Anne; Iwasiw, Carroll; Donelle, Lorie; Compeau, Deborah
Actor-Network Theory is a research lens that has gained popularity in the nursing and health sciences domains. The perspective allows a researcher to describe the interaction of actors (both human and non-human) within networked sociomaterial contexts, including complex practice environments where nurses and health technology operate. This study will describe Actor-Network Theory and provide methodological considerations for researchers who are interested in using this sociotechnical lens within nursing and informatics-related research. Considerations related to technology conceptualization, levels of analysis, and sampling procedures in Actor-Network Theory based research are addressed. Finally, implications for future nursing research within complex environments are highlighted.
Background Nurse anaesthetists in the US have faced continued, repeated challenges to their profession. Regardless, they have met these challenges and have established themselves as major anaesthesia care providers. In this paper we address the research question: How do certified registered nurse anaesthetists (CRNAs) manage the socio-political context in which they provide care for their patients? Methods Grounded theory was used to explore how nurse anaesthetists protect and promote their profession. Purposive, snowball, and theoretical sampling was used and data were collected through participant observation and interviews conducted at a conference of the professional association, an educational program, by telephone, email exchanges, and time spent in operating rooms and an outpatient surgical clinic. Analysis included coding at increasingly abstract levels and constant comparison. Results The basic social process identified was Keeping Vigil Over the Profession, which explains how nurse anaesthetists protect and promote their profession. It is comprised of three contextual categories: Establishing Public Credibility through regulatory and educational standards, Political Vigilance and taking action in governmental and policy arenas, and Tending the Flock through a continuous information loop between local and administrative/political levels. Conclusions From our study of the context of nurse anaesthesia practice, it is clear that CRNAs are dedicated to protecting their ability to provide high quality patient care by maintaining constant vigilance over their profession. PMID:20633286
Yektatalab, Shahrzad; Seddigh Oskouee, Fatemeh; Sodani, Mansour
Family plays an important role in health and illness, and preparing the nurses to assess and improve the family functioning and relationship based on a theoretical framework is of critical importance. This randomized controlled trial was performed to evaluate the effectiveness of Bowen system theory on marital conflict in the family nursing practice. A total of 42 couples referring to the family court of Shiraz, Iran were randomly assigned to either the intervention (receiving eight 90-minute sessions of Bowen systemic family therapy) or the control group (receiving no interventions). Outcomes were measured before, after and after one month of the follow up by marital conflict questionnaire and analyzed using repeated measure ANOVAs and t-test. The study results revealed no statistically significant differences between the study groups regarding the total marital conflict scores (t = 2.8, p = .935) or any of the seven subscales of conflict before the intervention (p > .05). However, a significant difference was observed between the two groups in this regard immediately and one month after the intervention (p < .05). The results demonstrated a significant difference between the intervention and control groups regarding the conflict scores and its subscales during the three study periods and groups (F = 79.43, p < .001). This study highlighted the importance of applying Bowen systemic family therapy by nurses in decreasing marital conflicts. Similar studies with larger sample sizes and longer follow-ups are recommended to be conducted on the issue.
Jeffs, Lianne; Sidani, Souraya; Rose, Donald; Espin, Sherry; Smith, Orla; Martin, Kirsten; Byer, Charlie; Fu, Kaiyan; Ferris, Ella
An evolving body of literature suggests that the implementation of evidence based clinical and professional guidelines and strategies can improve patient care. However, gaps exist in our understanding of the effect of implementation of guidelines on outcomes, particularly patient outcomes. To address this gap, a measurement framework was developed to assess the impact of an organization-wide implementation of two nursing-centric best-practice guidelines on patient, nurse and organizational level outcomes. From an implementation standpoint, we anticipate that our data will show improvements in the following: (i) patient satisfaction scores and safety outcomes; (ii) nurses ability to value and engage in evidence based practice; and (iii) organizational support for evidence-informed nursing care that results in quality patient outcomes. Our measurement framework and multifaceted methodological approach outlined in this paper might serve as a blueprint for other organizations in their efforts to evaluate the impacts associated with implementation of clinical and professional guidelines and best practices.
Arizona State Dept. of Education, Phoenix.
Part of a health occupations program, these instructional units consist of materials for use by those who are studying to become practical nurses. Covered in the units are the following: the nursing care of mothers and newborns (obstetrics, prenatal care and complications, patient needs, care of the newborn, prematurity, medications, and cultural…
Urology nursing has developed as a specialty over the past few decades in response to several factors, workload demands being a prime reason. Nurses are taking on additional roles and activities including procedures such as cystoscopy and prostate biopsy, and running nurse-led clinics for a variety of urological conditions. Audits of advanced urological nursing practice have shown this care to be of a high standard and investigative procedures performed by these nurses match the diagnostic quality of existing services. Professional urological nursing organizations support the professional needs of these nurses, but the provision of education and training for advanced practice activities remains an unaddressed need. A range of confusing advanced urology nursing titles exists, and uncertainty regarding the roles and scope of practice for these nurses remains a concern. Acceptance and support from medical colleagues is required for the success of advanced urological nursing practice, but opinions on these roles remain divided.
This paper presents an outline of Lacan's theory of the human subject, in particular focusing on Lacan's concepts of the real, symbolic and imaginary registers, and how an understanding of these can inform change and practice in mental health nursing. Mental health nursing is under pressure to define itself as a practice distinct from other professions in the field, and to respond in new ways to promoting mental health to the individual and a wider public. Lacan's theory of the subject is of particular relevance to mental health nurses working with mental distress but has received little attention in mental health nursing literature. Six implications for practice are outlined in terms of: against normalization, the importance of the function of the symptom, what cannot be known, meaning as ever-changing, against empathy and against holistic ideas of the self.
Lee, Mei-Hsiu; Lee, Shui-Chuen; Lee, Shu-Chen
Literature articles and clinical observation suggest disease and environmental factors as primary causes of the low self-esteem and stigmatization that typify most psychiatric patients. These patients are at risk of injury when subjected to inappropriate physical restraint. Hospital staffs, including nurses, are in immediate and close contact with psychiatric patients. Mencius's and Kant's thoughts on human dignity can enhance reflections on clinical nursing practices. Mencius's belief that preserving life is not the most desirable thing and death is not the most hated thing can help nurses realize the human dignity of psychiatric patients by understanding that, as an unrighteous act is more detestable than death, the meaning and value of righteousness are greater than life itself. In light of Kant's views on human dignity, nurses should treat patients as goals rather than means. Exploring such ideas can raise nursing quality, restore a positive sense of humanity to psychiatric patients, and develop nursing values and meaning to a higher plane.
Grealish, Laurie; Smale, Lacey Anne
The transfer of nursing education into the higher education sector occurred over a 10-year period in Australia (1985-1994). Australian nurse leaders settled on a single outcome measure to be applied for all nursing graduates in the form of national competency standards. While this move enabled diversity, the lack of consistency in curriculum design has subsequently led to increasing confusion for clinicians who support students' learning in clinical placements. Using a shared critical reflection method, the authors reviewed (1) the evaluation comments from nurses in one nursing unit of a hospital in one Australian jurisdiction and (2) an historical review of nursing literature at the time of the transfer of nursing education into the higher education sector. The reflection suggests that the aim of the transfer, to create critical thinking graduates, has been undermined by the implicit clinical education practices that have since emerged. In order to address the contemporary challenges for clinical staff working with students from multiple universities, as well as increased student numbers to address the nursing shortage, we recommend a new approach to curriculum design: a national clinical curriculum drawn from social, as well as cognitive, learning theory that at once informs clinicians of students' potential abilities and provides the scope to accommodate the increasingly difficult and critical learning requirements of tertiary-based nursing students.
Kurt Lewin, the originator of action research, proposed that it was valuable not only for innovating change, but also the process of change could lead to new insights into the nature of the problem that was being tackled. This action research project developed and evaluated a teaching model that aimed to help RGN (registered general nurse) students to bridge the theory-practice gap. During the course of this work, the possible reasons for a theory-practice gap started to become clear. This paper provides a discussion of these factors. The viewpoint for this discussion is that of the student nurse. The student is assumed to 'own' the problem and it is from her perspective that the theory-practice gap is analysed. The paper includes a critical examination of books, lectures, the school curriculum and ward nursing practice. Finally, possible solutions to the theory-practice problem are discussed and it is hoped that these will provide a rational basis for tackling the problem.
Rogers, Melanie; Wattis, John
Spirituality is an important aspect of holistic care that is frequently overlooked. This is because of difficulties in conceptualising spirituality and confusion about how it should be integrated into nursing care. This article explores what is meant by spirituality and spiritually competent practice. It examines attitudes to spirituality, describes factors that might affect the integration of spirituality into nursing care and offers practical guidance to equip nurses to incorporate spirituality into their practice.
As part of this year's centenary celebrations, the RCN is showcasing the best nursing practice, focusing on that which often goes unobserved. Nurses, healthcare assistants and nursing students are asked to share ideas and innovations for improving practice and patient care. These will contribute to the development of a library of good practice and the RCN will invest in a small number of the successful projects. The closing date is 31 December.
Moore, Scott Emory; Holaday, Bonnie; Meehan, Nancy; Watt, Paula J
The purpose of this article is to evaluate mHealth as a tool for research and development of nursing theories. Mobile health (mHealth) is one of the most promising new advances in health care technology. mHealth is defined as the use of mobile technology in the provision of health care delivery or health promotion (Qiang, Yamamichi, Hausman, & Altman, 2011). The need for innovative and effective interventions for the prevention and management of chronic illness is evident. The use of mHealth interventions in the treatment and monitoring of chronic illness is still young but shows great promise. Currently, the public health and psychological sciences are using their theories to guide interventional studies by operationalizing concepts through mHealth's multifaceted capabilities for patient interaction. Outcomes measures from chronic illness-mHealth studies are thematically evaluated by using theoretical nursing outcome-related concepts of Meleis's transitions theory and Mishel's uncertainty in illness theory. Despite a small sample of articles, there are strong themes of activation and engagement within this literature review. The application of nursing theory in mHealth offers a new method to operationalize theoretical concepts, test theory-based interventions, and gain new contextual insight into the health-illness patient experience.
Curran, Mary K
The American Nurses Association advocates for nursing professional development (NPD) specialists to have an earned graduate degree, as well as educational and clinical expertise. However, many NPD specialists have limited exposure to adult learning theory. Limited exposure to adult learning theory may affect NPD educational practices, learning outcomes, organizational knowledge transfer, and subsequently, the professional development of the nurses they serve and quality of nursing care. An examination of current teaching practices may reveal opportunities for NPD specialists to enhance educational methods to promote learning, learning transfer, and organizational knowledge and excellence. This article, the first in a two-part series, examines best practices of adult learning theories, nursing professional development, curriculum design, and knowledge transfer. Part II details the results of a correlational study that examined the effects of four variables on the use of adult learning theory to guide curriculum development for NPD specialists in hospitals.
Shanta, Linda L; Connolly, Maria
King's theory is a broad theory designed to provide a framework for nursing (I.M. King, 1981), whereas emotional intelligence (EI; J.D. Mayer & P. Salovey, 2004) is a theory that is specific for addressing potential competency in dealing with emotions and emotional information. J.D. Mayer, P. Salovey, D.R. Caruso, and G. Sitarenios (2001) defined EI as the "ability to recognize the meaning of emotions and their relationships and to use them as a basis for reasoning and problem solving" (p. 234). These researchers believed that EI is related to cognitive intellect through the ability to use reasoning by way of information to find meaning. J.D. Mayer and P. Salovey (2004) argued that the skills that comprise EI were likely enhanced through obtaining a liberal education infused with values exploration. J.D. Mayer, P. Salovey, D.R. Caruso, and G. Sitarenios (2001) contended that there are 4 branches of abilities that create EI: (a) the skill of perceiving emotion within oneself and others, (b) assimilation of an emotion to facilitate thinking, (c) understanding and knowledge of emotion, and (d) conscious regulation of emotion. Each level or branch builds upon the previous one, and awareness of what each branch offers the individual in enhancing relationships with others is a key component of healthy emotional interactions. This article will provide a theoretic foundation based upon King's interacting systems theory (IST; 1981) that embraces EI as a crucial component in the nurse's ability to provide holistic care for patients, peers, and themselves. King's IST underscores the necessity of nurses possessing abilities of EI as they care for others but does not fully describe a mechanism to understand and incorporate emotions within the complex nurse-patient interactions and communications that are part of the nursing process.
Moss, Cheryle; Grealish, Laurie; Lake, Sarah
Within nursing education, graduate pedagogies are relatively unexplored, with research commonly focused upon undergraduate and continuing education. In order to address the increasingly complex organisational challenges in the workplace, mid-career nurses and midwives are turning to graduate education. In one graduate course on cultures of learning in the workplace, a constructivist approach to learning was adopted. Post-course analysis of data, from the feedback on the course from students, student choice of assignment topics, and reflections of the course facilitators, revealed three pedagogies unique to graduate education. The pedagogies were labelled 'keeping the space open', 'theoretical concepts as tools', and 'resonance and action as praxis'. The intended outcome of the course is revealed in a fourth theme, 'developing practice in the workplace'. This evaluation suggests that constructivist pedagogies used with graduate students may be different to those pedagogies used with undergraduate and continuing education students. We argue that graduate pedagogies move nursing education beyond strategies that seek integration of theory and practice, towards a dialectic between theory and practice.
Describes Rosemary Rizzo Parse's Man-Living-Health theory that was used to describe how gerontological nursing knowledge could be developed through a nursing conceptual model that includes a defined practice and research methodology. (Author/JOW)
By using the concepts of intrinsicality/extrinsicality as analytic tools, the theology-based nursing theories of Ann Bradshaw and Katie Eriksson are analyzed regarding their explicit and/or implicit understanding of vocation as a motivational factor for nursing. The results show that both theories view intrinsic values as guarantees against reducing nursing practice to mechanistic applications of techniques and as being a way of reinforcing a high ethical standard. The theories explicitly (Bradshaw) or implicitly (Eriksson) advocate a vocational understanding of nursing as being essential for nursing theories. Eriksson's theory has a potential for conceptualizing an understanding of extrinsic and intrinsic motivational factors for nursing but one weakness in the theory could be the risk of slipping over to moral judgments where intrinsic factors are valued as being superior to extrinsic. Bradshaw's theory is more complex and explicit in understanding the concept of vocation and is theologically more plausible, although also more confessional.
Bultemeier, Kaye I
Nursing in Malawi has been predominately a technical trade and only recently has begun the transition to a profession with autonomy and advanced degree preparation. Nursing theories provide a framework for the evolution of nursing to an independent profession. Theories provide a means for the articulation of the nursing role to other members of the healthcare team including consumers. Healthcare and human needs are basic and the guidance provided by nursing theories, including Nightingale's, gives language and structure to the education of nurses as the profession moves into advanced practice in a developing country.
Stilos, Kalli; Moura, Shari L; Flint, Frances
Current nursing literature recognizes the need to honor the concept of ambiguity. Nurses experience uncertainty with handling or honoring complexity and ambiguity when confronted with times of struggle. Traditional models of care fall short as patients and families define their expectations of the healthcare system. Nurses bear witness to the discomfort caused by the unknown in their daily practice. They are challenged to address their feelings, unsure of what to anticipate, what to say, or how to respond to their patients. Uncertainty diminishes the opportunity for meaningful dialogue between nurses and other people. Nurses attempting to ease the discomfort of ambiguity by providing patients or families with reassurance, offering advice on how to fix problems, or avoiding talking about situations often express dissatisfaction. Nurses should be invited to explore ambiguity and seek understanding through dialogue and nursing knowledge. Encouraging nurses to define the meaningfulness in nursing practice that embraces human science theory will help relieve some of the ambiguity that exists in current practice. This article will explore the concept of ambiguity, highlight how nursing theory based on human science can support practice, and propose recommendations for practice.
Peplau, H E
Peplau discusses major features of the theory of interpersonal relations. She describes her theory as among the most useful to apply during nursing practice in order to understand nurse-patient interactive phenomena. Peplau addresses how she derived constructs from clinical data and identified their congruence with nursing practice. She further addresses the specific concepts of her theory and their relations, and specific uses of the theory in practice.
Danbjørg, Dorthe Boe; Birkelund, Regner
This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories.
Shea, Linda; Frisch, Noreen
The purpose of this article is to examine Dossey's theory of integral nursing in relation to its major theoretical source, Wilber's integral theory. Although several nursing scholars have written about integral theory in relation to nursing scholarship and practice, Dossey's theory of integral nursing may be influencing how nurses take up integral theory in a significant way due to an extensive outreach in the holistic nursing community. Despite this wide circulation, the theory of integral nursing has yet to be reviewed in the nursing literature. This article (a) compares Dossey's theory of integral nursing with Wilber's integral theory and (b) contrasts Dossey's integral approach with another integral approach used by other scholars of integral theory.
Kohlenberg, Eileen; Kennedy-Malone, Laurie; Crane, Patricia; Letvak, Susan
The inclusion of gerontology content in the nursing curriculum is paramount as our population of older adults grows. As one of 10 recipients of the John A. Hartford Foundation/AACN awards for Enhancing Gerontological and Geriatric Nursing Education for Advanced Practice Nursing Programs, we successfully integrated gerontological/ geriatric content throughout core courses for all concentrations taught at the master's level. The Nurse Practitioner and Clinical Nurse Specialist Competencies for Older Adult Care were used as a guide to integrate gerontological nursing content across the core courses. We present examples of content, strategies, and evaluation methods that demonstrate infusion of gerontology in a nursing theory course, research course, and healthcare law and policy course. Twenty-two of the competencies are addressed in these core courses and provide a foundation for further development in the support and specialty courses for the nurse practitioner, clinical nurse specialist, nursing administrator, nurse educator, and nurse anesthetist. We also present helpful Web-based resources for older adult care.
Dyess, Susan MacLeod; Chase, Susan K
This article reveals processes that support theoretical development for holistic nursing in the context of a faith community. The emerging processes enhance the articulation of the holistically focused practice, add clarity to faith community nursing activities and outcomes, and contribute to theoretical clarification and development. Theoretical clarity is essential to guide faith community nursing practice, research, and education because there is tremendous potential for the specialty practice to contribute to the health of a community across the continuum of caring and because to date there has been no unifying model for this practice proposed. A lack of a theoretical basis can result in disparate and disconnected approaches to studying, testing, and promoting the practice.
Adams, Jeffrey M; Natarajan, Sudha
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.
Noel, Dianne L
Many health care and academic centers have adopted Watson's Theory of Human Caring as their guiding principle; the theory is also used in other disciplines, such as library science. Human caring theory offers occupational health nurses as structure that not only defines a focus for practice, but also provides a basis for moral and philosophical practice analyses. In particular, nurses may find this theory useful in confirming the definition of "caring" and reconsidering what nursing is all about. More importantly, consideration and application of this theory may lead to research on its applicability to the field of occupational health nursing. This article presents the science and philosophy of human caring, specifically Watson's Theory of Human Caring. Two case studies are presented that demonstrate how the theory could be used to evaluate occupational health nursing practice. To demonstrate its possible relevance as an occupational health nursing framework, an analysis of and comparison to existing occupational health nursing guidelines are detailed and discussed.
If nursing practice is guided by nursing theory, then decision-making processes should be filtered through the theory in such a way that makes the outcomes of the process both unique and useful to nursing. This article presents a discussion of the formulation of a decision-making process based on Orem's self-care deficit nursing theory that produces specific diagnostic statements about the relationship between individuals' therapeutic self-care demand and their self-care agency.
Empowering teaching strategies encourage leadership, critical thinking, problem solving, and collegiality and discourage passivity, isolation, and subordination. Empowerment prepares nurses for professional practice in hospitals. (SK)
Segaric, Cheryl A; Hall, Wendy A
Despite recognition of the importance of family in health-care and progress in family theory development, there has been limited transfer of family theory to acute care nursing practice. We argue that this family theory-practice gap results from a persistent lack of conceptual clarity in family nursing and other barriers. Lack of conceptual clarity takes the form of conceptual overlap and semantic inconsistency, as well as the complexity of language found in the family nursing literature. Barriers include practice contexts, relational problems, and knowledge types. Our exploration begins with a brief discussion of the intimate link between nursing theory and practice followed by an overview of some issues associated with the family nursing theory-practice gap. Based on a synthesis of family nursing literature, problems associated with conceptual clarity in family nursing theory are explored. We conclude with recommendations for family nursing research to develop concepts grounded in nursing practice.
Falk, Kristin; Falk, Hanna; Jakobsson Ung, Eva
A key area for consideration is determining how optimal conditions for learning can be created. Higher education in nursing aims to prepare students to develop their capabilities to become independent professionals. The aim of this study was to evaluate the effects of sequencing clinical practice prior to theoretical studies on student's experiences of self-directed learning readiness and students' approach to learning in the second year of a three-year undergraduate study program in nursing. 123 nursing students was included in the study and divided in two groups. In group A (n = 60) clinical practice preceded theoretical studies. In group (n = 63) theoretical studies preceded clinical practice. Learning readiness was measured using the Directed Learning Readiness Scale for Nursing Education (SDLRSNE), and learning process was measured using the revised two-factor version of the Study Process Questionnaire (R-SPQ-2F). Students were also asked to write down their personal reflections throughout the course. By using a mixed method design, the qualitative component focused on the students' personal experiences in relation to the sequencing of theoretical studies and clinical practice. The quantitative component provided information about learning readiness before and after the intervention. Our findings confirm that students are sensitive and adaptable to their learning contexts, and that the sequencing of courses is subordinate to a pedagogical style enhancing students' deep learning approaches, which needs to be incorporated in the development of undergraduate nursing programs.
Asheervath, J.; Blevins, D.R.
Written in outline format, this reference will help nurses further their understanding of advanced nursing procedures. Information is provided on the physiological, psychological, environmental, and safety considerations of nursing activities associated with diagnostic and therapeutic procedures. Special consideration is given to the areas of pediatric nursing, nursing assessment, and selected radiologic and nuclear medicine procedures for each system. Contents: Clinical Introduction. Clinical Nursing Practice: Focus on Basics. Focus on Cardiovascular Function. Focus on Respiratory Function. Focus on Gastrointestinal Function. Focus on Renal and Genito-Urological Function. Focus on Neuro-Skeletal and Muscular Function. Appendices.
Weese, Meghan M; Jakubik, Louise D; Eliades, Aris B; Huth, Jennifer J
Previous studies examining predictors of pediatric nurse protégé mentoring benefits demonstrated that protégé perception of quality was the single best predictor of mentoring benefits. The ability to identify the mentoring practices that predict specific benefits for individual nurses provides a better understanding of how mentoring relationships can be leveraged within health care organizations promoting mutual mentoring benefits. This descriptive correlational, non-experimental study of nurses at a northeast Ohio, Magnet® recognized, free-standing pediatric hospital advances nursing science by demonstrating how mentoring practices benefit pediatric nurse protégés.
Valek, Rebecca M; Greenwald, Beverly J; Lewis, Carolyn C
The authors discuss the psychological factors associated with weight loss maintenance and the use of Pender's health promotion model as a guide for the construction of clinical interventions to address these factors. The psychological factors include internal drive for weight maintenance, ongoing self-monitoring, long-term flexibility, positive mood and emotions, appropriate goals, and management of external stimuli. Nurse practitioners can help combat obesity trends through caring for patients in a holistic manner. Periodic psychological needs-assessments for patients who desire to maintain weight loss may further promote long-term success in weight management.
Working in Partnership, the Department of Health's report on the 1994 review of mental health nursing, implies that mental health nurses should develop anti-oppressive approaches to nursing practice. There is a notable absence of articles within the nursing literature which specifically address this issue. This is possibly because the historical and ideological issues which have informed the development of mental health nursing are complex and difficult to unravel. However, an integration of the theories of David Cooper and Frantz Fanon may provide an appropriate starting point for the development of a theory of anti-oppressive practice which addresses some of the issues specific to mental health nursing.
Sofhauser, Cynthia D
In order to present the state of the science of hostility among and across disciplines, a review of the literature was completed. The knowledge gained may influence nursing practice. Scholarly works from nursing, medical and basic sciences, psychology, sociology, education, philosophy, business, communication, and criminology were reviewed. Similar patterns in the use of the concept were discovered. The patterns revealed five themes: hostility as a health-risk factor, hostility as a factor in family relationships, hostility as a factor in perceived challenge, hostility as a factor in criminal behavior, and hostility as a factor in the workplace. Based on the knowledge gained about hostility, implications for nursing practice related to changing the hostile working environment for nurses were suggested using modeling and role-modeling nursing theory.
Vandemark, Lisa M
Psychotherapy is an accepted role of the advanced practice psychiatric nurse. Nursing theorists, notably Hildegard Peplau and Margaret Newman, offer guidance on the psychological and professional development of the nurse. This paper examines Newman's theory of health as expanding consciousness and the concept of awareness of self in Peplau's theory, and suggests that psychiatric advanced practice nursing programs consider the need for nurses to develop self-knowledge to facilitate the nurse-patient relationship and to improve outcomes of patient care in psychotherapy.
Bishop, Christine E.; Squillace, Marie R.; Meagher, Jennifer; Anderson, Wayne L.; Wiener, Joshua M.
Purpose: To estimate the impact of nursing home work practices, specifically compensation and working conditions, on job satisfaction of nursing assistants employed in nursing homes. Design and Methods: Data are from the 2004 National Nursing Assistant Survey, responses by the nursing assistants' employers to the 2004 National Nursing Home Survey,…
The purpose of this updated manual is to define and describe standardized nursing languages, highlight how nursing languages are a part of the nursing process, and illustrate through case examples how nursing languages are used in school nursing practice. This manual also summarizes the history and development of three nursing classifications, the…
Oaks, Geneva; Drummond, Susan
California Baptist University School of Nursing opened in September 2006 as the first baccalaureate nursing education program in Riverside, California. Under the direction of Dr. Constance Milton, the curriculum was cocreated using Parse's humanbecoming school of thought as a framework. In August 2008, nursing students traveled to Rwanda where they bore witness to the transformation after the 1994 genocide. Dimensions and processes of Parse's practice methodology-illuminating meaning by explicating what is with languaging, synchronizing rhythms while dwelling with ups and downs in the struggle of connecting-separating, and mobilizing transcendence as moving beyond with the not-yet while transforming- emerged in the students' journaling as lived all-at-once amid reverence that honored the dignity and worth of the Rwandan people.
Mitty, Ethel; Flores, Sandi
The person with dementia uses behavior to communicate, but their behavior is altered by the combination of neurological damage and impairment, altered interpersonal relationships and reactions of others, and the individual's loss or weakening of their lifelong defenses or coping mechanisms. This article discusses the routes by which behavior can be understood and describes a constellation of needs of a person with dementia that has a unique fit with person-centered care. Three evidence-based models (theories) and interventions specific to dementia behaviors are discussed: the Need-Driven Dementia-Compromised Behavior Model, the Progressively Lowered Stress Threshold Model, and the utilization of self-identity roles. Montessori-based activities are another approach to person-centered dementia care that respect, as do the models, the dignity, worthiness and interests of the person afflicted with dementia. The models discussed in this article all seek to improve the quality of life of the person with dementia. Other than those at the profound end stage of dementia, most sufferers can communicate feelings. Subjective quality of life must be determined based on the self-report of the person suffering with dementia so that treatment interventions and effectiveness are grounded in that person's reality.
Kourkouta, Lambrini; Papathanasiou, Ioanna V.
Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient. To achieve this, however, nurses must understand and help their patients, demonstrating courtesy, kindness and sincerity. Also they should devote time to the patient to communicate with the necessary confidentiality, and must not forget that this communication includes persons who surround the sick person, which is why the language of communication should be understood by all those involved in it. Good communication also is not only based on the physical abilities of nurses, but also on education and experience. PMID:24757408
Gray-Miceli, Deanna; de Cordova, Pamela B; Crane, Giles L; Quigley, Patricia; Ratcliffe, Sarah J
Reducing falls in nursing homes requires a knowledgeable nursing workforce. To test knowledge, 8 validated vignettes representing multifactorial fall causes were administered to 47 nurses from 3 nursing homes. Although licensed practical nurses scored higher than registered nurses in individual categories of falls, when we computed the average score of all 8 categories between groups of registered nurses and licensed practical nurses, registered nurses scored higher (F = 4.106; P < .05) in identifying 8 causal reasons for older adults to fall.
There have been very few investigations into how any single nursing theory has actually evolved historically. In this paper, a trajectory of theoretical development in nursing is explored through reviewing the theoretical development of a single nursing theory-transitions theory. The literature related to transitions theory was searched and retrieved using multiple databases. Ninety-nine papers were analyzed according to type of theory, populations of interest, sources of theorizing, and theoretical methods. Transitions theory originated in research but was initially borrowed. It also arose in research with immigrants and from national and international collaborative research efforts. A product of mentoring, transitions theory is used widely in nursing education, research, and practice. Diverse thoughts related to transitions theory coexist. For future theoretical development in nursing, we need to remain open to new ideas and continue to engage in multiple collaborative efforts.
Reed, P G
Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice-based theory, as well as nursing theory-based practice.
Clinton, Patricia; Sperhac, Arlene M
The purpose of this article was to provide the background and rationale for the practice doctorate in nursing. The American Association of Colleges of Nursing's Position Statement on the Practice Doctorate in Nursing, approved in October 2004, will be discussed. Outlined are some of the changes that will be needed in education, regulation, and advanced practice. Common questions and concerns that advanced practice nurses have, including titling, salary, and transitioning to the doctor of nursing practice degree, will be addressed.
Sherman, Deborah Witt
Describes the role and responsibilities of advanced-practice nurses in palliative care and nursing's initiative in promoting high-quality care through the educational preparation of these nurses. (JOW)
Schoenhofer, Savina O
Drawing on a story of a nursing situation for practical context, this article explores the meaning of intentionality within the theoretical context of Nursing as Caring. May's definition of intentionality as the structure that gives meaning to experience is interwoven with the concepts of the theory of Nursing as Caring to explore the topic. Mayeroff's concepts of hope and commitment contribute to an understanding of intentionality in relation to Nursing as Caring. The major thesis of this article, that intentionality is consistently choosing personhood as a way of life and the aim of nursing, is demonstrated in the practice situation.
DeMarco, Rosanna F; Pulcini, Joyce; Haggerty, Lois A; Tang, Trinh
Recently, the American Association of Colleges of Nursing (AACN) resolved that a new practice degree, the doctorate in nursing practice (DNP), is to become the terminal practice degree and minimum education standard for advanced practice nurses by the year 2015(American Association of Colleges of Nursing. (2004). AACN position statement on the practice doctorate in nursing. Retrieved July 1, 2007, from http://www.aacn.nche.edu.html). The DNP will have a clinical-intensive focus. Advanced practice nurses potentially impacted by this resolution will include nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists. A task force at the William F. Connell School of Nursing at Boston College conducted an electronic survey in 2006 in an attempt to understand nurses' thoughts about doctoral preparation and the interest of nurses in Massachusetts in pursuing doctoral study. A self-selected group of 376 nurses participated in the study. Nurses identified both positive and negative perceptions related to the degree's viability and practicality, with a majority (55%) preferring the DNP as an educational option.
Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon
School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…
Bungay, Vicky; Stevenson, Janine
Most research about regulatory policy change concerning expanded nursing activities has emphasized advanced practice roles and acute care settings. This study is a contribution to the small pool of research concerned with regulatory policy implementation for nurses undertaking expanded nursing practice activities in a public health context. Using the regulatory changes in certified nursing practice in one Canadian province as our starting point, we investigated the experiences of nurse leaders in implementing this change. Using a qualitative interpretive descriptive approach informed by tenets of complexity theory, we examined the experiences of 16 nurse leaders as situated within the larger public health care system in which nurses practice. Two interrelated themes, (a) preparing for certification and (b) the certification process, were identified to illustrate how competing and contrasting demands between health care and regulatory organizations created substantial barriers to policy change. Implications for health service delivery and future research are discussed.
Schafer, P J
Knowledge in nursing requires development of theories that address both the science and art of the professional practice discipline. "A Theory of Clinical Nursing" was analyzed to explicate the epistemologic dimensions within an historic perspective. Epistemologic dimensions defined by the philosophy of science--approaches to theory development, sources of knowledge, and methodology--were characterized from two perspectives, scientific inquiry and historicism. The major perspectives in the scientific mode, namely, mechanism, empiricism, logical positivism, and logical empiricism, were analyzed along the three dimensions of theory development, sources of knowledge, and methodology. Trends in theoretical developments in nursing were related to the scientific and historic perspectives and to the epistemologic dimensions. Juxtaposing the diversity of knowledge required for nursing science and practice, and the values systems of the practitioners, revealed the inadequacy of the scientific model. Nursing knowledge explication required several modes of inquiry to articulate the scientific basis of the discipline and the art of delivery of the practice. The historicist approach framed scientific work with the prevailing World View. The Rubin theory was located within the matrix of approaches to inquiry and perspectives in nursing science. Labeled by the theorist as both a nursing research and a nursing care model, "A Theory of Clinical Nursing" represented a transition model of nursing, undergirded by the major conceptualizations and methodologies of field, psychoanalytic, and social behaviorist traditions, but implicitly coalescing the art with the science of nursing. The theory addressed core concepts of person, situation, and nursing care, as well as major process themes of change and interaction. Nursing theories of a more narrow range, such as maternal role attainment and maternal identity, nested within the theory, while subsequent theoretical clarifications and
Pieper, Barbara; Colwell, Janice
Advanced practice nursing education is at a crossroads. Societal changes, increased health care demands, and leadership nursing organizations have identified the need of a doctor of nursing practice (DNP) degree as the advanced practice degree. WOC nurses need to examine DNP programs when considering returning for an advanced practice degree. This article explores nursing education at the doctorate level and areas the WOC nurse should consider when making a decision about attending a program. The WOC nurse needs to understand the similarities and differences of the doctor of philosophy and the DNP, issues about each program and its completion, personal factors, and the application process. Although selecting a doctoral program is a daunting experience, the education will provide opportunities for the WOC nurse to excel as a scholar, thus influencing the profession and the practice.
THIS BOOK has a logical format making it easy to follow. It begins with the conceptualisation of nursing knowledge by discussing the nature of knowledge, nursing models, theories, philosophies and practice.
Mitty, Ethel; Flores, Sandi
Admission assessment, generally conducted by a registered nurse, is autonomous, without opportunity for dialogue with colleagues and other health care professionals and bounded by the nurse's knowledge and skills, state regulations, facility practices, and marketing. The fact that some states permit admission and retention of nursing home level-of-care residents and provision of end-of-life care means that the assessment has to be able to predict the resident's likely trajectory of well-being as well as chronic illness exacerbation. The nurse must have a clear perspective on staff competencies and judge whether additional education or training will be necessary. This article reviews assessment standards of practice as put forth by the American Assisted Living Nurses Association as part of its application for recognition of assisted living nursing as specialty nursing practice by the American Nurses Association. The role of the Licensed Practical Nurse/Licensed Vocational Nurse in resident assessment is also discussed.
Dickerson, Pamela S
The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice.
In most states, the role of an advanced practice nurse is dependent on practice protocols that provide an organized method for analyzing and managing a disease or major symptom. They are also used to control the process of medical care and to specify steps in the delivery of that care. Creating appropriate practice protocols is one of the most important precursors to implementing the advanced practice role, because they virtually drive the clinician's ability to treat or manage clinical situations or disease states. This article outlines the steps involved in developing practice protocols and discusses the content that should be included in a protocol, providing an example of narrative and algorithm format protocols. Pros and cons, as well as legal issues related to practice protocols, are also presented.
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.
Armstrong, Alan E
Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the 'therapeutic' or 'helping' nurse-patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics' action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further.
The learning opportunities presented in nurses' storied accounts of practice are explored. This exploration is achieved through analysis and discussion of three nurse's stories documented in the literature, and uses Benner's (1991) narratives of learning theme as the conceptual framework. The narrative of learning sub themes: being open to experience, liberation, and disillusionment are examined. This examination suggests nurses stories can be used to: discover nursing knowledge, develop shared understandings of what it is to be a nurse, examine nursing's culture and ethics, document interactions for research, teaching and learning, and identify and preserve the practice of nursing. Whereas edited stories from the literature only begin to demonstrate the possibilities for learning that stories offer, through them alternative ways of learning about nursing, exploring nursing practice and developing nursing knowledge are presented.
Tarlier, Denise S; Browne, Annette J
Remote Nursing Certified Practice (RNCP) was introduced in 2010 to regulate nursing practice in remote, largely First Nations communities in British Columbia, Canada. These are communities that often experience profound health and health-care inequities. Typically nurses are the main health-care providers. Using a critical social justice lens, the authors explore the clinical and ethical implications of RNCP in terms of access to equitable, high-quality primary health care.They examine the fit between the level and scope of health services provided by registered nurses working under RNCP and the health needs of remote First Nations communities. In doing so, they draw comparisons between nurse practitioners (NPs) and outpost nurses working in NP roles who historically were employed to provide health care in these communities.The authors conclude by calling for nursing regulations that support equitable, high-quality primary care for all British Columbians.
Banks, Cassie M; Gilmartin, Heather; Fink, Regina M
Nurses practicing in the rural setting have faced a unique challenge in maintaining competency in low-volume, high-risk procedures. This study assessed the effectiveness of a focused, multifaceted educational intervention on the retention of nursing knowledge related to central venous access devices care and maintenance. A pretest-posttest intervention study design was used at a 58-bed rural healthcare facility in a Western state. This study demonstrates a statistically significant increase in functional nursing knowledge in the postintervention period.
Jackson, Janet R; Clements, Paul T; Averill, Jennifer B; Zimbro, Kathie
In a time of chaotic and unpredictable health care, it is vital for nursing to employ a nursing leadership theory that is specifically applicable to nurses and will holistically, and comprehensively address and support both the science and art of this honored profession. The authors propose that Nursing Leadership Knowing can address and impact the myriad issues confronting managers and administrators within the turbulent health care industry, with the ultimate goals of quality comprehensive patient care and improved employee satisfaction. They believe that Nursing Leadership Knowing, grounded in the realties of nursing experience, is a logical theoretical extension that can be translated into nursing leadership practice particular and specific focus on empirics and evidence-based practice will not attend to the robust and multidimensional underpinnings of the lived experience that is so vital to nursing as a caring profession. The ideal of nursing leadership theory is not a single-focused shadow of its history, but a rich, inclusive, multi-faceted network of knowing. As such, Nursing Leadership Knowing provides a forum for leaders to enhance their practice, as well as their relationship with their employees, which ultimately translates into optimal care for the patients we serve.
Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica
Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.
Stanton, M P; Packa, D
Nursing case management is a blend of individual case- and/or disease-management activities used in urban hospitals or community health settings. The authors propose that in rural communities, a third form of case management is also used. Nursing case management in the rural community has a broader and more diverse scope of practice than nurse case managers practicing in urban settings.
Montgomery, Kathryn Lothschuetz
In today's society, health care systems are characterized by change, unpredictability, increasing speed of information and knowledge exchanges, redefined organizational boundaries and hierarchy, emphasis on value, teamwork, interdisciplinary collaboration, diversity, and interconnectedness. This new reality has forced nurse educators to redefine nursing leadership and prepare the Doctorate of Nursing Practice (DNP) leader through innovative courses offering experiential learning based on complex adaptive systems and quantum leadership theory. This article describes the experiential learning approach and integrated learning experience for DNP students.
Malwela, Thivhulawi; Lebese, Rachel T.
Background Professional midwives have an important role to play in midwifery training to produce a competent midwife. According to the social learning theory, professional midwives act as role models for students. When allocated for clinical learning experiences in the training hospitals, students will have the opportunity to observe the well-trained, skilled, and experienced professional midwives. The whole process will enable students to integrate theory with practice and they will become competent. Aim The aim of this study was to determine the factors affecting integration of midwifery nursing science theory with clinical practice as perceived by midwives. Setting The study was conducted at the training hospitals in Vhembe district of the Limpopo Province, South Africa. These hospitals were: Donald Fraser, Siloam, and Tshidzini. Methods A qualitative explorative, descriptive and contextual design was used. A Non-probability, convenient sampling method was used to select 11 midwives from the following hospitals: Donald Fraser, Siloam, and Tshidzini, in Vhembe district. In-depth individual interviews were conducted. Data were analysed through open coding method. Result One theme and five sub-themes emerged from the analysed data, namely: shortage of midwives, attitudes towards student midwives, reluctance to perform teaching functions, language barriers, and declining midwifery practice standards. Conclusion Shortage of midwives in the clinical areas led to fewer numbers of mentors whom the students could observe and imitate to acquire clinical skills. Some of the midwives were reluctant to teach students. Recommendations were made for both training institutions and hospitals to employ preceptors for students in the clinical practical. PMID:27380847
Kooker, Barbara Molina; Shoultz, Jan; Codier, Estelle E
The National Center for Health Workforce Analysis projects that the shortage of registered nurses in the United States will double by 2010 and will nearly quadruple to 20% by 2015 (Bureau of Health Professionals Health Resources and Services Administration. . Projected supply, demand, and shortages of registered nurses, 2000-2020 [On-line]. Available: http:bhpr.hrsa.gov/healthworkforce/reports/rnprojects/report.htm). The purpose of this study was to use the conceptual framework of emotional intelligence to analyze nurses' stories about their practice to identify factors that could be related to improved nurse retention and patient/client outcomes. The stories reflected evidence of the competencies and domains of emotional intelligence and were related to nurse retention and improved outcomes. Nurses recognized their own strengths and limitations, displayed empathy and recognized client needs, nurtured relationships, used personal influence, and acted as change agents. Nurses were frustrated when organizational barriers conflicted with their knowledge/intuition about nursing practice, their communications were disregarded, or their attempts to create a shared vision and teamwork were ignored. Elements of professional nursing practice, such as autonomy, nurse satisfaction, respect, and the professional practice environment, were identified in the excerpts of the stories. The shortage of practicing nurses continues to be a national issue. The use of emotional intelligence concepts may provide fresh insights into ways to keep nurses engaged in practice and to improve nurse retention and patient/client outcomes.
Reimer, Andrew P.; Moore, Shirley M.
Aim This paper presents a middle-range Theory of Flight Nursing Expertise. Background Rotary-wing (helicopter) medical transport has grown rapidly in the USA since its introduction, particularly during the past 5 years. Patients once considered too sick to transport are now being transported more frequently and over longer distances. Many limitations are imposed by the air medical transport environment and these require nurses to alter their practice. Data sources A literature search was conducted using Pubmed, Medline, CINAHL, secondary referencing and an Internet search from 1960 to 2008 for studies related to the focal concepts in flight nursing. Discussion The middle-range Theory of Flight Nursing Expertise is composed of nine concepts (experience, training, transport environment of care, psychomotor skills, flight nursing knowledge, cue recognition, pattern recognition, decision-making and action) and their relationships. Five propositions describe the relationships between those concepts and how they apply to flight nursing expertise. Implications for nursing After empirical testing, this theory may be a useful tool to assist novice flight nurses to attain the skills necessary to provide safe and competent care more efficiently, and may aid in designing curricula and programmes of research. Conclusion Research is needed to determine the usefulness of this theory in both rotary and fixed-wing medical transport settings, and to examine the similarities and differences related to expertise needed for different flight nurse team compositions. Curriculum and training innovations can result from increased understanding of the concepts and relationships proposed in this theory. PMID:20337803
Jaeger, Audrey J.; Dunstan, Stephany; Thornton, Courtney; Rockenbach, Alyssa B.; Gayles, Joy G.; Haley, Karen J.
When making decisions that impact student learning, college educators often consider previous experiences, precedent, common sense, and advice from colleagues. But how often do they consider theory? At a recent state-level educators' meeting, the authors of this article asked 50 student affairs educators about the use of theory in their practice.…
Incivility in nursing education is a complicated problem which causes disruptions in the learning process and negatively affects future nursing practice. This mixed method research study described incivility as well as incivility's effects through extensive literature review and application of a modified Incivility in Nursing Education (INE) survey. The INE included six demographic items, four quantitative sections, and five open-ended questions. The survey examined emergency nurses' perceptions of incivility and how the experience affected their personal nursing practice. The INE was initially tested in a 2004 pilot study by Dr. Cynthia Clark. For this research study, modifications were made to examine specifically emergency nurse's perceptions of incivility and the effects on their practice. The population was a group of nurses who were members of the emergency nurses association in a Midwestern state. In the quantitative component of the Incivility in Nursing Education (INE) survey, the Likert scale questions indicated that the majority of the participants reported witnessing or experiencing the uncivil behaviors. In the qualitative section of the INE survey, the participants reported that although they have not seen incivility within their own academic career, they had observed faculty incivility with nursing students when the participants were assigned as preceptors as part of their emergency nursing practice.
Choi, JiSun; Flynn, Linda; Aiken, Linda H.
Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…
Aliakbari, Fatemeh; Parvin, Neda; Heidari, Mohammad; Haghani, Fariba
Learning theories are the main guide for educational systems planning in the classroom and clinical training included in nursing. The teachers by knowing the general principles of these theories can use their knowledge more effectively according to various learning situations. In this study, Eric, Medline, and Cochrane databases were used for articles in English and for the Persian literature, Magiran, Iran doc, Iran medex, and Sid databases were used with the help of keywords including social cognitive learning, learning theory, behavioral theory, cognitive theory, constructive theory, and nursing education. The search period was considered from 1990 to 2012. Some related books were also studied about each method, its original vision, the founders, practical application of the training theory, especially training of nursing and its strengths and weaknesses. Behaviorists believe that learning is a change in an observable behavior and it happens when the communication occurs between the two events, a stimulus and a response. Among the applications of this approach is the influence on the learner's emotional reactions. Among the theories of this approach, Thorndike and Skinner works are subject to review and critique. Cognitive psychologists unlike the behaviorists believe that learning is an internal process objective and they focus on thinking, understanding, organizing, and consciousness. Fundamentalists believe that learners should be equipped with the skills of inquiry and problem solving in order to learn by the discovery and process of information. Among this group, we will pay attention to analyze Wertheimer, Brunner, Ausubel theories, Ganyeh information processing model, in addition to its applications in nursing education. Humanists in learning pay attention to the feelings and experiences. Carl Rogers support the retention of learning-centered approach and he is believed to a semantic continuum. At the other end of the continuum, experiential learning is
Aliakbari, Fatemeh; Parvin, Neda; Heidari, Mohammad; Haghani, Fariba
Learning theories are the main guide for educational systems planning in the classroom and clinical training included in nursing. The teachers by knowing the general principles of these theories can use their knowledge more effectively according to various learning situations. In this study, Eric, Medline, and Cochrane databases were used for articles in English and for the Persian literature, Magiran, Iran doc, Iran medex, and Sid databases were used with the help of keywords including social cognitive learning, learning theory, behavioral theory, cognitive theory, constructive theory, and nursing education. The search period was considered from 1990 to 2012. Some related books were also studied about each method, its original vision, the founders, practical application of the training theory, especially training of nursing and its strengths and weaknesses. Behaviorists believe that learning is a change in an observable behavior and it happens when the communication occurs between the two events, a stimulus and a response. Among the applications of this approach is the influence on the learner's emotional reactions. Among the theories of this approach, Thorndike and Skinner works are subject to review and critique. Cognitive psychologists unlike the behaviorists believe that learning is an internal process objective and they focus on thinking, understanding, organizing, and consciousness. Fundamentalists believe that learners should be equipped with the skills of inquiry and problem solving in order to learn by the discovery and process of information. Among this group, we will pay attention to analyze Wertheimer, Brunner, Ausubel theories, Ganyeh information processing model, in addition to its applications in nursing education. Humanists in learning pay attention to the feelings and experiences. Carl Rogers support the retention of learning-centered approach and he is believed to a semantic continuum. At the other end of the continuum, experiential learning is
Amaducci, Giovanna; Iemmi, Marina; Prandi, Marzia; Saffioti, Angelina; Carpanoni, Marika; Mecugni, Daniela
Many faculty argue that theory and theorizing are closely related to the clinical practice, that the disciplinary knowledge grows, more relevantly, from the specific care context in which it takes place and, moreover, that knowledge does not proceed only by the application of general principles of the grand theories to specific cases. Every nurse, in fact, have a mental model, of what may or may not be aware, that motivate and substantiate every action and choice of career. The study describes what the nursing theoretical model is; the mental model and the tacit knowledge underlying it. It identifies the explicit theoretical model of the professional group that rapresents nursing partecipants, aspects of continuity with the theoretical model proposed by this degree course in Nursing.. Methods Four focus groups were made which were attended by a total of 22 nurses, rapresentatives of almost every Unit of Reggio Emilia Hospital's. We argue that the theoretical nursing model of each professional group is the result of tacit knowledge, which help to define the personal mental model, and the theoretical model, which explicitly underlying theoretical content learned applied consciously and reverted to / from nursing practice. Reasoning on the use of theory in practice has allowed us to give visibility to a theoretical model explicitly nursing authentically oriented to the needs of the person, in all its complexity in specific contexts.
Praeger, Susan; Zimmerman, Barbara
The purpose of this article is to present a state-by-state summary of rules and regulations governing school nursing practice in the United States. Official government and agency sites were reviewed to determine providers of services in schools, criteria for becoming a school nurse, protection of titling, mandates for school nursing, and the…
Schaffer, Marjorie A; Anderson, Linda J W; Rising, Shannon
School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic survey on their use of public health interventions as defined by the wheel. Although 67% of the participants were not familiar with the Public Health Intervention Wheel, respondents reported conducting activities that were consistent with the Wheel interventions. Screening, referral and follow-up, case management, and health teaching were the most frequently performed interventions. Intervention use varied by educational level, age of nurse, years of practice, and student population. The Public Health Intervention Wheel is a relevant and useful framework that provides a language to explain population-based school nursing practice.
... Outlook Occupational Outlook Handbook Handbook of Methods Research Papers Copyright Information Contact & Help Economic Releases Latest Releases » ... and licensed vocational nurses may advance to supervisory positions. Some LPNs and LVNs advance to other healthcare ...
Sperhac, Arlene M; Clinton, Patricia
A great deal of work has been done during the past several years since the American Association of Colleges of Nursing voted in October 2004 to move advanced practice nursing to the doctoral level by 2015. Following the approval, task forces were formed to address curriculum issues and the strategies for transitioning advanced practice nursing education from the master's level to the doctorate of nursing practice (DNP). The DNP curriculum contains content on leadership, management, and other topics that are needed to address some of the issues in the health care system that traditionally have not been included in most master of science in nursing curricula, as well as additional essential content and nurse practitioner competencies. As pediatric nurse practitioners and other advanced practice nurses go forward in their careers, the DNP may have an impact on their role. In this article, the background of the DNP movement, changes in advanced practice nursing education, and the concerns of currently practicing pediatric nurse practitioners prepared at the master's level will be addressed.
Redknap, Robina; Twigg, Di; Rock, Daniel; Towell, Amanda
Historically, mental health services have faced challenges in their ability to attract and retain a competent nursing workforce in the context of an overall nursing shortage. The current economic downturn has provided some respite; however, this is likely to be a temporary reprieve, with significant nursing shortages predicted for the future. Mental health services need to develop strategies to become more competitive if they are to attract and retain skilled nurses and avoid future shortages. Research demonstrates that creating and maintaining a positive nursing practice environment is one such strategy and an important area to consider when addressing nurse retention. This paper examines the impact the nursing practice environment has on nurse retention within the general and mental health settings. Findings indicate, that while there is a wealth of evidence to support the importance of a positive practice environment on nurse retention in the broader health system, there is little evidence specific to mental health. Further research of the mental health practice environment is required.
Dickson, Geri L; Flynn, Linda
In this article, we describe the depth of knowledge and skill nurses used in making decisions regarding the safe processes and practices of medication administration. Using grounded theory, we identified the essence of medication safety by nurses as the theme of clinical reasoning. Nurses used two medication safety processes within the clinical reasoning theme-maintaining medication safety and managing the environment-together with six categories of patient-focused medication safety practices in the first process and four categories of environmental-focused safety practices within the second process. These processes and practices present an emerging model of safe medication administration developed from the narratives of 50 medical-surgical nurses. This model provides researchers with the basis for the development of systemic policies for safer medication administration for patients. Health care professional educators might also find the results useful in developing curricula focused on patient safety as the foundation of quality care.
Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba
In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.
Mackereth, C J
In the winter of 1992, a postal survey was conducted on all practice nurses in Gateshead, England. The aim of the research was to describe the work of practice nurses (nurses working with and employed by general practitioners), with particular reference to health promotion and communication, and to explore the practice nurses' perceptions of their roles. The research found little conformity about what practice nurses do, apart from practical tasks. This confirms the essentially practical nature of their work, with poor role definition with regard to screening, health promotion and prevention. Training was found to vary, indicating a need for improvement. Women's health and surveillance of the health of elderly people were used to illustrate these issues. A wide consensus was found about what tasks are appropriate to practice nurses, indicating either that the list of tasks used in the survey accurately describes their potential role or that they are prepared to perform most tasks. Practice nurses perceive themselves as the specialists in health promotion although it was not possible to gain an understanding of whether they had a conception of the wider issues involved, which illustrated a limitation of survey methods. The information obtained will be relevant in the debate about the future of practice nurses, as well as the future of primary health care services in general.
Abitz, Tracey L
The importance of cultural competence in every nursing practice setting in today's world cannot be understated. Unconscious bias can have detrimental effects on therapeutic relationships and health outcomes. Nursing models of cultural competence by Purnell, Leininger, and Campinha-Bacote are reviewed. The Kleinman Model and LEARN Model offer questions and guidelines to facilitate assessment of patients' understanding of illness and treatment. The Infusion Nursing Standards of Practice contains elements of diversity and cultural competence throughout. Self-reflection of one's own values, beliefs, biases, and practice as an infusion nurse will promote the development of cultural competence.
Cantrell, Mary Ann
Pediatric oncology nursing practice must incorporate both the science and the art of the discipline to foster positive physical and psychosocial treatment outcomes for pediatric oncology patients, especially those outcomes related to their health-related quality of life. In this article, the art of nursing care is described within the context of scientifically based care, and the art of nursing practice is evident in the implementation of the scientific principles and standards for pediatric oncology nursing practice. The author proposes that the art of pediatric oncology nursing practice ought to be evident in care activities that the nurse provides within a therapeutic relationship that is steeped in nursing presence. Although the art of nursing care and the nature of an effective therapeutic relationship is tacit, valued knowledge among pediatric oncology nurses, as well as children and adolescents with cancer and their families, it is difficult to describe and challenging to quantify its effect on patient care outcomes. This article discusses the art of pediatric oncology nursing practice and its influence on treatment outcomes.
Describes the individualized program of Mountain Open High School which at first coincidentally resembed Maurice Gibbons'"Walkabout" concept and was subsequently more consciously shaped by theory. Students move through three phases culminating in challenging independent projects of practical use. (MJL)
von Klitzing, Waltraut; Stoll, Hansruedi; Trachsel, Edith; Aldorf, Kurt; Bernhard, Annelis; Eze, Germaine; Spirig, Rebecca
A prerequisite to providing evidence-based care is the ability to comprehend the nursing research literature, most of which is published in English. To facilitate this understanding, a course on "reading the research literature for evidence-based practice in English" was developed by an interdisciplinary team for staff nurses at the University Hospital Basel. The pilot course was offered to nurses who specialized in cancer care. It was led by the oncology Advanced Practice Nurse (APN) from the Department of Medicine. Research articles focusing on the management of chronic illness and cancer pain management were assigned and read. The course consisted of ten 90 minute lessons. The evaluation was designed to address the following questions: 1. Did participation in the course improve the oncology related knowledge of the nurses? 2. Did participation in the course improve the nurses' English language skills? 3. At what level of difficulty did the nurse participants perceive the course to be? 4. Were course participants able to use their newly acquired knowledge to teach their nursing colleagues on the ward? The course evaluation demonstrated that the 15 participants significantly improved their oncology knowledge through this process but that their English skills did not improve. The participants were able to present lectures on their wards based on the course literature, which were positively evaluated by their colleagues and the APN course leader. The participants perceived the course as being sophisticated but also effective at demonstrating the use of English-language research literature for one's own nursing practice.
Lindh, Inga-Britt; Barbosa da Silva, António; Berg, Agneta; Severinsson, Elisabeth
This article aims to deepen the understanding of courage through a theoretical analysis of classical philosophers' work and a review of published and unpublished empirical research on courage in nursing. The authors sought answers to questions regarding how courage is understood from a philosophical viewpoint and how it is expressed in nursing actions. Four aspects were identified as relevant to a deeper understanding of courage in nursing practice: courage as an ontological concept, a moral virtue, a property of an ethical act, and a creative capacity. The literature review shed light on the complexity of the concept of courage and revealed some lack of clarity in its use. Consequently, if courage is to be used consciously to influence nurses' ethical actions it seems important to recognize its specific features. The results suggest it is imperative to foster courage among nurses and student nurses to prepare them for ethical, creative action and further the development of professional nursing practices.
Hem, Marit Helene; Heggen, Kristin
The Norwegian Nurses' Association recently (2001) approved a new code of ethics that included compassion as one of the basic values in nursing care. This paper examines the idea of compassion in the context of the Bible story of the Good Samaritan using an analysis of qualitative data from nurses' clinical work with psychiatric patients. The aim is to show how the idea of compassion challenges nursing practice. Thereafter, the paper discusses the benefits of and premises for compassion in care work. The results show that nurses tend not to be guided by compassion in their work with patients. The organisation of the day-to-day work in the hospital ward, the division of labour between nurses and doctors, and the nurses' approach to nursing were identified as influencing this tendency. The study shows that compassion is a radical concept with a potential to promote greater respect for patients' dignity.
The Emotional Freedom Technique (EFT) is defined and described as a clinical procedure for the relief of psychological and physical distress that patients often bring to the attention of nurses. Frequently referred to as "tapping," this technique combines the cognitive reprocessing benefits of exposure and acceptance therapy with the energetic disturbance releases associated with acupuncture and other energy therapies. More than 60 research articles in peer-reviewed journals report a staggering 98% efficacy rate with the use of this procedure from psychological distress (posttraumatic stress disorder, phobias, anxiety, depression, etc.) to physical conditions (asthma, fibromyalgia, pain, seizure disorders, etc.) to performance issues (athletic, academic). Perhaps because of this, this technique has encountered a fair degree of skepticism within the health care community. Easily taught as a self-help aid that patients can administer to themselves, EFT becomes an efficacious tool in the hands of nurses who are seeking whole person approaches for the healing of a wide variety of psychological and physical conditions. A conceptual framework, mechanisms of action, evidence of safety, literature review, and case studies are also included.
Levitt, Cheryle; Adelman, Deborah S
The teaching and learning of nursing theory, at all program levels, is challenging due to the complexity and abstract nature of its content, the dry nature in which the study of theory often is approached, a perception of disconnect from practice, and faculty discomfort and avoidance of the subject matter. Adapting creative educational strategies to the online environment is an ongoing challenge for educators. Role-play relates well to the constructivist basis of creating personal meaning based on the individual's experiences. This article examines the use of role-play as an educational strategy for teaching nursing theory in an online baccalaureate program. In a core professional issues course, students adopt the persona of a specific nursing theorist, interacting with other "nursing theorists" played by their peers. Student engagement and active learning reflect excitement and interest, and course evaluations have been extremely positive for this content and method.
Santos, S S; da Nóbrega, M M
This is a bibliographic study where the authors tried to analyse the interpersonal relationships of nursing from Hildegard E. Peplau following the conceptual pattern of analysis and evolution proposed by Thibodeau. It describes the concepts of person, environment, health and nursing; the source and procedures used to this theory formation; and its generalization, use, acceptance and significance for nursing. It shows the importance of its application in nursing practice because the interpersonal process is a primary stage in nursing assistance.
Lima, Rogério Silva; Lourenço, Eliana Bernardes; Rosado, Sara Rodrigues; Fava, Silvana Maria Coelho Leite; Sanches, Roberta Seron; Dázio, Eliza Maria Rezende
Objective To understand the meanings that nursing staff gives to nurse's managerial practice in the inpatient unit. Methods This is an exploratory and descriptive research with qualitative approach, conducted in a general hospital in a Southern city of Minas Gerais State. We used the Theory of Social Representations as theoretical framework. The study sample were composed by 23 nursing technicians and five nursing assistants. Data collection was conducted through semi-structured interviews, from December 2011 to January 2012. For data analysis we used the discourse analysis, according to social psychology framework. Results The meanings attributed to management occurred from the closeness/distance to staff and to patients` care actions. Conclusions The managerial nurse, perceived as a process apart from care, is classified as non familiar practice, of hard understanding and valuation.
Hoare, Karen J; Mills, Jane; Francis, Karen
The terminology used to analyse data in a grounded theory study can be confusing. Different grounded theorists use a variety of terms which all have similar meanings. In the following study, we use terms adopted by Charmaz including: initial, focused and axial coding. Initial codes are used to analyse data with an emphasis on identifying gerunds, a verb acting as a noun. If initial codes are relevant to the developing theory, they are grouped with similar codes into categories. Categories become saturated when there are no new codes identified in the data. Axial codes are used to link categories together into a grounded theory process. Memo writing accompanies this data sifting and sorting. The following article explains how one initial code became a category providing a worked example of the grounded theory method of constant comparative analysis. The interplay between coding and categorization is facilitated by the constant comparative method.
Canam, Connie J
Much emphasis has been placed on the importance of nurses' articulating what they do to counteract the invisibility of nursing practice. Yet there has been minimal focus on why nurses are silent. This article explores the link between technical and caring discourses and nurses' silence and suggests an alternative discourse that conceptualizes nursing as a knowledge-driven enterprise that shifts the focus from what nurses do to what nurses know by promoting nurses' practice knowledge as a language for articulating their practice.
Coombs, Maureen A; Moorse, Sue E
This paper proposes that the current use of physical assessment skills within critical care nursing practice is part of a on-going nursing role development process. A review of the critical care nursing role highlights how nurses in this setting have always been responsive to patient management needs. In exploring one recent nursing role development, the critical care outreach nurse, it is suggested that enhanced assessment skills enable these practitioners to safely and competently assess critically ill patients out of the intensive care environment. The use of patient case studies in this paper, demonstrate how the theory of a more intensive physical assessment knowledge base can be applied in the everyday practice of an critical care outreach nurse. Through such systematic patient review, patient management plans can be agreed and ward based practitioners can be supported in the on-going treatment of sick ward patients. The use of the cases presented also highlights the complexity of the outreach nurse's practice in addressing clinical management and team management issues.
Shirey, Maria R
Evidence-based nursing practice (EBNP) is the wave of the future. Increasingly, EBNP is being identified as a key to quality and excellence in nursing services. Incorporating evidence into practice is necessary to deliver scientifically sound patient care. In addition, understanding the importance of evidence is crucial for meeting the excellence requirements of Magnet designation. Despite the growing popularity of EBNP and its documented significant benefits, the literature demonstrates that only 15% of the nursing workforce consistently practices within an EBNP framework. If EBNP adoption is to increase in the profession, it will require the active efforts of nurse leaders to pursue an aggressive innovation diffusion strategy. The purpose of this article is to discuss the nurse leader's role in facilitating EBNP in nursing using a theoretical framework grounded in innovation diffusion theory. The article develops 4 areas of focus. First, the components of innovation diffusion theory are discussed. Second, a pertinent empirical review of the EBNP adoption literature is presented. Third, strategies for applying innovation diffusion theory to facilitate EBNP adoption are proposed. Lastly, the article ends with a leadership call to action.
Nursing knowledge has traditionally been examined and developed through the main research approaches based on the positivist, interpretive or phenomenological philosophies. These approaches are used either from a single and individual stance or combined to address particular research questions. They all, however, retain a focus that deals primarily or exclusively with what can be measured, observed or expressed as a fundamental unit of analysis to reconstruct, interpret and explain nursing practice. In this paper, Vince Ramprogus challenges the traditional approach to how nursing knowledge is defined and the common understanding of the purpose of nursing research. It is argued that adhering to empirical rigour while investigating or measuring nursing practice interferes with the very act and experience of nursing. Indeed, it becomes an either/or situation. It is also argued that nursing is not an empirical subject, and, therefore, the purpose of researching nursing is not about seeking the truth but about improving practice to achieve better patient care. The arguments are intended to provoke discussion and debate rather than to present a set position.
Raimondo, Maria Lúcia; Fegadoli, Débora; Méier, Marineli Joaquim; Wall, Marilene Loewen; Labronici, Liliana Maria; Raimondo-Ferraz, Maria Isabel
Integrative review, held in the databases LILACS, SciELO and BDENF from January 2005 to May 2009, aimed to summarize the Brazilian scientific production based on Orem's Nursing Theory. We obtained 23 articles, analyzed by simple descriptive statistics. It was found that 100% of the studies focused on adults. Of this total, 65,22% returned to the chronicle diseases. In 39,15% of the searches, the theory was used in full and in 34,80% one of the constructs. 91,30% of publications aimed to the construction and deployment of the structured and theoretically grounded practice of care. It was concluded that the theory has been used as theoretical and philosophical basis to justify the practice of nursing in a variety of situations in order to emphasize the role of the nurse in the care.
Fitzgerald, Cynthia; Kantrowitz-Gordon, Ira; Katz, Janet; Hirsch, Anne
Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change. PMID:22220273
Paton, Brenda I
Significant research has been conducted and disseminated on preceptorship as an essential component in teaching and evaluating student learning in the final clinical practicum. The preceptorship triad-formally defined as an equilateral relationship among a nurse preceptor, faculty member, and undergraduate nursing student-overlooks the contextual challenges preceptors encounter. Preceptors develop relationships in the clinical setting to enhance teaching, and more importantly, to ensure student practice reflects the depth of clinical reasoning and skill acquisition necessary for safe and competent practice. Using descriptive surveys and qualitative focus groups, a research collaborative among academia, practice, and professional regulating bodies was established in southern Alberta, Canada, to research the types of knowledge nurses acquire and integrate to successfully assess, evaluate, and teach undergraduate nursing students in the clinical environment. This article describes the research findings and highlights the professional practice knowledge of nurse preceptors.
Randell, B P
On September 21, 1990, at the University of California, Los Angeles, Neuropsychiatric Institute and Hospital, six nurse theorists participated in a panel discussion on theory development for the 21st century. The theorists included Dorothy Johnson, Betty Neuman, Dorothea E. Orem, Rosemarie Rizzo Parse, Martha E. Rogers and Callista Roy. The panel provided the participants the opportunity to speculate on the course for future development of nursing knowledge. Three questions were posed to the panel relating to the development of their models, the direction nursing theory will take in the 21st century, and current research emerging from the extant theories. The panel also addressed questions from the audience.
Velloso, Isabela Silva Câncio; Ceci, Christine; Alves, Marília
Reflections on power relations in nursing practice involves questions related to the daily practice of nursing staff as well the subjectivity of those involved in them. Nursing practice is more than a practice in itself. It assumes the dimension of meaning ascribed to it by different subjects who interact in the places where the practice takes place. We propose a reflection about power relations in nursing practice, considering their complexity, the many processes that constitute them and the circumstances that determine the ways of thinking about and acting in relation to them. Such reflection implies to think about the subject's subjectivity the way professional boundaries are established, and the effects of these relations upon the subjects involved, since power relations are in continuous transformations.
Morrall, Peter; Goodman, Benny
When in the latter part of the 20th century nurse 'training' in the UK left the old schools of nursing (based within the health delivery system) and entered universities, the promise was not just a change of focus from training to education but an embracement of 'higher' education. Specifically, nurses were to be exposed to the demands of thinking rather than just doing - and critical thinking at that. However, despite a history of critical perspectives informing nursing theory, that promise may be turning sour. The insidious saturation of the university system in bureaucracy and managerialism has, we argue, undermined critical thinking. A major funding restructuring of higher education in the UK, coinciding with public concern about the state of nursing practice, is undermining further the viability of critical thinking in nursing and potentially the acceptability of university education for nurses. Nevertheless, while critical thinking in universities has decayed, there is no obvious educational alternative that can provide this core attribute, one that is even more necessary to understand health and promote competent nursing practice in an increasingly complex and globalising world. We propose that nurse academics and their colleagues from many other academic and professional disciplines engage in collegiate 'moral action' to re-establish critical thinking in UK universities.
Vought-O'Sullivan, Victoria; Meehan, Nancy K; Havice, Pamela A; Pruitt, Rosanne H
Competency-based continuing education is critical to the professional development of school nurses to ensure the application of timely, age-appropriate clinical knowledge and leadership skills in the school setting. School nurses are responsible for a large number of students with a variety of complex and diverse health care needs. Benner's theory of novice to expert provides a framework for the development of roles and competencies in the practice of school nursing. This manuscript synthesizes research reviewed in 15 articles. Common themes found in the articles include the importance of continuing education and identified barriers to attainment. In response, methods to access continuing education and financial resources are presented.
Moreira, Lilian Hortale de Oliveira; Loyola, Cristina Maria Douat
The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patient's needs or requests.
Simmonds, Anne H
Advocacy has been positioned as an ideal within the practice of nursing, with national guidelines and professional standards obliging nurses to respect patients' autonomous choices and to act as their advocates. However, the meaning of advocacy and autonomy is not well defined or understood, leading to uncertainty regarding what is required, expected and feasible for nurses in clinical practice. In this article, a feminist ethics perspective is used to examine how moral responsibilities are enacted in the perinatal nurse-patient relationship and to explore the interaction between the various threads that influence, and are in turn affected by, this relationship. This perspective allows for consideration of contextual and relational factors that impact on the way perinatal nursing care is given and received, and provides a framework for exploring the ways in which patient autonomy, advocacy and choice are experienced by childbearing women and their nurses during labour and birth.
This paper historicizes the taken-for-granted acceptance of reflection as a fundamental professional practice in nursing. It draws attention to the broad application of reflective practice, from pedagogy to practice to regulation, and explores the epistemological basis upon which the authority of reflective discourse rests. Previous work has provided a series of critiques of the logic and suitability of reflective practice across all domains of nursing. The goal of this paper is to commence a history of nursing's reflective identity. The paper begins with a discussion of Dewey and Schön then focuses on Habermas's Theory of Communicative Action as the epistemological basis of reflective practice's standing as a authoritative discourse in nursing.
McCloskey, Joanne Comi; Donahue, William; Bulechek, Gloria M.
The identification of nursing interventions that are core to each clinical specialty will be useful in the development of nursing information systems, staff education programs and evaluations, referral networks, certification and licensing examinations, curricula, and research and theory construction. (Author/JOW)
Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla
Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…
de Meneses, Mary
Discusses incorporating nontraditional concepts of learning in nursing education. Elements explored include the split brain theory, school design, teaching styles, teacher's role, teaching strategies, adding variety to the curriculum, and modular learning. (CT)
Diers, Donna; Hendrickson, Karrie; Rimar, Joan; Donovan, Donna
Nursing units are social systems whose function depends on many variables. Available nursing data, combined with a theory of organizational diagnosis, can be used to understand nursing unit performance. One troubled unit served as a case study in organizational diagnosis and treatment using modern methods of data mining and performance improvement. Systems theory did not prescribe how to fix an underbounded system. The theory did suggest, however, that addressing the characteristics of overbounded and underbounded systems can provide some order and structure and identify helpful resources. In this instance, the data analysis served to help define the unit's problems in conjunction with information gained from talking with the nurses and touring the unit, but it was the theory that gave hints for direction for change.
Castner, Jessica; Ceravolo, Diane J; Foltz-Ramos, Kelly; Wu, Yow-Wu
Nurses' control over practice is essential to nursing care quality and fosters teamwork at the point of care delivery. This article describes a study to measure the impact of nurses' control over their practice from the perspective of teamwork. The purpose of this study was to measure the relationship of control over practice to the five following dimensions of teamwork: team structure, leadership, situation monitoring, mutual support, and communication. The study method was a secondary analysis of 456 surveys from registered nurses working in a five-hospital system. Study results demonstrated that the global measure of teamwork correlated with control over practice and nursing experience, but not with teamwork training. All five individual dimensions of teamwork were perceived as better for those who had a high level of control over practice compared to those who did not. In the discussion section, we consider situation monitoring since this dimension demonstrated an interaction effect between teamwork training and control over practice. Nursing control over practice demonstrates a positive relationship with teamwork and should be considered in future education, policy, and research efforts. Further study is needed to understand control over practice as a potential moderator or mediator of other predecessors of effective teamwork.
Rogers, Helen W.; And Others
This curriculum guide provides teachers with up-to-date information and skill-related applications needed by the practical nurse. The volume contains three sections and 24 instructional units: Personal Vocational Relationships (6 units), Nutrition (3 units), and Basic Nursing Principles and Applied Skills (15 units covering such topics as…
Bergren, Martha Dewey
This Question and Answer (Q&A) article addresses practice issues related to school health records and school nursing documentation that were posed by school nurses in the field. Specifically, the questions addressed concern the following: education records, medication privacy issues, sharing of sensitive health information, privacy of…
Berbiglia, Violeta A
Although Dorothea Orem's Self-Care Deficit Nursing Theory has been used for curricula framework for years, it was not until 2001 that Orem identified the nursing practice sciences and the foundational nursing sciences and specified the appropriate content for the two sciences. The broad purpose of this paper is to reinforce the importance of utilizing nursing theories as curricular conceptual frameworks. The specific purpose is to delineate the appropriate content for baccalaureate programs that adopt a Self-Care Deficit Nursing Theory conceptual framework for their curriculum.
Nursing practice needs a theoretical foundation. As in any other discipline, theories form the core of nursing science. They contribute to the definition of nursing and to the evolution of professional domains. Depending on their level of abstraction and their range ("grand theories") they can guide actions, have an orientating, but also a critical function. Furthermore, theories serve to legitimate and justify nursing in the public. This is especially important, if politics and society have high expectations in the nursing profession. The current concept of a critical theory of nursing science has a critical focus on repressions and deficits in nursing practice, but also is aimed at achieving reasonable nursing practice. This theory is emancipatorical and normative as well. It is following Foucault's analysis of power and explicating the "Frankfurt School of Critical Theory" as a critique of the conditions of working, understanding, recognising, self, time and nature.
Rolim, Karla Maria Carneiro; Pagliuca, Lorita Marlena Freitag; Leitão Cardoso, Maria Vera Lúcia M
Theories are propositions created to evaluate nursing care, allowing nurses to consider and incorporate them in their professional practice. This Masters study was aimed at thinking critically about the practical usefulness of the concepts of Humanistic Nursing Theory. This descriptive-reflexive study was carried out in 2004 and used Meleis' model for the analysis of theories. The "critique of theory" segment was taken from this model to be used as an analytical tool, with emphasis on the "usefulness" parameter. The critical analysis revealed the notorious "usefulness" of interpersonal relations and dialogue, which can be used in daily practice at the Newborn Intensive Care Unit, valuing the human affective relations, which are essential for nursing care. Nursing practice should be guided by theoretical, philosophical, and methodological reference frameworks, responsible for making professionals reflect critically on themselves and their practice.
Davies, Jacqueline; Heyman, Bob; Bryar, Rosamund; Graffy, Jonathan; Gunnell, Caroline; Lamb, Bryony; Morris, Lana
Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and
Georges, Jane M
The purpose of this article was to critique and synthesize the trajectory of the work of Dr Jane Georges in Advances in Nursing Science over the past decade in the development of an emancipatory theory of compassion, with implications for contemporary nursing. Specifically, this article (1) summarizes and critiques the work in each stage of its development, describing missing elements at each stage and subsequent development of ideas built upon previous work, and (2) proposes future directions for the work, including the proposal of a theory of compassion within the emancipatory paradigm to guide further scholarly inquiry in nursing.
Milton, Constance L
Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing.
MacDonnell, Judith A
This article describes findings from a qualitative policy study focused on female nurses' activism in relation to lesbian health. Critical feminist analysis and comparative life history methodology were applied to career histories obtained from 10 diversely situated female nurses across Ontario, Canada. The findings show that nursing activist practices are informed by advocacy experiences that foster inclusive professional and community education plus formal education processes that shape their political socialization. Implications for nursing theory include the development of political knowledges and practices that support caring science, sociopolitical knowing, and primary healthcare nursing practice in a community context.
The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.
Purposeful reflection is consistent with adult learning theory. It is known to lead to a deeper understanding of issues and to develop judgment and skill. Required by law to ensure members' competence in their professional practice, the College of Nurses of Ontario recommends and has developed a tool for evaluating reflective practice. The tool focuses on key attributes said to be demonstrated by competent practitioners, including critical thinking (CT) and job knowledge. This study aimed to determine whether nurses engage in reflective practice and whether they perceive that it enhances their CT ability. Surveys were sent to 60 gastroenterology nurses at a large teaching hospital; 34 surveys were anonymously returned. All respondents engaged in reflective practice, and 24 reported using the college's tool. Nineteen respondents strongly agreed that their nursing practice had improved as a result. Critical thinking is difficult to assess because of a lack of clear-cut performance criteria. Improvement of CT was difficult to evaluate from the responses, even though all respondents participated in reflective practice. Both CT and reflective practice need to be better defined in order to examine and explain their relationship.
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
Prepared by practical nursing educators, this document is intended to serve as a tool for (1) self-evaluation by educational programs in practical nursing, (2) evaluation for accreditation by the National League for Nursing, and (3) appraisal of plans for the development of new practical nursing programs. The statements, whcih are organized into…
Valentine, Julie L
An evaluation of the Integrated Practice Model for Forensic Nursing Science () is presented utilizing methods outlined by . A brief review of nursing theory basics and evaluation methods by Meleis is provided to enhance understanding of the ensuing theoretical evaluation and critique. The Integrated Practice Model for Forensic Nursing Science, created by forensic nursing pioneer Virginia Lynch, captures the theories, assumptions, concepts, and propositions inherent in forensic nursing practice and science. The historical background of the theory is explored as Lynch's model launched the role development of forensic nursing practice as both a nursing and forensic science specialty. It is derived from a combination of nursing, sociological, and philosophical theories to reflect the grounding of forensic nursing in the nursing, legal, psychological, and scientific communities. As Lynch's model is the first inception of forensic nursing theory, it is representative of a conceptual framework although the title implies a practice theory. The clarity and consistency displayed in the theory's structural components of assumptions, concepts, and propositions are analyzed. The model is described and evaluated. A summary of the strengths and limitations of the model is compiled followed by application to practice, education, and research with suggestions for ongoing theory development.
Kirk, Timothy W
Understanding, shared meaning, and mutual trust lie at the heart of the therapeutic nurse-patient relationship. This article introduces the concept of clinical intimacy by applying the interpersonal process model of intimacy to the nurse-patient relationship. The distinction between complementary and reciprocal behaviours, and between intimate interactions and intimate relationships, addresses background concerns about the appropriateness of intimacy in nursing relationships. The mutual construction of meaning in the interactive process between nurses and patients is seen to lie at the heart of clinical intimacy as a hermeneutic enterprise. Intimacy is distinguished from empathy based on intentionality and the status and location of meaning. Reasons for continued investigation into clinical intimacy as an explanatory model for nursing as a hermeneutic practice are presented.
Effective use of simulation is dependent on a complete understanding of simulation's central conceptual elements. Deliberate practice, a constituent of Ericsson's theory of expertise, has been identified as a central concept in effective simulation learning. Deliberate practice is compatible with simulation frameworks already being suggested for use in nursing education. This paper uses Wilson's Method of concept analysis for the purpose of exploring the concept of deliberate practice in the context of clinical simulation in nursing education. Nursing education should move forward in a manner that reflects best practice in nursing education.
Rudolfsson, Gudrun; von Post, Iréne; Eriksson, Katie
This article is a synthesis of 2 qualitative studies focusing on patients', anesthetists', and operating-room nurses' experiences of the perioperative dialogue and employing grounded theory as the method of analysis. The aim of the synthesis was to achieve a new holistic understanding of health in the perioperative dialogue. The synthesis highlights the importance of being in communion in a continuous whole due to continuity of care for the creation of health in both patients and nurses.
Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla
Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.
Managers provide the critical link between the delivery of nursing care and the administration. It is vital for nurse managers to provide a work environment that supports professional nursing practices. Staff nurses are taught how to carry out clinical functions. For them to develop and practice advanced clinical skills, managers have to buffer the pressures of daily operations. They must ask themselves, "Am I committed to my employees?" "Am I an enthusiastic role model for my employees?" "Do I use positive motivating techniques?" "Do I know each of my employees personally as a unique individual?" "What can I do to create an environment that supports my employees?" and "How can I make each of my employees feel respected and worthy?" If the manager, whether experienced or not, can answer these questions honestly and apply motivational techniques differently, he or she will be the best kind of manager: a true leader.
The purpose of this article is to propose Empowered Holistic Nursing Education (EHNE) as a midrange theory--developed through induction, explication, deduction, and retroduction--to help nurse educators teach holistically and create a student-centered classroom, to establish a theoretical basis for a nursing pedagogy reflecting nursing's foundational principles, and to guide future research. The model's 5 core concepts, how to use the model as a pedagogy for practice, and its application to research will be presented. Holistic nursing will be defined, and traditional holistic nursing, holistic pedagogy, and emancipatory pedagogy will each be described.
Lewallen, Lynne Porter
Self-evaluation is required for institutions of higher learning and the nursing programs within them. The literature provides information on evaluation models and instruments, and descriptions of how specific nursing education programs are evaluated. However, there are few discussions in the nursing education literature of the practical aspects of nursing education program evaluation: how to get started, how to keep track of data, who to involve in data collection, and how to manage challenging criteria. This article discusses the importance of program evaluation in the academic setting and provides information on practical ways to organize the evaluation process and aggregate data, and strategies for gathering data from students, graduates, alumni, and employers of graduates.
Chimner, N E; Easterling, A
A 528-bed community teaching hospital redesigned its patient care delivery system, implementing a collaborative practice model on the 30-bed inpatient rehabilitation unit in April 1990. This model is a patient-centered delivery model that encourages the healthcare team to facilitate the achievement of patient outcomes within effective time frames and with an appropriate use of resources. The collaborative practice model includes a nurse case manager's role for the staff nurse, which had as its frame-work the concept of nursing case management. Tested project management techniques were used to ensure a successful implementation process. Various strategies, such as using project teams and providing educational programs, were used to respond to the issues of role conflict and overlap, especially between social workers and nurse case managers. The implementation of this model provided a number of benefits, including improved interdisciplinary relationships and decreased length of stay.
Upchurch, Sandra; Brosnan, Christine A.; Grimes, Deanna E.
A process for teaching research synthesis to advanced practice nurses includes two courses: a first research applications course in which students build bibliographic databases, practice statistical analysis, and develop search skills; and a second course in which they complete literature reviews or meta analyses of research on clinical practice…
The purpose of this study was to examine the leadership practices perceived by nursing education leaders as measured by the Leadership Practices Inventory (LPI). The framework used was a contemporary transformational leadership model described in "The Leadership Challenge" ("4th ed.") by Dr. James Kouzes and Dr. Barry Posner,…
This article highlights the importance of effective communication skills for nurses. It focuses on core communication skills, their definitions and the positive outcomes that result when applied to practice. Effective communication is central to the provision of compassionate, high-quality nursing care. The article aims to refresh and develop existing knowledge and understanding of effective communication skills. Nurses reading this article will be encouraged to develop a more conscious style of communicating with patients and carers, with the aim of improving health outcomes and patient satisfaction.
Callaghan, D; Williams, A
Discussion in this paper is based on findings drawn from research undertaken within a qualitative framework of analysis, and with the purpose of exploring people's perceptions of living with diabetes, including the nursing care they receive. A major theoretical concern is to demonstrate the importance of placing patients' and clients' experiences at the centre of nursing interest and practice. It is argued that understanding a disease process should of necessity include an understanding of the concerns of those who live with it. Findings related to the following research questions are discussed: first, what are the challenges of living with diabetes? and second, what are people's perceptions of the nursing care they receive?
Airth-Kindree, Norah; Vandenbark, R Todd
Students in an RN-BSN completion program capstone course investigated and critically evaluated mobile medical applications using an information literacy conceptual framework. Students also analyzed their potential usefulness as a resource in nursing practice. Student evaluations focused on usability and applicability when recommending the use of mobile applications as a point-of-care reference tools. This pilot assignment offers an innovative teaching strategy for integrating 1 aspect of informatics instruction into the nursing curriculum.
Phillips, Holly; Maw, Heather; Mee, Steve; Buckley, Alison; Corless, Louise
This series has explored the value of patient narratives in enabling nurses to reflect on how their practice is perceived by, and affects, patients and their families. This article describes how two student learning disability nurses used patient and carer narratives to highlight the effect of a hospital trust's lack of toilet provision for people with physical impairments, using the stories to persuade the trust to develop appropriate facilities.
McCann, Sue A.; Chase, Allister Benjamin; Tawa, Marianne C.
ABSTRACT Mycosis fungoides is the most common form of cutaneous T-cell lymphoma. Stage IA and IB mycosis fungoides cutaneous T-cell lymphoma can be effectively controlled by skin-directed therapies such as the mechlorethamine gel approved by the Food and Drug Administration. Dermatology nurses play a key role in promoting good patient compliance through patient education about mycosis fungoides cutaneous T-cell lymphoma disease, proper administration of mechlorethamine gel, and connecting patients with patient assistance programs or other supportive services. This article provides the dermatology nurse with a background about early-stage mycosis fungoides cutaneous T-cell lymphoma, skin-directed treatment options, questions that a patient may ask about mycosis fungoides cutaneous T-cell lymphoma and mechlorethamine gel, and patient education tools such as questions dermatology nurses may ask of their patients and a patient handout outlining mechlorethamine gel administration.
Hawkins, Joellen W.
The development of nursing models can be traced to the inception of nursing as a profession. Florence Nightingale laid the foundation for current nursing practice and differentiated nursing from medicine. The late 19th and early 20th centuries contributed a number of important nurse theorists, better known for other contributions to the neophyte…
Fenton, Mary V.; Brykczynski, Karen A.
A comparison of results of two studies regarding the actual practice of clinical nurse specialists and nurse practitioners revealed a shared core of advanced practice competencies as well as distinct differences between practice roles. (JOW)
The purpose of this paper is to describe the use of a nursing theory-based strategy to create an undergraduate nursing clinical course that extended the nursing curriculum to meet the requisites for University Honors College credit. Using the middle range theory of story theory, this innovative teaching strategy had two goals: to plan nursing care with a focus on the human response to illness, and to integrate this strategy into an existing clinical course. Methods of teaching the theory and application to practice are described.A schedule is provided that outlines and describes how the experience was put into action, documented, and discussed. Use of this strategy raised the quality of the clinical experience for all students.This quality was seen in the ability to expand the curriculum, and in the student course evaluations. Students were able to understand theory, apply it to practice, and plan holistic nursing care.
A community practice framework is presented as the synthesis of research findings from the analysis of a critical ethnonursing study of women in recovery from chemical dependence. Critical Social Theory is used to examine the paradoxical experiences of women from their lifeworld and system within the community. The framework focuses on the mutual moral caring actions of the community nurse and the women in the recovery. It is supported by the concepts of transcultural nursing ethics. The utility of the framework is to promote clarity of speech and parity of community membership for women in recovery from chemical dependence and their return to the community.
Kramer, Marlene; Schmalenberg, Claudia; Maguire, Patricia; Brewer, Barbara B; Burke, Rebecca; Chmielewski, Linda; Cox, Karen; Kishner, Janice; Krugman, Mary; Meeks-Sjostrom, Diana; Waldo, Mary
This mixed-methods study uses interviews, participant observations, and the CWEQII empowerment tool to identify structures and attributes of structures that promote control over nursing practice (CNP). Nearly 3,000 staff nurses completed the Essentials of Magnetism (EOM), an instrument that measures CNP, one of the eight staff nurse-identified essential attributes of a productive work environment. Strategic sampling is used to identify 101 high CNP-scoring clinical units in 8 high-EOM scoring magnet hospitals. In addition to 446 staff nurses, managers, and physicians on these high-scoring units, chief nursing officers, chief operating officers, and representatives from other professional departments are interviewed; participant observations are made of all unit/departmental/hospital council and interdisciplinary meetings held during a 4 to 6 day site visit. Structures and components of viable shared governance structures that enabled CNP are identified through constant comparative analysis of interviews and observations, and through analysis of quantitative measures.
Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition) McCormack Brendan and McCance Tanya (Eds) Person-Centred Practice in Nursing and Health Care: Theory and Practice (Second edition) 288pp £29.99 Wiley Blackwell 9781118990568 1118990560 [Formula: see text].
This book is a good example of how nursing approaches are transferable to other healthcare disciplines. In this revision, the subject has been expanded to cover healthcare in a broader sense and in non-hospital settings.
Chung, Seon Yoon; Staggers, Nancy
Informatics competencies are a necessity for contemporary nurses. However, few researchers have investigated informatics competencies for practicing nurses. A full set of Informatics competencies, an instrument to measure these competencies, and potential influencing factors have yet to be identified for practicing nurses. The Nursing Informatics Competencies Questionnaire was designed, tested for psychometrics, and used to measure beginning and experienced levels of practice. A pilot study using 54 nurses ensured item comprehension and clarity. Internal consistency and face and content validity were established. A cross-sectional survey was then conducted on 230 nurses in Seoul, Korea, to determine construct validity, describe a complete set of informatics competencies, and explore possible influencing factors on existing informatics competencies. Principal components analysis, descriptive statistics, and multiple regression were used for data analysis. Principal components analysis gives support for the Nursing Informatics Competencies Questionnaire construct validity. Survey results indicate that involvement in a managerial position and self-directed informatics-related education may be more influential for improving informatics competencies, whereas general clinical experience and workplace settings are not. This study provides a foundation for understanding how informatics competencies might be integrated throughout nurses' work lives and how to develop appropriate strategies to support nurses in their informatics practice in clinical settings.
Van Hulle Vincent, Catherine; Wilkie, Diana J; Wang, Edward
We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses' management of children's pain. RCP is an interactive, content-focused, and Kolb's experiential learning theory-based intervention. Using a one-group, pretest-posttest design, we evaluated feasibility of RCP and pretest-posttest difference in scores for nurses' beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnaire (PBPQ, alpha=.83) before and after they completed the RCP and an Acceptability Scale afterward. Mean total PBPQ scores significantly improved from pretest to posttest as did simulated practice scores. After RCP in actual hospital practice, nurses administered significantly more ibuprofen and ketorolac and children's pain intensity significantly decreased. Findings showed strong evidence for the feasibility of RCP and study procedures and significant improvement in nurses' beliefs and pain management practices. The 2-hr RCP program is promising and warrants replication with an attention control group and a larger sample.
Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa
Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.
This article calls upon Canadian nursing leaders to examine the merits and downsides of the new practice doctorate degree - the Doctor of Nursing Practice (DNP). The impetus for the DNP arose from within the American nursing profession in order to address the knowledge and skills needed by advanced practice nurses to work in today's complex healthcare environment. The DNP is the newest practice doctorate degree and in 2015 will be the entry to practice degree required of all new advanced practice nurses in the United States. Advanced practice nurses who will have the practice doctorate include clinical nurse specialists, nurse practitioners, nurse midwives and nurse anaesthetists. With the establishment and acceptance of the DNP in the United States, American advanced practice nurses will have a different knowledge base than Canadian advanced practice nurses. The evolution and state of advanced practice nursing in Canada are discussed in this article. Canadian nursing leaders must discuss the DNP, its merits and downsides within the Canadian context and begin to make informed decisions about whether or not the DNP should come to Canada.
Delack, Sandi; Martin, Jean; McCarthy, Ann Marie; Sperhac, Arlene M
Nurse residency programs for newly licensed RNs are a critical component in bridging the clinical practice gap between education and practice. In May 2013, the Institute of Pediatric Nursing invited leaders from pediatric nursing organizations and children's hospitals to attend a forum on nurse residency programs for pediatric nurses. This article presents a summary of the discussions that occurred during the forum and makes recommendations for addressing issues related to nurse residency programs.
District nurse (DN) care delivery has undergone substantial change in recent years due to changing demographics and service delivery demands that have called for a move of care delivery from secondary to primary care. The title District Nurse is recorded with the Nursing and Midwifery Council (NMC) on completion of the Specialist Practice Qualification in District Nursing (SPQ DN), which purports to be a 'transformational' course that prepares future caseload holders to manage their team and prioritise care delivery effectively. This article explores the need for assertiveness skills in this role in response to Australian research, and outlines the pedagogic interventions implemented during the SPQ DN course to enhance this skill. Assertiveness scores were monitored for the duration of the course and demonstrated a significant increase-a topic that is now the subject of a future, funded study.
Doody, Owen; Doody, Catriona M
Traditionally, nurses have been over-managed and led inadequately, yet today they face unprecedented challenges and opportunities. Organisations constantly face changes that require an increasingly adaptive and flexible leadership. This type of adaptive leadership is referred to as 'transformational'; under it, environments of shared responsibilities that influence new ways of knowing are created. Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas. This leads to followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is shared. This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration.
Guenther, Robin; Hall, Anna Gilmore
Mounting evidence indicates that buildings can be a significant cause of human illness and environmental degradation. According to the United States (US) Environmental Protection Agency, indoor air pollution is one of the top five environmental risks to public health in the US. This may be related, to a large extent, to the fact that US citizens spend as much as 95% of their time indoors. Health care leaders, designers, and architects, recognizing the connection between health and the buildings in which much time is spent, are engaging in sustainable design and construction for healthy, 'green' buildings. The purpose of this article is to assist nurses in understanding the impact that unhealthy buildings can have on nurses and nursing practice and to provide tools and resources to assist nurses in transforming the health care industry with the goal of creating healing environments and reducing the negative environmental impact of the health care industry. First definitions, current initiatives, and motivations related to sustainable designs will be presented. Next sustainable health care design strategies, such as site planning, clean transportation, water conservation, healthy materials selection, indoor environmental quality, and also the benefits of sustainable design will be discussed. The article will conclude by sharing a variety of resources nurses can use to create healing environments in health care settings.
Sakalys, Jurate A
Using fictional and autobiographical literature in nursing education is a primary way of understanding patients' lived experiences and fostering development of essential relational and reflective thinking skills. Application of literary theory to this pedagogic practice can expand conceptualization of teaching goals, inform specific teaching strategies, and potentially contribute to socially consequential educational outcomes. This article describes a theoretical schema that focuses on pedagogical goals in terms of the three related skills (i.e., reading, interpretation, criticism) of textual competence.
Taplay, Karyn; Jack, Susan M; Baxter, Pamela; Eva, Kevin; Martin, Lynn
Background. Implementing simulation requires a substantial commitment of human and financial resources. Despite this, little is known about the strategies used by academic nursing leaders to facilitate the implementation of a simulation program in nursing curricula. Methods. A constructivist grounded theory study was conducted within 13 nursing programs in Ontario, Canada. Perspectives of key stakeholders (n = 27) including nursing administrators (n = 6), simulation leaders (n = 9), and nursing faculty (n = 12) were analyzed using the constant comparison method. Results. Nursing leaders, specifically nursing administrators and simulation leaders who successfully led the adoption and incorporation of simulation into nursing curricula, worked together and utilized negotiating, navigating, and networking strategies that impacted the adoption and incorporation of simulation into nursing curricula. Conclusions. Strategies that were found to be useful when planning and executing the adoption and incorporation of an innovation, specifically simulation, into nursing curricula provide practical approaches that may be helpful to nurse leaders when embarking upon an organizational change.
Hudacek, Sharon Smith; DiMattio, Mary Jane K; Turkel, Marian C
HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "From Academic-Practice Partnership to Professional Nursing Practice Model," found on pages 104-112, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 28, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the benefits and barriers to participation in a community-based academic-practice partnership. Identify three
Kalischuk, Ruth Grant; Thorpe, Karran
Creative thinking is a critical link in the teaching-learning process, one that enhances problem solving in nursing practice. This article describes a conceptualization of creativity based on focus groups with 12 post-RN students and two nurse educators. Inherent within the major theme, striving for balance, were three subthemes-enhancing self-esteem, working within structure, and making time for reflection (i.e., process). When participants achieved balance, both personally and professionally, they experienced increased creative energy that resulted in creative expression, subsequently displayed in educational endeavors and clinical practice (i.e., product). Strategies for fostering creativity and criteria for evaluating creativity are offered, and implications for nurse educators, managers, and practitioners are examined.
This paper explores Jacques Derrida's strategy of deconstruction as a way of understanding and critiquing nursing theory and practice. Deconstruction has its origins in philosophy, but I argue that it is useful and relevant as a way of challenging the dominant paradigm of any discipline, including nursing. Because deconstruction is notoriously difficult to define, I offer a number of examples of deconstruction in action. In particular, I focus on three critiques of reflective practice by the meta-narrative of evidence-based practice (EBP) and attempt to show how those critiques can be directed back at EBP itself. I conclude with the observation that EBP is open to many of the criticisms that it directs at other discourses, including problems of a lack of empirical evidence, of distortions due to memory, and of falsification of the 'facts'.
Sportsman, Susan; Hawley, Linda J.; Pollock, Susan; Varnell, Gayle
An expert panel identified 20 business concepts important for a family nurse practitioner curriculum. A focus group of practitioners verified the concepts and clarified relevant information to be taught. The business concepts center on management and operations of a clinical practice. (SK)
Ohio State Univ., Columbus. Vocational Instructional Materials Lab.
Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for practical nursing. The list contains units (with and without subunits), competencies, and competency builders that…
Sportsman, S; Hawley, L J; Pollock, S; Varnell, G
The faculties of three schools of nursing involved in a collaborative family nurse practitioner (FNP) program designed a study to address issues involved in preparing the nurse practitioner for the challenges of practice management in the clinical environment. The purposes of the study were to (1) identify business concepts necessary to successfully manage a primary care practice; (2) determine which of these concepts should be incorporated into an FNP curriculum; and (3) clarify information to be taught regarding each identified concept. Fifty-four business concepts related to primary care were identified from a literature review. A survey was then developed to assess the extent to which the identified concepts were necessary for an FNP to effectively manage a practice. Seven experts and five FNP faculty responded to the survey. The Content Validity Index (CVI) defined by Lynn (1986) was applied and 20 concepts necessary for an FNP to effectively manage a practice were identified. A focus group that included nurse practitioners (both faculty and nonfaculty) from the three collaborative sites connected by interactive telecommunications determined that all 20 of the identified concepts should be included in an FNP curriculum. Additionally, the focus group clarified relevant information to be taught regarding each identified concept.
Holmes, Dave; Federman, Cary
This article presents the results of a nursing research that aimed at describing the practice of nursing in an extreme environment where social control and psychiatric nursing care are inextricably enmeshed with one another. The study results indicate that the Correctional Psychiatric Centre (CPC) is a site where two antagonistic discourses (that of the hospital and that of the prison) are contending for the human resources in place. Given that the asylum and the prison are as such two distinct institutions, the correctional psychiatric centre constitutes an ideological space that results from the fusion of both the psychiatric and penal apparatuses. However, characteristics commonly attributed to prisoners, such as 'lying', 'dangerous', 'monstrous' and 'manipulative' are superimposed on the nurses' common theoretical representation that a patient is a person to whom care is provided. Monstrosity was a term regularly employed to describe particular types of inmates. The literature on monsters in quite informative in order to understand the impact of such a representation of forensic psychiatric nursing practice.
Malina, Debra P; Izlar, Janice J
Of the recognized advanced practice registered nursing (APRN) specialties, Certified Registered Nurse Anesthetists (CRNAs) have historically experienced the most vigorous and organized resistance from outside entities regarding rights to practice to the full scope of their education and experience. Opposition to nurse anesthetists practicing to the full scope of their education and training is present in the clinical arena and educational milieu.
Ervin, Naomi E
The volume of evidence for nursing practice has increased as a result of research and scientific discoveries. Yet we are still struggling with the dilemma of how to get evidence into nursing practice. Estimates are that it takes 20 years before innovations are fully put into use. Research is one type of knowledge to be used in practice. Nursing and patient care would benefit from moving more toward knowledge based on research and evidence. This article reviews barriers to and facilitators of using evidence in nursing practice and discusses a model for promoting the systematic use of evidence in practice. The author also offers suggestions for increasing the evidence base of nursing practice. Using evidence in nursing practice is important for all nurses, but requires more that the attention of the individual nurse.
Holtrop, Jodi Summers; Baumann, Jeanne; Arnold, Anita K; Torres, Trissa
This study used nurses as practice change consultants to help primary care medical practices improve their delivery of health behavior services to patients. Nurse consultants worked with 20 practices from 2 healthcare systems. In each practice, the nurses helped clinicians and staff to develop a practice-specific protocol so that they could identify and intervene with the health behavior of their patients. As a result of the nurse consultant intervention, health behavior delivery was improved. This article describes the specific methods and the lessons learned through this study. We encourage practices to use nurse consultants as one way of improving quality of care.
Gyurko, Charlene C
In 2009, the National League for Nursing reported that there are over 3.4 million persons in the United States employed in nursing in the roles of Registered Nurses (RNs) and Advanced Practice Nurses (APRNs). In 2007, the Bureau of Labor Statistics also reported that in 2006, there were over 749,000 Licensed Practical Nurses (LPNs) working in the United States with a projected increase of 14% by 2016. Buerhaus et al, in 2009, stated that between 2016 and 2025, it is estimated that the U.S. will need over 260,000 registered nurses (RNs) Using the conceptual framework of Vroom's expectancy theory on motivation as well as theories addressing student and career development, this paper demonstrates a synthesis of Vroom's model with other educational theories and its application to nursing education, specifically the prediction of motivation to advance one's nursing education. By putting Vroom's theory into a context, Vroom's fairly simple model could help nurse educators predict the factors that make for success in midcareer educational advancement--and even possibly manipulate those factors to increase that success. In today's economy, that practical part seems too good to lose.
This article charts the development of a project, funded by the Queen's Nursing Institute and Queen's Nursing Institute Scotland, to develop voluntary standards that reflect the contemporary and future practice of district nurses. The standards are designed to enhance, but not replace, the Nursing and Midwifery Council standards for district nurse specialist practice. The project encompassed the four UK countries and gathered data from a wide range of sources to inform the new standards that were launched in September 2015.
While it is claimed in the nursing literature that reflective thinking is the approach par excellence for learning and advancing the art and practice of nursing, few empirical studies have been undertaken in this area to date. Sense-Making, a qualitative research method, was utilized to obtain and analyse data from interviews with 10 registered nurses in order to study reflective thinking in actual nursing practice. Ten non-routine nursing situations were analysed for the presence of reflective thinking. Time-line interviews of the events resulted in a total of 59 micro-moments, each of which was explored in terms of the thinking processes utilized to make sense of the situation as well as the focus of their thought. 'Pre-perceptions' played an important part in how the respondents perceived their situation. Reflective thinking was extensively manifest, especially in moments of doubt and perplexity, and consisted of such cognitive activities as comparing and contrasting phenomena, recognizing patterns, categorizing perceptions, framing, and self-questioning in order to create meaning and understanding. Self-questioning was identified as a significant process within reflective thinking. By exploring and analysing the type of questions respondents were asking themselves, the study uncovered three hierarchical levels of reflective thinking. Respondents most often engaged in reflective thinking-for-action which centred on the here and now in order to act. Reflective thinking-for-evaluation focused on creating wholeness and contributed to the realization of multiple perceptions and multiple responses. Reflective thinking-for-critical-inquiry could not be demonstrated in the study sample. The findings of this study resulted in the development of a model of reflective thinking, which is discussed in terms of the implications for learning in nursing practice.
This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale - a 'Good Samaritan' story - which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and moral agency. I then consider this relationship from the perspectives of two twentieth century philosophers: Emmanuel Levinas and Michel Foucault. Levinas' basic point is that the experience of ethical subjectivity is made possible through others: the demand to respond to the existence of others is the basic social structure that precedes individual freedom. If Levinas posits intersubjectivity as a fundamental or primitive feature of the moral realm, Foucault poses an even more basic question: how have moral subjects and relations of obligation been constituted? The aim of ethical inquiry, for Foucault, is to describe the network of discourses, institutions, relations, and practices through which certain kinds of subjects are constituted and constitute themselves, e.g. as a kind of person who can act morally. Finally, I consider some recent research in philosophy of nursing which illustrates how Levinasian and/or Foucauldian perspectives can deepen understanding of nurses' moral practices, specifically, the work of Norwegian public health nurses, Canadian pediatric nurses, and Irish midwives. I suggest that in spite of the instability of morality in general and the particular ethical challenges that face nurses, there are grounds for hope and possible strategies for living in unstable times.
Rondeau, K V; Wagar, T H
Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain
Kolcaba, Katharine; Tilton, Colette; Drouin, Carol
The application of theory to practice is multifaceted. It requires a nursing theory that is compatible with an institution's values and mission and that is easily understood and simple enough to guide practice. Comfort Theory was chosen because of its universality. The authors describe how Kolcaba's Comfort Theory was used by a not-for-profit New England hospital to provide a coherent and consistent pattern for enhancing care and promoting professional practice, as well as to serve as a unifying framework for applying for Magnet Recognition Status.
Marks, Rachel; Hodgen, Jeremy; Coben, Diana; Bretscher, Nicola
This paper examines nursing students' experiences of the teaching and assessment of numeracy for nursing. Data from interviews with eight student nurses at a large school of nursing in the United Kingdom are analysed using a constructivist grounded theory approach to explore their perceptions of any disjunctures between the ways in which numeracy…
Martin, Kathleen D; Molitor-Kirsch, Shirley; Elgart, Heidi; Ruffolo, Daria C; Sicoutris, Corinna; Meredith, Denise
The need for advanced practice nurses (APN) has expanded over the past several decades as a result of the changing healthcare environment. Increased patient acuity and decreased resident work hours have lead to a need for additional clinical expertise at the bedside. APNs are becoming an integral part of the acute care delivery team in many trauma programs and intensive care units. To date little has been published regarding the role of the APN in Trauma Centers. This article outlines the wide variety of responsibilities and services provided by a select group of nurse practitioners who work in trauma centers throughout the United States.
MacDonald, Kathleen; Paterson, Kirstie; Wallar, Jessica
Clinical practice placements are an essential component of pre-registration nursing programmes. Integration into a new team in an unfamiliar setting, which has its own values, practices, culture and language, can be stressful for nursing students. This article presents and discusses students' reflections on preparing for, entering and leaving practice placements. Ten students who participated in fortnightly group reflective sessions, discussed and analysed their learning experiences while on practice placements in an acute hospital. The challenges the students encountered were deconstructed using a group narrative approach. The students experienced ethical dilemmas around patient dignity, consent and advocacy as well as factors external to the practice setting, such as navigating systems and processes to access information before starting practice placements, managing household duties and academic workloads while working long shifts, and managing fatigue and loneliness. The students devised recommendations for other students to enable them to navigate their practice placements effectively and enhance their learning experience. Raising awareness among academic and practice placement staff of the challenges students encounter before and during their practice placement is essential to assist students to succeed and maximise their learning potential.
Wood, Pamela J
Storytelling and narrative are widely used in nurse education and the value of narrative-based curricula, such as those governed by narrative pedagogy, is well recognised. Storytelling stimulates students' imagination, a central feature of narrative learning. One form of story and imagination yet to be fully considered by educators is the historical story and historical imagination. The use of historical storytelling creates a temporal dissonance between the story and reader that stimulates readers' imagination and response, and enables them to gain rich insights which can be applied to the present. Reader-response theory can support educators when using narrative and storytelling. This article presents an analysis of graduate nursing students' reader-responses to a nurse's story from the past. This narrative learning group used their historical imagination in responding to the story and prompted and challenged each other in their interpretation and in translating their responses to their current nursing practice. The article discusses this analysis within the context of reader-response theory and its potential application to narrative-based learning in nurse education. Historical stories stimulate historical imagination and offer a different frame of reference for students' development of textual competence and for applying insights to the present.
Maeve, M K; Vaughn, M S
The number of incarcerated persons in the United States has been increasing dramatically over the last two decades. Incarcerated men and women have increased rates of serious and chronic physical and mental illnesses and therefore require substantial health care efforts. Caring for prisoners is a difficult and often unrewarding experience for health care providers, particularly within a social climate that encourages noncaring behaviors. This article critically analyzes three philosophic stances toward nursing care with prisoners and suggests their philosophic commensurability within traditional nursing practice. Implications for nursing practice, research, and education are discussed.
dos Santos, José Luís Guedes; Erdmann, Alacoque Lorenzini
Objective: to elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. Method: a mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index - Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Results: based on the results obtained with the Brazilian Nursing Work Index - Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. Conclusion: it is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses. PMID:26625992
Houston, S; Luquire, R
Outcomes management as a patient management system has been designed to impact and improve select outcomes. Central to the development and implementation of best practice senario identified throughout outcomes management is the advanced practice nurse. SLEH has been in the forefront of development and implementation of an outcomes management program. This article describes the outcomes management position and shares the job description and performance evaluation used at this institution. The tools allow for measuring and quantifying the impact of the outcomes manager position on improving patient outcomes. The improvement of outcomes has increased the value of the advanced practice nurse and provided the institution with a solid future necessary for survival in a managed care market.
This paper discusses a definition of the content of the computerized nursing data base developed by the Nursing Department for the Clinical Center Medical Information System at the National Institutes of Health in Bethesda, Maryland. The author describes the theoretical framework for the content and presents a model to describe the organization of the nursing data components in relation to the process of nursing care delivery. Nursing documentation requirements of Nurse Practice Acts, American Nurses Association Standards of Practice and the Joint Commission on Accreditation of Hospitals are also addressed as they relate to this data base. The advantages and disadvantages of such an approach to computerized documentation are discussed.
Almonte, Angelica L C
In response to the 2004 tsunami disaster in the Indian Ocean, the U.S. Navy deployed teams aboard the USNS Mercy to provide aid during Operation Unified Assistance (OUA). To date, few research studies have examined how Navy nurses prepared for and clinically performed during this relief operation. The current article describes the challenges faced by Navy nurses throughout OUA. A purposive convenience sample was recruited; 11 participated. Data were collected from interviews, observations, field notes, memos, and a demographic tool. Information was categorized, coded, compared to incoming data, then analyzed using Strauss and Corbin's open coding, axial coding, and selective coding methods. A theoretical model was developed to illustrate how participants experienced the mission. Key lessons learned were that most were unprepared for providing pediatric care, and saying "No" in delivering care. Recommendations include: deployment of advanced-practice nurses (specialists in pediatrics and well-mental health) and predeployment training on moral distress.
Spetz, Joanne; Dyer, Wendy T; Chapman, Susan; Seago, Jean Ann
Despite evidence that hospital use of licensed practical nurses (LPNs) declined in the 1990s, the current registered nurse (RN) shortage has prompted interest in LPNs as substitutes for RNs. Hospitals, being the dominant employer of RNs, have an economic incentive to use less expensive LPNs as substitutes. Beside wages, there are several forces underlying hospital demand for LPNs. In this article, the authors model and estimate hospital demand for LPNs as a function of nurse wages and hospital, market, and patient characteristics using a longitudinal data set of short-term general hospitals in the United States. The authors find evidence that higher RN wages increase hospital demand for LPNs, both in levels and relative to RNs, suggesting that hospitals at least partially substitute RNs with LPNs.
This is the first of two articles exploring the concept of concordance in practice. This first paper draws on psychology, research in clinical practice and social participation theory to argue for a concordant approach to nursing care. Where most writers have confined discussions on concordance to medicines management, the author seeks to widen the debate to explore the value of the principle across the whole spectrum of nursing practice. Studies describing patient involvement are mapped against Arnstein's model of citizen participation to determine true levels of patient-practitioner working. The outcomes of care delivered in a paternalistic way are compared with those arising from patient-practitioner partnership working across a range of healthcare settings. The values underpinning concordance and the relationships and skills necessary to achieve and sustain it are considered. A recommendation for practice is that concordance needs to be taught as a central part of the healthcare process rather than merely an ethical principle in healthcare education. The power of the nurse-patient relationship on which concordance is built needs to be recognised and valued. The principle of concordance will be more feasible in practice when accompanied by other initiatives that promote public participation in education review commissioning and standard setting.
Eickhoff, Mary Ann
There is currently a nursing shortage in the United States. By 2022, the Bureau of Labor Statistics (BLS) expects, the number of job openings for Practical Nurses (PN) will be 168,500, an increase of 25% over 2012 (BLS, 2014). Nursing education does not currently meet present, much less future needs. Nursing programs have limited space; according…
Reid, Jamee Noell
This document is a comprehensive guide for instructors to use in teaching the final phase of the practical nursing program. This revised volume contains information related to medical-surgical nursing, mental health nursing, and career success. The section on medical-surgical nursing is composed of many units, dealing with the following subjects:…
Manley, Kim; Hills, Val; Marriot, Sheila
This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle D, the provision of person-centred care.
Casazza, Martha E.
Uses case studies of students to outline the theories related to cognitive development and different ways of understanding what knowledge is. Organizes four sets of concepts: (1) the construct of intelligence; (2) different ways of knowing; (3) the nature of constructivism; and (4) the active, strategic process of learning. Contains 19 references.…
Ip, Barry; Cavanna, Annlouise; Corbett, Beverley
This paper examines the recent development of a computer-assisted learning program--in Practice--at the School of Health Science, in the University of Wales Swansea. The project, which began in 2001, was developed in close collaboration with The Meningitis Trust, the aim being to produce a software package to increase nursing students' knowledge…
Swider, Susan M; Krothe, Joyce; Reyes, David; Cravetz, Michelle
This article describes the most recent efforts by the Quad Council of Public Health Nursing organizations to review and revise the competencies for PHN practice, and highlights the implications of these competencies for practice, education, and research. The Quad Council is a coalition of four nursing organizations with a focus on public health nursing and includes the Association of Community Health Nursing Educators; the Association of Public Health Nursing (known prior to July 1, 2012 as the Association of State and Territorial Directors of Nursing); the Public Health Nursing section of the American Public Health Association; and the Council on Economics and Practice of the American Nurses' Association. The Quad Council competencies are based on the Council on Linkages competencies for public health professionals and were designed to ensure that public health nursing fits in the domain of public health science and practice.
cognitive theory of moral development as set forth by Kohlberg. Crisham explained building on the works of Piaget in the early 30’s, Kohlberg (1976...late 1980s, nursing research has addressed caring as a central theme to nursing. In 1989, Jean Watson’s philosophy and theory of human caring in nursing
Rural hospitals will be affected by changes in nursing anticipated in the future. Welcome changes will be the maturity and life experiences new graduates will bring to the work setting, knowledge of computers, and a broadening database. New graduates will also know various methods of care delivery, including case management, and will be able to select the delivery system that best meets the needs of the patients and institution. They will be more autonomous and possess leadership and management skills. With their knowledge of community as well as institutional nursing, they will be able to draw upon the skills of both groups to bring the two areas of nursing into continuity of care for patients. A difficulty ahead for rural hospitals is recruitment of new graduates, the majority of whom will have established families and lives elsewhere. And the practice of developing their own employees for higher levels of nursing will be compounded by the doubling of time necessary to complete nursing programs in the future.
information, humans have developed cognitive processes to quickly filter decision-making requests according to probable importance. If determined routine...aspects of group social dynamics. To cope with the daily flood of life’s information, humans have developed cognitive processes to quickly filter...1965). Also refer to theories of Cognitive Psychology, specifically the idea of the individual as an information processing system. Ellul and
Kennedy, Holly Powell
Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians’ individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient’s best interest can be viewed as their “agency for safety.” However, collective agency for safety and commitment to support nurses in their advocacy role is missing in many perinatal care settings. This paper draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse’s role in maintaining safety during labor and birth in acute care settings, and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care. PMID:20147827
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.
Feely, M; Long, A
This paper presents a theory of connectivity, which was formulated from the findings of a Classical Grounded Theory study that was designed to capture a sample of people's perceptions of living with depression or caring for individuals with depression. Data were collected from: (1) a focus group consisting of people with depression (n = 7), of which five were patients in the community and two were nurses; (2) one-to-one interviews with patients in the community (n = 5) and nurses (n = 5), three of whom had experienced depression from both sides of the caring process; and (3) two 'happy accident' focus groups (n = 25; n = 18) comprising of healthcare workers with a shared understanding of depression. Purposeful sampling was used initially. Thereafter, in keeping with one of the key tenets of grounded theory, theoretical sampling was used until theoretical saturation occurred. Data were analysed using the constant comparative approach together with the NVivo qualitative analysis software package. The core category that emerged was 'connectivity' relating to the connections and disconnections, which people make in their lives. Six key categories emerged all of which were integrated with the core category. Hence, connectivity provided a significant platform for understanding and responding to the life experience of depression. They were: (1) life encounters on the journey to naming; (2) depression: What's in a name? The silent thief; (3) tentative steps to health care; (4) connective encounters and challenges; (5) connecting with self; and (6) self-connection maintenance. Subsequently, a theory, 'Depression: a psychiatric nursing theory of connectivity', surfaced from the overall findings. We argue that this theory of connectivity provides a framework that people working in the field of holistic treatment and care could use to better understand and respond to the life experience of people living with depression.
Nicely, Bruce; DeLario, Ginger T
Registered nurses were some of the first nonphysician organ transplant and donation specialists in the field, both in procurement and clinical arenas. Nursing theories are abundant in the literature and in nursing curricula, but none have been applied to the donation process. Noted nursing theorist Virginia Henderson (1897-1996), often referred to as the "first lady of nursing," developed a nursing model based on activities of living. Henderson had the pioneering view that nursing stands separately from medicine and that nursing consists of more than simply following physicians' orders. Henderson's Principles and Practice of Nursing is a grand theory that can be applied to many types of nursing. In this article, Henderson's theory is applied to the intensely focused and specialized area of organ donation for transplantation. Although organ donation coordinators may have backgrounds as physicians' assistants, paramedics, or other allied health professions, most are registered nurses. By virtue of the inherent necessity for involvement of the family and friends of the potential donor, Henderson's concepts are applied to the care and management of the organ donor, to the donor's family and friends, and in some instances, to the caregivers themselves.
Schultz, E D
Academic advising is an important faculty role; it not only assists students in selecting appropriate courses, but it also helps them make choices about personal and career goals. Using a theoretical framework to guide the advising process can make advising sessions more efficient and effective. One nursing theory, modeling and role-modeling, is presented here as a framework for student advising. Modeling and role-modeling theory can guide the advisor to establish a caring interpersonal relationship with the student and plan individualized strategies to meet educational goals.
Carr, Ruby C.
The purpose of the study was to review the entire practical nursing program and to make recommendations for its long-term organization and objectives. Relevant information concerned (1) the history of practical nursing, (2) purpose, membership, and related information on four professional nursing organizations, (3) state and federal legislation…
This article offers a synthesis of the significant developments and progress of family nursing in Sweden. A review was conducted to locate Swedish family nursing research produced over the past 10 years. CINAHL, Medline, and PubMed were the primary databases used to locate approximately 75 family nursing studies conducted in Sweden. The majority of the studies used descriptive methods with data collected from surveys and interviews involving nurses and family members either together or individually. Only a few of the studies examined family nursing interventions. This article also reports the results of a recent survey of Swedish nurses that examined how family nursing is used in practice. After 10 years of creating a strong foundation for family-focused nursing in Sweden, there is still a need for nurse researchers, educators, and administrators to collaborate in the implementation of family nursing to practice.
The main provisions of the European Convention on Human Rights were incorporated into UK law in the Human Rights Act 1998. Human Rights were described by Lord Hoffman in 'Matthews v Ministry of Defence'  as the rights essential to the life and dignity of the individual in a democratic society. The fundamental nature of the rights demand that district nurses must inform their practice with a clear understanding of the main provisions of the Act and how they apply to health care.
The recruitment and retention of nurses continues to be an issue which the nursing profession must address. This paper will argue that the resolution of this problem lies in greater collaboration between the higher education and health care sectors. Collaborative strategies should focus on two major aspects. First of all, strategies to bridge the theory-practice gap are important for the retention of new graduates. Secondly, support for first-line nurse managers is needed since these managers are significant in the assimilation of new graduates into the workforce.
Meyer, Raquel M; O’Brien-Pallas, Linda L
meyer r.m. & o’brien-pallas l.l. (2010)Nursing services delivery theory: an open system approach. Journal of Advanced Nursing66(12), 2828–2838. Aim This paper is a discussion of the derivation of the Nursing Services Delivery Theory from the application of open system theory to large-scale organizations. Background The underlying mechanisms by which staffing indicators influence outcomes remain under-theorized and unmeasured, resulting in a ‘black box’ that masks the nature and organization of nursing work. Theory linking nursing work, staffing, work environments, and outcomes in different settings is urgently needed to inform management decisions about the allocation of nurse staffing resources in organizations. Data sources A search of CINAHL and Business Source Premier for the years 1980–2008 was conducted using the following terms: theory, models, organization, organizational structure, management, administration, nursing units, and nursing. Seminal works were included. Discussion The healthcare organization is conceptualized as an open system characterized by energy transformation, a dynamic steady state, negative entropy, event cycles, negative feedback, differentiation, integration and coordination, and equifinality. The Nursing Services Delivery Theory proposes that input, throughput, and output factors interact dynamically to influence the global work demands placed on nursing work groups at the point of care in production subsystems. Implications for nursing The Nursing Services Delivery Theory can be applied to varied settings, cultures, and countries and supports the study of multi-level phenomena and cross-level effects. Conclusion The Nursing Services Delivery Theory gives a relational structure for reconciling disparate streams of research related to nursing work, staffing, and work environments. The theory can guide future research and the management of nursing services in large-scale healthcare organizations. PMID:20831573
Butcher, Diane L; MacKinnon, Karen A
Changes to practical nurse education (with expanded scopes of practice) align with the increasing need for nurses and assistive personnel in global acute care contexts. A case in point is this critical exploration of Canadian practical nursing literature, undertaken to reveal predominating discourses and relationships to nursing disciplinary knowledge. The objectives of this poststructural critical review were to identify dominant discourses in practical nurse education literature and to analyze these discourses to uncover underlying beliefs, constructed truths, assumptions, ambiguities and sources of knowledge within the discursive landscape. Predominant themes in the discourses surrounding practical nurse education included conversations about the nurse shortage, expanded roles, collaboration, evidence-based practice, role confusion, cost/efficiency, the history of practical nurse education and employer interests. The complex relationships between practical nursing and the disciplinary landscape of nursing are revealed in the analysis of discourses related to the purpose(s) of practical nurse education, curricula/educational programming, relationships between RN and PN education and the role of nursing knowledge. Power dynamics related to employer needs and interests, as well as educational silos and the nature of women's work, are also revealed within the intersection of various discourses.
McCormick, S A
Congestive heart failure (CHF) is an enormous burden on society and the health care system. The role of the advanced practice nurse (APN) in CHF is multifaceted and combines inpatient, outpatient, and community patient care skills. Case management and quality management have been traditional focuses, with a high level of practice impact on patient care. Outcomes management in the APN role for CHF care is the future for measurable outcomes and maximum impact on organizational values. Because outcomes management is an evolving field for the APN, focus on a chronic disease such as CHF is a very valuable tool for implementation.
Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.
Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led…
Evans, Alicia M; Glass, Nel; Traynor, Michael
It is well established, following Menzies' work, that nursing practice produces considerable anxiety. Like Menzies, we bring a psychoanalytic perspective to a theorization of anxiety in nursing and do so in order to consider nursing practice in the light of psychoanalytic theory, although from a Lacanian perspective. We also draw on Bataille's notion of 'surplus'. These concepts provide the theoretical framework for a study investigating how some clinical nurses are able to remain in clinical practice rather than leave the profession or seek work at a distance from the bedside. We conducted focus groups and present here an analysis of two fragments of nurses' speech. We found the nurses responded from one of two positions. In the first position, the nurses focus on doctors, complain about the surplus afforded them, and call for it to be eliminated. In this way, the nursing group is similar to other groups, considered by Bataille, who also attempt to get rid of a surplus. However, in the second position, the nurses stay with the surplus, tolerating it as they nurse the patient. This latter position is one where the nurse practises with a focus on the patient rather than being distracted by their dispute over the doctor's privilege. The importance of this paper is in its illustration of two distinct positions from which the nurse can practise: one that is not optimal because the nurse is distracted and the other that is more focused on practice, and thus the nurse is in a position to provide the best care possible to patients.
Castanha, Maria de Loudes; Zagonel, Ivete Palmira Sanson
This study aims to comprehend the healthcare team perception about the (in)visibility of care practice of being a nurse in pediatric critical care units, according to Paterson and Zderad Humanist Theory. This is a qualitative research that combines the phenomenological approach. For data collection, it was used semi-structured interviews with nurses, physicians, psichologists, physiotherapists, nurse aides and hygienization employes working in pediatric critical care units of a hospital in Curitiba. The analysis followed the steps proposed by Giorgi and presented six categories, being three related to nurses' perception and three related to the multiprofessional team. Based on these statements it was possible to outline a conceptual model of nurses' perception about invisibility in their care practice, and also showed ways to obtain nurses' visibility.
Choi, Kristen R
Complex psychological trauma is a phenomenon resulting from severe interpersonal trauma that can negatively affect how individuals experience health care. However, few theories conceptualizing complex trauma exist, and it has received only limited attention in the nursing literature. The purpose of this theory synthesis was to organize two theories of (a) self-regulation and (b) self-dysregulation following complex psychological trauma into a single conceptual framework for use in nursing practice. This article used the theory synthesis approach described by Walker and Avant. The theory has potential to advance nursing science by helping nurses and other health professionals understand how trauma can alter self-regulatory processes and result in unique challenges in care delivery. It also has potential to prevent retraumatization of trauma survivors at the hands of health care providers.
McIntyre, Michael L.; Murphy, Steven A.
As academics who interact with senior and mid-level business managers on a regular basis, both informally and as consultants, the authors often note that ideas of theory and practice are not well developed among people outside of academia. It is posited that this deficit offers the prospect of less than optimal approaches to matters such as…
The work of mental health nurse is interactive in nature, the priority of which is the effective development and maintenance of a therapeutic relationship with clients. This field of nursing bases its practice on theories from many schools of thought in order to provide clients with the highest quality of care. One such theory is that of Carl Rogers whose practice as a psychotherapist was based on his Theory of Self-Concept. This paper examines the development of the Theory of Self-Concept from the works of Cooley, Mead, Allport and Rogers and relates to the therapeutic alliance between a primary nurse and a client who has been medically diagnosed as being 'depressed'. The implications for practice are considered and some of the difficulties of utilizing Rogers' theory on an in-patient unit are explored. The paper emphasizes the need for nurses to be aware of the use of such theories in order to enrich the care that clients receive. It also highlights the need for nurses to be aware of their own 'self' when working with clients, a state that can only be achieved if the nurses themselves have adequate clinical supervision and an environment which is supportive of such work.
Tanga, Hazel Y
Nurses who divert drugs pose significant threats to patient safety, but also become a liability to healthcare organizations and the nursing department where the diversion occurred. Healthcare and nursing leaders have a responsibility to ensure that security systems are in place to prevent diversion and protect patients if nursing impairment is suspected as a result of drug diversion. Nursing leaders must consider legal, regulatory, ethical, humanistic, and practical considerations in resolving this issue.
Elsom, Stephen; Happell, Brenda; Manias, Elizabeth
Significant changes to the delivery of mental health services have resulted in the expansion of the community mental health nursing role. This qualitative study was undertaken to explore the extent to which community mental health nurses are currently engaged in expanded forms of practice. Focus groups were undertaken with community mental health nurses (n = 27) from metropolitan and rural Victoria, Australia. Thematic analysis identified the following major themes: reported practice, consumers as beneficiaries of expanded practice, risk of harm and litigation, and barriers to expanded practice. The findings emphasize the need for significant changes in current legislation if expanded practice for nurses is to become a reality.
Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung
Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. PMID:27508923
Ávalos-Carranza, María Teresa; Amador-Olvera, Eric; Zerón-Gutiérrez, Lydia
It is often said that it is easier to learn what is observed and practiced on a daily basis; to the need to effectively link theory with practice considered in the process of teaching and learning, many strategies have been developed to allow this process to be carried out in a more efficiently maner. It is, therefore, very important to recognize that an appropriate teacher/student relationship is essential for students to acquire the skills and abilities required.
This article examines field studies of nursing work published in the English language between 1993 and 2003 as the first step towards an empirically based reformulation of the nursing mandate. A decade of ethnographic research reveals that, contrary to contemporary theories which promote an image of nursing work centred on individualised unmediated caring relationships, in real-life practice the core nursing contribution is that of the healthcare mediator. Eight bundles of activity that comprise this intermediary role are described utilising evidence from the literature. The mismatch between nursing's culture and ideals and the structure and constraints of the work setting is a chronic source of practitioner dissatisfaction. It is argued that the profession has little to gain by pursuing an agenda of holistic patient care centred on emotional intimacy and that an alternative occupational mandate focused on the healthcare mediator function might make for more humane health services and a more viable professional future.
Beitz, J M
Clinical nursing education represents one of the most challenging aspects of the faculty role because nursing educators are being required to teach crucial aspects of comprehensive clinical practice to students in limited time periods and in increasingly demanding, high-acuity affiliation sites. State-of-the-art research in metacognition provides a stimulating array of instructional strategies that can assist in this process and provide an impetus for further cognitive inquiry in nursing. The article analyzes metacognition, explores its historical roots, delineates its relationship to memory theory, and describes a range of metacognitive strategies that are useful to faculty and students in nursing.
Yorks, L; Sharoff, L
The transformation from traditional nursing practice to holistic nursing is one that requires recognition of multiple ways of knowing. Transformative learning theory reflects a strong bias toward cognitive epistemology and propositional knowing. This epistemology, labeled here as truncated, rests on an understanding of experience derived from pragmatism. This article describes an extended epistemology derived from the work of John Heron that better reflects the full range of knowing utilized by holistic nurses. This epistemology provides a foundation for innovative approaches for the development of holistic awareness in the training and continuing professional development of nurses. One such approach, collaborative inquiry, is described.
Purkis, Mary E; Bjornsdottir, Kristin
This paper provides an analysis of nursing as a knowledgeable discipline. We examined ways in which knowledge operates in the practice of home care nursing and explored how knowledge might be fruitfully understood within the ambiguous spaces and competing temporalities characterizing contemporary healthcare services. Two popular metaphors of knowledge in nursing practice were identified and critically examined; evidence-based practice and the nurse as an intuitive worker. Pointing to faults in these conceptualizations, we suggest a different way of conceptualizing the relationship between knowledge and practice, namely practice as being activated by contextualized knowledge. This conceptualization is captured in an understanding of the intelligent creation of context by the nurse for nursing practice to be ethical and effective.
Miller, Jason E.
The distinction between doctor and nurse has been historically visible to patients, and the scope of practice for each healthcare provider has been clearly marked by a wall of separation rooted in state law. In fact, even the titles by which these providers have been addressed have remained constant, with the term “doctor” being reserved for reference to physicians. With the advent of the new doctor of nursing practice degree, however, the clear distinction between doctor and nurse is in jeopardy. Moreover, accompanying the push toward a practice doctorate for advanced nursing practice is a call for the expansion of the scope of advanced nursing practice. The urgent questions at hand are the following: First, is a practice doctorate necessary or even appropriate for advanced nursing practice? Second, should the scope of advanced nursing practice be extended at this time? In addition to the increased educational requirements placed on aspiring advanced practice nurses and the associated increase in costs of obtaining the requisite education, requiring a practice doctorate for advanced practice nursing risks blurring the line between doctor and nurse and creates a potential for patient confusion. A true need for requiring a practice doctorate for advanced practice nursing has not been demonstrated. Moreover, the states should tread carefully when considering expanded roles for advanced practice nurses to avoid creating conflict within the medical community. Considering the level of qualification of today's medical school applicants, perhaps we should be training more physicians to meet the demand head-on rather than creating a separate practice doctorate to fill the gap. PMID:19099003
"Dimensions of possible variation" is a phrase that now occupies a safe place in the literature describing the application of education theory to education practice: "asking yourself what could be changed [in the task], while using the same approach or technique, opens up dimensions of possible variation. A set of exercises forming a sequence of…
Okumbe, J. A.
This book provides the reader with principal theories and practices of management in educational organizations. It attempts to widen both the breadth and depth of the body of knowledge in this area of specialization. The work provides useful reference material for students and scholars at the undergraduate and postgraduate levels in universities…
Young, Richard F.; Astarita, Alice C.
Ortega (2011) has argued that second language acquisition is stronger and better after the social turn. Of the post-cognitive approaches she reviews, several focus on the social context of language learning rather than on language as the central phenomenon. In this article, we present Practice Theory not as yet another approach to language…
Ronald, Kate, Ed.; Ritchie, Joy, Ed.
In their breakthrough anthology of women's rhetoric, "Available Means," Kate Ronald and Joy Ritchie presented the first comprehensive collection of women's rhetorical theory and practice from the third century B.C. to 2001. With that expansive gathering of women's rhetoric, they raised questions about gender, difference, and the rhetorical canon,…
Savin-Baden, Maggi; Van Niekerk, Lana
This article offers an overview of the method of narrative inquiry and explores competing trends in the use of the approach. It not only examines the theories relating to the method but also offers practical guidance on using narrative inquiry, including an exploration of what might count as a narrative and ways of analysing narrative data. The…
Keefe, James W.
This monograph builds upon rapid developments in the field of learning styles during the past few years, providing useful information about the theory, research, instrumentation, and practice of learning style. The first section presents an overview of learning style and addresses the school learning process, learning style concept, cognitive…
Vellone, E; Piras, G
Peplau's theory is one of the early Nursing theories, published in 1952. The nurse-patient relationship consists of four steps (orientation, identification, development and conclusion). In these steps nurse could have the role of foreign, reliable person, teacher, guide in nursing care, substitute and consultant. Nurse-patient relationship is influenced by psychobiological experiences (needs, frustrations, conflicts and anxiety) which need dynamism. Peplau thinks that Nursing care is an important opportunity for nurse because she can help patient to complete the infancy psychological tasks (learning to rely on other people, learning to show satisfaction, self-identifying, and developing ability in sharing) if these are not completed. For these reasons Nursing, by Peplau, is a maturation strength of civilization.
Journal of Professional Nursing, 2002
This white paper from the American Association of Colleges of Nursing depicts the current environment of nursing practice, including supply and demand. It describes work environments that support professional practice and outlines eight indicators for the practice environment. Contains 48 references and an appendix with suggested questions for…
Jacobsen-Webb, Marilyn-Lu, Ed.
The purposes of this conference were: (1) to present research representing a variety of topics and study designs; (2) to disseminate findings of nursing research; and (3) to stimulate the use of research and theory as a basis for clinical, educational, and administrative practice. The keynote address and two invited presentations are presented in…
Degen, Greta M.
The purpose of this study was to illuminate the qualitatively different ways in which three nurses with an associate degree (ADN) and three nurses with a baccalaureate degree (BSN) experience, conceptualize, perceive, and understand their own nursing practice within the context of their educational background. Using a phenomenographic methodology…
Lusk, Marilyn; Decker, Ilene
One baccalaureate nursing program and five community college programs collaboratively developed a shared philosophy, curriculum design, and model for nursing education and practice. The model takes a holistic view of the client/patient's mind, body, and spirit engaged in life-changing transitions and depicts the role of nursing care. (SK)
National Association for Practical Nurse Education and Service, Inc., New York, NY.
The third in a series of pamphlets on practical nursing education, this document contains information on accreditation standards governing nursing programs. Included are announcements of: (1) available accreditation and consultation services, (2) policies regulating accreditation eligibility, (3) standards of ethics by which nursing programs are…
Feldbaum, Eleanor G.; Levitt, Morris J.
This report focuses on nursing educational and practice issues that government officials may have to address in the near future. The report provides statistical information on nurses, compares statistics for white and black nurses, and recommends policies for the future. Data was gathered for the report during a three-year study of 5,175…
Rice, Susan K.; Biordi, Diana L.; Zeller, Richard A.
This descriptive correlational study assessed school nurses' knowledge of and perceived relevance of the "Standards of Professional School Nursing Practice". Of the 1,162 Ohio school nurses sent questionnaires, 345 returned usable questionnaires (30%). The typical respondent was a 50-year-old Caucasian woman with 24 years of nursing…
Hsiao, Chiu-Yueh; Tsai, Yun-Fang
The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness.
McCurry, Mary K; Revell, Susan M Hunter; Roy, Sr Callista
Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved.
Infection is spread in hospital mainly by hands, making hand decontamination the most important means of preventing dissemination. There is some evidence to suggest that when access to hand-decontaminating agents is poor or the agents available are disliked, hands are washed too seldom, increasing risks of cross-infection. However, little attention has been paid to the use of towels and factors which promote their use, although it is known that damp hands transfer bacteria more readily than dry ones and that hands which become sore through poor drying have higher bacterial counts, contributing to the risk of cross-infection. This paper reports the results of the Nursing Times Hand Drying survey designed to assess nurses' access to hand decontamination agents and towels. The results suggest that the 112 nurses who participated were aware of the need for attention to hand hygiene but that access to both hand-decontaminating agents and paper towels was variable. Forty-one per cent complained of a shortage of soap and although nearly all used paper towels, these were in many cases of poor quality. Such towels were perceived as damaging to hands, leaving them feeling damp and sore. Good-quality, soft, paper towels were much appreciated by respondents in this sample. It is concluded that the quality of paper towels contributes to good infection control practice.
Lagerwey, Mary D
This paper presents a discourse analysis of publications of the Christian Reformed Church regarding its Rehoboth Mission near Gallup, New Mexico, among the Navajo. All issues of The Banner, Acts of Synod of the Christian Reformed Church, the Rehoboth Hospital Bulletin, and the Annual Report of the Rehoboth Mission from 1880 to the present were reviewed for references to health-care at Rehoboth from 1903 to 1943. Four religiously framed discourses were identified: discourses justifying provision of health-care at the mission, discourses of the Navajos as immature and potentially dangerous, needing to be civilized, discourses of cleanliness, and discourses of calling. This paper adds to a growing body of knowledge about religious frames within which nurses have practiced in North America.
Dombrowski, Jill J; Snelling, Anastasia M; Kalicki, Michelle
Health promotion practice has evolved over the past four decades in response to the rising rates of chronic disease. The focus of health promotion is attaining wellness by managing modifiable risk factors, such as smoking, diet, or physical activity. Occupational health nurses are often asked to conduct worksite health promotion programs for individuals or groups, yet may be unfamiliar with evidence-based strategies. Occupational health nurses should lead interprofessional groups in designing and implementing worksite health promotion programs. This article introduces occupational health nurses to health promotion concepts and discusses evidence-based theories and planning models that can be easily introduced into practice.
"Mind of Compassion", as elaborated by Mencius, emphasizes practice in life. It is a concept also highly valued in Confucian. The moral practice stressed by Confucian is a categorical imperative. Because the main concern is on life itself, moral actions should be taken "as is," without the need to refer to any other conditions. Nursing practice deals with patient diseases and death. Such is precisely the environment in which moral practice should take place. Professional healthcare workers may make very good use of the values and meanings of this moral practice and employ such to its fullest. As Mencius' "Mind of Compassion" reflects the main essence of nursing practice, its elaboration can be highly beneficial in nursing care. This article uses Mencius' concept as well as relevant Western theories and concepts (e.g., caring, empathy and sympathy) to clarify the main values and ways to practice a meaningful life.
Fratzke, Jason; Tucker, Sharon; Shedenhelm, Heidi; Arnold, Jackie; Belda, Tom; Petera, Michael
Innovative strategies that preserve nursing time for direct patient care activities are needed. This study examined the utility, feasibility, and acceptability of voice recognition (VR) software to document nursing care and patient outcomes in an electronic health record in a simulated nursing care environment. A phase 1 trial included 5 iterative experiments with observations and nurse participant feedback to allow enhancements to the speech detection capabilities and refinement of the technology, software, and processes. Utility ratings improved over time; however, interference on nursing care remained a concern throughout. Nurse participants favored keyboard entry electronic health record, largely due to software and technical issues, but also relative to the culture shift the new technology brings to nursing practice. Successful adoption of VR technology by nursing will be dependent on receptiveness of the nurses and perceived benefits, timely access to education and training, and minimization of barriers to using the software.
Elaine, Hardy; DeBasio, Nancy; Warmbrodt, Lynn; Gartland, Myles; Bassett, William; Tansey, Michael
Research College of Nursing and the Rockhurst University Helzberg School of Management Health Care Initiative collaborated to offer the Executive Nurse Practice: Health Care Leadership track to Research College of Nursing graduate students. This effort was not only cost effective, but also offered expert faculty in both the fields of nursing and business. The curriculum is an integration of both fields and faculties from both institutions as they communicate and collaborate each semester to successfully coordinate the track.
Mundinger, Mary O.; Cook, Sarah Sheets; Lenz, Elizabeth R.; Piacentini, Karen; Auerhahn, Carolyn; Smith, Jennifer
Advanced practice nurses are assuming increasingly accountable roles in primary health care. A doctor of nursing practice degree would signify the high level of competency they achieve. Columbia University's training model is an example of the preparation needed for this level of professional practice. (SK)
Broussard, A B; Delahoussaye, C P; Poirrier, G P
The practice role of nurse educators has emerged as a mechanism to unite practice, research, and education. The long-term outcome of such a synthesis should be an improvement in the quality of nursing care delivered to clients. Clinically focused nursing research designed by nurse educators who maintain a practice role or nurse clinicians who maintain a teaching role has the potential to unify and thus advance the profession. The authors discuss the historical background from which the practice role evolved, and efforts of recent nursing leaders to facilitate the incorporation of the nursing practice role by educators. Models for faculty practice are identified, and advantages of faculty practice are reviewed. The authors also describe barriers to the establishment of faculty practice, contemporary developments impacting faculty practice, and research needed to advance faculty practice. Nurse educators in many academic communities in the 1990s are discovering that not only must they produce scholarly work in addition to their teaching and service to the university and community, but that they may also be under growing pressure to be engaged in clinical practice. This pressure may be self-imposed or may be an expectation of their colleagues in nursing education or the administrators of their nursing programs. The focus of this research brief will be to describe the historical background from which this "new" role evolved, to discuss strategies or models developed to facilitate the faculty practice role, and to identify faculty practice issues that have emerged with the adoption of this role in academia. An additional focus will be to critically review faculty practice-related research performed since Chicadonz' (1987) review.
In this this essay, the author addresses the close connection between mixed methods research and nursing practice. If the assertion that research and practice are parallel processes is accepted, then nursing practice may be considered "invisible mixed methods research," in that almost every encounter between a nurse and a patient involves collection and integration of qualitative (word) and quantitative (number) information that actually is single-case mixed methods research.
Atkin, Karl; Lunt, Neil
Interviews with 56 practice nurses, 29 general practitioners (GPs), 23 health administrators, and 1 government official revealed that nurses use a variety of education and training opportunities; GPs largely let nurses take responsibility for their continuing education. The informal nature of training opportunities and lack of funding were…
Yang, Jinhua; Liu, Yanhui; Huang, Chunping; Zhu, Lefeng
A higher turnover rate was identified in Chinese staff nurses and it was highly correlated with lower commitment. Empowering work environments that support professional practice have been positively related to nurse outcomes. This study was to integrate structural empowerment theory with magnet hospital characteristics and provide empirical evidence on the relationships between structural empowerment, professional practice environments and organizational commitment. A cross-sectional design was used to examine the relationships in a sample of 750 full-time nurses employed in five Chinese hospitals in 2011. Structural equation modeling was used to test the proposed hypotheses. The results support the hypothesized model. Professional practice environments partially mediated the relationship between empowerment and organizational commitment. Our findings suggest that higher empowerment facilitates the professional practice environments and commitment of these nurses.
Rooted in traditional Chinese medicine, the use of acupressure to alleviate symptoms, support the healing process, promote relaxation, and improve overall health has grown considerably in the West. The effects of acupressure--like those of acupuncture, with which it shares a theoretical framework--cannot always be explained in terms of Western anatomical and physiologic concepts, but this noninvasive practice involves minimal risk, can be easily integrated into nursing practice, and has been shown to be effective in treating nausea as well as low back, neck, labor, and menstrual pain. The author discusses potential clinical indications for the use of acupressure, describes the technique, explains how to evaluate patient outcomes, and suggests how future research into this integrative intervention might be improved.
Eliason, Michele J.
Argues that nursing practice and theory cannot be ethical unless cultural factors are taken into consideration and that ethical/transcultural nursing is central to the philosophy and practice of nursing. (Author)
Choi, JiSun; Flynn, Linda; Aiken, Linda H.
Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. Design and Methods: The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes. Results: Controlling for individual and nursing home characteristics, staff RNs’ participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs’ job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied. Implications: A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction. PMID:21908803
Despite scientific advances in pain management, inadequate pain relief in hospitalized patients continues to be an on-going phenomenon. Although nurses do not prescribe medication for pain, the decision to administer pharmacological or other interventions for pain relief is part of nursing practice. Nurses play a critical role in the relief of…
Lee, Sheuan; Pai, Hsiang-Chu; Yen, Wen-Jiuan
The International Council of Nurses (ICN) issued the title, Positive Practice Environments: Quality Workplaces = Quality Patient Care, as the theme of International Nurses Day in 2007. An appeal is being made for all ICN National Nursing Associations to focus on improving practice environments and protecting nursing staff. The purpose of the study was to explore the perceived practice environment of nurses in Taiwan on the basis of the tool kit of positive environments designed by ICN, involving the eight dimensions of safety, supplies, resources, pay, continuing education, support, equipment, and respect. A self- administered Practice Environment Survey Scale was used. The findings indicated that participants were mostly female, the average age was 34.15 years old, and most of them worked in northern Taiwan (33.4%). The perceived practice environment score was determined as a percentage, and the average score among nurses was 65. The three lowest scores were recorded in the domains of pay, resources and equipment. There were significant differences in the perceived practice environment scores among participants' demographic characteristics (p < .05). Nurses recorded more negative practice environment scores than administrators. The results will be useful in the formulation of nursing policy and in nursing administration.
Frantz, Rita A
Fundamental to planning, implementing, and sustaining a quality Doctor of Nursing Practice (DNP) program is access to the resources needed to foster a learning environment that prepares nurses for advanced practice and leadership in the future redesigned health care system. This creates formidable challenges for schools and colleges of nursing as they endeavor to address the nation's need for an increased supply of advanced practice nurses to provide access to high-quality, cost-effective care for an aging population. This article describes the essential resources needed to support the delivery of a DNP program and the proposed strategies needed to address the resource challenges.
Evidence-based healthcare, the organized translation of knowledge into practice, and the implementation of evidence in practice have become vital in nursing care and health policy. Evidence translation is an essential concept that relates to the knowledge development and core competence of advanced practice nurses (APNs). The present article introduces the development and definitions of nursing evidence translation. The evidence-based nursing perspectives of Techne and Phronesis are used to illustrate the characteristics and nature of knowledge translation. The evidence translation models are introduced and the barriers that are often encountered during the three stages of evidence translation are explained. The final section discusses the future development of evidence translation.
Spurr, Shelley; Bally, Jill; Ogenchuk, Marcella; Peternelj-Taylor, Cindy
This article presents a proposed holistic Framework for Exploring Adolescent Wellness specific to the discipline of nursing. Conceptualized as a practical adolescent wellness assessment tool, the framework attends to the physical, spiritual, psychological and social dimensions of adolescent health. Through the discussion of a reconstructed case study the framework's application to nursing practice is illustrated. Nurses are distinctly positioned to promote adolescent wellness. This approach facilitates the exploration of the multiple influences on the health of adolescents, across a variety of clinical practice specialties and settings, by nurses of varying experiences.
Dyess, Susan M; Sherman, Rose O; Pratt, Beth A; Chiang-Hanisko, Lenny
With the growing complexity of healthcare practice environments and pending nurse leader retirements, the development of future nurse leaders is increasingly important. This article reports on focus group research conducted with Generation Y nurses prior to their initiating coursework in a Master’s Degree program designed to support development of future nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this qualitative study conducted to capture perspectives about nursing leaders and leadership. Conventional content analysis was used to analyze and code the data into categories. We discuss the three major categories identified, including: idealistic expectations of leaders, leading in a challenging practice environment, and cautious but optimistic outlook about their own leadership and future, and study limitations. The conclusion offers implications for future nurse leader development. The findings provide important insight into the viewpoints of nurses today about leaders and leadership.
Walker-Cillo, Gayle A; Harding, Andrew
One of the most difficult arenas in the emergency environment for the new and seasoned clinical nurse specialist is the clinical remediation of professional nursing staff. It is easy to say that each person must be treated the same, but the foundation of each practice issue and problem is unique. Identifying and utilizing a standardized process with which concerns are addressed on the basis of theoretical models, expert nursing knowledge, and standards of practice are the keys to success.
Shever, Leah L; Titler, Marita G; Mackin, Melissa Lehan; Kueny, Angela
The purpose of this article was to describe nursing practices (e.g., assessment, interventions) around fall prevention, as perceived by nurse managers in adult, medical-surgical nursing units. One hundred forty nurse managers from 51 hospitals from across the United States participated. Descriptive frequencies are used to describe nurse manager responses. The most commonly used fall risk assessment tool was the Morse Fall Risk Assessment Tool (40%). The most common fall prevention interventions included bed alarms (90%), rounds (70%), sitters (68%), and relocating the patient closer to the nurses' station (56%). Twenty-nine percent of nurse managers identified physical restraints as an intervention to prevent falls whereas only 10% mentioned ambulation. No nurse manager identified that RN hours per patient-day were adjusted to prevent falls or fall-related injuries. More work is needed to build systems that ensure evidence-based nursing interventions are consistently applied in acute care.
Swanson, C S
A spirit-focused conceptual model of nursing views the person as a spiritual being whose life and purpose arise from a personal relationship with God. The individual's definition of God determines how he or she responds to stimuli, sets goals, and establishes purpose in life. Consequently, this definition influences the professional nursing relationship, and the nurse's and patient's concepts of health and perceptions of the environment. The pediatric nurse practitioner and client are the primary examples of practice examined in this study.
Calzone, Kathleen A; Jenkins, Jean; Culp, Stacey; Bonham, Vence L; Badzek, Laurie
Aim Genomics has the potential to improve personalized healthcare. Nurses are vital to the utilization of genomics in practice. This study assessed nursing attitudes, receptivity, confidence, competency, knowledge and practice in genomics to inform education efforts. Materials & methods Cross-sectional study of registered nurses who completed an online Genetic/Genomic Nursing Practice Survey posted on a national nursing organization website. Results A total of 619 registered nurses participated. The largest proportion of education level were nurses with a baccalaureate degree (39%). Most (67.5%) considered genomics very important to nursing practice. However, 57% reported their genomic knowledge base to be poor or fair. The mean total knowledge score correct response rate was 75%. Yet 60% incorrectly answered that diabetes and heart disease are caused by a single gene variant. Most (64%) had never heard of the Essential Nursing Competencies and Curricula Guidelines in Genomics. Higher academic education or post licensure genetic education increased family history collection in practice. Conclusion Most nurses are inadequately prepared to translate genomic information into personalized healthcare. Targeted genomic education is needed to assure optimal workforce preparation for genomics practice integration. PMID:24363765
Prior, Patsy; Wilkinson, Jill; Neville, Stephen
The role of practice nurses is a specific feature of the modernisation agenda of the New Zealand health service. Increasing importance is being placed on service improvement through effective decision making and enhanced clinical performance. To contribute to the development of primary health care it is crucial that nurses have the skills to appropriately implement research based and other evidence in practice. This study involved 55 West Auckland practice nurses working in the general practice setting. The aim of the study was to describe nurses' perceptions of their use of evidence-based practice, attitudes toward evidence-based practice and perceptions of their knowledge/skills associated with evidence-based practice. An additional aim was to determine the effect of educational preparation on practice, attitudes and knowledge/skills toward evidence-based practice. A descriptive survey design was selected for this study. The results demonstrated that nurses' attitudes toward evidence-based practice, knowledge and skills relevant to the implementation of evidence-based practice and the educational preparation of the nurses were important factors influencing the effective utilisation and application of research results in practice. Educational interventions are identified as an integral aspect of implementing evidence-based practice and enhancing practice nurses' knowledge and skill relevant to the use of evidence in practice. Further research is needed to assess the contextual factors which can inhibit or promote achievement of evidence-based practice by practice nurses.
Jahanpour, Faezeh; Azodi, Parviz; Azodi, Farzan; Khansir, Ali Akbar
Background Clinical training is an integral part of nursing education; however, some studies have shown that it is not always efficient. Objectives This study aimed to find out the factors that can impede nursing students’ clinical learning. Materials and Methods In this qualitative study, data were collected via reflective journal writing. Purposeful sampling was used, and 12 senior nursing students were recruited to the study. The data were analyzed using a content analysis method. Results Three main categories were derived, including inappropriate communication, ineffective role models, and theory-practice gaps. Students perceived that inappropriate communication between instructors, staff members, and students had the greatest impact on student learning. The competence of clinical instructors and staff is an important factor affecting students’ training. The clinical learning environment does not always integrate theory and practice together. Conclusions Nursing students did not experience effective clinical learning. Having expert instructors and supportive communication are important factors in creating a clinical learning environment. PMID:27579332
The evolution of science and our society raises ethical questions in medical and nursing practice. These give rise to the requirement for individual and collective reflection in order to consider the consequences of decisions and to judge on sometimes complex choices. This reflection concerns both nursing practices and the organisation of the health system.
Nurse practitioners produce excellent patient outcomes and should be allowed to practice to the full extent of their education and training. In addition to clinical skills, nurse practitioners need to understand the business side of practice in order to ensure fair and equitable compensation.
Weiss, Josie A
Inviting advanced practice nursing students to participate in faculty research can be an innovative way to interest students in using current evidence as the basis for their practice. The author discusses strategies for effectively engaging graduate nursing students into research projects in ways that broaden the students' perspectives and strengthen their healthcare decision-making skills.
Florczak, Kristine; Poradzisz, Michele; Hampson, Susan
The authors of this column put forth a call for more grand theory to be used as the basis of nursing research. To that end, complexity theory and the Neuman systems model are reviewed followed by a discussion of the links that occur between them. Then evidence of the increased use of middle-range theory as the foundation of current nursing research is put forth. Finally, there is a discussion about the authors' conclusion that the complexity of the phenomena of interest for nursing research requires theories to be used as underpinnings that are more abstract and less reductionistic.
Talley, Linda B; Thorgrimson, Diane H; Robinson, Nellie C
Grooming nurses at all levels of the organization to master health care executive skills is critical to the organization's success and the individual's growth. Selecting and executing next steps for nursing leadership team development is critical to success. Leaders must make it their responsibility to provide nurses with increased exposure to quality, safety, and financial data, thereby allowing nurses to translate data while achieving and sustaining successful outcomes. The work of the CNO Dashboard to measure, report, trend, and translate clinical and non-clinical outcomes must be integrated throughout all levels of nursing staff so that nursing practice is positioned to continually strive for best practice. The education and evolution of nurses as business managers is critical to building a strong RN workforce.
Hessels, Amanda J.; Flynn, Linda; Cimiotti, Jeannie P.; Cadmus, Edna; Gershon, Robyn R.M.
Objectives Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals. Methods This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals. Results Nurses missed delivering a significant amount of necessary patient care (10–27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events. Conclusions This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care. PMID:27547768
Background There is a scarcity of research published on clinical scholarship. Much of the conceptualisation has been conducted in the academy. Nurse academics espouse that the practice of nursing must be built within a framework of clinical scholarship. A key concept of clinical scholarship emerging from discussions in the literature is that it is an essential component of enabling evidence–based nursing and the development of best practice standards to provide for the needs of patients/clients. However, there is no comprehensive definition of clinical scholarship from the practicing nurses. The aim of this study was to contribute to this definitional discussion on the nature of clinical scholarship in nursing. Methods Naturalistic inquiry informed the method. Using an interpretative approach 18 practicing nurses from Australia, Canada and England were interviewed using a semi-structured format. The audio-taped interviews were transcribed and the text coded for emerging themes. The themes were sorted into categories and the components of clinical scholarship described by the participants compared to the scholarship framework of Boyer [JHEOE 7:5-18, 2010]. Results Clinical scholarship is difficult to conceptualise. Two of the essential elements of clinical scholarship are vision and passion. The other components of clinical scholarship were building and disseminating nursing knowledge, sharing knowledge, linking academic research to practice and doing practice-based research. Conclusion Academic scholarship dominated the discourse in nursing. However, in order for nursing to develop and to impact on health care, clinical scholarship needs to be explored and theorised. Nurse educators, hospital-based researchers and health organisations need to work together with academics to achieve this goal. Frameworks of scholarship conceptualised by nurse academics are reflected in the findings of this study with their emphasis on reading and doing research and translating it
Neher, Margit; Ståhl, Christian; Ellström, Per-Erik; Nilsen, Per
As rheumatology nursing develops and extends, knowledge about current use of knowledge in rheumatology nursing practice may guide discussions about future knowledge needs. To explore what perceptions rheumatology nurses have about their knowledge sources and about what knowledge they use in their practice, 12 nurses working in specialist rheumatology were interviewed using a semi-structured interview guide. The data were analyzed using conventional qualitative content analysis. The analysis yielded four types of knowledge sources in clinical practice: interaction with others in the workplace, contacts outside the workplace, written materials, and previous knowledge and experience. Colleagues, and physicians in particular, were important for informal learning in daily rheumatology practice. Evidence from the medical arena was accessed through medical specialists, while nursing research was used less. Facilitating informal learning and continuing formal education is proposed as a way toward a more evidence-based practice in extended roles.
Payne, Lesle Karns
The author in this article presents a theory of decision-making in nursing, specifically a middle-range theory of intuitive decision-making in nursing created through the synthesis of Patricia Benner's model of skill acquisition in nursing and Damasio's somatic marker hypothesis. The author proposes that Damasio's somatic state is equivalent to what Benner has identified as intuition. When a nurse is faced with a decision, intuition, if developed, is a somatic state that creates a measurable physiological biasing signal (skin conductive response) that helps in making an advantageous decision. Research, educational, clinical and theoretical implications are discussed.
Palumbo, Mary Val; McIntosh, Barbara; Rambur, Betty; Naud, Shelly
The expected retirement of the largest cohort of nurses will push the RN workforce below projected need by 2020. The challenges of managing a nursing workforce with the majority of nurses over 45 years of age are now necessitating attention to polices for recruitment and retention of older nurses, particularly in rural areas. This convenience sample study employed a mailed survey to investigate perceptions of nurses in 12 institutions (four hospitals, seven home health agencies, and one nursing home serving a small rural state). The goal was to explore rural RNs' perceptions of intent to stay in their current position, with their organization, and employment as a nurse; organizational and unit-level culture regarding older nurses in the workplace; importance of specific human resource practices/policies to their own intention to stay; and extent to which these human resource practices/policies are currently done. The results indicate that although there are similarities across age cohorts, important differences exist that can be addressed to create career-span sensitive policies and practices. This study provides an indicator of progress or lack of progress in addressing older nurse recruitment and retention, and also offers guidance for differentiating policies and practices for younger and older nurses.
Crossetti, Maria da Graça; Dias, Vera
The authors describe the strategies used for the construction and implementation of a classification model computerized used in the nurses' of an academical hospital daily professional. The classification is structured in the theoretical reference of Benedet and Bub (1999) whose taxonomia has for base the theory of the basic needs of Horta (1979), Carpenito (1997) and NANDA (1999). The model constitute a reality in practice and a progress in the production of the knowledge of the Brazilian nursing.
Crowder, Sharron J; Ironside, Pamela M; Cangany, Martha; Roddy, Wanda Spann
Doctor of Nursing Practice (DNP) students need to be effective health policy leaders and contribute their expertise to legislative discussions. Nursing faculty have unique opportunities to prepare future DNP health policy leaders through legislative experiential learning opportunities. Yet, the creation of legislative fellowships can seem challenging. This article describes a state legislative fellowship based on Kolb's experiential learning theory and explores ways faculty can support DNP student preparation.
McMillan, Diana E; Bell, Sandy; Benson, Ember E; Mandzuk, Lynda L; Matias, Debra M; McIvor, Marilyn J; Robertson, Judy E; Wilkins, Krista L
Knowledge development of theory can be challenging for graduate nursing students when they experience deficits related to theoretical foundations, evaluation, or application. This article recounts the experiences of the students and course facilitator with a graduate-level nursing science and theory course, which required critical analysis of a concept, theory critique, and poster presentation. The idea for this article was generated when the students realized the profound importance of nursing theories and their applicability to practice and research. Students' anxiety gave way to enthusiasm with the implementation of teaching and learning strategies based on adult learning theory. Knowles' four characteristics of adult learners are discussed in relation to the experiences of the students and course facilitator. These characteristics include learners' wish to be self-directed, need to bring life experiences to their learning, recognition of their social and occupational role competencies, and need to take a more immediate, problem-solving approach to their learning.
Allan, Helen; Barber, Debbie
This paper discusses data from a case study of fertility nursing practice. An ethnographic case study approach using participant observation and nine semi-structured interviews with staff and patients was undertaken. The data were analysed thematically and these themes are discussed in this paper. We present the meaning a small group of nurses working in a fertility unit in the UK attach to new roles and the ways in which changes in practice may be influenced. The nurses in this study believed that nature of the task demanded changes to practice and they identified personal, interpersonal and socio-cultural factors which influenced these changes. These new roles facilitated greater continuity of care for patients. This paper discusses the effects of these new roles on knowing and intimacy in nurse - patient relationships. The data suggests that new nursing roles, which are based on "traditional" nursing and "new" technical skills, are fragile and may not be shared across a professional community.
Lachat, Maryanne F; Scott, Carol A; Relf, Michael V
This article describes current nursing practice for pregnant women with HIV. In the United States, the number of new cases of HIV continues to rise in women of childbearing age. Women often learn of their HIV status when a pregnancy involves them in the healthcare delivery system. Since the manifestation of the disease in 1981, there have been significant advances in treatment, and now, among pregnant women testing positive for HIV, the risk of perinatal transmission can be decreased to 1% with pharmacologic intervention. Yet, HIV disease poses many new challenges to the woman testing positive who is considering pregnancy or who is already pregnant. The progression of the symptoms of AIDS is similar to the common symptoms of pregnancy; the HIV medications may also cause these symptoms. Adherence to the HIV medication regime is necessary for ongoing viral suppression, for missed doses can initiate drug resistance and the whole categories of antiretroviral drugs may become ineffective. Additionally, the HIV stigma continues to impact those infected and interferes with the access to healthcare. HIV poses a major challenge for the nurse caring for the childbearing woman.
Aholaakko, Teija-Kaisa; Metsälä, Eija
Aseptic practices prevent exposure of a surgical wound to microbes, operating theatre environment and personnel. The circulating nurse assists the operating theatre personnel and supervises aseptic practices preventing surgical site infections. In the absence of analytical tools, few studies exist on intraoperative nursing-related aseptic practices. This study introduces recommendations to assess the role of the circulating nurse in aseptic practices. The authors used international recommendations and research findings to construct a 20-item self-report instrument with a demonstrated reliability across the scale. The authors structured the scale based on three phases: establishment; maintenance; and disestablishment of a sterile operating field. The tool was tested among operating theatre and day surgery nurses, and compared the differences in the mean acceptance rates of aseptic practice recommendations based on background characteristics. College-level nurses and nurses with 15 or more years' work experience accepted the recommendations at higher levels than bachelor-level nurses and nurses with less work experience. Continual assessment of the evidence base and comprehensive evaluation represent important components in further developing the tool. A reasonable number of items covering clinical practice are necessary for assessing the effectiveness and cost-effectiveness of aseptic practices, and a larger response rate is needed to validate the tool in future.
Hern, Marcia J; Vaughn, Gretchen; Mason, Debby; Weitkamp, Tina
In today's global workplace, both nursing practice and education need to promote international health. Nurses from a comprehensive 373-patient-bed hospital at Cincinnati Children's Hospital Medical Center and faculty from the College of Nursing, University of Cincinnati, in southwest Ohio have successfully collaborated to develop several unique international nursing exchange programs. The goals of these programs are to increase cultural sensitivity and nursing knowledge relevant to a global community. The essential components used in creating and implementing the programs with Scotland, Honduras, and Korea will serve as an international workplace model for others, especially for those settings focused on children and family health care.
Shirey, Maria R
Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.
Jeffers, Brenda Recchia; Robinson, Sherry; Luxner, Karla; Redding, Donna
Increasing use of evidence-based practice (EBP) within complex healthcare organizations requires the identification of individuals who will support and facilitate new practice patterns. In a large Midwestern hospital, a diverse group of academic nursing faculty functioning as mentors to develop clinical nurses' skills in the use of EBP has demonstrated early success. This article highlights the context, challenges, and successes of faculty mentors for developing nursing staff's involvement in and use of EBP.
Peirce, Anne Griswold; Smith, Jennifer A
Ethical questions dealt with by nurses who have Doctor of Nursing Practice (DNP) degrees include traditional bioethical questions, but also business and legal ethics. Doctorally prepared nurses are increasingly in positions to make ethical decisions rather than to respond to decisions made by others. The traditional master's-degree advanced practice nursing curriculum does not address the extended expertise and decision-making skills needed by DNP practitioners as they face these new types of ethical dilemmas. We propose that a curricular framework that addresses clinical, research, business, and legal ethics is needed by all DNP students.
Morrison-Sandberg, Leslie F; Kubik, Martha Y; Johnson, Karen E
Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led obesity prevention programs, and school nurses' interest in implementing obesity prevention programs. Semistructured interviews were conducted with key informants from 21 Minnesota school districts (urban = 7; suburban = 8; and rural = 6), who were licensed school nurses (LSNs). Findings indicated that LSNs provided some primary and secondary obesity prevention services. Key informants felt school nurses, administrators, and parents would be supportive of school-based, LSN-led obesity prevention efforts. Interest in increasing efforts was limited by time constraints, staffing, and resources. School nurses are well positioned to provide prevention services that will contribute to reducing childhood obesity.
Johnson, E D
Cited author searches were conducted in Nursing Citation Index to determine its utility in locating clinical studies that apply the conceptual frameworks of Dorothea Orem, Callista Roy, Martha Rogers, Betty Neuman, and Dorothy Johnson. Fully 75 percent of the relevant papers would have been missed by a conventional subject/textword search in the MEDLINE or CINAHL databases. Had Nursing Citation Index not been available, only 22 percent of relevant papers could have been retrieved by cited author searches of Social Science Citation Index. In summary, Nursing Citation Index provides an important indexing link between nursing theory and nursing research. PMID:2655783
Johnson, E D
Cited author searches were conducted in Nursing Citation Index to determine its utility in locating clinical studies that apply the conceptual frameworks of Dorothea Orem, Callista Roy, Martha Rogers, Betty Neuman, and Dorothy Johnson. Fully 75 percent of the relevant papers would have been missed by a conventional subject/textword search in the MEDLINE or CINAHL databases. Had Nursing Citation Index not been available, only 22 percent of relevant papers could have been retrieved by cited author searches of Social Science Citation Index. In summary, Nursing Citation Index provides an important indexing link between nursing theory and nursing research.
Mehrdad, Neda; Joolaee, Soodabeh; Joulaee, Azadeh; Bahrani, Naser
Background: Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators’ knowledge and attitude on EBP. Materials and Methods: This was a descriptive study conducted in nursing faculties of two major universities of medical sciences affiliated to Ministry of Health and Medical Sciences in Tehran, Iran. Data were gathered using a three-section questionnaire. Content and face validity was further enhanced by submitting it to nursing research and education experts. Statistical analysis was carried out using SPSS 11 software. Results: According the results, nursing faculties’ knowledge of EBP was mainly moderate (47.1%). Significant statistical relationship was found between the level of knowledge with education and teaching experience in different nursing programs. Nurses generally held positive attitudes toward EBP (88.6%) and there was no statistical significant relationship with demographic variables. Conclusion: Nursing educators are in a position to influence nursing research in clinical practice in the future. Therefore, it is critical to achieve implementation of EBP and be a change agent for a paradigm shift toward EBP. PMID:23922597
Guy, Jacqui; Taylor, Christine; Roden, Janet; Blundell, Jennifer; Tolhurst, Gerda
The Australian nurse teacher competencies were introduced in 1996; however, the researchers perceived that changes to the health care system and a nursing workforce shortage may have affected nurse teacher roles over the past decade. This study aimed to explore perceptions of nurse teachers on the applicability of the current Australian nurse teacher competencies to practice, and modify the nurse teacher competencies to better reflect current practice. Methodology utilized mixed methods, and data collection was via focus groups, telephone interviews, and survey data. Results revealed that participants were mostly positive about the original competency statements, although there were some variations between items. Themes that emerged from the qualitative data were: changing trends in health care; preparation for teaching; understanding of the competencies, contextual influences on education role; nurse teachers as change agents, and resource management. Conclusions were that the Australian nurse teacher competencies (1996) were reflective of the current generic roles of nurse teachers however some of the competencies needed reframing to meet the current needs of nurse teachers. However, changes needed to be made in areas such as reducing complex language, inclusion of technology, and cultural competencies. Nurse teachers were supportive of the research because they valued the teacher competencies for reflection on their practice and the development of portfolios, job descriptions and performance appraisals.
Stringer, Marilyn; Rajeswaran, Lakshmi; Dithole, Kefalotse; Hoke, Linda; Mampane, Patricia; Sebopelo, Sheila; Molefe, Margret; Muecke, Marjorie A; Rich, Victoria L; Polomano, Rosemary C
To forge strong relationships among nurse scholars from the University of Pennsylvania School of Nursing, Philadelphia, PA (USA); University of Botswana School of Nursing, Gaborone, Botswana; the Hospital of the University of Pennsylvania, Philadelphia; Princess Marina Hospital (PMH), Gaborone; and the Ministry of Health of Botswana, a strategic global partnership was created to bridge nursing practice and education. This partnership focused on changing practice at PMH through the translation of new knowledge and evidence-based practice. Guided by the National Institutes of Health team science field guide, the conceptual implementation of this highly successful practice change initiative is described in detail, highlighting our strategies, challenges and continued collaboration for nurses to be leaders in improving health in Botswana.
In 1995, South Korea passed the Mental Health Act, and since this time it has developed many mental health policies and facilities. The aim of this study is to understand and explore the experience of nursing students in the changed psychiatric practice environment since 1995. The present study is a qualitative thematic analysis. Interviews were conducted with 11 third and fourth grade nursing students who had experienced psychiatric practice in South Korea. A thematic analysis of 11 in-depth student interviews identified three themes: 'orientation before psychiatric practice', 'facing the mental hospital', and 'change and choice'. After practicing, nursing students developed positive attitude regarding psychiatry. Educators will have to focus more on education and support in order for the students to maintain positive attitude throughout their experience. The research herein shows that the role of the educators and psychiatric nurses is extremely important for nursing students in the elimination of a negative attitude towards psychiatry.
Willis, Odette P.
This course outline provides information to be used by students in conjunction with Nursing 89, a seminar on the legal aspects of nursing to be offered starting in Spring 1982 at Diablo University (California). General information is provided first, including a class calendar, a statement defining the purpose of the course, an outline of…
Larsson, Laura S; Butterfield, Patricia
:Nurses are increasingly the primary contact for clients concerned about health problems related to their environment. In response to the need for nursing expertise in the field of environmental health, the Institute of Medicine (IOM), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute of Nursing Research (NINR) have designed core competencies for the nursing profession. The IOM competencies focus on four areas: (1) knowledge and concepts; (2) assessment and referral; advocacy, ethics, and risk communication; and (4) legislation and regulation. The competencies establish a baseline of knowledge and awareness in order for nurses to prevent and minimize health problems associated with exposure to environmental agents. To address the known difficulties of incorporating new priorities into established practice, nurses attending an environmental health short course participated in a nominal group process focusing on the question, "What specific actions can we take to bring environmental health into the mainstream of nursing practice?" This exercise was designed to bring the concepts of the national initiatives (IOM, NINR, ATSDR) to the awareness of individual nurses involved in the direct delivery of care. Results include 38 action items nurses identified as improving awareness and utilization of environmental health principles. The top five ideas were: (1) get environmental health listed as a requirement or competency in undergraduate nursing education; (2) improve working relationships with interdepartmental persons-a team approach; (3) strategically place students in essential organizations such as NIOSH, ATSDR, or CDC; (4) educate nurse educators; and (5) create environmental health awards in nursing. The 38 original ideas were also reorganized into a five-tiered conceptual model. The concepts of this model include: (1) developing partnerships; (2) strengthening publications; (3) enhancing continuing education; (4) updating nursing
The purpose of this Heideggerian phenomenological study was to uncover the meanings of the clinical experiences of registered nurses working in maternity settings after they studied maternity nursing from a woman-centered, feminist perspective in a generic baccalaureate nursing program. Purposeful sampling was conducted to locate and recruit nurses who had graduated from this nursing program between the December 1996 and December 1998 semesters and were currently working in a maternal-newborn clinical setting. Each participant had taken the required woman-centered, maternity-nursing course during her/his undergraduate education. Data collection included an individual, open-ended interview that focused on the nurses' descriptions of their everyday practices as maternity nurses. Nineteen maternal-newborn nurses between the ages of 23 and 43 years who had been in practice from six months to three years were interviewed. The constitutive patterns identified from the interviews were: “Otherness,” “Being and Becoming Woman-Centered,” and “Tensions in Practicing Woman-Centered Care.” Findings revealed that the nurses had a raised awareness of oppressive maternity care practices and applied ideology of woman-centeredness as a framework for providing more humanistic care. Creating woman-centered maternity care meant negotiating tensions and barriers in medically focused maternity settings and looking for opportunities for advocacy and woman-empowerment. The barriers the nurses faced in implementing woman-centered care exposed limitations to childbearing choices and nursing practices that remain problematic in maternity care. PMID:17273327
Introduction Communication skills training, responsibility, respect, and self-awareness are important indexes of changing learning behaviours in modern approaches. Aim The aim of this study was to investigate the efficacy of three learning approaches, collaborative, context-based learning (CBL), and traditional, on learning, attitude, and behaviour of undergraduate nursing students. Materials and Methods This study was a clinical trial with pretest and post-test of control group. The participants were senior nursing students. The samples were randomly assigned to three groups; CBL, collaborative, and traditional. To gather data a standard questionnaire of students’ behaviour and attitude was administered prior to and after the intervention. Also, the rate of learning was investigated by a researcher-developed questionnaire prior to and after the intervention in the three groups. Results In CBL and collaborative training groups, the mean score of behaviour and attitude increased after the intervention. But no significant association was obtained between the mean scores of behaviour and attitude prior to and after the intervention in the traditional group. However, the mean learning score increased significantly in the CBL, collaborative, and traditional groups after the study in comparison to before the study. Conclusion Both CBL and collaborative approaches were useful in terms of increased respect, self-awareness, self-evaluation, communication skills and responsibility as well as increased motivation and learning score in comparison to traditional method. PMID:27190926
Griffith, Richard; Tengnah, Cassam
The numbers of district nurse clinics are continuing to grow in primary care and they provide timely and more cost effective intervention for patients. The clinics provide exciting opportunities for district nurses but also carry an increased risk of exposure to liability. This article discusses some of the key areas of accountability underpinning the duty of care of district nurses working in nurse-led clinics.
DeBrew, Jacqueline Kayler
The American Association of Colleges of Nursing (AACN), which defines the expectations of a new baccalaureate-prepared nurse, includes a liberal education as a desired outcome for bachelor of science in nursing (BSN) graduates. A liberal education is thought to provide the professional nurse with the skills needed to practice nursing, including…
Wilkinson, Jane; Kemmis, Stephen
Inspired by Theodore Schatzki's "societist" approach--in which he advocates a notion of "site ontologies"--in this article, we outline our theory of practice architectures (a theory about what practices are composed of) and ecologies of practices (how practices relate to one another). Drawing on case studies of four Australian…
The remodelling of the NHS requires a strong general practice nurse (GPN) workforce within general practice. The challenges facing general practice nursing are set within the current policy context and recent available evidence and illustrated by drawing upon the experience of a current GPN working in London. It is argued that there is a need to support the professional development of GPNs and nurture the next generation of potential GPNs if the current shortage of GPNs is to be addressed. PMID:28356920
Cody, William K
Paternalistic practices, wherein providers confer a treatment or service upon a person or persons without their consent, ostensibly by reason of their limited autonomy or diminished capacity, are widespread in healthcare and in societies around the world. In the United States, paternalism in health and human services is widespread and probably increasing with newly emergent forms. Numerous issues surround paternalistic practices. In this column, the author examines these issues in relation to theory development in healthcare and nursing as well as theory as a guide to practice. It is suggested that scientific and ethical knowing are not separate but must be united in theoretical structures that include both in unity, along with an appreciation of the infinite complexity of life as it is humanly lived. It is also suggested that nursing's unique theory base of frameworks that honor human dignity and focus on human experience offers an opportunity for leadership in further developing theoretical frameworks that transcend paternalistic practices.
Jiang, Lin; He, Hong-Gu; Zhou, Wen-Guang; Shi, Su-Hua; Yin, Ting-Ting; Kong, Yue
The aim of this paper is to examine the relationships among nurses' knowledge of, attitudes towards and level of competence in nursing practice, as well as factors influencing nurses' competence in nursing practice, in typhoon disaster relief work. A cross-sectional descriptive study was conducted using a self-developed questionnaire to obtain data from 607 nurses working in four tertiary hospitals and two secondary hospitals in Fujian, China, in November 2011. Our findings show that the nurses' average percentage scores on their responses to questions in the domains of knowledge, attitudes and practice were 66.33%, 68.87% and 67.60%, respectively. The findings demonstrated a significant positive relationship between nurses' attitudes and their practice. Nurses' working unit, prior training in typhoon disaster relief, current position of employment and attitudes were significant predictors of nurses' competence in practice. The results indicate that strategies need to be developed for nurses to improve their knowledge, attitudes and practice.
Rog, Debra J.
This article illustrates the synergistic role between practice and theory in evaluation. Using reflective practice, the author reviews her own work as well as the work of other evaluators to illustrate how theory can influence practice and, in turn, how evaluation practice can inform and grow theory, especially evaluation theory. The following…
Laver, Shaorn; Croxon, Lyn
Engaging nursing students in the complexities of care across community, acute, rehabilitation and residential aged care settings is challenging. Equally challenging is conceptualising and promoting diverse and comprehensive health assessments across care settings that reflect clinical reality, inform clinical decision making, traverse theory and practice, and transform clinical practice knowledge. This article describes the use of narrative and evolving case study as a teaching-learning tool utilised by the authors in a third year undergraduate gerontic nursing subject in a pre-service nursing degree at a rural university. Principles of transformative learning and strengths based nursing were drawn upon in the development of the case study. The aim of the approach was to draw on embedded knowledge and the experiences of students and academics from assorted practice settings to facilitate understanding of the lived experiences of an older community dwelling couple. Using social learning strategies students were encouraged to analyse and think critically and creatively about the situations they were presented with. They identified possible solutions that would be acceptable to the couple. Building on the older couple's strengths, achievements and personal social capital, the aim was to develop a positive paradigm for health and the way older people are viewed by nursing students.
Schäfer, Ursi Barandun; Hirsbrunner, Therese; Jäger, Susanne; Näf, Ernst; Römmich, Sabine; Horlacher, Kathrin
At the Solothurn Hospitals (soH), 13 academically educated nurses are responsible for the development of nursing care with the goal to improve patient-oriented, effective, appropriate, and economic care. The strategy contains three priorities: a) expert care of single patients in demanding situations, b) sustained application of organisational methods such as primary nursing, nursing process, and skill/grade mix, and c) design and management of practice development projects related to specific patient groups. A first evaluation with qualitative and quantitative methods showed that the exemplary care of single patients by expert nurses was evaluated as positive for the patients as well as for the teams on two wards by nurses who were interviewed. After the introduction of primary nursing, the application rate was 81 to 90 % and the introduction of fall prevention methods in geriatric rehabilitation decreased the fall rate from 8.2 to 5.5 per 1000 patient days. A comparision with the literature shows that the expert nurses of soH perform both, working at the bedside and being responsible for practice development projects, as specialised Advanced Practice Nurses (APNs). APNs at the Solothurn Hospitals work also as generalists when organisational methods need to be consolidated. Their successes depend from their integration into the hierarchy and both, into the nursing as well as into the interprofessional teams. Competencies in Transformational Leadership also are essential at all management levels.
Radzvin, Linda Clerici
Registered nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence of their decisions regarding ethical challenges, nurses report experiencing moral distress. This experience is often manifested by such feelings as anger, guilt, and sadness, and has been identified as a contributing factor to burnout and turnover in nursing. The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. A random sample of 800 CRNAs from the registry of the American Association of Nurse Anesthetists was selected to participate in this study. Participating nurses were asked to complete a demographic data survey and the Ethics Stress Scale. Three hundred surveys were analyzed for this study. The data supported the assumption that CRNAs do experience moral distress in their nursing practice. Although a small number of nurse anesthetists experienced high levels of moral distress, CRNAs generally experienced moderate levels of moral distress. Moral distress was associated with situations in which anesthetists believed they were aware of the morally correct course of action but were unable to follow through with these behaviors. Also, CRNAs reported physical and psychological manifestations in relation to moral distress.
Pickwell, S M
Relatively little data has been collected documenting the scope of family nurse practitioner (FNP) clinical practice, and virtually no research definitively describes the quality of that practice. Physicians have led the way in quantitative collection of practice content information. The resulting analyses have determined not only the most common diagnoses in primary care but also the content of teaching and research in family practice. Nurse clinicians, educators, and researchers have assumed this content to be pertinent to FNP practice as well. This article describes the major studies of family physician practice and the few studies of nurse practitioner/FNP practice, and advocates intensified review of FNP clinical content as an empirical basis for practice, education, and research.
In this article I outline an original form of ethical theory that I call exemplarist virtue theory. The theory is intended to serve the philosophical purposes of a comprehensive moral theory, but it is also intended to serve the practical purpose of moral education by structuring the theory around a motivating emotion--the emotion of admiration.…
Dellefield, Mary Ellen
Human resource practices including supervision and management are associated with organizational performance. Evidence supportive of such an association in nursing homes is found in the results of numerous research studies conducted during the past 17 years. In this article, best practices related to this topic have been culled from descriptive, explanatory, and intervention studies in a range of interdisciplinary research journals published between 1990 and 2007. Identified best practices include implementation of training programs on supervision and management for licensed nurses, certified nursing assistant job enrichment programs, implementation of consistent nursing assignments, and the use of electronic documentation. Organizational barriers and facilitators of these best practices are described.
Simulation is often used in nursing education as a teaching methodology. Simulation is rooted in adult learning theory. Three learning theories, cognitive, social, and constructivist, explain how learners gain knowledge with simulation experiences. This article takes an in-depth look at each of these three theories as each relates to simulation.…
Lee, Jane A.; And Others
The study, conducted in 1971, assessed characteristics of licensed practical nurses (LPN's) who worked in occupational health nursing. The survey instrument, a questionnaire, was returned by 591 LPN's in occupational health and provided data related to: personal characteristics, work and setting, administrative and professional functioning,…
Billingsley, Luanne; Wyld, David
Radio frequency identification (RFID) technology can save nurses time, improve quality of care, en hance patient and staff safety, and decrease costs. However, without a better understanding of these systems and their benefits to patients and hospitals, nurses may be slower to recommend, implement, or adopt RFID technology into practice.
Christian nurses are challenged by the process of incorporating faith and Christianity into their career. Nurse educators are particularly challenged to embed Christian principles into the tenure and promotion journey. Developing a God-inspired plan takes time and patience. Prayer, reflective practice, evaluation, decisions, and follow-through are areas that can be incorporated to infuse faith throughout the tenure and promotion process.
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
The document is intended to serve as a tool for self-evaluation by educational programs, evaluation for accreditation by the National League for Nursing, and appraisal of plans for the development of new practical nursing programs. The statements, which are organized into criteria and related guidelines, cover the areas of philosophy and…
Berkram, Gelene Marie
This descriptive study identified demographic, organizational, and satisfaction data of faculty in nursing education programs in rural states who do and do not engage in faculty practice. Out of a total of 509 surveys which were sent to faculty from 35 nursing schools located in twelve rural states, 366 surveys were returned for a 72% response…
Clark, Jill Macleod; And Others
A study examined how student, teacher, and practitioner/manager perceptions of the philosophy and practice of nursing changed during the Project 2000 demonstration program, which marked a dramatic revision of the curriculum taught at colleges of nursing across England and Wales. Data were collected from the following: literature review;…
Richie, Mary Fern; And Others
Psychiatric nursing faculty practice offers the academic nurse opportunity to generate salary support and integrate students into the real world of mental health care. It promotes scholarship and knowledge-building and has a direct impact on the lives of patients. (Author/JOW)
Bucknall, T; Copnell, B; Shannon, K; McKinley, D
In the emergence of the evidence based practice movement, critical care nurses have struggled to identify scientific evidence on which to base their clinical practice. While the lack of critical care nursing research is a major concern, other important issues have significantly stalled the implementation of evidence even when it is available. A descriptive study of 274 critical care nurses was undertaken to examine nursing research activity in Victorian critical care units. The study aimed to identify critical care nurses' research skills, the barriers encountered in participation and implementation and the current availability of resources. Results revealed that 42 per cent of the nurses who participated in the study believed that they were not prepared adequately to evaluate research, and less than a third believed they were sufficiently skilled to conduct valid scientific studies. An association was found between nurses' ability to confidently perform research activities and higher academic qualifications. The study found that there is a lack of organisational support and management commitment for the development of evidence based nursing. In order to facilitate the implementation of evidence based practice, clinicians must be made aware of the available resources, be educated and mentored when carrying out and using clinical research, and be supported in professional initiatives that promote evidence based practice. It is argued that this will have positive implications for patient outcomes in the critical care environment.
Schoessler, Mary; Waldo, Mary
The purpose of this article is to present a process model of the development of a newly graduated nurse. The model is useful in helping new graduates interpret their experience during their first crucial months in practice and can be used by organizations to design developmentally appropriate support strategies. The model integrates novice to expert skill acquisition, adult learning, and transition theory.
Applying theory to practice in student affairs is dominated by the assumption that formal theory is directly applied to practice. Among the problems with this assumption is that many practitioners believe they must choose between their lived experiences and formal theory, and that graduate students are taught that their experience "does not…
Livsey, Kae R
This study examines the associations between professional behaviors of baccalaureate nursing students and student perceptions of select factors within the clinical learning environment, including the role of clinical faculty leadership. Participants (n=243) were recruited from a randomly selected list of 1000 members of the National Student Nurses Association (NSNA) among sixteen states within the Southern region of the United States. Results revealed a direct relationship exists between student perceptions of structural empowerment in their clinical learning environment and professional nursing practice behaviors among students. Also found was that relationships between variables in the model are significantly strengthened by student perceptions of strong leadership behaviors of clinical faculty. Findings from this study may assist nurse educators by contributing knowledge relevant to support/facilitate the transition of individuals from student nurses to professional registered nurses and, thus enhance the impact of professional nurses' contributions in healthcare delivery.
Bartz, Claudia; Coenen, Amy; Hong, Woi-Hyun
The International Council of Nurses (ICN) is a federation of 129 national nurses associations. The International Classification for Nursing Practice (ICNP) is a programme of the ICN. The purpose of this paper is to describe the development and maintenance processes of the ICNP Programme that are used to increase participation. These include processes by which the ICNP was and continues to be developed, tested, distributed and implemented worldwide, with emphasis on the current version, ICNP Version 1.0. The ICNP is a unified nursing language that facilitates cross-mapping among local terms and existing terminologies. ICNP conforms to current terminology standards and criteria, for example, ISO standards and HL7. The ICNP Alpha and Beta Versions documented the progress of concept validation and classification of nursing phenomena and interventions. The ICNP Beta 2 Version was a combinatorial terminology organized in two multi-axial structures representing nursing phenomena and nursing actions. The ICNP Version 1.0, launched in 2005, changed the relatively straight-forward multi-axial structure into a compositional terminology through the application of description logics using Web Ontology Language (OWL) within Protégé, an ontology development environment. ICNP Version 1.0 is also represented in a multiaxial model (7-Axis) for nurses to compose nursing diagnosis, intervention and outcome statements. Language translations and clinical information systems applications are required to make the ICNP Version 1.0 available to nurses at the point of healthcare delivery. ICNP data collected in healthcare environments provide standardized terminology for nursing that allows comparison of nursing practice across health care settings, specialties and countries; facilitate data-based clinical and management decision making; and contribute to the development of guidelines and standards for best practices and optimal outcomes for patients, families and communities.
Garrett, Bernie M; MacPhee, Maura
This paper provides readers with an overview of some contemporary issues associated with nursing regulation and scope of practice in Canada. Issues with the current organizational structure of nursing regulation and its impact on nursing advocacy in Canada are explored. An argument is presented that nursing regulation needs more consistency and collaboration in Canada. Several examples are used to illustrate this. Fragmentation of regulation is explored and regulatory disciplinary processes are examined in relation to some countries with similar professional structures. The impact of changes in the regulatory status of complementary and alternative health practitioners on nursing is also critiqued. We provide recommendations for future policy and practice to better pave the way for nursing scope and regulatory clarity.
Bonnel, W B
Knowledgeable practitioners with the skills needed to serve in a variety of clinical settings are the primary objective of the Adult-Geriatric Advanced Nursing Program and the FNP elective, Advanced Practice Nursing Care of the Frail Elderly. The continued blending of long term and acute care settings will further cloud and challenge the school responsible for educating APNs in the care of older adults, particularly the frail elderly. Education needs to provide flexibility for students through new service designs such as interactive computer courses. Nurses with an orientation to the future should consider geriatric nursing education.
Clinical decisions and clinical judgements are important elements of nursing practice because they have a direct effect on patient care. A four-stage information processing framework was used to critique a decision to carry out chest examination and auscultation during the routine assessment of a child's asthma status. The use of this process demonstrates that nurses apply a combination of analytical and intuitive strategies when making decisions. Nurses who manage the care of patients in nurse-led clinics need to acquire advanced assessment skills to support their clinical decision making.
Thompson, J L
This discussion presents a critical appraisal of recent works in Advances in Nursing Science that have dealt with metatheoretical concerns. In metatheoretical analysis, such as that presented by Silva and Rothbart, nurses are beginning to focus on the traditions that have guided research. This process should be extended by reviewing historical stages of development in empiricist and postempiricist philosophy. Recent work in postempiricist philosophy is especially important since it can help nursing transcend historicist insights. Continental philosophy goes beyond historicist critique by focusing on practical discourse within a community of investigators. This is a stage of development that can be rationally decisive for the scientific development of nursing.
Thompson, Brent W
Handheld computers have the power to transform nursing care. The roots of this power are the shift to decentralization of communication, electronic health records, and nurses' greater need for information at the point of care. This article discusses the effects of handheld resources, calculators, databases, electronic health records, and communication devices on nursing practice. The US government has articulated the necessity of implementing the use of handheld computers in healthcare. Nurse administrators need to encourage and promote the diffusion of this technology, which can reduce costs and improve care.
Heartfield, Marie; Morello, Andrea; Harris, Melanie; Lawn, Sharon; Pols, Vincenza; Stapleton, Carolyn; Battersby, Malcolm
Practice nurses in Australia are now funded to facilitate chronic condition management, including self-management support. Chronic disease management requires an established rapport, support and proactivity between general practitioners, patients and the practice nurses. To achieve this, training in shared decision making is needed. e-Learning supports delivery and achievement of such policy outcomes, service improvements and skill development. However, e-learning effectiveness for health care professionals' is determined by several organisational, economic, pedagogical and individual factors, with positive e-learning experience linked closely to various supports. This paper reinforces previous studies showing nurses' expanding role across general practice teams and reports on some of the challenges of e-learning. Merely providing practice nurses with necessary information via web-based learning systems does not ensure successful learning or progress toward improving health outcomes for patients.
Foglesong, Dianne H.
Describes a problem-focused audit used to measure the impact of a staff development offering on pain relief. Concludes that the audit provided concrete evidence that the class on pain did influence nursing practice and affected patients directly. (NRJ)
Matumoto, Silvia; Fortuna, Cinira Magali; Kawata, Lauren Suemi; Mishima, Silvana Martins; Pereira, Maria José Bistafa
This study aims to present the re-signification process of the meanings of nurses' clinical practice in primary care from the perspective of extended clinic and permanent education. An intervention research was carried out with the approval of an ethics committee. Nine nurses participated in reflection groups from September to December 2008 in Ribeirão Preto-SP-Brazil. The redefinition process of the meanings proposed by the institutional analysis was mapped. The results point out that the nurses perceive differences in clinical work, by acknowledging the sense of user-centered clinical practice; daily limits and tensions and the need for support from managers and the team to deal with users' problems and situations. They identify the necessity to open space in the schedule to do that. It was concluded that nurses' clinical practice is being consolidated, and that collective analysis processes permit learning and the reconstruction of practices.
Willis, Danny G; DeSanto-Madeya, Susan; Ross, Richard; Sheehan, Danielle Leone; Fawcett, Jacqueline
This article presents an explication of spiritual healing situated within 3 nursing conceptual models (Neuman's systems model, Rogers' science of unitary human beings, and Roy's adaptation model) and 1 middle-range theory (Watson's theory of human caring), all of which include a focus on spirituality. These models and the theory are the vehicle for translation of themes of spiritual healing extracted from data provided by 30 adult male survivors of childhood maltreatment into nursing practice. This discipline-specific translational scholarship advances the profession of nursing.
Ellis, Irene; Chater, Keri
The purpose of this paper is to explore and describe the process of transition that nurses experience when moving from the acute sector to a specialist area of community nursing. Issues explored include the increased movement of nurses into the community sector, the experience of culture shock and changes in nursing roles. Transition issues including the need for effective management and infrastructure support, mentoring and preceptorship, skills acquisition and continuing education will be examined. Joint implementation of what is successful at both university and industry levels can improve the transition to community nursing.
Lee, Hyun Jung
Objectives This study is to cross-map telephone nursing consultation documentations with International Classification for Nursing Practice (ICNP; ver. 1.0 concepts). Methods The narrative telephone nursing consultation documentations of 170 ophthalmology nursing unit patients were analyzed. The nursing statements were examined and cross-mapped with the Korean version of the ICNP ver. 1.0. If all the concepts of a statement were mapped to ICNP concepts, it was classified as 'completely mapped'. If any concept of a statement wasnot mapped, it was classified as 'partially mapped'. If none of the concepts were mapped, it was classified as 'not mapped'. Results A total of 738 statements wereused for documenting telephone nursing consultations. These statements were divided into 3 groups according to their content: 1) 294 nursing phenomena-related statements (72 unique statements), 2) 440 nursing actions-related statements (76 unique statements), and 3) 4 other statements (2 unique statements). In total, 189 unique nursing concepts extracted from 150 unique statements and 108 concepts (62.44%) were mapped onto ICNP concepts. Conclusions This study demonstrated the feasibility of computerizing narrative nursing documentations for electronic telephone triagein the ophthalmology nursing unit. PMID:21818446
The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments.
Porr, Caroline J
This Clinical Concepts article concerns the relational tools required by public health nurses to establish relationships with single mothers living on public assistance, mothers who are vulnerable and often stigmatized. The implications of stigmatization for relationship building are highlighted based on previous research investigating how public health nurses working in Canadian jurisdictions establish professional caring relationships with this cohort of mothers. Public health nurses employed interactional strategies including engaging in a positive manner and offering verbal commendations which served as effective relational tools to break through mothers' walls of defensiveness and to resume the dynamic process of relationship building. Building Relationship is a key practice standard for public health nurses and is instrumental to their work at both individual and community levels to improve social determinants of health. The author concludes with recommendations to facilitate building relationships during everyday public health nursing practice.
Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik
Aim: To explore the mechanisms through which nurse practice environment dimensions, such as nurse–physician relationship, nurse management at the unit level and hospital management and organizational support, are associated with job outcomes and nurse-assessed quality of care. Mediating variables included nurse work characteristics of workload, social capital, decision latitude, as well as work engagement dimensions of vigor, dedication and absorption. Background: Understanding how to support and guide nurse practice communities in their daily effort to answer complex care most accurate, alongside with the demand of a stable and healthy nurse workforce, is challenging. Design: Cross-sectional survey. Method: Based on earlier empirical findings, a structural equation model, designed with valid measurement instruments, was tested. The study population included registered acute care hospital nurses (N = 1201) in eight hospitals across Belgium. Results: Nurse practice environment dimensions predicted nurses’ ratings of job outcome variables as well as quality of care. Features of nurses’ work characteristics, e.g., perceived workload, decision latitude, social capital, and the three dimension of work engagement, played mediating roles between nurse practice environment and outcomes. A revised model, using various fit measures, explained 60% of job outcomes and 47% of nurse-assessed quality of care. Conclusion: The findings in this study show that nurse work characteristics as workload, decision latitude, and social capital, alongside with nurse work engagement (e.g., vigor, dedication, and absorption) influence nurses’ perspective of their nurse practice environment, job outcomes, and quality of care. The results underline aspects to considerate for various stakeholders, such as executives, nurse managers, physicians, and staff nurses, in setting up and organizing health care services. PMID:25431563
Care, Wm. Dean
A study identified characteristics and motivating factors that influenced licensed practical nurses (LPNs) to participate in a registered nursing (RN) upgrading program at a hospital in western Canada. A literature review considered the concepts of motivation, participation, adult learning, and life transitions and explored a variety of models and…
Benoliel, Jeanne Quint
The fact that ethics has become important to nurses is a reflection of two types of developments: (1) rapid expansion and application of biomedical technology, and (2) the human rights movement. Therefore, nursing involves an increasing number of activities with both moral and technical implications. (SSH)
Williams, Marjory; Avolio, Alice E; Ott, Karen M; Miltner, Rebecca S
The Office of Nursing Services of the Department of Veterans Affairs (VA) piloted implementation of the clinical nurse leader (CNL) into the care delivery model and established a strategic goal in 2011 to implement the CNL role across the VA health care system. The VA Office of Nursing Services CNL Implementation and Evaluation (CNL I&E) Service was created as one mechanism to facilitate that goal in response to a need identified by facility nurse executives for consultative support for CNL practice integration. This article discusses strategies employed by the CNL I&E consultative team to help facility-level nursing leadership integrate CNLs into practice. Measures of success include steady growth in CNL practice capacity as well as positive feedback from nurse executives about the value of consultative engagement. Future steps to better integrate CNL practice into the VA include consolidation of lessons learned, collaboration to strengthen the evidence base for CNL practice, and further exploration of the transformational potential of CNL practice across the care continuum.
Thomas-Hawkins, Charlotte; Flynn, Linda; Lindgren, Teri G; Weaver, Susan
Little is known regarding the specific managerial activities or best practices that nurse managers in outpatient hemodialysis settings use to achieve positive safety outcomes. The purpose of this study was to identify and describe specific managerial practices used by nurse managers in outpatient hemodialysis units to enhance patient safety and quality of care. A descriptive qualitative design was used. Seventeen nurse managers in outpatient hemodialysis units comprised the study sample. Telephone interviews were conducted, and qualitative content analysis was used to encode the data. Nurse managers identified patients, staff, the dialysis unit environment, and the dialysis organization as sources of safety risks. Nurse manager safety practices illuminated from the data were complex and multifaceted, and were aimed at reducing patient, staff environmental, and organization risks. The findings from this study offer a description and a better understanding of the practices in which nurse managers in outpatient hemodialysis units engage to keep patients safe in their units, and they underscore the critical role of nurse managers in creating and maintaining patient safety within outpatient hemodialysis settings.
Langan, Joanne C; Tadych, Rita A; Kao, Chia-Chan
Although many have suggested strategies to resolve the nursing shortage, few have considered inactive RNs. This pilot study investigated reasons why nurses leave the practice, the type of work environment and resources necessary to entice RNs to return to practice, and the specific skills required to assist RNs in feeling confident and competent to return to practice. Herzberg's Two-Factor Theory was used to study motivation and hygiene factors enticing RNs to practice. A screening questionnaire was sent to 1,004 randomly selected RNs in Missouri to determine who were licensed but not practicing. Fifty-two full questionnaires were mailed and 33 (63%) were returned. Quantitative data were analyzed using SPSS, whereas qualitative data were coded and analyzed using manifest content analysis. The lack of motivators such as recognition of one's work and achievements was one reason why RNs left the practice. The hygiene factors of money, improved working conditions, refresher courses, and health insurance would motivate RNs to return to practice. Those wishing to entice inactive nurses to practice will need to offer sign-on bonuses or make the hourly wages and benefits package very competitive. This study indicates that nurses value flexible working hours, part-time opportunities, consideration of family lives, and positive relationships with administrators.
Johnston, James Scott
This book presents John Dewey's theory of inquiry and applies it to various areas of the primary, middle, and secondary school curricula. "Deweyan Inquiry" brings Dewey's theory of inquiry together with educational theory and practice. James Scott Johnston uses Dewey's late masterpiece "Logic: The Theory of Inquiry" as a guide and looks at inquiry…
Discusses why translation theory has had an inadequate impact on translation practice and gives specific examples of ways in which translation theory can provide the translator with general principles and methods of translating idioms. (SED)
This paper describes how an innocent venture outside the confines of academia to update my nursing skills completely changed the focus of my research. I was deeply involved in the theoretical development of my thesis, which I thought was a feminist exploration of the meaning of health for mid-life women. I was immersed in feminist theory and was exploring the work of the French Feminists. I had written comprehensive draft chapters about nursing, women's bodies and science. While I was absorbed in my theoretical exploration I decided to venture back into practice to improve my nursing skills. I am still unsure why I chose to do this; however, in hindsight, my theoretical exploration was inexorably pushing me in that direction. While my conscious thinking was focused on my stated topic, my subconscious (my intuition) turned me towards another. Being confronted with the reality of nursing practice through working with staff nurses in a gynaecological ward caused a major disjunction in every aspect of my research: the topic, my methodology and the setting, and the experience challenged my feelings about nurses and nursing. This inevitably led to a dramatic and fundamental change in my research.
Clinically based nurses often question the value of nursing theory, ultimately resulting in the reluctance to implement nursing theory into practice. This clinical practicum project successfully used Nightingale's primary tenets, such as building trust, self-assessment, and group leadership, as a theoretical framework in a nursing practice group for the purpose of teaching a group of preadolescent children about negative peer pressure. Preadolescent children are particularly vulnerable to peer group culture. Proactive strategies, as demonstrated through this project, can be used to positively influence children's behavior toward each other during the formative middle years. Group sessions addressed such topics as moral beliefs and values, bullying, and saying "no" to peer pressure and were structured using a variety of contemporary resources to develop interactive exercises that engaged the children and enhanced group communication. The children and their parents reported positive outcomes from the nurse-led group sessions.
Palmer, Deborah; El Miedany, Yasser
The extensive use of biological agents in recent years for the treatment of rheumatological diseases has required a steep learning curve for the specialist nurses who manage and work in this specialty. Safe prescribing of biological therapies requires good infrastructure and specialist nursing personnel. With additional training, the specialist nurse may take responsibility for a number of tasks in the patient pathway including screening, treatment administration, patient education, prescription coordination for home drug delivery, patient support, monitoring and data collection. Biological treatment is becoming more widely used in several specialities, in particular gastroenterology, dermatology and ophthalmology. Since 2002, rheumatology specialist nurses have taken the lead in assessment and providing biologic therapy, not only for patients suffering from rheumatic diseases but also for those with immune-mediated inflammatory disorders. The unique nature and variable safety profiles of these agents led to the development of immune-mediated inflammatory disease infusion (IMID) centres and highlighted the importance of having biological specialist nurses. This article will discuss the evolution of the IMID/biologic specialist nurse role and how IMID services started with goodwill from the rheumatology nurse specialists to develop into a main component of the holistic approach to care.
Bechtel, G A; Davidhizar, R; Tiller, C M; Quinn, M E
Health care reform, innovations in technology, and the need to make health care cost-effective have affected all aspects of health care practice and education. Critical thinking skills, interpersonal and communication skills, leadership and motivation skills, computer literacy, and cultural sensitivity are all capabilities nursing graduates must now possess if they are to practice effectively in the complex and competitive contexts that today define the health care marketplace. Partnerships with community agencies are essential if faculty are to prepare a new generation of nurses who will be proficient in the skills that 21st-century nursing practice will demand. Although academic institutions have made some changes to meet marketplace demands, nursing educators, practitioners, and researchers must thoroughly reconceptualize their philosophies and retool their curricula in response to these changes.
Romero Ruiz, Adolfo; Parrado Borrego, Gema; Rodríguez González, José; Caparrós Miranda, Isabel S; Vargas Lirio, M Isabel; Ortiz Fernández, Primitiva
There is currently around one million people receiving oral anticoagulants in Spain. The drug most used is acenocoumarol, which requires coagulation monitoring to ensure that the patient is within its normal therapeutic range. Patients usually start this treatment in a hospital clinic and, when they are stabilised, they are referred to primary care, where they are followed-up by their community nurses. The usual practice is that nurses are responsible for changes in the dose when the patients are outside the range. This practice is not performed by hospital nurses, despite having sufficient experience and knowledge to adequately manage these types of patients. An Advanced Nursing Practice model has been introduced into the Haematology management unit of the Hospital Universitario Virgen de la Victoria, Málaga. This involves various aspects of attention and care of patients on anticoagulant therapy, and includes adjusting the doses of their treatment following a catalogue of therapeutic and diagnostic ranges.
Hitchings, Kim S; Capuano, Terry Ann; Herzog, Mary Ellen
More than 25 years ago, the name "Friends of Nursing" was adopted by an academic, community Magnet(®) hospital to signify a model for community support of nursing. From inception, the intent was to recruit philanthropic dollars to promote recognition of and excellence in nursing practice, education, and research. Although philanthropy in health care settings is common, what is unique about this program is the long-standing, dedicated conceptual framework for nursing philanthropy and the very significant number of philanthropic dollars from literally thousands of donors to support a diverse range of activities to affect and advance the professional excellence of nurses and the quality of patient care. This model has been successfully replicated within a wide variety of other health care organizations and nursing services throughout the United States and abroad.
Freed, Patricia E; McLaughlin, Dorcas E
Contemporary nursing education is highly invested in the development of the academic, critical, and empirical aspects of education that represent the science of nursing, and concomitantly less attentive to the development of the creative, interpersonal aspects of education typically associated with the art of nursing. This represents a reversal of historic patterns in nursing education, but the pendulum may have swung so far that there could be costs to nursing practice unless the creative, interpersonal aspects of education can be reclaimed and balanced. Ideas and suggestions regarding how nurse educators might foster the creation of cultures of thinking, which represent whole-brain, integrated teaching approaches that are based on emerging neurocognitive evidence, are discussed.
Jamieson, Isabel; Taua, Chris
Many nurses leave nursing and never return. Others return after a period of time. Given the global shortage of nurses a better understanding of these movements is needed. The present study focused on nurses who had been out of nursing for more than five years, and explored factors that influenced their leaving and return to practice. All the nurses who had undertaken a Competency Assessment Programme at a given New Zealand tertiary institution during 2005 were invited to participate. Of the 70 questionnaires mailed out 32 (44.5%) were completed and returned. Quantitative data were analysed using Microsoft Excel, and the qualitative data were coded and analysed by means of content analysis. For each, leaving and returning, three key issues emerged. Nurses left for personal reasons, to seek a career change, or because of poor working conditions. They returned when they had the personal freedom to do so, for fiscal reasons, or because they were motivated by some sense of unfinished business. These findings indicate that it is important for educators involved with Competency Assessment Programmes to collaborate with employers in ensuring that there are opportunities for re-entry to positive work environments, with a degree of flexibility that suits the demographic characteristics of those nurses returning to practice.
Buckley, Thomas; Donoghue, Judith; Heartfield, Marie; Bryce, Julianne; Cox, Darlene; Waters, Donna; Gosby, Helen; Kelly, John; Dunn, Sandra V.
This article describes the context and development of the new Nurse Practitioner Standards for Practice in Australia, which went into effect in January 2014. The researchers used a mixed-methods design to engage a broad range of stakeholders who brought both political and practice knowledge to the development of the new standards. Methods included interviews, focus groups, surveys, and work-based observation of nurse practitioner practice. Stakeholders varied in terms of their need for detail in the standards. Nonetheless, they invariably agreed that the standards should be clinically focussed attributes. The pillars common in many advanced practice nursing standards, such as practice, research, education, and leadership, were combined and expressed in a new and unique clinical attribute. PMID:26162455
Cader, Raffik; Campbell, Steve; Watson, Don
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.
Paré, Guy; Sicotte, Claude; Moreault, Marie-Pierre; Poba-Nzaou, Placide; Nahas, Georgette; Templier, Mathieu
We investigated the effects of the introduction of mobile computing on the quality of home care nursing practice in Québec. The software, which structured and organized the nursing activities in patients' homes, was installed sequentially in nine community health centres. The completeness of the nursing notes was compared in 77 paper records (pre-implementation) and 73 electronic records (post-implementation). Overall, the introduction of the software was associated with an improvement in the completeness of the nursing notes. All 137 nurse users were asked to complete a structured questionnaire. A total of 101 completed questionnaires were returned (74% response rate). Overall, the nurses reported a very high level of satisfaction with the quality of clinical information collected. A total of 57 semi-structured interviews were conducted and most nurses believed that the new software represented a user-friendly tool with a clear and understandable structure. A postal questionnaire was sent to approximately 1240 patients. A total of 223 patients returned the questionnaire (approximately 18% response rate). Overall, patients felt that the use of mobile computing during home visits allowed nurses to manage their health condition better and, hence, provide superior care services. The use of mobile computing had positive and significant effects on the quality of care provided by home nurses.
Bergen, Ann; While, Alison
The present paper examines the mechanisms by which health and social care policies put forward by the Government may be translated into community nursing practice. Data from a research project on community nurse case managers were re-examined in the light of two classic theories often cited by policy analysts (i.e. implementation theory and 'street-level bureaucracy'). It was found that the extent to which nurses adopted the case management role, and the model of choice, depended on four major interrelated variables, namely: (1) the clarity of policy guidance; (2) the extent to which it coincided with professional (nursing) values; (3) local practices and policies; and (4) the personal vision of the community nurse. It is argued that this framework may have wider relevance, and this was tested out in two ways. First, major change in one of these variables (Government policy) over time was analysed for its effect on case management practice via the remaining variables. Secondly, an unrelated, but policy-initiated, nursing issue (nurse prescribing) was briefly examined in the light of the framework. It is suggested that this framework may be of some use when considering the likely practice response to policy-related changes in community nursing.
Talbert, Tukea L
The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders.
Seed, Mary S; Torkelson, Diane J; Karshmer, Judith F
The national movement to transform the health care delivery systems must include a focus on mental health treatment. To address similar deficits across other practice domains, the Clinical Nurse Leader (CNL) role has been created. The CNL is a master's degree that prepares a nurse to use a systems perspective to improve outcomes for a cohort of patient, deliver care based on best practices, and coordinate care in a multidisciplinary team. Applying the CNL role to mental health care could help psychiatric mental health nursing be at the forefront in the transformation of mental health care delivery.
Højskov, Ida E; Glasdam, Stinne
The admission interview is usually the first structured meeting between patient and nurse. The interview serves as the basis for personalised nursing and care planning and is the starting point for the clinic's documentation of the patient and his course of treatment. In this way, admission interviews constitute a basis for reporting by each nurse on the patient to nursing colleagues. This study examined how, by means of the admission interview, nurses constructed written documentation of the patient and his course of treatment for use by fellow nurses. A qualitative case study inspired by Ricoeur was conducted and consisted of five taped admission interviews, along with the written patient documentation subsequently worked out by the nurse. The findings were presented in four constructed themes: Admission interviews are the nurse's room rather than the patient's; Information on a surgical object; The insignificant but necessary contact; and Abnormalities must be medicated. It is shown how the nurse's documentation was based on the admission interview, the medical record details on the patient (facts that are essential to know in relation to disease and treatment), as well as the nurse's preconception of how to live a good life, with or without disease. Often, the patient tended to become an object in the nurse's report. It is concluded that in practice, the applied documentation system, VIPS, comes to act as the framework for what is important to the nurse to document rather than a tool that enables her to document what is important to the individual patient and his special circumstances and encounter with the health system.
Tennessee State Board for Vocational Education, Murfreesboro. Vocational Curriculum Lab.
THE LESSON PLANS FOR A UNIT ON MENTAL NURSING IN THE PRACTICAL NURSE EDUCATION PROGRAM WERE DEVELOPED BY A GROUP OF REGISTERED NURSES HOLDING TENNESSEE TEACHING CERTIFICATES. STUDENTS SELECTED FOR THE PROGRAM SHOULD BE HIGH SCHOOL GRADUATES OR EQUIVALENT. THE LESSONS DESIGNED FOR USE BY A REGISTERED NURSE CERTIFIED FOR TEACHING GIVE OBJECTIVES,…
How many times have we read a report or piece of research that suggests nurses could be taking on more of the work currently performed by doctors? It is invariably accompanied by figures suggesting that the NHS would save squillions of pounds every year if only consultants and GPs let nurses take on more responsibilities. Not only that, but access to services would improve and outcomes would be unaffected or might even be enhanced.
The first in a five-part series on sociology offers an overview of the debate about the relationship between sociology and nursing. Although sociological education is currently limited within nurse education, there is a long-held argument for its relevance. With a growing emphasis on preventative and public healthcare, sociology may yet prove its usefulness. Subsequent articles cover four of the key social factors affecting health.
Newham, Roger Alan
Philosophical and empirical work on the nature of the emotions is extensive, and there are many theories of emotions. However, all agree that emotions are not knee jerk reactions to stimuli and are open to rational assessment or warrant. This paper's focus is on the condition or conditions for compassion as an emotion and the likelihood that it or they can be met in nursing practice. Thus, it is attempting to keep, as far as possible, compassion as an emotion separate from both moral norms and professional norms. This is because empirical or causal conditions that can make experiencing and acting out of compassion difficult seem especially relevant in nursing practice. I consider how theories of emotion in general and of compassion in particular are somewhat contested, but all recent accounts agree that emotions are not totally immune to reason. Then, using accounts of constitutive conditions of the emotion of compassion, I will show how they are often likely to be quite fragile or unstable in practice and particularly so within much nursing practice. In addition, some of the conditions for compassion will be shown to be problematic for nursing practice. It is difficult to keep ideas of compassion separate from morality, and this connection is noticeable in the claims made of compassion for nursing and so I will briefly highlight one such connection that of the need for normative theory to give an account of the value that emotions such as compassion presume and that compassionate motivation is separate from moral motivation and may conflict with it. The fragility or instability of the emotion of compassion in practice has implications for both what can be expected and what should be expected of compassion; at least if what is wanted is a realist rather than idealist account of "should."
Callister, Lynn Clark; Matsumura, Gerry; Lookinland, Sandra; Mangum, Sandra; Loucks, Carol
With the increasing emphasis on evidence-based nursing practice, nurse educators need to more fully implement teaching strategies that help students gain critical thinking skills related to inquiry and understand the importance of evidence-based nursing practice. Research and scholarship emphases in one baccalaureate nursing program, student-identified benefits, and challenges associated with incorporating inquiry across the curriculum are described in this article. In clinical journal entries, students described the following benefits associated with curricular emphasis on inquiry: increased interest in evidence-based nursing practice and participating in the generation of research; enhanced critical thinking skills through the development of knowledge, experience, and competencies; increased motivation to continue professional growth and development by participating in lifelong learning; the desire to become better consumers of research findings; better understanding of the "real world" of clinical research; and increased desire to pursue graduate studies in nursing. The challenge to promote student growth toward competence in the application of evidence-based principles in clinical practice is ongoing.
Staggers, N; Gassert, C A; Curran, C
Valid and comprehensive nursing informatics (NI) competencies currently are lacking. Meanwhile, nursing leaders are emphasizing the need to include NI in nursing curricula, as well as within the roles of practicing nurses in all settings. This article presents the initial work of a team of NI experts toward development of a valid and reliable set of NI competencies. Previous work primarily has focused on computer-related skills, rather than examining a broad definition of informatics competencies. For this current work, NI competencies encompass all skills, not only computer-related skills, as well as knowledge and attitudes needed by nurses. The first two authors created a database of NI competencies from the existing literature. A larger panel of NI experts then affirmed, modified, added, or deleted competencies from this database. Competencies were placed into four distinct skill levels. Definitions of each skill level and an initial master list of competencies are provided.
The school leader's behaviors are inspired by theories, and theories are intrinsic to practice. This paper provides an overview of an emerging perspective in educational administration, critical theory. The paper first highlights the philosophies of Immanuel Kant, Fichte, Hegel, Marx, and the Frankfurt School. It then discusses critical theory…
Johnson, R. Burke; Stefurak, Tres
In "Towards a systemic theory of gifted education", Ziegler and Phillipson offer a useful critique of current research and the current paradigm in gifted education. They provide an interesting and useful merging of systems theory with their actiotope model, and using this paradigm they suggest many fruitful areas for future research. However, the…
Millberg, Lena German; Berg, Linda; Brämberg, Elisabeth Björk; Nordström, Gun; Ohlén, Joakim
The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful.
Hochtritt, Lisa; Thulson, Anne; Delaney, Rachael; Dornbush, Talya; Shay, Sarah
Once a month, art educators from the Denver metro area have been gathering together in the spirit of inquiry to explore issues of the perceived theory and daily practice divide. The Theory Loves Practice (TLP) group was started in 2010 by Professors Rachael Delaney and Anne Thulson from Metropolitan State University of Denver (MSU) and now has 40…
Beam, Rita J; O'Brien, Ruth A; Neal, Michelle
Reflective practice is defined as a cyclical process involving a series of phases in which an individual describes a salient event, attends to his/her positive and negative feelings about the event, and ultimately reexamines the experience in an effort to understand and to plan how he or she would act in a similar situation in the future. This paper describes how the concept of reflective practice is integrated into the evidence-based Nurse-Family Partnership (NFP) program. The pivotal role of the nursing supervisor in guiding nurses to engage in reflection on their work with families is emphasized. Exemplars drawn from the experience of 2 NFP nursing supervisors are presented to illustrate how reflection in the NFP program is operationalized. The benefits as well as the challenges to the use of reflective practice are also discussed. While anecdotal comments from NFP nurses and supervisors are cited to suggest how the regular use of reflective practice has the potential to improve implementation of the program with families, the authors further propose that research is needed to more rigorously examine the benefits that reflective practice may have on the quality of program implementation, family outcomes, and the retention of nurses working in the NFP program.
Bell, Sue Ellen; Hulbert, James R
Translating social justice into clinical nurse specialist (CNS) practice involves not only facilitating equitable access to healthcare resources but also changing the definition of health from individual centric to population based. Clinical nurse specialists working within hospitals or healthcare systems generally have not explored the ethical conflicts between demand and available healthcare resources. Application of social justice to CNS practice requires microallocation decisions in direct patient care and macroallocation decisions in the distribution of all societal goods that alleviate health disparities. This article reviews the meaning, history, and current basis for the application of the principle of social justice to CNS practice.
Cost-effective nursing practice is essential to succeed today as resources allocated to health care are declining. Realizing that any change poses a threat to our security, it is imperative that stakeholders be permitted to participate in decision-making processes affecting their work. An honest, open exchange of ideas towards cost-effective practices should be encouraged. Cost-effective behaviours are influenced significantly by negative attitudes with regard to loss of human resources, increased workload, and potential pay cuts. This article describes innovative strategies which could promote successful cost-effective nursing practice, including working smarter, not working harder. Topics addressed are attitude, awareness and empowerment.
Hammad, Sawsam Mohammad; Al-Hussami, Mahmoud; Darawad, Muhammad Waleed
In Jordan, there is a gap in literature regarding nurses' practices of enteral nutrition. Thus, the purpose of this study was to assess nurses' practices regarding enteral nutrition of critically ill adult patients. A descriptive, cross-sectional design was used to collect data through self-reported questionnaires and descriptive analyses were used to display the results of the study. The results revealed that some aspects of enteral nutrition practices were consistent with the current best evidences such as initiation time of enteral nutrition and backrest elevation. On the contrary, some aspects showed variations and inconsistency with current best evidences such as the amount of high gastric residual volume and its management. Nurses' practices regarding enteral nutrition were not consistent with international guidelines. This inconsistency can predispose patients to underfeeding. Enhancement of research utilization is highly recommended as well as establishing evidence-based guidelines.
Allan, H T; Smith, P
This paper considers two questions: what pedagogies for teaching nursing are used in nurse education research? Are these pedagogies transferred to learning in the workplace? We argue that there are underpinning pedagogies identified in nurse education research in the area of workplace and work based learning which are broadly qualitative, action orientated and focused on knowledge generation. Such pedagogies are rooted in a philosophy of teaching and learning where learning is seen as active, reflective and socially constructed. We consider possible answers to these questions through an exploration of empirical work by Evans et al. (2009) which has focused on knowledge transfer in the workplace. Their work offers insights into how pedagogies can be applied to nurse education research which in turn may be transferred into the workplace. In particular, they argue that the concept of knowledge transfer is outdated and we should focus instead on how knowledge learnt in one context (the academy) is re-contextualised in another (the workplace). We also draw on Aranda and Law's (2007) paper on the debates concerning the use of sociology in nurse education to explore competing narratives. We conclude that the pedagogies identified in educational research are not transferred to nurse education and practice yet offer an alternative view of knowledge transfer as illustrated by Evans et al.'s work which explores how learning in the workplace may be facilitated more effectively. We conclude that the lack of transfer of nurse education research pedagogies to practice learning undermines the position of nurse teachers within the academy as nurse education becomes a practice or professional discipline without a discrete disciplinary base.
Coetzee, Siedine Knobloch; Klopper, Hester C
"Compassion fatigue" was first introduced in relation to the study of burnout among nurses, but it was never defined within this context; it has since been adopted as a synonym for secondary traumatic stress disorder, which is far removed from the original meaning of the term. The aim of the study was to define compassion fatigue within nursing practice. The method that was used in this article was concept analysis. The findings revealed several categories of compassion fatigue: risk factors, causes, process, and manifestations. The characteristics of each of these categories are specified and a connotative (theoretical) definition, model case, additional cases, empirical indicators, and a denotative (operational) definition are provided. Compassion fatigue progresses from a state of compassion discomfort to compassion stress and, finally, to compassion fatigue, which if not effaced in its early stages of compassion discomfort or compassion stress, can permanently alter the compassionate ability of the nurse. Recommendations for nursing practice, education, and research are discussed.
Sebastian, Juliann G; White Delaney, Connie
This article examines development opportunities for faculty teaching in Doctor of Nursing Practice (DNP) programs. Although faculty development for DNP programs is similar to that of other academic programs, faculty may need different strategies for teaching, scholarship, and service because DNP programs focus on translation of science into practice, systems-level changes, clinical scholarship, and the highest levels of advanced nursing practice. Faculty and student collaboration across DNP and PhD programs provide new approaches for translating research into practice and generating practice questions in need of further scientific development. Specific faculty development strategies for facilitating this collaboration are essential. Capstone projects pose special opportunities for faculty development due to the integration of these projects within diverse practice environments, with differing expectations, regulations, and pacing compared with research. Linking new care delivery models with health informatics is expected to facilitate rapid translation of research and development of improvements in practice.
Clinical supervision of nursing students is a key component of nursing education. The clinical setting provides students with an opportunity to develop a professional identity, knowledge base, and the ability to transfer classroom knowledge to the clinical setting. This paper suggests a model of clinical supervision that will address how to bridge the pre-existing theory-practice gap in nursing education through an attitude of caring and the utilization of caring behaviours based on Leininger's theory of culture care. Key concepts included in this model are: communication, collaboration, application, reflection and evaluation, these concepts comprise the CCARE model of clinical supervision.
This is the second in a two-part unit on health promotion in sexual health. Part 1 outlined various theories and models on the issue. This part examines the factors that contribute towards successful health promotion, such as an effective communication style. It outlines how nurses can put health-promotion theory, competencies and guidance into practice.
Ritter, J; Fralic, M F; Tonges, M C; McCormac, M
Changes within the health care system necessitate changes in nursing practice. Given the financial environment and the need to balance the cost/quality equation, case management will become increasingly important and has the potential to become the predominant care delivery system of the 1990s. This transition represents a tremendous opportunity for nursing. The CCM role offers many potential advantages and benefits for individual nurses and the profession as a whole. Nurses practicing as case managers have the opportunity to function in a highly professional, independent manner with a great deal of interdisciplinary collaboration. In addition to the challenges and satisfactions of the work itself, the nurse case manager may also enjoy a higher salary and more scheduling control and flexibility. The broader advantages of case management include its benefits to patients and institutions and its fit with current trends in the health care environment. Nurse case managers manage hospital systems to produce optimal clinical outcomes for patients in the shortest time using as few resources as possible. This approach to care delivery places nurses in a position to demonstrate the tremendous contribution they can make to achieving the institution's goal of delivering high-quality, cost-effective care. Thus, case management fits extremely well with current trends in health care financing and outcome measurement. The model described in this article illustrates one approach to implementing these important concepts in a critical care setting.
Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim
Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements.
Fressancourt, Yves; Quémeneur, Éric; Bertho, Kilian; Dubourg, Olivier
Intervening in the event of a major crisis in France and abroad, the national gendarmerie intervention group carries out complex and specific operations in varied conditions and environments. Due to the multiplicity and dangerousness of the missions, adapted and integrated medical support is essential. In this context, nurses provide operational medical assistance as close as possible to the intervention. This nursing practice in an exceptional environment requires specific knowledge and intensive training.
Reilly, Christine E; McDanel, Heather
1. Mental health needs exist in medically underserved areas and can be addressed in nurse-managed, community-based health centers. 2. Cognitive therapy techniques can be used in community-based health centers to intervene and alleviate patients' distress and improve their adherence to treatment. 3. A training program in cognitive therapy can help advanced practice nurses and other health care providers implement the techniques needed to address many behavioral and mental health problems.
Lyons, Stacie Salsbury; Specht, Janet Pringle; Karlman, Susan E.
Registered nurses make measurable contributions to the health and wellness of persons living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively impact resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based upon eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness of this framework for professional nursing practice. PMID:20077966
Rockett, Hannah; Thompson, Hilaire J; Blissitt, Patricia A
Current evidence shows that fever and hyperthermia are especially detrimental to patients with neurologic injury, leading to higher rates of mortality, greater disability, and longer lengths of stay. Although clinical practice guidelines exist for ischemic stroke, subarachnoid hemorrhage, and traumatic brain injury, they lack specificity in their recommendations for fever management, making it difficult to formulate appropriate protocols for care. Using survey methods, the aims of this study were to (a) describe how nursing practices for fever management in this population have changed over the last several years, (b) assess if institutional protocols and nursing judgment follow published national guidelines for fever management in neuroscience patients, and (c) explore whether nurse or institutional characteristics influence decision making. Compared with the previous survey administered in 2007, there was a small increase (8%) in respondents reporting having an institutional fever protocol specific to neurologic patients. Temperatures to initiate treatment either based on protocols or nurse determination did not change from the previous survey. However, nurses with specialty certification and/or working in settings with institutional awards (e.g., Magnet status or Stroke Center Designation) initiated therapy at a lower temperature. Oral acetaminophen continues to be the primary choice for fever management, followed by ice packs and fans. This study encourages the development of a stepwise approach to neuro-specific protocols for fever management. Furthermore, it shows the continuing need to promote further education and specialty training among nurses and encourage collaboration with physicians to establish best practices.
Gale, J; Marshall-Lucette, S
Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery.
LeFlore, Judy L.; Thomas, Patricia E.
Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system. PMID:27465446
Marucci, Anna Rita; De Caro, Walter; Petrucci, Cristina; Lancia, Loreto; Sansoni, Julita
ICNP is a standardized nursing terminology included within acknowledged terminologies by WHO, it is a relevant aspect of ICN programs and strategies. This paper aims to describe structure and characteristics of ICNP terminology as well as to highlight how this tool can be useful both in practice and in terms of nursing professional development. This version looks like a pyramid with seven axes describing different areas of nursing and related interventions, enriched by two special axes related to pre-coordinated Diagnosis / Outcomes (DC) and Operations (IC) which facilitate daily use in practice. In order to clarify how this tool can be actually be used in daily nursing practice some examples are provided, clarifying how adopting the current version of ICNP terminology (2015 release) Diagnosis/Outcomes and Interventions can be built. The ICNP Italian Centre is committed to introduce it to Italian nurses as a tool for sharing and disseminating terminology in our Country, having as main final aim to achieve even in Italy, professional visibility objectives promoted in different ways by the International Council of Nurses.
Miller, Louise C; Devaney, Susan W; Kelly, Glenda L; Kuehn, Alice F
Attrition in the public health nursing work force combined with a lack of faculty to teach public health prompted development of a "long-distance" learning project. Practicing associate degree nurses enrolled in an online course in population-based practice worked with experienced public health nurse "e-mentors." Student-mentor pairs worked through course assignments, shared public health nursing experiences, and problem-solved real-time public health issues. Nursing faculty served as coordinators for student learning and mentor support. Over 3 years, 38 student-mentor pairs participated in the project. Students reported they valued the expertise and guidance of their mentors. Likewise, mentors gained confidence in their practice and abilities to mentor. Issues related to distance learning and e-mentoring centered around use of technology and adequate time to communicate with one another. E-mentoring is a viable strategy to connect nurses to a learning, sharing environment while crossing the barriers of distance, agency isolation, and busy schedules.
As the advanced practice nursing initiative in Canada gains momentum, effort is being directed towards clarifying and defining advanced practice roles. A qualitative study was undertaken to increase understanding of the clinical nurse specialist role of advanced practice. Sixteen nurses who worked in advanced practice roles, organizing and providing healthcare for children with complex health needs and their families across the continuum of care, participated in in-depth conversations about the nature of their practice, the knowledge that informs it and the factors that influence it. Findings suggest that clinical nurse specialists have a unique role in the organization and delivery of healthcare for specialized populations with complex health needs in their dual focus on the system level of healthcare and on population health needs. Initiatives directed to children and families within the study participants' specialties included program development, consultation and educational outreach and the development of clinical guidelines and policies. Although the nurses described their practice as focusing both on individual children and families and on the population of children and families within their specialty, it is at the population level that they see their greatest potential for contributing to the delivery of high-quality, cost-effective healthcare.
Burkitt, Ian; Husband, Charles; Mackenzie, Jennifer; Torn, Alison
The processes whereby nurses develop the skills and knowledge required to deliver individualized and holistic care were examined in a 2-year study of nurses in a range of clinical settings and a university department of nursing in England. Members of two research teams of qualified nurses joined various communities of nursing practice as…
Kjervik, Diane K.; Leonard, Dianne J.
Responses from 409 registered nurses, 105 nurse managers, 144 nurse educators, and 31 licensed practical nurses indicated that 92% were willing to retool, defined as prepare for evolving nursing roles. They were less likely to be aware of employer expectations or supports for retooling. Areas needing development included critical thinking,…
Pritchard, Toni L. Early
The nursing shortage is compounded by nursing student attrition. Schools of nursing have limited enrollment, making the admission process an important factor in resolving the ongoing nursing shortage. The purpose of this study was to identify preadmission criteria that accurately identify applicants to practical/vocational nursing (P/VN) schools…
Martsolf, D S; Mickley, J R
Although nursing has recognized spirituality as an important aspect of holistic patient care, exactly what spirituality means has remained rather amorphous. The purpose of this article is to present aspects of spirituality found in modern nurse theorists' ideas. These aspects are presented both in relation to reciprocal interaction or simultaneous action world-views and in relation to the extent of focus on the concept within the model or theory. This discussion will provide the researcher and practitioner with additional theoretical understanding on which to ground investigations and base practice.
Christie, Wanda; Jones, Sara
Lateral violence (LV), a deliberate and harmful behavior demonstrated in the workplace by one employee to another, is a significant problem in the nursing profession. The many harmful effects of LV negatively impact both the work environment and the nurse's ability to deliver optimal patient care. In this article, the authors explain how Conti-O'Hare's Theory of the Nurse as Wounded Healer can be used in situations of lateral violence to resolve personal and/or professional pain, build therapeutic relationships, and promote positive work environments. A working model of the theory is applied to the experience of LV in nursing to demonstrate the nurse's path from being the 'walking wounded' to becoming a 'wounded healer.' Implications of this theory for promoting the process of healing and creating an environment that disenables violence are presented; an example is provided. The authors conclude that both practitioners and managers must be aware of the occurrence of LV and of the need for healing. They note that the 'journey of the walking wounded' is an ideal pathway to bring about this healing. As nurses promote health in their patients, they must also promote health in themselves and one another.
Ribeiro, M C; Bertolozzi, M R
Considering the side effects of environmental changes over the population's health, a theoretical model is proposed in this study in order to incorporate ecologic matters into the nursing practices. The reference for this work is the eco-socialist-marxist theory. The model is based on the analysis of the capitalist economic process, its production technologies and consumption. It is known that this economic model generates ecoinequalities and anthropogenic impacts that rebound on the health-disease profile of the population. The nursing action, permeated by ecological awareness, can prevent and also combat ecoinequalities and destructive human actions on the environment.
Henry, B.; McAuliffe, M.
A survey was conducted of the anaesthesia services provided by nurses and the education available to them in this field in 107 countries. Among the procedures carried out were general anaesthesia, spinal blocks and tracheal intubation. The implications of the findings for health planning and policy-making are discussed with particular reference to workforce structure and women's involvement in it. PMID:10212519
Mindfulness is becoming more widely recognised and increasing thought is devoted to how it, along with compassion, can benefit health professionals. This article explores the concepts of mindfulness and compassion and the positive effect they may have on staff and patients. It outlines how nurses can practise these activities, and presents a case study highlighting the benefits that have been reported.
Kalischuk, Ruth Grant; Thorpe, Karran
The concept of creativity was explored in focus groups with 12 nursing students and 2 faculty. Their perceptions centered on the theme of striving for balance, which enabled them to be most creative. Strategies for fostering creativity were related to this theme and three subthemes: enhancing self-esteem, working within structure, and making time…
dos Santos, Mateus Casanova; Leite, Maria Cecília Lorea; Heck, Rita Maria
This is an investigative case study with descriptive and participative character, based on an educational experience with the Simulation in Nursing learning trigger. It was carried out during the second semester of the first cycle of Faculdade de Enfermagem (FEN), Universidade Federal de Pelotas (UFPel). The aim is to study the recontextualization of pedagogic practice of simulation-based theories developed by Basil Bernstein, an education sociologist, and to contribute with the improvement process of education planning, and especially the evaluation of learning trigger. The research shows that Bernstein's theory is a powerful tool semiotic pedagogical of practices which contributes to the planning and analysis of curricular educational device.
Heartfield, Marie; Gibson, Terri
This paper reports the findings of a research project designed to identify national issues impacting on the development of a mentoring framework for nurses in general practice in Australia. The project comprised the first phase of a three-phase study commissioned by the Australian Government Department of Health and Ageing to develop a contemporary, flexible and sustainable mentoring framework that enhances the capacity of nurses to contribute to general practice outcomes. Key stakeholders and influential informants from around Australia were brought together via a national teleconference to identify issues surrounding the development of such a framework. Outcomes focussed on major themes concerning choice, relationships, structures and resources. Here, we consider the issues and challenges identified in light of some contemporary case studies from outside the field of nursing in the hope of sparking new ideas and strategies. A case study from an Australian practice nurse is included. No research has been conducted on mentoring for nurses in general practice in Australia to date, highlighting an urgent need for new models and their evaluation.
Mosqueda-Díaz, Angélica; Vílchez-Barboza, Vivian; Valenzuela-Suazo, Sandra; Sanhueza-Alvarado, Olivia
This article reflects on the Critical theory, stemming from the most important philosophical concepts and the modifications it has endured over time. Thereafter, we expose the contribution of the Critical theory to Nursing. This emphasizes on the contextual analysis of the phenomena and it is a self-critique to prevent dogmatisms and totalitarianisms. It postulates that in order to establish a truth, we must consider the historical conditions within which said truth emerges. Jürgen Habermas, with his Theory of Communicative Action, reorients the original postulates of the Critical theory, making it more coherent from the social point of view, through the Guiding Interests of Knowledge. Nursing professionals who follow the Critical theory highlight the need to improve the description of the construction of knowledge with an emancipating and liberating purpose, which permits Nursing to provide responses to approach reality through a global and dialectic vision and from a democratic position of knowledge, construct research from the social situational reality that is part of its daily experience; everything that can be unified as a "Philosophy of Nursing Care", which should be incorporated onto the professional formation of the discipline and onto the research area.
Mister, Brenda J.
There has been a dramatic increase in the nation's racial and ethnic minority populations over recent years. This increase is placing a higher demand on the health care industry to provide culturally competent care to these diverse populations. This challenge is met with yet another problem as the nation faces a critical shortage of nurses, particularly minority nurses. This shortage is only expected to worsen over the next several years. As schools of nursing across the country are being asked to increase the number of nursing program graduates, specifically minorities, they are confronted with a double edged sword as retention rates are decreasing, and attrition rates are increasing. This is particularly troublesome when many racial and ethnic minority nursing students do not graduate. This qualitative study was implemented to assess and understand the perceived educational experiences of racial and ethnic minority nursing students enrolled in a rural community college nursing program on the Eastern Shore of Maryland. Eight voluntary nursing students who identified themselves as either a racial or ethnic minority participated in the study. Data were collected by: individual audio-taped interview sessions; audio-taped focus group sessions; and documentation of field notes. Participants also provided demographic information and were asked to provide a brief written response to a scenario regarding increasing the recruitment and retention rates of minority nursing students. All data were analyzed utilizing the constant comparative method. Results of the study revealed six different themes: personal support systems and peer relationships; college services and academic resources; faculty support; cultural understanding versus cultural insensitivity; personal attributes of self-efficacy/advice for future nursing students; and suggestions for college and nursing program improvement. After the major themes were examined one central theme, a grounded theory, was born. The
Harwood, Lori; Ridley, Jane; Lawrence-Murphy, Julie Ann; White, Sharon; Spence-Laschinger, Heather K; Bevan, Joy; O'Brien, Karen
The purpose of this study was to examine the effect of a renal nursing professional practice model (PPM) on nurses'perceptions of empowerment, characteristics of practice environments and the impact on nursing care outcomes in a university-based teaching hospital in Canada. Quantitative and qualitative methodologies were used. This paper will focus on the qualitative results. Content analysis was the data analysis method used. The following themes emerged: 1) Attunement, familiarity/knowing the patient, going the distance, 2) Patient outcomes, consistency and continuity of care, autonomy/taking the initiative, 3) Nurse rewards: satisfaction and accountability, empowerment/input, and 4) Facilitating systems: communication, support and assignment. The quantitative results had a significant (p = .005) improvement post-PPM implementation in the nursing foundations for quality of care subscale of the Practice Environment Scale of the Nursing Work Index (NWI-PES) and organizational relationships (p =.016) measured by the Conditions of Work Effectiveness II (CWEQ-II) questionnaires. This study provides evidence for PPMs and primary nursing as effective frameworks to positively impact nursing and patient outcomes in a hemodialysis unit.
Sharpnack, Patricia A; Moon, Hope M; Waite, Pam
Today's practicing nurse faces many challenges and opportunities, and as a result, new graduate readiness for practice has increasing importance. Research completed by the Nursing Executive Center, the Advisory Board's research membership serving nursing administrators, acknowledged a considerable disparity between graduate nurse competencies and the expectation of employing healthcare systems. A pilot project designed to guide preceptors in the role of educator fostered the development of new nurse competencies that helped facilitate transition to professional practice.
Kwekkeboom, Kristine L; Bumpus, Molly; Wanta, Britt; Serlin, Ronald C
Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses.
LaRose, Patrick S., Sr.
The role of the registered nurse has evolved over the years as technology has changed and the practice of nursing has advanced. There are many factors that influence how a new nurse enters practice; however, confidence appears to play a large role in the way nursing students see themselves and how this self perception regulates transition to…
Frakes, Michael A; Evans, Tracylain
The federal government spends nearly 15% of the budget on Medicare services annually, and advanced practice nurses are eligible for reimbursement from that pool. The regulations governing reimbursement are complex because of the social, political, and financial pressures involved in their development. Although economic viability and due diligence considerations make it incumbent on advanced practice nurses to understand the rules, the profession, as a whole, has knowledge deficits in this area. The essentials of regulatory development and structure are reviewed and considerations for optimizing reimbursement are described.
Balint, Katherine A; George, Nancy M
The role of the Faith Community Nurse (FCN) is a multifaceted wholistic practice focused on individuals, families, and the faith and broader communities. The FCN is skilled in professional nursing and spiritual care, supporting health through attention to spiritual, physical, mental, and social health. FCNs can help meet the growing need for healthcare, especially for the uninsured, poor, and homeless. The contribution of FCNs on, primary prevention, health maintenance, and management of chronic disease deserves attention to help broaden understanding of the scope of FCN practice.
Doody, Owen; Noonan, Maria
Ethics is fundamental to good research practice and the protection of society. From a historical point of view, research ethics has had a chequered past and without due cognisance there is always the potential for research to do harm. Research ethics is fundamental to research practice, nurse education and the development of evidence. In conducting research, it is important to plan for and anticipate any potential or actual risks. To engage in research, researchers need to develop an understanding and knowledge of research ethics and carefully plan how to address ethics within their research. This article aims to enhance students' and novice researchers' research ethics understanding and its application to nursing research.
Pye, Sherry; Green, Angela
Since its development in 1998, the Cardiology Advanced Practice Nurse team has been plagued by retention issues. The coordinator for the team developed this leadership project while participating in the 2008 to 2009 Maternal-Child Health Leadership Academy sponsored by Sigma Theta Tau International and Johnson & Johnson. The focus of this project was to develop, implement, and evaluate initiatives to empower the advanced practice nurse team, promote their professional development, and ultimately improve retention of team members. Although evaluation data show progress toward addressing work environment issues, retention remains an ongoing problem.
Potvin, Louise; Gendron, Sylvie; Bilodeau, Angèle; Chabot, Patrick
The innovative practice that resulted from the Ottawa Charter challenges public health knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of public health programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114
McCormick, K A; Lang, N; Zielstorff, R; Milholland, D K; Saba, V; Jacox, A
The American Nurses Association (ANA) Cabinet on Nursing Practice mandated the formation of the Steering Committee on Databases to Support Clinical Nursing Practice. The Committee has established the process and the criteria by which to review and recommend nursing classification schemes based on the ANA Nursing Process Standards and elements contained in the Nursing Minimum Data Set (NMDS) for inclusion of nursing data elements in national databases. Four classification schemes have been recognized by the Committee for use in national databases. These classification schemes have been forwarded to the National Library of Medicine (NLM) for inclusion in the Unified Medical Language System (UMLS) and to the International Council of Nurses for the development of a proposed International Classification of Nursing Practice. PMID:7850567
Zimmerman, Sheryl; Shier, Victoria; Saliba, Debra
The nursing home culture change movement aims to improve resident quality of life and quality of care by emphasizing the deinstitutionalization of nursing home culture and focusing on person-centered care. This article briefly reviews the history of culture change, discusses some of the challenges related to culture change in nursing homes, and overviews the conceptualization and select models of culture change. Building from this background, it critiques current understanding, identifies critical research questions, and notes key issues arising during a workshop that addressed existing and emerging evidence in the field. This review and analysis provide a context for how 9 accompanying papers in this supplemental issue of The Gerontologist fill identified evidence gaps and provide evidence for future practice and policies that aim to transform nursing home culture.
Krautscheid, Lorretta C
Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission's 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student's ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the results of a three-year review of undergraduate student nurse performance (n = 285) related to effective clinical communication. Changes in teaching-learning strategies, implementation of a standardized communication tool, and clinical enhancements which resulted in improved student competency, will be presented.
Attempts to give some idea of how reinforcement and other learning principles work in practice with students in ordinary schools by using as reference three workshops for teachers run by educational psychologists in Birmingham in 1975. (Author/RK)
The number of blogs and related online activities continues to grow exponentially each year. Patients increasingly are turning to the Internet for personalized, timely, and relevant health information; blogs remain a large source of that information. Nurses and other healthcare professionals can harness the informational, educational, networking, and supportive power of blogs, as well, and should understand how to access and use blogs for professional use.
de Shazer, S
"Useful distinctions in conceptual schemes lead to explanatory or descriptive metaphors that have a clear form. Muddles, on the other hand, are created when useful distinctions that could be drawn are not[,] or when an unnecessary distinction is drawn" (5, p. 71; italics omitted), or when when a useful distinction is minimized or blurred. The field of family therapy (particularly its theories), as a whole, has various muddles of each kind. The purpose of this essay is to describe some of these muddles (in the field and its theories) and to suggest that the distinctions (a) between descriptions of doing therapy that exclude the therapist and descriptions of doing therapy that include the therapist (1, 5-9, 11), (b) between explanation and description, and (c) between ideology and grounded theory, are useful, and that in de-radicalizing and minimizing these distinctions, these differences creates mayhem and muddle--a veritable fog of non-clarity.
Keller, Linda O; Schaffer, Marjorie A; Schoon, Patricia M; Brueshoff, Bonnie; Jost, Rose
Preparation of the public health nursing (PHN) workforce requires public health nurses from academia and practice to collaborate. However, a shortage of PHN clinical sites may lead to competition between schools of nursing for student placements. The Henry Street Consortium, a group of 5 baccalaureate schools of nursing and 13 local health departments in the state of Minnesota, developed a model for collaboration between PHN education and practice. This paper describes the development process--the forming, storming, norming, and performing stages--experienced by the Henry Street Consortium members. The consortium developed a set of entry-level core PHN competencies that are utilized by both education and practice. It developed menus of learning opportunities that were used to design population-based PHN clinical experiences. In addition, the consortium created a model for training and sustaining a preceptor network. The members of the Henry Street Consortium collaborated rather than competed, used consensus for decision making, and respected and accepted different points of view. This collaboration significantly impacted how schools of nursing and local health departments work together. The consortium's ability to retain its relevance, energy, and momentum for both academic and agency partners sustains the collaboration.
Risling, Tracie; Ferguson, Linda
Although the community of practice (CoP) concept has been heavily utilized in business literature since its inception in the 1990s, it has not been significantly featured in nursing research. With student-centered approaches increasingly infusing nursing classrooms, including opportunities for collaborative learning and the development of student learning communities, it may be time to ask: Do we practice what we teach? Nursing academia faces challenges related to recruitment and retention, scholarly productivity and engagement of new faculty, and increasing demands for collaborative research. Challenges, some would argue, that could be addressed through CoPs; a sentiment reflected in the recent expansion of nursing CoP literature. What is the current state of the application of this concept in nursing academia and what barriers present in the promotion and development of CoPs in the academy? This article addresses these questions and provides guidance for those in search of community.
Heath, Janie; Crowell, Nancy A
We report on the findings of a national survey that examined factors that influence faculty's intentions to integrate tobacco education in their advanced practice nursing curricula. The addiction component of tobacco use is taking its toll on the health of 48 million smokers in the United States. Several national health authorities recommend and/or mandate that tobacco prevention and tobacco cessation be addressed at every point of entry in the health care delivery system. However, there is increasing evidence that health care providers may not be adequately prepared to meet national goals and/or standards. One hundred sixty-one advanced practice nursing faculty in the United States completed an 88-item survey regarding external factors (e.g., personal history of tobacco use, clinical practice, and current tobacco topics taught) and components of the Theory of Reasoned Action model (including perceived self-efficacy, behavioral beliefs, subjective norms, and control beliefs related to tobacco education). Descriptive statistics, chi(2) analysis, Pearson correlation, and linear regression were used to analyze the data. The findings revealed that sex (chi(2) = 7.949, P = .024), level of education (chi(2) = 26.853, P = .0005), years of academic teaching (chi(2) = 19.418, P = .013), and combined clinical and course responsibility (chi(2) = 10.430, P = .0236) were significant external (demographic) factors and that behavioral beliefs (attitude about tobacco education) demonstrated the strongest relationship with intention scores (r = 0.876, P < .0005). Overall, 62.7% of nurse practitioners reported high scores (>or=5, on a scale of 1-7) for intentions to integrate tobacco education, as compared with 37.5% of nurse midwives, 30.3% of clinical nurse specialists, and 8.7% of nurse anesthetists. This study adds to the growing body of evidence that nursing curricular gaps with tobacco education exist and that national efforts are needed to ensure that widespread changes occur
Ulman, Elinor, Ed.; Dachinger, Penny, Ed.
The essays in this collection are grounded in theoretical underpinnings which range from Freud to Montessori. The focus encompasses educational and psychiatric concerns. Essays are organized in 4 parts. Part 1, "Theory of Art Therapy," includes: (1) "Art Therapy: Problems of Definition" (Elinor Ulman); (2) "Therapy is Not Enough: The Contribution…
Katzell, Raymond A.; Thompson, Donna E.
Presents theories of motivation classified as those dealing either with exogenous causes or with endogenous processes. The following strategies for improving work motivation are discussed: (1) personal motives; (2) incentives and rewards; (3) reinforcement; (4) goal-setting techniques; (5) personal and material resources; (6) social and group…
Gestalt therapy, a particular type of psychotherapy, draws on existential and various Eastern philosophies, and aims to enable the individual to seek his or her own solutions to personal problems. Literally translated as 'whole', Gestalt focuses the individual to appreciate and experience the present. This article examines the Gestalt theory and considers its application to a terminally ill client and his wife.
Levinsky, Frieda L.
This paper presents a discussion of the theory of bilingual education, including ideas developed by several linguistic researchers. Various aspects of bilingual education are discussed including objectives, definition, raison d'etre, dominance and balance, learning, types, and barriers. Second language learning is considered along with reasons for…
Procter, Susan; Griffiths, Lauren; Fanning, Agnes; Wallman, Lizzie; Loveday, Heather P
Aims To identify education priorities for practice nursing across eight London Clinical Commissioning Groups (CCGs); to identify the education, training, development and support needs of practice nurses in undertaking current and future roles.
Peters, Kathleen; Halcomb, Elizabeth J; McInnes, Susan
As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and models of clinical placement. This paper uses qualitative research methods to explore the perspectives of 12 Australian general practice nurses who have experience in facilitating undergraduate clinical placements about the relationships between HEIs and nurses. Findings are presented in the following three themes: (1) Appropriate preparation for placement: They don't know what primary health really means, (2) Seeking greater consultation in the organisation of clinical placements: they've got to do it one way for everyone, and (3) Uncertainty and lack of support: I had no contact with the university. Clinical placements in general practice can be an innovative strategy providing non-traditional, yet high quality, teaching and learning experiences for undergraduate nursing students. To optimise the quality of these placements, however, it is essential that HEIs provide appropriate support to the practice nurses mentoring these students.
Finnell, Deborah S; Nowzari, Shahrzad; Reimann, Brie; Fischer, Leigh; Pace, Elizabeth; Goplerud, Eric
ABSTRACT. Substance use screening, brief intervention, and referral to treatment (SBIRT) should be an integral part of the scope of nursing practice. This commentary is an appeal for nurses to advance their knowledge and competencies related to SBIRT. The question of how to move SBIRT into the mainstream of nursing practice was posed to several leaders of federal agencies, health care and nursing organizations, nurse educators, and nurse leaders. The authors provide recommendations for moving this set of clinical strategies (i.e., SBIRT) into day-to-day nursing practice.
The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting within the scope of their VA employment. Certified Registered Nurse Anesthetists (CRNA) will not be included in VA's full practice authority under this final rule, but comment is requested on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking. The final rulemaking establishes the professional qualifications an individual must possess to be appointed as an APRN within VA, establishes the criteria under which VA may grant full practice authority to an APRN, and defines the scope of full practice authority for each of the three roles of APRN. The services provided by an APRN under full practice authority in VA are consistent with the nursing profession's standards of practice for such roles. This rulemaking increases veterans' access to VA health care by expanding the pool of qualified health care professionals who are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision of physicians, and it permits VA to use its health care resources more effectively and in a manner that is consistent with the role of APRNs in the non-VA health care sector, while maintaining the patient-centered, safe, high-quality health care that veterans receive from VA.
Warne, T; McAndrew, S
Drawing upon post doctoral reflections of a shared methodology, the authors explore the use of bricolage as a way of better understanding the inter-related connections between theory, nursing practice and the felt experiences of service users. The origins of bricolage can be traced back to the work of Levi-Strauss, and Denzin and Lincoln's contribution to qualitative methodologies. Bricolage is a multifaceted approach to the research process. Differing epistemological positions and mixed methods of data collection are utilised to bring a richer understanding of human beings and the complexities of their lived experiences. For the bricoleur the object of inquiry, cannot be separated from its context, that is the language used to describe it, its historical situatedness and the social and cultural interpretations of its meaning as an entity in the world. The paper discusses the importance of being able to move beyond the notion of the research method being merely a procedure, to one that respects the complexities of the lived world.
Felton, Anne; Royal, Jan
Rapid changes during the past two decades have seen a growing challenge to prepare newly qualified nurses who are clinically competent and confident to meet the demands of contemporary healthcare. Recent publications emphasise the need to prioritise clinical skills in nurse education (DH 2012a, Francis, 2012). This discussion reports on a project scoping the clinical skills required within pre-registration nursing curricula and considers how this has influenced curriculum development at one Higher Education Institution in the UK. This paper reports on the project analysis of nursing and healthcare policy, identifying six core themes of skills relevant for nursing practice. Furthermore it explores the findings of a series of focus groups with nursing practitioners and managers identifying priorities for clinical skills in the pre-registration curriculum. These highlighted a broad range of skills required of newly qualified practitioners, which pose a challenge for integration within nurse education. How this challenge has been addressed through the incorporation of these skills themes throughout a new pre-registration curriculum is also examined.
Long, Huey B.; And Others
This book contains the following collection of papers: "Self-Directed Learning: Emerging Theory and Practice" (Long); "Self-Directed Orientation toward Learning: A Learning Style" (Bonham); "Self-Direction and Problem Solving: Theory and Method" (Peters); "Facilitating Self-Directed Learning: Not a Contradiction…
Indrisano, Roselmina, Ed.; Squire, James R., Ed.
Providing a foundation in which researchers may build future research and theory and in which teachers may design more effective classroom practice, this book presents 12 essays that bring together the contributions of researchers and teacher-scholars to present the significant theory and research related to the writing process. The book is…
Shepherd, Paul L.
Investigates the development of gerontological knowledge and its translation to practice. Discusses design, relevance, and dissemination of theory, and offers suggestions to practitioners for implementing research theories. Encourages both researchers and practitioners to make attitudinal changes to eliminate communication barriers. (University of…
Treloar, Anna; McMillan, Margaret; Stone, Teresa
Storytelling is a valuable adjunctive method of preparing undergraduate mental health nursing students for practice. To explore the possibilities of this method of teaching, 100 stories were collected from experienced nurses working in mental health and analysed using a case study methodology. The aim was to explore the purpose of clinical anecdotes told by experienced nurses working in mental health settings to undergraduates and new recruits, with an ancillary purpose of looking at the implications of these anecdotes for the exploration of contemporary mental health practice and education. A framework for student discussion of stories is provided. The insights gained illuminate not only the history of mental health nursing and the daily activities of nurses working in mental health, but also some of the deep-level skills developed and used by these nurses as they work in the complexity and ambiguity of an imperfect world where the job requires managing the unexpected every shift, and where there might not always be a textbook-perfect solution to clinical situations.
Yin, Teresa J C
Nursing is an applied science. While there is a wide range of nursing theories and nursing care models, resolving the health problems and meeting the health needs of clients is the common objective of all in the nursing profession. The nursing profession may be subdivided into hospital clinical nursing and community health nursing (CHN). CHN is further subdivided into public health nursing, school health nursing, and industrial health nursing. The past 60 years has been a period of significant growth and improvement in Taiwan that has enhanced the nation's socioeconomic condition, general living standards, and general public health. The nursing profession has seen profound progress as well, not only in terms of content but also in terms of nursing care models, which are increasingly framed around core public health needs and take into consideration different health perspectives. Nursing in Taiwan has gradually established its own professional function and autonomy.
responded favorably to enriched jobs--the size of the increase was srall but was statistically significant. In su:i:ary, the research findings supported...Hawthorne Effect). The second criticism was that most stuc’ies failed to make a statistical test of significance to decide whether or not an effect...Foresran and Company, 1968. Schwab, D. P., Olean-Gottlieb, J. D., & Heneman, H. G., Il. Between-subjects expectancy theory research : A statistical review
Contemporary nursing is based on a conglomerate of theoretical nursing models. These models each incorporate four central concepts: person, health, environment, and nursing. By defining these concepts, nurses develop an individual framework from which they base their nursing practice. As an aspiring nurse practitioner in the gastroenterology field, I have retrospectively assessed my personal definitions of person, health, environment, and nursing. From these definitions, I am able to incorporate specific theoretical frameworks into my personal belief system, thus formulating a basis for my nursing practice. This foundation is comprised of the influence of nursing theorists Jean Watson, Sister Callista Roy, Kolcaba, Florence Nightingale, and Ida J. Orlando; the Perioperative Patient-Focused Model; Watson's Theory of Human Caring; theories regarding transpersonal human caring and healing; and feminist theories. Therefore, this article describes self-examination of nursing care by defining central nursing concepts, acknowledging the influence of nursing theorists and theories, and developing a personal framework from which I base my nursing practice.
The nursing profession prides itself on its ability to reflect on practice to improve patient care. Yet we have seen a number of high-profile cases in recent years where care has not been provided at the level you would expect.
Ethics, by its definition, is a philosophical discipline which enables human beings to behave, to act and to be, in the best way possible, between themselves and towards their environment. In private nursing practice, the ethical dimension is based on personal reflection which enables each individual to adapt their attitude in order to act for the best.
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
Papers on "Current Issues and Their Implications for Practical Nurse Programs" included in the document were authored by Margaret McLaughlin, Ruth B. Edelson, and Kenneth G. Skaggs. Summaries of presentations by Robert M. Morgan and Helen K. Powers are also included. (JK)
Springer, Pam; Carey, Jean
This Idaho instructor's guide lists tasks and enabling objectives, outlines instruction, and provides handout masters, overhead masters, and tests for intravenous therapy (IV) instruction for licensed practical nurses. Following an introduction and a list of criteria for successful completion of IV therapy courses, the document lists tasks and…
Rogers, Helen V.; Reid-Sloan, Jamee
This curriculum guide, revised from a 1975 edition, provides teachers with up-to-date information and skill-related applications needed by practical nurses. It includes 4 sections and 24 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities, information sheets, assignment…
Hahn, Joan Earle; Aronow, Harriet Udin
Background: Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community-based health care systems. As they age into middle years, they are at increased risk for functional decline. This paper presents a description of an advanced practice nurse (APN) intervention used in a pilot…
Davis, Marcella Z., Ed.; And Others
A major portion of the collection of 20 readings authored by practicing professionals consists of field observations presented both as raw data (field notes) and as analyzed and organized data. About the work of nurses in a variety of settings, a recurrent theme is that work behavior is greatly influenced by organizational and structural elements…
Kenny, Richard F.; Van Neste-Kenny, Jocelyne M. C.; Park, Caroline L.; Burton, Pamela A.; Meiers, Jan
We report here on an exploratory formative evaluation of a project to integrate mobile learning into a Western Canadian college nursing program. Third-year students used Hewlett Packard iPAQ mobile devices for five weeks in a practice education course in April-May, 2007. Koole's (2009) "Framework for the Rational Analysis of Mobile…
Fitzgerald, Sheila T.; Hill, Martha N.; Santamaria, Barbara; Howard, Cheryl; Jadack, Rose
Responses from 1,107 nurses working with asthma patients showed positive to neutral views of consensus reports with practice recommendations from professional associations, government, and health agencies. Most felt the reports were a better source of information than colleagues, textbooks, or journals. However, 75% were unaware of one major set…
Ravanipour, Maryam; Bahreini, Masoud; Ravanipour, Masoumeh
Background: Peer learning is an educational process wherein someone of the same age or level of experience level interacts with other students interested in the same topic. There is limited evidence specifically focusing on the practical use of peer learning in Iran. The aim of this study was to explore nursing students’ experiences of peer learning in clinical practice. Materials and Methods: A qualitative content analysis was conducted. Focus groups were used to find the students’ experiences about peerlearning. Twenty-eight baccalaureate nursing students at Bushehr University of Medical Sciences were selected purposively, and were arranged in four groups of seven students each. The focus group interviews were conducted using a semi-structured interview schedule. All interviews were tape-recorded, transcribed verbatim, and analyzed using conventional content analysis method. Results: The analysis identified four themes: Paradoxical dualism, peer exploitation, first learning efficacy, and socialization practice. Gained advantages and perceived disadvantages created paradoxical dualism, and peer exploitation resulted from peer selection and peer training. Conclusion: Nursing students reported general satisfaction concerning peer learning due to much more in-depth learning with little stress than conventional learning methods. Peer learning is a useful method for nursing students for practicing educational leadership and learning the clinical skills before they get a job. PMID:26097860
This paper explores the implications of Michel Foucault's philosophical analyses for understanding nursing practice. Foucault describes power within a given society as unfolding not through large-scale events but rather through a complex 'micro-physics'. Power operates upon the human body. With the increasing use of observation, in understanding both the natural and social world, the body has become the subject of the 'gaze'. The body as object, however, is neither a universal belief nor truth but a product of ways of perceiving and examining it. In relation to nursing, the subjection of the body to the 'gaze' and the practices of the institutional environment of the hospital are important for understanding the knowledge formulated. The power of practice is in the generation of knowledge. The nature and form of knowledge is instrumental in establishing the quality of nurse-patient relationships. This paper explores, through the particular exemplar of the patient in intensive care, the power of present practices to shape knowledge, and thereby dictate and limit the quality of the nurse-patient relationship.
Nagle, Lynn M; Crosby, Kristine; Frisch, Noreen; Borycki, Elizabeth; Donelle, Lorie; Hannah, Kathryn; Harris, Alexandra; Jetté, Sylvie; Shaben, Tracy
Information and communication technologies (ICT) have brought about significant changes to the processes of health care delivery and changed how nurses perform in clinical, administrative, academic, and research settings. Because the potential benefits of ICT are significant, it is critical that new nurses have the knowledge and skills in informatics to provide safe and effective care. Despite the prevalence of technology in our day to day lives, and the potential significant benefits to patients, new nurses may not be prepared to work in this evolving reality. An important step in addressing this need for ICT preparation is to ensure that new graduates are entering the work force ready for technology-enabled care environments. In this paper, we describe the process and outcomes of developing informatics entry-to-practice competencies for adoption by Canadian Schools of Nursing.
The development of the Victorian mental health nurse practitioner youth early psychosis, is a pioneer advance in clinical psychiatric/mental health nursing. This paper will explore and describe the scope of practice for the youth early psychosis mental health nurse practitioner candidate, and how the model is informed by relevant literature. The role description and context of the nurse practitioner candidate, which is synonymous with the role of the endorsed nurse practitioner, is described. Advanced practice nursing is discussed in terms of what the nurse practitioner literature says and contrasted with perceptions of a clinical nurse's everyday practice. Inherent challenges and issues are highlighted that need to sit in the background of any picture being painted of the mental health nurse practitioner role in Victoria into the future. An alternative perspective in the mental health care of the young person is proposed for the nurse practitioner scope of practice.
Siaki, Leilani A; Lentino, Cynthia V; Mark, Debra D; Hopkins-Chadwick, Denise L
Despite the Institute of Medicine's goal of 90% of all practice being evidence-based by 2020, educational and practice institutions are not on target to achieve this goal. Evidence-based practice is one of 5 core elements of the Army Nurse Corps' patient care delivery system and a key focus of the Hawaii State Center for Nursing. In order to increase evidence-based practice (EBP), a civilian-military partnership was formed to include healthcare organizations in the state, optimize resources, and share strategies for successful practice changes statewide. The partnership has been successful in meeting each of these goals using national EBP competencies and Bloom's taxonomy as a guide. The article presents a discussion regarding the history, processes, and outcomes of this partnership.
Pyfer, Jean L.
There are at least three ways in which educational theory can be used in practice: (1) to reexamine our traditional approaches, (2) to provide direction in future practice, and (3) to generate research. Reexamination of traditional approaches through analysis and utilization of theoretical methods is one means of promoting constant growth and…
The three books reviewed in this article represent the continuous effort to make visible the significant bridge between theory and practice in the fields of literacy and children's literature. While the authors maintain distinct purposes for their creations, the texts each speak to a strong theoretical support for the practices they describe. The…
Acuña-Reyes, Raquel; Cigarroa-Martínez, Didier; Ureña-Bogarín, Enrique; Orgaz-Fernández, Jose David
Objectives: Determine the domain of preventive dentistry in nursing personnel assigned to a primary care unit. Methods: Prospective descriptive study, questionnaire validation, and prevalence study. In the first stage, the questionnaire for the practice of preventive dentistry (CPEP, for the term in Spanish) was validated; consistency and reliability were measured by Cronbach's alpha, Pearson's correlation, factor analysis with intra-class correlation coefficient (ICC). In the second stage, the domain in preventive dental nurses was explored. Results: The overall internal consistency of CPEP is α= 0.66, ICC= 0.64, CI95%: 0.29-0.87 (p >0.01). Twenty-one subjects in the study, average age 43, 81.0% female, average seniority of 12.5 were included. A total of 71.5% showed weak domain, 28.5% regular domain, and there was no questionnaire with good domain result. The older the subjects were, the smaller the domain; female nurses showed greater mastery of preventive dentistry (29%, CI95%: 0.1-15.1) than male nurses. Public health nurses showed greater mastery with respect to other categories (50%, CI95%: 0.56-2.8). Conclusions: The CDEP has enough consistency to explore the domain of preventive dentistry in health-care staff. The domain of preventive dentistry in primary care nursing is poor, required to strengthen to provide education in preventive dentistry to the insured population. PMID:25386037
This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries.
Plummer, Marilyn; Molzahn, Anita E
A critical appraisal of the concept, quality of life, as used in nursing theories, is presented in a historically situated context. This approach to concept analysis was selected to illuminate the subjective, contextual, and fluid nature of the concept. Based on this review, quality of life is defined as an intangible, subjective perception of one's lived experience. From a review of Peplau's, Rogers', Leininger's, King's, and Parse's conceptualizations of quality of life, it is concluded that it may be viable to replace health with quality of life as a metaparadigm concept for nursing.
Nairn, Stuart; Pinnock, David
Bourdieu is an important thinker within the sociological tradition and has a philosophically sophisticated approach to theoretical knowledge and research practice. In this paper, we examine the implication of his work for nursing and the health sciences more broadly. We argue that his work is best described as a reflexive realist who provides a space for a nonpositivist approach to knowledge that does not fall into the trap of idealism or relativism. We emphasize that Bourdieu was not an abstract theorist, but only utilized theories to understand and explain the social world in all its empirical complexity. Theory is emphasized over method without denying the importance of method. We then provide a brief overview of some of his key concepts: habitus, field and capital. His work is a scientifically astute practice that has an emancipatory purpose, with particular resonance to the problems of nursing as a social practice. Some have criticized Bourdieu for undermining agency and we briefly address this issue, but argue that his conceptual framework helps us to understand what endures in social practice and why change is often problematic. In short, this paper argues that Bourdieu's work is a fruitful resource for critiquing existing nursing approaches that are preoccupied with agency over structure.
Primary and acute care settings are the focus of a concerted effort to implement evidence-based practice (EBP) in health care; yet, little attention has been given to use of EBP among school nurses. The aims of this study were to (a) describe current use of EBP among school nurses attending a national school nurse conference, (b) describe…
Cunningham, Donna D
We frequently hear the word simulation in nursing educatioh. Research has been done on the use of high fidelity simulation in registered nursing programs. High fidelity simulators are expensive and require more than one faculty to facilitate. The question remains: Does every nursing program require a high fidelity simulation laboratory? This article will define the three levels of fidelity and describe the incorporation of a medium fidelity simulation into a practical nursing program and will describe the benefits of simulation use. The article will assist the faculty and students new to simulation, and allow them to choose the equipment and scenarios that will be most advantageous for their individual programs. The choice of equipment, scenarios, and fidelity often depends upon the space, time, funds, and faculty available. Simulation adds an important component to nursing education. Using simulation wisely helps students practice in a controlled environment without danger to living patients. The lessons learned will someday play into a "life or death" scenario, and the patient will not be a simulation mannequin.
Gaumer, Gary L; Koeniger-Donohue, Rebecca; Friel, Christina; Sudbay, Mary Beth
The purpose of this study is to describe the use of information technology by advance practice nurses. A survey of 519 graduates of the Simmons College nurse practitioner program was conducted. Areas of investigation included the nurse practitioner's use of informatics technology, perception of information technology competence, adequacy of information technology training and support in the workplace, specific information technology health functions used in the workplace, and perceived benefits of using information technology. The data on the 249 usable responses were analyzed using descriptive statistics. These analyses compare the use of information technology by type of job, specialty, years of practice, and setting of work. Results indicate that more than 90% of nurse practitioners utilize computers at work, yet a large fraction of them still have low self-perception of information technology competence, believe initial training at the work site was inadequate, and believe that academic preparation for information technology was also inadequate. There is considerable variation in these measures across nurse practitioner specialties, settings of care, job characteristics, and experience.
de Sena, Adnairdes Cabral; do Nascimento, Eliane Regina Pereira; Maia, Ana Rosete Camargo Rodrigues
Research that aimed to analyze the care of nurses to patients, in the daily professional practice, provided in the preoperative period for patients undergoing elective surgery. It is a descriptive research with a qualitative approach that involved 15 nurses from Surgical Units and two nurses from the Surgical Centre of a hospital in the southern region of Brazil. Data was collected in semi-structured interviews conducted from April to July 2011. Data was analyzed using the Collective Subject Discourse (CSD) technique. The information obtained generated three CDS focused on the following ideas: administrative care, instruction in the preoperative period and surgical care in the immediate preoperative period. The results showed that caring consists mostly of giving instructions to the patient in the preoperative period. It is concluded that the care was directed to the physical aspects to the detriment of the psychological, in disagreement with the assistance methodology adopted in the hospital, supported by the Theory of Basic Human Needs.
Young, Susan; Guo, Kristina L
The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.
Sánchez-Martín, C Inmaculada
The increase in chronic diseases and the progressive ageing of the population is a source of concern for the different agencies with responsibility for health care. This has led to the creation of many documents focused on the analysis of the current situation and care of chronic diseases, including the WHO recommendations intended to assist countries and health services design and implement strategies that will address the existing demand, control and prevention of chronic diseases. In addition, there is a need to respond to the demand generated by chronic diseases in every sense, and from the different systems it is becoming more difficult to get enough support from multidisciplinary teams where the nurse has a central importance. While chronic diseases are becoming a threat due to the costs they generate, it is also an opportunity for nursing to be at the forefront for advanced care requirements, performed by professionals with recognized advanced clinical skills and ability for case management while monitoring and controlling complex chronic patients. The different services of the National Health System have introduced nurses that play different roles (cases managers, liaison nurses, advanced practice nurses and so on). However, it could be argued that they are not being trained to a desirable development level. It is therefore time for health care authorities to determine the role of the advanced practice nurse in relation to functional positions, and allow them to make an advance in the development of unified skills for the whole National Health System. From our experience we have learned that the advanced practice nurse is a resource that helps in the sustainability of services, thanks to the efficiency shown in the results obtained from the care given to both chronic and complex chronic patients.
Melnyk, Bernadette Mazurek; Fineout-Overholt, Ellen; Gallagher-Ford, Lynn; Kaplan, Louise
This descriptive survey assessed the perception of evidence-based practice (EBP) among nurses in the United States. Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence-based best practices. A descriptive survey was conducted with a random sample of 1015 RNs who are members of the American Nurses Association. Although nurses believe in evidence-based care, barriers remain prevalent, including resistance from colleagues, nurse leaders, and managers. Differences existed in responses of nurses from Magnet® versus non-Magnet institutions as well as nurses with master's versus nonmaster's degrees. Nurse leaders and educators must provide learning opportunities regarding EBP and facilitate supportive cultures to achieve the Institute of Medicine's 2020 goal that 90% of clinical decisions be evidence-based.
As American society becomes increasingly diverse, and the nursing profession does not, there has been a focus on promoting both cultural competence and diversity within the profession. Although culture and diversity are widely discussed in nursing education, the issue of racism may be avoided or suppressed. Institutionalized racism within nursing education must be acknowledged and discussed before nursing education may be transformed. Madeleine Leininger's Culture Care Theory is an established nursing theory that emphasizes culture and care as essential concepts in nursing. Theoretical frameworks abound in nursing, and Culture Care Theory may be underutilized and misunderstood within nursing education. This article examines the issue of racism in nursing education and recommends Culture Care Theory as a relevant framework for enhancing both cultural competence and diversity.
Cardot, J M; Hulot, T; Le Bricon, C; Stockis, A
This paper gives a definition and some basic knowledge about Laboratory Information Management Systems (LIMS) as well as their impact on the organisation, the laboratory and the co-workers. The major advantages and disadvantages of LIMS are pointed out. Two practical experiences are described. The first is related to an in house development of a PC based system which has to integrate a Vax VMS system (Multichrom) and PC based analytical and analysis softwares. The second experience is dealing with the selection and implementation of a commercial package in a pharmacokinetic laboratory. In both cases the human and time aspects were important.
The conclusion of a previous article by Pistolesi is that the increment of lift due to ground effect is largely attributable to the effect of induction of the free vortices, and is practically equivalent to a virtual increase in aspect ratio. The ground clearance was of the order of magnitude comparable to the wing chord. New reports by Le Seur and Datwyler treat the case of minimum distance from the ground and is confined to the plane problem only. The author briefly reviews these reports and also one by Timotika. References to all the reviewed reports are in the attached bibliography.
Moorer, Oyweda W; Meterko, Mark; Alt-White, Anna C; Sullivan, Jennifer L
In the past decade, the use of information technology (IT) to support healthcare delivery has greatly expanded. Introducing new clinical information systems and updating existing systems require continued learning and training among registered nurses (RNs) and other clinicians. Consequently, a 5-item measure was designed as a subscale to the Practice Environment Scale of the Nursing Work Index. This new subscale, the Nursing Information Technology Subscale (NITS) measures RNs' perception of the extent to which IT in their practice environment supports patient care delivery. A psychometric evaluation of the NITS was conducted at 8 Veterans Affairs hospitals. The findings demonstrated that this brief subscale has acceptable reliability as well as convergent and discriminant validity.
Brown, Janet Witucki
Margaret Newman's theory of health as expanding consciousness provides an excellent nursing perspective for nursing grounded theory research studies. Application of this nursing theory to grounded theory research provides a unitary-transformative paradigm perspective to the sociological underpinnings of grounded theory methodology. The fit between this particular nursing theory and grounded theory methodology is apparent when purpose, timing, process, and health outcomes of the two are compared. In this column, the theory of health as expanding consciousness is described and the theory's research as praxis methodology is compared to grounded theory methodology. This is followed by a description of how the theory of health as expanding consciousness can be utilized as a perspective for nursing grounded theory research.
Mississippi Research and Curriculum Unit for Vocational and Technical Education, State College.
This document, which is intended for use by community and junior colleges throughout Mississippi, contains curriculum frameworks for the course sequences in the practical nursing program. Presented in the introductory section are a description of the program and suggested course sequence. Section I lists baseline competencies, and section II…
This article, the first of two looking at nursing ethics and research, outlines the foundations and development of an ethical framework for nursing research. The two dominant theories of ethics--utilitarianism and deontology--are described as they relate to the rights of individuals undergoing the research. Each of these approaches has limitations and in some instances choosing the right action may be difficult. The guiding ethical standards of beneficence/non-maleficence, respect for human dignity, justice, informed consent and vulnerable subjects are reviewed for the reader as they relate to undertaking research. This knowledge will help nurses conduct, participate in, or use research that is based on ethically sound principles. The second article will explore and explain the relationship between these guiding principles and the elemental steps of the research process.
Krishnasamy, M; Corner, J; Bredin, M; Plant, H; Bailey, C
This paper considers methodological and philosophical issues that arose during a multi-centre, randomized controlled trial of a new nursing intervention to manage breathlessness with patients with primary lung cancer. Despite including a diverse range of instruments to measure the effects of the intervention, the uniqueness of individuals' experiences of breathlessness were often hidden by a requirement to frame the study within a reductionist research approach. Evidence from the study suggests that breathlessness is only partly defined when understood and explored within a bio-medical framework, and that effective therapy can only be achieved once the nature and impact of breathlessness have been understood from the perspective of the individual experiencing it. We conclude that to work therapeutically we need to know how patients interpret their illness and its resultant problems and that this demands methodological creativity.
Omura, Mieko; Levett-Jones, Tracy; Stone, Teresa Elizabeth; Maguire, Jane; Lapkin, Samuel
Interprofessional communication and teamwork are essential for medication safety; however, limited educational opportunities for health professionals and students to develop these skills exist in Japan. This study evaluated the impact of an interprofessional multimedia learning resource on registered nurses' and nursing students' intention to practice in a manner promoting medication safety. Using a quasi-experimental design, Japanese registered nurses and nursing students (n = 203) were allocated to an experimental (n = 109) or control group (n = 94). Behavioral intentions of medication safety and the predictor variables of attitudes, perceived behavioral control, and subjective norms were measured using a Japanese version of the Theory of Planned Behavior Medication Safety Questionnaire. Registered nurses in the experimental group demonstrated a greater intention to collaborate and practice in a manner that enhanced medication safety, evidenced by higher scores than the control group on all predictor variables. The results demonstrate the potential for interprofessional multimedia learning resources to positively impact the behaviors of Japanese registered nurses in relation to safe medication practices. Further research in other contexts and with other cohorts is warranted.
Anderson, Jacqueline J; Mokracek, Marilyn; Lindy, Cheryl N
St. Luke's Episcopal Hospital in Houston established a best-practice council as a strategy to link nursing quality to evidence-based practice. Replacing a system based on reporting quality control and compliance, this Best Practice Council formed interdisciplinary teams, charged them each with a quality issue, and directed them to change practice as needed under the guidance of the St. Luke's Episcopal Hospital Evidence Based Practice Model. This article reviews the activities of the Best Practice Council and the projects of teams assigned to study best practice in (1) preventing bloodstream infection (related to central lines), (2) preventing patient falls, (3) assessing and preventing pressure ulcers, and (4) ensuring good hand-off communication.
Mann, Elizabeth G; Medves, Jennifer; Vandenkerkhof, Elizabeth G
Mobile technology presents new opportunities for nursing education and ultimately the provision of nursing care. The aim of this study was to explore the utility of mobile technology in undergraduate nursing education. In this evaluation study, undergraduate nursing students were provided with iPod Touch devices containing best practice guidelines. Computer self-efficacy was assessed, and the Theory of Planned Behavior was used to identify potential predictors of the use of mobile technology. Questionnaires were completed at baseline (n = 33) and postimplementation (n = 23). Feedback on feasibility issues was recorded throughout the study period. Students generally found the devices useful, and few technical problems were identified; however, lack of skill in using the devices and lack of support from staff in the clinical setting were commonly identified issues. Self-efficacy scores were high throughout the study. Attitudes, perceptions of the desirability of use, perceived personal control over use, and intentions of using the device were lower postimplementation than at baseline. Attitude toward the technology predicted intention to use the device after graduation. Mobile technology may promote evidence-informed practice; however, supporting students' acquisition of related skills may optimize use. Successful integration of mobile technology into practice requires attention to factors that affect student attitudes.