Sample records for nursing working process
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Baraki, Zeray; Girmay, Fiseha; Kidanu, Kalayou; Gerensea, Hadgu; Gezehgne, Dejen; Teklay, Hafte
2017-01-01
The nursing process is a systematic method of planning, delivering, and evaluating individualized care for clients in any state of health or illness. Many countries have adopted the nursing process as the standard of care to guide nursing practice; however, the problem is its implementation. If nurses fail to carry out the necessary nursing care through the nursing process; the effectiveness of patient progress may be compromised and can lead to preventable adverse events. This study was aimed to assess the implementation of nursing process and associated factors among nurses working in selected hospitals of central and northwest zones of Tigray, Ethiopia, 2015. A cross sectional observational study design was utilized. Data was collected from 200 participants using structured self-administered questionnaire which was contextually adapted from standardized, reliable and validated measures. The data were entered using Epi Info version 7 and analyzed using SPSS version 20 software. Data were summarized and described using descriptive statistics and multivariate logistic regression was used to determine the relationship of independent and dependent variable. Then, finally, data were presented in tables, graphs, frequency percentage of different variables. Seventy (35%) of participants have implemented nursing process. Different factors showed significant association. Nurses who worked in a stressful atmosphere of the workplace were 99% less likely to implement the nursing process than nurses who worked at a very good atmosphere. The nurses with an educational level of BSc. Degree were 6.972 times more likely to implement the nursing process than those who were diploma qualified. Nurses with no consistent material supply to use the nursing process were 95.1% less likely to implement the nursing process than nurses with consistent material supply. The majority of the participants were not implementing the nursing process properly. There are many factors that hinder them from applying the nursing process of which level of education, knowledge of nurses, skill of nurses, atmosphere of the work place, shortage of material supply to use the nursing process and high number of patient load were scientifically significant for the association test.
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[Role transition and working adaption in new nursing graduates: a qualitative study].
Ho, Hsueh-Hua; Liu, Pei-Fen; Hu, Hsiao-Chen; Huang, Su-Fei; Chen, Hsiao-Lien
2010-12-01
The role transition process is full of stresses and challenges for nurses. Between 35-61% nurses leave their job within the first year. Past cross-sectional quantitative studies have not provided deep descriptions of either the dynamic role transition or work adaption processes of new nurses. The purpose of this study was to understand the role transition experience of new nurses as they transitioned into clinical practice during their first three months on the job. A qualitative approach was used. Data were collected through a semi-structured interview from 50 new nurses. Data were analyzed using category-content analysis. Three stages were identified in the new nurse work adaption process over the first three-month period. These included (1) Understanding: New nurse knowledge and skills are insufficient to handle routine work, adapting to the role transition is difficult, feelings of anxiety emerge related to fears of incompetence, communication difficulties must be faced in the handover process, new nurses adopt feelings of attachment to their preceptors, they must work to adopt appropriate attitudes and approaches to nursing practice, and support is sought from family, teachers and friends; (2) Acclimation: Learning to care for patients independently, seeking role models, learning to adapt to night shifts, trying to identify with co-workers, and seeking support from colleagues, preceptors and head nurses; (3) Acceptance: Managing nursing work better in terms of time and organization, feeling gradual acceptance from co-workers, restoring personal enthusiasm for work, starting to consider other, non-work related matters, experiencing and appreciating the support of co-workers and head nurses. CONCLUSIONS/IMPLICATION: New nurses face a critical role transition process through their first three months on the job. Guidance and leadership from experienced nurses and multiple support systems can assist new nurses to acclimate to their role. Research results provide information for educators and administrators to better understand the adaption process of new nurses, and offer a reference for developing future strategies to improve nurse competency in handling their work.
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Halbesleben, Jonathon R B; Rathert, Cheryl; Williams, Eric S
2013-01-01
Burnout is very common and has significant negative outcomes for both nurses and patients. However, this literature has only recently begun to address the processes that explain why health care provider burnout leads to negative patient outcomes. This article extends that literature by examining how satisfaction with work processes impacts the link between nurse burnout and work-arounds. The purpose of this study was to examine the relationships between emotional exhaustion and potentially unsafe work practices (work-arounds) in the context of nursing administration of medication. The data were collected using online survey software and pencil-and-paper surveys returned directly to the researchers. The study was conducted among nurses in 2 acute care hospitals in the Midwestern United States. For one of the samples, data on work-arounds were provided by the nurses' supervisors. For the other sample, data were collected at a 6-month interval. The survey included measures of emotional exhaustion (the Maslach Burnout Inventory), work-arounds, and nurse satisfaction with medication administration processes. We found that exhaustion was associated with greater use of work-arounds of medication administration processes. We also found that when nurses were more satisfied with the medication administration process, exhausted nurses were less likely to engage in work-arounds. The findings suggest that although exhaustion in nurses can lead to potentially unsafe practices, satisfaction with the work process can either exacerbate or reduce the problem.
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Who cares? Offering emotion work as a 'gift' in the nursing labour process.
Bolton, S C
2000-09-01
Who cares? Offering emotion work as a 'gift' in the nursing labour process The emotional elements of the nursing labour process are being recognized increasingly. Many commentators stress that nurses' 'emotional labour' is hard and productive work and should be valued in the same way as physical or technical labour. However, the term 'emotional labour' fails to conceptualize the many occasions when nurses not only work hard on their emotions in order to present the detached face of a professional carer, but also to offer authentic caring behaviour to patients in their care. Using qualitative data collected from a group of gynaecology nurses in an English National Health Service (NHS) Trust hospital, this paper argues that nursing work is emotionally complex and may be better understood by utilizing a combination of Hochschild's concepts: emotion work as a 'gift' in addition to 'emotional labour'. The gynaecology nurses in this study describe their work as 'emotionful' and therefore it could be said that this particular group of nurses represent a distinct example. Nevertheless, though it is impossible to generalize from limited data, the research presented in this paper does highlight the emotional complexity of the nursing labour process, expands the current conceptual analysis, and offers a path for future research. The examination further emphasizes the need to understand and value the motivations behind nurses' emotion work and their wish to maintain caring as a central value in professional nursing.
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Nurse manager cognitive decision-making amidst stress and work complexity.
Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M
2013-01-01
The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity. Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions. This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes. The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes. Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes. Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.
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Participative leadership in the management process of nightshift nursing.
da Costa, Diovane Ghignatti; Dall'Agnol, Clarice Maria
2011-01-01
This is a qualitative, exploratory, descriptive study, aiming to identify the perceptions of nurses regarding the leadership process and to analyze how this process takes place on the nightshift. Data collection was performed through the Focus Groups Technique, with 13 nightshift nurses of a public teaching hospital. Two categories that resulted from the thematic analysis are the focus of this article: the context of nightshift nursing work and leadership from the perception of the nightshift nurses. Teamwork is an important condition to vitalize the participatory perspective of the leadership process, given the necessary relationship of support and integration, above all in the nightshift nursing work. This exercise challenges the nurse in the solidification of a culture that promotes spaces for reflection regarding the work, integrating leadership with a learning process that is constituted through constructive bonds between the workers.
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What do nurses and midwives value about their jobs? Results from a discrete choice experiment.
Scott, Anthony; Witt, Julia; Duffield, Christine; Kalb, Guyonne
2015-01-01
To examine nurses' and midwives' preferences for the characteristics of their jobs. A discrete choice experiment of 990 nurses and midwives administered as part of a survey of nurses and midwives in Victoria, Australia. Autonomy, working hours, and processes to deal with violence and bullying were valued most highly. Nurses and midwives would be willing to forgo 19% and 16% of their annual income for adequate autonomy and adequate processes to deal with violence and bullying, compared to poor autonomy and poor processes for violence and bullying. They would need to be paid an additional 24% to increase their working hours by 10% ($73 per hour). Job characteristics that were less important were shift work, nurse to patient ratios, and public or private sector work. Policies to improve retention and job satisfaction of nurses and midwives should initially focus on autonomy, processes to deal with violence and bullying, and reasonable working hours. Further research on the cost-effectiveness of these different policies is needed. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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[Information technology and hospital care: reflection on the meaning of the work].
Fonseca, Cláudia Maria Barboza Machado; dos Santos, Mônica Loureiro
2007-01-01
The purpose of this paper is to present the experience of nurses since the introduction of information technology in hospital work processes. It analyzes the meaning of information technology within the subjectivity and perception of healthcare in nursing work in a general hospital. As a theoretical background, it takes studies of work psychodynamics/psychopathology, referred to healthcare work processes and their repercussions on worker health. This qualitative inquiry strives to understand the significance of this subject in nursing routines. The field research was based on semi-structured interviews and non-systematic observation of some nursing activities, noting some resistance to change among the nurses, with difficulties in organizing the work and introducing them to new ways of handling their tasks. Faced by a machine, they feel trapped and isolated. This leads to the conclusion that the implementation of information technology interferes significantly in the work processes of the nurses participating in this study, and may adversely affect their health in the future.
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Nurses' professionalism in Canada: a labor process analysis.
Campbell, M L
1992-01-01
This article draws on a body of research conducted by the author over the past ten years on the social organization of nursing work. It explores questions surrounding nurses' contemporary labor process control and its meaning for nurses' professionalization and proletarianization. Both are dynamic processes, changing as public administration of the Canadian health care system changes and as nurses are successful in winning more complete self-regulation. Nurses are currently being articulated more and more securely to dominant ideas of public sector management through textually mediated technologies. Nurses find new upwardly mobile careers and challenging, responsible, and more respected work. However, as the generation of objective information for professional accountability, cost-accounting, and managerial decision-making becomes unified in computerized patient information systems, producing and using such information becomes a central and determining core of everyday nursing work. It organizes nurses into a "managed" practice of patient care, contradictory for them in many ways. Outstanding among these contradictions is a new professionalized standpoint of cost-efficiency that subordinates nurses' traditional interests and grounding of their work in the standpoint of care.
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Northern nursing practice in a primary health care setting.
Vukic, Adele; Keddy, Barbara
2002-12-01
This paper explicates the nature of outpost nursing work, and/or the day-to-day realities of northern nursing practice in a primary health care setting in Canada. The study was carried out to systematically explore the work of nurses in an indigenous setting. Institutional ethnography, pioneered by Dorothy Smith was the methodology used to guide this research. The theoretical perspective of this methodology does not seek causes or links but intends to explicate visible practices. It is intended to explicate the social organization of specific discourses that inform work processes of nurses working in remote indigenous communities. The data originated from various sources including spending 2 weeks in a northern remote community shadowing experienced nurses, taking field notes and audio taping interviews with these nurses. One of the two researchers was a northern practice nurse for many years and has had taught in an outpost nursing programme. As part of the process, texts were obtained from the site as data to be incorporated in the analysis. The lived experiences have added to the analytical understanding of the work of nurses in remote areas. Data uncovered documentary practices inherent to the work setting which were then analysed along with the transcribed interviews and field notes derived from the on-site visit. Identifying disjuncture in the discourse of northern nursing and the lived experience of the nurses in this study was central to the research process. The results indicated that the social organization of northern community nursing work required a broad generalist knowledge base for decision making to work effectively within this primary health care setting. The nurse as 'other' and the invisibility of nurses' work of building a trusting relationship with the community is not reflected in the discourse of northern nursing. Trust cannot be quantified or measured yet it is fundamental to working effectively with the community. The nurses in this study saw building trust to promote health and well-being in communities as very important, yet very difficult to achieve. The difficulty in part stems from the constraining, structural, administrative, historical, cultural and political contextual realities that have shaped northern community nursing.
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[Working conditions of community nurses].
Kułagowska, Ewa; Kosińska, Maria
2010-01-01
To ensure the most efficient workplace health promotion it is essential to identify and monitor health conditions of employees and all components of the work process, as well as to recognize their cause-effect relationships. Community nurses form an occupational group with a specific type of workplace that is usually located in the patient's place of residence and thus not inspected in terms of safety and hygiene. The aim of the study was to identify working conditions of community nurses with special reference to occupational hazards. An anonymous questionnaire was used as a major tool of this survey. It contained 33 questions, concerning the work process, working conditions, work loads and arduousness, hazards and work-related complaints. The questionnaire was completed by 86 community nurses working in the Upper Silesia region. Community nurses generally assessed their work as hard. A more thorough analysis revealed that nursing and curative care, nursing and hygienic care and rehabilitation were regarded by community nurses as hard, whereas social diagnostics and curative diagnostics were assessed as much easier tasks. Excessive physical load, forced position at work, aggressive patients, patients' aggressive family members, dangerous domestic animals, low quality of technical devices in patients' homes were reported as the greatest hazards. The obtained results reveal that working conditions of community nurses do not ensure their safety at work.
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Seeking Connectivity in Nurses' Work Environments: Advancing Nurse Empowerment Theory.
Udod, Sonia
2014-09-01
The purpose of this study was to investigate how staff nurses and their managers exercise power in a hospital setting in order to better understand what fosters or constrains staff nurses' empowerment and to extend nurse empowerment theory. Power is integral to empowerment, and attention to the challenges in nurses' work environment and nurse outcomes by administrators, researchers, and policy-makers has created an imperative to advance a theoretical understanding of power in the nurse-manager relationship. A sample of 26 staff nurses on 3 units of a tertiary hospital in western Canada were observed and interviewed about how the manager affected their ability to do their work. Grounded theory methodology was used. The process of seeking connectivity was the basic social process, indicating that the manager plays a critical role in the work environment and nurses need the manager to share power with them in the provision of safe, quality patient care. Copyright© by Ingram School of Nursing, McGill University.
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Voldbjerg, Siri Lygum; Laugesen, Britt; Bahnsen, Iben Bøgh; Jørgensen, Lone; Sørensen, Ingrid Maria; Grønkjaer, Mette; Sørensen, Erik Elgaard
2018-06-01
To describe and discuss the process of integrating the Fundamentals of Care framework in a baccalaureate nursing education at a School of Nursing in Denmark. Nursing education plays an essential role in educating nurses to work within healthcare systems in which a demanding workload on nurses results in fundamental nursing care being left undone. Newly graduated nurses often lack knowledge and skills to meet the challenges of delivering fundamental care in clinical practice. To develop nursing students' understanding of fundamental nursing, the conceptual Fundamentals of Care framework has been integrated in nursing education at a School of Nursing in Denmark. Discursive paper using an adjusted descriptive case study design for describing and discussing the process of integrating the conceptual Fundamentals of Care Framework in nursing education. The process of integrating the Fundamentals of Care framework is illuminated through a description of the context, in which the process occurs including the faculty members, lectures, case-based work and simulation laboratory in nursing education. Based on this description, opportunities such as supporting a holistic approach to an evidence-based integrative patient care and challenges such as scepticism among the faculty are discussed. It is suggested how integration of Fundamentals of Care Framework in lectures, case-based work and simulation laboratory can make fundamental nursing care more explicit in nursing education, support critical thinking and underline the relevance of evidence-based practice. The process relies on a supportive context, a well-informed and engaged faculty, and continuous reflections on how the conceptual framework can be integrated. Integrating the Fundamentals of Care framework can support nursing students' critical thinking and reflection on what fundamental nursing care is and requires and eventually educate nurses in providing evidence-based fundamental nursing care. © 2018 John Wiley & Sons Ltd.
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Foley, Barbara Jo; Kee, Carolyn C; Minick, Ptlene; Harvey, Susan S; Jennings, Bonnie M
2002-05-01
The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals. Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities. A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables. Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment. This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.
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Tvedt, Christine; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir
2012-01-01
Objectives The purpose of this study was to identify organisational processes and structures that are associated with nurse-reported patient safety and quality of nursing. Design This is an observational cross-sectional study using survey methods. Setting Respondents from 31 Norwegian hospitals with more than 85 beds were included in the survey. Participants All registered nurses working in direct patient care in a position of 20% or more were invited to answer the survey. In this study, 3618 nurses from surgical and medical wards responded (response rate 58.9). Nurses' practice environment was defined as organisational processes and measured by the Nursing Work Index Revised and items from Hospital Survey on Patient Safety Culture. Outcome measures Nurses' assessments of patient safety, quality of nursing, confidence in how their patients manage after discharge and frequency of adverse events were used as outcome measures. Results Quality system, nurse–physician relation, patient safety management and staff adequacy were process measures associated with nurse-reported work-related and patient-related outcomes, but we found no associations with nurse participation, education and career and ward leadership. Most organisational structures were non-significant in the multilevel model except for nurses’ affiliations to medical department and hospital type. Conclusions Organisational structures may have minor impact on how nurses perceive work-related and patient-related outcomes, but the findings in this study indicate that there is a considerable potential to address organisational design in improvement of patient safety and quality of care. PMID:23263021
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[Working conditions in operating rooms].
Kułagowska, Ewa
2007-01-01
The aim of this study was to get acquainted with the opinions of the nursing staff on working conditions at their workplace. The study was carried out in a group of 398 nurses working in various kinds of operating rooms at 11 public hospitals. A questionnaire was used as a major tool of this study. The questionnaires were filled in by 259 operating room nurses (circulating nurses) and 139 nurse-anesthetists. The collected data show that working conditions in operating rooms do not ensure safety of the nursing staff at work. The main sources of problems are: work organization, technical factors, work equipment, work space, knowledge of hazards and strenuous factors among nurses, ways of preventing and/or limiting them. These elements are serious occupational risk factors influencing the work process and health status of nurses.
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42 CFR 410.76 - Clinical nurse specialists' services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... the statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a clinical nurse specialist works with one or more physicians to deliver... collaboration, collaboration is a process in which a clinical nurse specialist has a relationship with one or...
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Knowledge management, health information technology and nurses' work engagement.
Hendriks, Paul H J; Ligthart, Paul E M; Schouteten, Roel L J
2016-01-01
Knowledge management (KM) extends the health information technology (HIT) literature by addressing its impact on creating knowledge by sharing and using the knowledge of health care professionals in hospitals. The aim of the study was to provide insight into how HIT affects nurses' explicit and tacit knowledge of their ongoing work processes and work engagement. Data were collected from 74 nurses in four wards of a Dutch hospital via a paper-and-pencil survey using validated measurement instruments. In a quasiexperimental research design, HIT was introduced in the two experimental wards in contrast to the two control wards. At the time of the HIT introduction, a pretest was administered in all four wards and was followed by a posttest after 3 months. Data were analyzed via partial least squares modeling. Generally, nurses' tacit knowledge (i.e., their insight into and their capacity to make sense of the work processes) appears to be a significant and strong predictor of their work engagement. In contrast, nurses' explicit knowledge (i.e., information feedback about patients and tasks) only indirectly affects work engagement via its effect on tacit knowledge. Its effect on work engagement therefore depends on the mediating role of tacit knowledge. Interestingly, introducing HIT significantly affects only nurses' explicit knowledge, not their tacit knowledge or work engagement. Nurses' tacit and explicit knowledge needs to be systematically distinguished when implementing HIT/KM programs to increase work engagement in the workplace. Tacit knowledge (insight into work processes) appears to be pivotal, whereas efforts aimed only at improving available information will not lead to a higher level of work engagement in nurses' work environments.
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The contribution of organization theory to nursing health services research.
Mick, Stephen S; Mark, Barbara A
2005-01-01
We review nursing and health services research on health care organizations over the period 1950 through 2004 to reveal the contribution of nursing to this field. Notwithstanding this rich tradition and the unique perspective of nursing researchers grounded in patient care production processes, the following gaps in nursing research remain: (1) the lack of theoretical frameworks about organizational factors relating to internal work processes; (2) the need for sophisticated methodologies to guide empirical investigations; (3) the difficulty in understanding how organizations adapt models for patient care delivery in response to market forces; (4) the paucity of attention to the impact of new technologies on the organization of patient care work processes. Given nurses' deep understanding of the inner workings of health care facilities, we hope to see an increasing number of research programs that tackle these deficiencies.
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Nursing staff work patterns in a residential aged care home: a time-motion study.
Qian, Siyu; Yu, Ping; Hailey, David
2016-11-01
Objective Residential aged care services are challenged by an increasing number of residents and a shortage of nursing staff. Developing strategies to overcome this challenge requires an understanding of nursing staff work patterns. The aim of the present study was to investigate the work processes followed by nursing staff and how nursing time is allocated in a residential aged care home. Methods An observational time-motion study was conducted at two aged care units for 12 morning shifts. Seven nurses were observed, one per shift. Results In all, there were 91h of observation. The results showed that there was a common work process followed by all nurse participants. Medication administration, documentation and verbal communication were the most time-consuming activities and were conducted most frequently. No significant difference between the two units was found in any category of activities. The average duration of most activities was less than 1min. There was no difference in time utilisation between the endorsed enrolled nurses and the personal carers in providing nursing care. Conclusion Medication administration, documentation and verbal communication were the major tasks in morning shifts in a residential aged care home. Future research can investigate how verbal communication supports nursing care. What is known about the topic? The aging population will substantially increase the demand for residential aged care services. There is a lack of research on nurses' work patterns in residential aged care homes. What does this paper add? The present study provides a comprehensive understanding of nurses' work patterns in a residential aged care home. There is a common work process followed by nurses in providing nursing care. Medication administration, verbal communication and documentation are the most time-consuming activities and they are frequently conducted in the same period of time. Wound care, physical review and documentation on desktop computers are arranged flexibly by the nurses. What are the implications for practitioners? When developing a task reallocation strategy to improve work efficiency, effort can be put into tasks that can be arranged more flexibly.
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Magnet status and registered nurse views of the work environment and nursing as a career.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
2007-05-01
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
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Magnet status and registered nurse views of the work environment and nursing as a career.
Ulrich, Beth T; Buerhaus, Peter I; Donelan, Karen; Norman, Linda; Dittus, Robert
2009-01-01
To compare how registered nurses view the work environment and the nursing shortage based on the Magnet status of their organizations. The upsurge in organizations pursuing and obtaining Magnet recognition provides increased opportunities to investigate whether and how registered nurses who are employed in Magnet organizations and organizations pursuing Magnet status perceive differences in the nursing shortage, hospitals' responses to the shortage, characteristics of the work environment, and professional relationships. A nationally representative sample of registered nurses licensed to practice in the United States was surveyed. The views of registered nurses who worked in Magnet organizations, organizations in the process of applying for Magnet status, and non-Magnet organizations were analyzed as independent groups. Significant differences were found. Although there is a clear Magnet difference, there are also identifiable differences that occur during the pursuit of Magnet recognition. Many organizations in the process of applying for Magnet status rated higher than Magnet organizations, indicating that there is much to do to maintain the comparative advantages for Magnet hospitals.
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[Computers in nursing: development of free software application with care and management].
dos Santos, Sérgio Ribeiro
2010-06-01
This study aimed at developing an information system in nursing with the implementation of nursing care and management of the service. The SisEnf--Information System in Nursing--is a free software module that comprises the care of nursing: history, clinical examination and care plan; the management module consists of: service shifts, personnel management, hospital indicators and other elements. The system was implemented at the Medical Clinic of the Lauro Wanderley University Hospital, at Universidade Federal da Paraiba. In view of the need to bring user and developer closer, in addition to the constant change of functional requirements during the interactive process, the method of unified process was used. The SisEnf was developed on a WEB platform and using free software. Hence, the work developed aimed at assisting in the working process of nursing, which will now have the opportunity to incorporate information technology in their work routine.
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Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement.
Lewis, Heather Smith; Cunningham, Christopher J L
2016-01-01
Burnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. The purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. Working nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. Findings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. There are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.
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Student nurses' experience working with mentally challenged individuals in South Africa.
Janse VAN Rensburg, E S; Poggenpoel, M; Myburgh, C P H
2012-11-01
South African student nurses experience emotional discomfort that might influence their adjustment and coping while working with mentally challenged individuals. Adjustment and coping might impact on their mental health and support needed while working in this challenging context. Student nurses working with mentally challenged individuals experience emotional discomfort that may result in work-related stress. The experiences of student nurses working with mentally challenged individuals were explored and described as it may influence their adjustment, coping and result in work-related stress, impacting on their mental health. The study used a qualitative, explorative, descriptive, contextual research design with a case study as strategy. Thirteen student nurses from a specific higher educational institution in Gauteng, South Africa, participated in the focus group interviews. The researcher utilized reflective journals, a reflective letter, naïve sketches, drawings and field notes to collect data. Data analysis was done according to Tesch's descriptive method of open coding and theme analysis. A central storyline emerged where student nurses described working with mentally challenged individuals as a process of personal transformation that was initiated by an engagement on a deeper emotional level with these individuals. The process of personal transformation started a journey towards the discovery of meaning for the self, as student nurses. Student nurses working in challenging environments during their training may experience emotional discomfort and need additional support in coping and adjustment within this context. The nurse educator plays an important role in providing this support to manage work-related stress as well as in creating learning opportunities for the student nurses working in challenging contexts. © 2012 Blackwell Publishing.
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Findings From a Nursing Care Audit Based on the Nursing Process: A Descriptive Study.
Poortaghi, Sarieh; Salsali, Mahvash; Ebadi, Abbas; Rahnavard, Zahra; Maleki, Farzaneh
2015-09-01
Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. This study aimed to audit nursing care based on a nursing process model. This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses' compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses' age (r = 0.26, P = 0.001) and work experience (r = 0.273, P = 0.001). Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools.
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Operational Failures and Interruptions in Hospital Nursing
Tucker, Anita L; Spear, Steven J
2006-01-01
Objective To describe the work environment of hospital nurses with particular focus on the performance of work systems supplying information, materials, and equipment for patient care. Data Sources Primary observation, semistructured interviews, and surveys of hospital nurses. Study Design We sampled a cross-sectional group of six U.S. hospitals to examine the frequency of work system failures and their impact on nurse productivity. Data Collection We collected minute-by-minute data on the activities of 11 nurses. In addition, we conducted interviews with six of these nurses using questions related to obstacles to care. Finally, we created and administered two surveys in 48 nursing units, one for nurses and one for managers, asking about the frequency of specific work system failures. Principal Findings Nurses we observed experienced an average of 8.4 work system failures per 8-hour shift. The five most frequent types of failures, accounting for 6.4 of these obstacles, involved medications, orders, supplies, staffing, and equipment. Survey questions asking nurses how frequently they experienced these five categories of obstacles yielded similar frequencies. For an average 8-hour shift, the average task time was only 3.1 minutes, and in spite of this, nurses were interrupted mid-task an average of eight times per shift. Conclusions Our findings suggest that nurse effectiveness can be increased by creating improvement processes triggered by the occurrence of work system failures, with the goal of reducing future occurrences. Second, given that nursing work is fragmented and unpredictable, designing processes that are robust to interruption can help prevent errors. PMID:16704505
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ERIC Educational Resources Information Center
Bacharach, Samuel B.; And Others
1990-01-01
Study of five sets of work process variables and their relationship to role conflict and overload among public sector nurses and engineers found managerial strategies appropriate for minimizing role conflict not necessarily appropriate for minimizing role overload. Some work process predictors may be similar across professions, and managerial…
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The influence of authentic leadership and areas of worklife on work engagement of registered nurses.
Bamford, Megan; Wong, Carol A; Laschinger, Heather
2013-04-01
To examine the relationships among nurses' perceptions of nurse managers' authentic leadership, nurses' overall person-job match in the six areas of worklife and their work engagement. Reports have highlighted the impact of demanding and unsupportive work environments on nurses' wellbeing, resulting in a need for strong nursing leadership to build sustainable and healthier work environments. A secondary analysis of data collected from a non-experimental, predictive design survey of a random sample of 280 registered nurses working in acute care hospitals was conducted. An overall person-job match in the six areas of worklife fully mediated the relationship between authentic leadership and work engagement. Further, authentic leadership, overall person-job match in the six areas of worklife and years of nursing experience explained 33.1% of the variance in work engagement. Findings suggest that nurses who work for managers demonstrating higher levels of authentic leadership report a greater overall person-job match in the six areas of worklife and greater work engagement. As nurse managers' play a key role in promoting work engagement among nurses, authentic leadership development for nurse managers focusing on self-awareness, relational transparency, ethics and balanced processing would be beneficial. © 2012 Blackwell Publishing Ltd.
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Johal, Sarbjit S; Mounsey, Zoe; Brannelly, Petula; Johnston, David M
2016-02-01
This report explores nurses' perspectives following the Canterbury (New Zealand) 2010-2011 earthquake sequence and the subsequent recovery process. Problem Little is known about the experiences of health care professionals during a disaster recovery process, and this research generates insights about the challenges faced. Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch (New Zealand) area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of longer term aspects of the recovery process. The interview transcripts were analyzed and coded using a grounded theory approach. The data analysis identified that the nurses had faced a number of challenges and these were characterized as practical, emotional, and professional. While some of the challenges were short-lived in the aftermath of the earthquakes, some were long-lasting due to the extended nature of the recovery process. Dealing with house damage, insurance negotiations, and working in damaged environments had a negative impact on the nurses. The nurses experienced a range of emotions, both negative and positive, after the disaster, though many had needed time to elapse before feeling able to reflect on their experiences. The findings suggest that secondary stressors have a negative impact on the psychosocial recovery process. The nurses recognized that they received support from others and were also required to focus on others. Keeping busy appeared to be the most common coping strategy. This lack of reflection on their experiences may have resulted in delayed emotional responses. Some of the nurses changed their work role, hours, and responsibilities suggesting that working in this environment was having a detrimental impact. The research indicates the challenges faced by nurses in the initial impact of the earthquakes and during the longer term recovery process. There is a need to consider the psychosocial impact of working and living in a post-disaster context and to develop support packages to ensure the health and well-being of nurses in this environment.
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Kim, MinYoung; Oh, Seieun
2016-01-01
The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. "Assimilating to the hierarchical culture" emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses' perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members' satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression.
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Kishi, Yuka; Inoue, Kumiyo; Crookes, Patrick; Shorten, Allison
2014-04-01
The purpose of the study was to investigate the experiences of Japanese nurses and their adaptation to their work environment in Australia. Using a qualitative research method and semistructured interviews, the study aimed to discover, describe, and analyze the experiences of 14 Japanese nurses participating in the study. A qualitative study. Fourteen Japanese registered nurses working in Australian hospitals participated in the study. Individual semistructured interviews were conducted from April to June in 2008. Thematic analysis was used to identify themes within the data. Analysis of qualitative open-ended questions revealed the participants' adaptation process. It consists of three themes or phases: seeking (S), acclimatizing (A), and settling (S), subsequently named the S.A.S. model. The conceptual model of the adaptation processes of 14 Japanese nurses working in Australia includes the seeking, acclimatizing, and settling phases. Although these phases are not mutually exclusive and the process is not necessarily uniformly linear, all participants in this study passed through this S.A.S. model in order to adapt to their new environment. The S.A.S. model of adaptation helps to describe the experiences of Japanese overseas qualified nurses working in Australian hospitals. Future research is needed to examine whether this model can be applied to nurses from other countries and in other settings outside Australia.
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McCullagh, Marjorie C; Berry, Peggy
2015-08-01
Occupational health nursing focuses on promotion and restoration of health, prevention of illness and injury, protection from work-related and environmental hazards, and corporate profitability. Quality education about the relationship between work and health is critical for nurses' success regardless of work setting, and is consistent with Healthy People 2020 goals, but is lacking or limited in some programs. This report introduces an innovative occupational health nursing curriculum for students enrolled in baccalaureate nursing programs. The process of designing and pilot testing this novel curriculum, its alignment with nursing competencies, and its format and learning activities are described. Preparing professional nurses to understand the role of the occupational health nurse and the relationship between work and health is an essential curricular consideration for contemporary nursing education. © 2015 The Author(s).
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The evolution and development of an instrument to measure essential professional nursing practices.
Kramer, Marlene; Brewer, Barbara B; Halfer, Diana; Hnatiuk, Cynthia Nowicki; MacPhee, Maura; Schmalenberg, Claudia
2014-11-01
Nursing continues to evolve from a task-oriented occupation to a holistic professional practice. Increased professionalism requires accurate measurement of care processes and practice. Nursing studies often omit measurement of the relationship between structures in the work environment and processes of care or between processes of care and patient outcomes. Process measurement is integral to understanding and improving nursing practice. This article describes the development of an updated Essentials of Magnetism process measurement instrument for clinical nurses (CNs) practicing on inpatient units in hospitals. It has been renamed Essential Professional Nursing Practices: CN.
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Güttler, Karen; Lehmann, Almut
2003-06-01
This paper is based on the project "nursing process, standardisation and quality in nursing care" which is funded by the BMBF. This venture aims to develop and constitute a structure for recordation and documentation of nursing processes in terms of a typology and to standardise patients data for an exchange. The typology results from both the outcomes of the actual analysis of 128 patients in hospitals, homes for the elderly and community health care centers and the research on nursing classifications. The contents of the typology has been developed in co-operation with nurses working in such institutions. The structure and transfer of the data set will be realised by an IT media based network. The range of the project is regional, national and international. In this project the Bremen Institute of Industrial Technology and Applied Work Science (BIBA-ATOP) was responsible for the project management and the development of the IT based structure of the typology. The contents of the typology have been developed by the Institute of Applied Nursing Research (iap).
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Quality nursing care: a qualitative enquiry.
Hogston, R
1995-01-01
In spite of the wealth of literature on quality nursing care, a disparity exists in defining quality. The purpose of this study was an attempt to seek out practising nurses' perceptions of quality nursing care and to present a definition of quality as described by nurses. Eighteen nurses from a large hospital in the south of England were interviewed. Qualitative analysis based on a modified grounded theory approach revealed three categories described as 'structure', 'process' and 'outcome'. This supports previous work on evaluating quality care but postulates that structure, process and outcome could also be used as a mechanism for defining quality. The categories are defined by using the words of the informants in order to explain the essential attributes of quality nursing care. The findings demonstrate how more informants cited quality in terms of process and outcome than structure. It is speculated that the significance of this rests with the fact that nurses have direct control over process and outcome whereas the political and economic climate in which nurses work is beyond their control and decisions over structure lie with their managers.
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Collaborative essay testing: group work that counts.
Gallagher, Peggy A
2009-01-01
Because much of a nurse's work is accomplished through working in groups, nursing students need an understanding of group process as well as opportunities to problem-solve in groups. Despite an emphasis on group activities as critical for classroom learning, there is a lack of evidence in the nursing literature that describes collaborative essay testing as a teaching strategy. In this class, nursing students worked together in small groups to answer examination questions before submitting a common set of answers. In a follow-up survey, students reported that collaborative testing was a positive experience (e.g., promoting critical thinking, confidence in knowledge, and teamwork). Faculty were excited by the lively dialog heard during the testing in what appeared to be an atmosphere of teamwork. Future efforts could include providing nursing students with direct instruction on group process and more opportunities to work and test collaboratively.
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Stab, Nicole; Hacker, Winfried
2018-05-01
The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.
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Assimilating to Hierarchical Culture: A Grounded Theory Study on Communication among Clinical Nurses
2016-01-01
The purpose of this study was to generate a substantive model that accounts for the explanatory social processes of communication in which nurses were engaged in clinical settings in Korea. Grounded theory methodology was used in this study. A total of 15 clinical nurses participated in the in-depth interviews. “Assimilating to the hierarchical culture” emerged as the basic social process of communication in which the participants engaged in their work environments. To adapt to the cultures of their assigned wards, the nurses learned to be silent and engaged in their assimilation into the established hierarchy. The process of assimilation consisted of three phases based on the major goals that nurses worked to achieve: getting to know about unspoken rules, persevering within the culture, and acting as senior nurse. Seven strategies and actions utilized to achieve the major tasks emerged as subcategories, including receiving strong disapproval, learning by observing, going silent, finding out what is acceptable, minimizing distress, taking advantages as senior nurse, and taking responsibilities as senior nurse. The findings identified how the pattern of communication in nursing organizations affected the way in which nurses were assimilated into organizational culture, from individual nurses’ perspectives. In order to improve the rigid working atmosphere and culture in nursing organizations and increase members’ satisfaction with work and quality of life, managers and staff nurses need training that focuses on effective communication and encouraging peer opinion-sharing within horizontal relationships. Moreover, organization-level support should be provided to create an environment that encourages free expression. PMID:27253389
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Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting
Lopez, Karen Dunn; Cary, Michael P; Kanak, Mary F
2010-01-01
Objective To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. Design A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Measurements Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time–motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Results Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive ‘head data’, temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Conclusion Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units. PMID:20442150
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Cognitive work analysis to evaluate the problem of patient falls in an inpatient setting.
Lopez, Karen Dunn; Gerling, Gregory J; Cary, Michael P; Kanak, Mary F
2010-01-01
To identify factors in the nursing work domain that contribute to the problem of inpatient falls, aside from patient risk, using cognitive work analysis. A mix of qualitative and quantitative methods were used to identify work constraints imposed on nurses, which may underlie patient falls. Data collection was done on a neurology unit staffed by 27 registered nurses and utilized field observations, focus groups, time-motion studies and written surveys (AHRQ Hospital Survey on Patient Culture, NASA-TLX, and custom Nursing Knowledge of Fall Prevention Subscale). Four major constraints were identified that inhibit nurses' ability to prevent patient falls. All constraints relate to work processes and the physical work environment, opposed to safety culture or nursing knowledge, as currently emphasized. The constraints were: cognitive 'head data', temporal workload, inconsistencies in written and verbal transfer of patient data, and limitations in the physical environment. To deal with these constraints, the nurses tend to employ four workarounds: written and mental chunking schemas, bed alarms, informal querying of the previous care nurse, and informal video and audio surveillance. These workarounds reflect systemic design flaws and may only be minimally effective in decreasing risk to patients. Cognitive engineering techniques helped identify seemingly hidden constraints in the work domain that impact the problem of patient falls. System redesign strategies aimed at improving work processes and environmental limitations hold promise for decreasing the incidence of falls in inpatient nursing units.
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Lannering, Christina; Ernsth Bravell, Marie; Johansson, Linda
2017-05-01
A structured and systematic care process for preventive work, aimed to reduce falls, pressure ulcers and malnutrition among older people, has been developed in Sweden. The process involves risk assessment, team-based interventions and evaluation of results. Since development, this structured work process has become web-based and has been implemented in a national quality registry called 'Senior Alert' and used countrywide. The aim of this study was to describe nursing staff's experience of preventive work by using the structured preventive care process as outlined by Senior Alert. Eight focus group interviews were conducted during 2015 including staff from nursing homes and home-based nursing care in three municipalities. The interview material was subjected to qualitative content analysis. In this study, both positive and negative opinions were expressed about the process. The systematic and structured work flow seemed to only partly facilitate care providers to improve care quality by making better clinical assessments, performing team-based planned interventions and learning from results. Participants described lack of reliability in the assessments and varying opinions about the structure. Furthermore, organisational structures limited the preventive work. © 2016 John Wiley & Sons Ltd.
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The global Filipino nurse: An integrative review of Filipino nurses' work experiences.
Montayre, Jed; Montayre, Jasmine; Holroyd, Eleanor
2018-05-01
To understand the work-related experiences of Philippine-trained nurses working globally. The Philippines is a major source country of foreign-trained nurses located globally. However, there is paucity of research on professional factors and career related issues affecting foreign-trained nurses' work experiences. An integrative review through a comprehensive search of literature was undertaken from November 2015 and was repeated in August 2016. Seven articles satisfied the selection criteria. Filipino nurses experienced differences in the practice of nursing in terms of work process, roles and autonomy. Moreover, they encountered challenges such as work-related discrimination and technical difficulties within the organisation. A clear understanding of Filipino nurses' work experiences and the challenges they have encountered suggests identification of important constructs influencing effective translation of nursing practice across cultures and health systems, which then form the basis for support strategies. It is critical to recognize foreign-trained nurses' experience of work-related differences and challenges as these foster favorable conditions for the management team to plan and continually evaluate policies around recruitment, retention and support offered to these nurses. Furthermore, findings suggest internationalization of nursing framework and standards integrating a transcultural paradigm among staff members within a work organisation. © 2017 John Wiley & Sons Ltd.
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Findings From a Nursing Care Audit Based on the Nursing Process: A Descriptive Study
Poortaghi, Sarieh; Salsali, Mahvash; Ebadi, Abbas; Rahnavard, Zahra; Maleki, Farzaneh
2015-01-01
Background: Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. Objectives: This study aimed to audit nursing care based on a nursing process model. Patients and Methods: This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses’ compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. Results: The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses’ age (r = 0.26, P = 0.001) and work experience (r = 0.273, P = 0.001). Conclusions: Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools. PMID:26576448
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E-documentation as a process management tool for nursing care in hospitals.
Rajkovic, Uros; Sustersic, Olga; Rajkovic, Vladislav
2009-01-01
Appropriate documentation plays a key role in process management in nursing care. It includes holistic data management based on patient's data along the clinical path with regard to nursing care. We developed an e-documentation model that follows the process method of work in nursing care. It assesses the patient's status on the basis of Henderson's theoretical model of 14 basic living activities and is aligned with internationally recognized nursing classifications. E-documentation development requires reengineering of existing documentation and facilitates process reengineering. A prototype solution of an e-nursing documentation, already being in testing process at University medical centres in Ljubljana and Maribor, will be described.
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Nursing lives in the blogosphere: A thematic analysis of anonymous online nursing narratives.
Castro, Aimee; Andrews, Gavin
2018-02-01
The aim of this study was to explore the work-life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. Many nurses participate on social media. Blogs have been advocated as a self-reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses' individual blogs for their potential to reveal nurses' perceptions of nursing work. The research design was qualitative description. Between May-August 2015, Internet search engines were used to discover lists of nursing blogs recommended by organizations representing nurses' interests. Recommended blogs were purposively sampled. Four anonymous blogs written by nurses from different nursing specialties met the sampling criteria. All 520 of their entries from 2014 were read and copied into NVivo 10, where an inductive coding process was followed. Three major themes arose in these nurses' online discussions of their work lives: they truly care about and value their nursing work, but they are feeling stressed and burnt out and they are using their anonymous blogs to share factors that frustrate them in their nursing work. Three main areas of frustration were revealed: teamwork problems, challenging patients and families, and management issues. Anonymous nursing blogs offer valuable, longitudinal insights into nurses' perceptions of their work lives. Nursing blogs should be further explored for ongoing insights into nurses' experiences of nursing work, as well as nurses' recommendations for addressing issues causing them to feel frustrated in their work environments. © 2017 John Wiley & Sons Ltd.
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de Almeida, L B; dos Santos, E S; Alves, D de B
1995-01-01
This paper relates a description about nursing notes in pactients promptuaries in relation to the distribution/reproduction/production process of knowledge in nursing. It was developed on an Intensive Care Unity from a Hospital in the teaching/assistance Sanitary District Barra/Rio Vermelho (Salvador-Bahia). The basic premise is that the nursing personal work superficial and sporadic notes just related to patients. Distribution/ reproduction/production process, that happen in the nursing work process isn't considered by it devaluation or just because, for nursing agents, only information about technical procedures related to patient care, expresses the nursing knowledge and so, must be registered. In order to reach the objective, 30% of the promptuaries of patients discharge from the ICU were studied and the nursing team was interviewed, during the months-november, december 1994. The analysis indicates that the way how the nursing notes are been made, results in hard communication among agents of health area and contributes to disqualify the nursing assistance that is given to patients, besides to limit the advance of the distribution/reproduction/production of knowledge in nursing.
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Vasconcelos, Selene Cordeiro; Lopes de Souza, Sandra; Botelho Sougey, Everton; de Oliveira Ribeiro, Elayne Cristina; Costa do Nascimento, José Jailson; Formiga, Mariana Bandeira; Batista de Souza Ventura, Luciana; Duarte da Costa Lima, Murilo; Silva, Antonia Oliveira
2016-01-01
Background: The mental health of nursing staff members influences the work process outcomes. Objective: Identify the work related factors that harms the nursing team’s mental health. Methods: Databases PubMed, Scopus, CINAHL and MEDLINE, by mating between the indexed descriptors in MeSH terms “mental health” and “occupational health nursing”. 783 articles were rescued to give a final sample of 18 articles. Integrative review in order to identify factors associated with the work process of the nursing staff that negatively affects mental health. Results: The main associated factors were work demands, psychological demands, violence, aggression, poor relationships with administrators, accidents involving the risk of exposure to HIV, stress and errors in the execution of labor activities. The main findings regarding the nursing staff’s mental health were post-traumatic stress disorder, depression, stress, major depressive episode and generalized anxiety disorder. Conclusion: Occupational nurses need to understand the complexities of mental health problems and substance use among nursing staff members to recognize, identify and care for workers at risk and offer adequate mental health care. Although the researches interests in this theme have increased, proving that all these factors contribute to the risk to mental health of nursing professionals, the protective measures and care are being neglected by managers in both private and public network . The health of nursing workers in question here is one more challenge for a profession that takes care of others in need, therefore, requires some caring with their own health. PMID:28217144
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Nichiata, Lúcia Yasuko Izumi; Padoveze, Maria Clara; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins; Costa, Angela Aparecida; Takahashi, Renata Ferreira; Bertolozzi, Maria Rita; de Araújo, Núbia Virgínia D'Ávila Limeira; Pereira, Erica Gomes; Dias, Vânia Ferreira Gomes; Cubas, Marcia Regina
2012-06-01
The CIPESC® is a tool that informs the work of nurses in Public Health and assists in prioritizing their care in practice, management and research. It is also a powerful pedagogical instrument for the qualification of nurses within the Brazilian healthcare system. In the teaching of infectious diseases, using the CIPESC® assists in analyzing the interventions by encouraging clinical and epidemiological thinking regarding the health-illness process. With the purpose in mind of developing resources for teaching undergraduate nursing students and encouraging reflection regarding the process of nursing work, this article presents an experimental application of CIPESC®, using meningococcal meningitis as an example.
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[Cellular transplantation laboratory: a new field of action for nurses].
Corradi, Maria Inês; da Silva, Sandra Honorato
2008-01-01
This article presents the experience of a nurse at a cellular transplantation laboratory. This laboratory goal is to isolate insulin producing cells for human transplantation. The nurse, as a member of an interdisciplinary team, took part in the planning of all work processes: working procedures and team training. The main activities under the nurse responsibilities include contamination control, on-the-job training and evaluation of the Quality of the procedures developed by the interdisciplinary team. Results have shown the effectiveness of the nurses' work in this new field.
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De Córdova, Maria Isabel Peñarrietade; Mier, Nelda; Quirarte, Nora Hilda Gonzales; Gómez, Tranquilina Gutiérrez; Piñones, Socorro; Borda, Alejandro
2013-11-01
This exploratory study conducted in Mexico and Peru investigated nurses' perceptions about their role in public health and working conditions. Health reform efforts in many countries are redefining the role of health professionals in public health. Little is known about the role of nurses working in public health contexts in Latin America. Fourteen focus groups were conducted in Mexico and Peru with 82 nurses working in government-sponsored community health centres. Data were analysed using a content analysis technique. Themes identified were: nurses' job descriptions in public health settings; organisational factors influencing the nurses' work, and influence of academic and social image factors. Management barriers and limited training influences the role and working conditions of public health nurses in Mexico and Peru. The professional role of nurses working in public health in Latin America is not well defined because of the health-care system infrastructure and the lack of a clear public health nurse job description. Further research is needed to better understand the role of public health nurses and strengthen their training, particularly in relation to nursing management encompassing abilities for decision-making processes and public health program planning and evaluation. © 2012 John Wiley & Sons Ltd.
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Tang, Charmaine J; Zhou, Wen T; Chan, Sally W-C; Liaw, Sok Y
2018-01-01
To explore the collaboration experiences of junior physicians and nurses in the general ward setting. Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. Nineteen junior physicians and nurses were interviewed in 2012 and 2013. Interviews were transcribed and analysed using thematic analysis. Junior physicians and nurses acknowledged the importance of working collaboratively to achieve better patient care, but they are struggling to cope due to heavy clinical workload, organisational constraints and differing power relationships. Nurses have to take on more responsibilities in the decision-making process of patients' care to foster effective interprofessional collaboration. The study calls for educational and organisational strategies to improve interprofessional collaboration between junior physicians and nurses. Nurse leaders should ensure that ward nurses are given a designated time to participate in ward rounds with physicians and have access to a communication tool that assists them in contributing proactively in the decision-making process of patient care. © 2017 John Wiley & Sons Ltd.
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Challenges of safe medication practice in paediatric care--a nursing perspective.
Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph
2013-05-01
To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.
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How Nurses Experience Their Work as a Learning Environment
ERIC Educational Resources Information Center
Skår, Randi
2010-01-01
This article explores and illuminates the meaning of nurses' experiences with their work as a learning environment. A qualitative hermeneutic approach guided the research process and the analysis and interpretation of the transcribed interview-texts of eleven graduate nurses. Three core themes emerged from these informants' descriptions of their…
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Use of electronic information systems in nursing management.
Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula
2010-05-01
The purpose of this study is to describe nurse managers' perceptions of the use of electronic information systems in their daily work. Several kinds of software are used for administrative and information management purposes in health care organizations, but the issue has been studied less from nurse managers' perspective. The material for this qualitative study was acquired according to the principles of focus group interview. Altogether eight focus groups were held with 48 nurse managers from both primary and specialized health care organizations. The nurse managers were asked in focus groups to describe the use of information systems in their daily work in addition to some other themes. The material was analyzed by inductive content analysis using ATLAS.ti computer program. The main category "pros and cons of using information systems in nursing management" summarized the nurse managers' perceptions of using electronic information systems. The main category consisted of three sub-categories: (1) nurse managers' perceptions of the use of information technology; (2) usability of management information systems; (3) development of personnel competencies and work processes. The nurse managers made several comments on the implementation of immature electronic information systems which caused inefficiencies in working processes. However, they considered electronic information systems to be essential elements of their daily work. Furthermore, the nurse managers' descriptions of the pros and cons of using information systems reflected partly the shortcomings of strategic management and lack of coordination in health care organizations. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
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The environment of professional practice and Burnout in nurses in primary healthcare
Lorenz, Vera Regina; Guirardello, Edinêis de Brito
2014-01-01
OBJECTIVES: to assess how nurses perceive autonomy, control over the environment, the professional relationship between nurses and physicians and the organizational support and correlate them with burnout, satisfaction at work, quality of work and the intention to quit work in primary healthcare. METHOD: cross-sectional and correlation study, using a sample of 198 nurses. The tools used were the Nursing Work Index Revised, Maslach Burnout Inventory and a form to characterize the nurses. To analyze the data, descriptive statistics were applied and Spearman's correlation coefficient was used. RESULTS: the nurses assessed that the environment is partially favorable for: autonomy, professional relationship and organizational support and that the control over this environment is limited. Significant correlations were evidenced between the Nursing Work Index Revised, Maslach Burnout Inventory and the variables: satisfaction at work, quality of care and the intent to quit the job. CONCLUSION: the nurses' perceptions regarding the environment of practice are correlated with burnout, satisfaction at work, quality of care and the intent to quit the job. This study provides support for the restructuring of work processes in the primary health care environment and for communication among the health service management, human resources and occupational health areas. PMID:25517928
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Robinson, Karen; Eck, Carol; Keck, Becky; Wells, Nancy
2003-09-01
Professional practice programs are designed to attract, retain, and reward nurses. This three-part series will describe Vanderbilt's performance-based career advancement system, the Vanderbilt Professional Nursing Practice Program (VPNPP). Part 1 outlines the overall program's foundation, philosophical background, and basic structure. The VPNPP is built upon Benner's work, distinguishing among four levels of practice: novice, competent, proficient, and expert. Work by many in the organization identified the expected behaviors for nurses at each level, which were then used to develop clear process evaluation criteria. Part 2 will examine the performance measurement and evaluation system created to support the program. The process of advancing within the program will be described in part 3.
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[Necessary changes for advancing nursing as caring science].
de Pires, Denise Elvira Pires
2013-09-01
The article aimed to reflect upon the challenges involved in strengthening Nursing as a caring science. It is founded on the sociological theory, connecting three approaches: the historical-dialectic materialism perspective about the working process in health care and nursing; the sociology of professions from a critical perspective; and the philosophy of science. The discussion is organized considering the aspects of Nursing as a discipline, work and health care profession. It sustains that knowledge production should be driven both by the purpose of Nursing work which is providing care to human beings with health needs and to advocate for the indispensable work conditions to a safe and responsible practice. It concludes that to strengthening Nursing it is necessary to produce knowledge to support nursing care and the political actions defending safe work conditions, the universal right to health as well safe and high quality care.
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Griffin, A P
1980-05-01
It is claimed that philosophy has a distinctive contribution to make to the education of nurses and their teachers, as well as to the development of nursing theory and research. After a brief characterization of philosophy and philosophy of education, stressing its relationship with thinking processes, and the development of personal values, the above claim is supported in the body of the article by discussion of four central concerns in nursing. First the concept of caring where cognitive, moral and attitudinal aspects are examined and secondly, the importance of gaining a moral and political consciousness of assumptions underlying a nurse's work. Thirdly, a discussion of some ethical and other implications in adopting a systems approach to the nursing process. Finally an anlysis of nursing theory and research which draws attention to the value of non-empirical work, and reiterates criticisms of the objectives approach as a research tool.
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Eltaybani, Sameh; Noguchi-Watanabe, Maiko; Igarashi, Ayumi; Saito, Yumiko; Yamamoto-Mitani, Noriko
2018-04-01
Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models. To identify the factors associated with long-term care nurses' intention to stay in their current workplace. A cross-sectional questionnaire survey. Two hundred and fifty-seven hospitals with long-term care wards across Japan. A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals. The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace. Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in gerontological nursing, and a high salary). By contrast, intention to stay was negatively associated with emotional exhaustion (0.93 [0.91-0.95]) and depersonalization (0.91 [0.89-0.93]). Intention to stay was associated with neither nurses' qualifications nor patient medical acuity. Reason for choosing the workplace, work engagement, getting support from the nurse manager, and perceived quality of care process are significant predictors of long-term care nurses' intention to stay in the workplace. Promoting such nurses' work engagement, provision of high-quality care, and access to educational opportunities might augment long-term care nurses' intention to stay. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Bridge to shared governance: developing leadership of frontline nurses.
Dearmon, Valorie A; Riley, Bettina H; Mestas, Lisa G; Buckner, Ellen B
2015-01-01
Transforming health care systems to improve quality is the responsibility of nurse executives and frontline nurses alike, yet frontline nurses are often ill-prepared to share leadership and accountability needed for transformation. The aim of this qualitative study was to describe the process used to build leadership capacity of frontline nurses engaged in resolving operational failures interrupting nursing care. The leadership development process served to bridge staff transition to shared governance. This institutional review board-approved qualitative research was designed to identify the effects of mentoring by the chief nursing officer and faculty partners on leadership development of frontline nurses working to find solutions to operational failures. Twelve nurses from 4 medical surgical units participated in a Frontline Innovations' nurse-led interdisciplinary group, which met over 18 months. Transcriptions of audiotaped meetings were analyzed for emerging process and outcome themes. The transcripts revealed a robust leadership development journey of frontline nurses engaged in process improvement. Themes that emerged from the mentoring process included engagement, collaboration, empowerment, confidence, and lifelong learning. The mentoring process provided frontline nurses the leadership foundation necessary to initiate shared governance.
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Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis.
Hernández-Marrero, Pablo; Fradique, Emília; Pereira, Sandra Martins
2018-01-01
Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations" (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses' current end-of-life care practices. Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described. All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients' preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses' involvement and practices in end-of-life decision-making.
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The importance of employment status in determining exit rates from nursing.
Daniels, Frieda; Laporte, Audrey; Lemieux-Charles, Louise; Baumann, Andrea; Onate, Kanecy; Deber, Raisa
2012-01-01
To mitigate nurse shortages, health care decision makers tend to employ retention strategies that assume nurses employed in full-time, part-time, or casual positions and working in different sectors have similar preferences for work. However, this assumption has not been validated in the literature. The relationship between a nurse's propensity to exit the nurse profession in Ontario and employment status was explored by building an extended Cox Proportional Hazards Regression Model using a counting process technique. The differential exit patterns between part-time and casual nurses suggest that the common practice of treating part-time and casual nurses as equivalent is misleading. Health care decision makers should consider nurse retention strategies specifically targeting casual nurses because this segment of the profession is at the greatest risk of leaving. Nurse executives and nurse managers should investigate the different work preferences of part-time and casual nurses to devise tailored rather than "one-size fits all" nurse retention strategies to retain casual nurses.
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Pruijssers, Addy; van Meijel, Berno; Maaskant, Marian; Keeman, Noortje; Teerenstra, Steven; van Achterberg, Theo
2015-07-01
This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline. Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process. This study employed a comparative multiple case study design. Qualitative and quantitative research methods. Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process. Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process. After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours. © 2015 John Wiley & Sons Ltd.
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Taking Root: a grounded theory on evidence-based nursing implementation in China.
Cheng, L; Broome, M E; Feng, S; Hu, Y
2018-06-01
Evidence-based nursing is widely recognized as the critical foundation for quality care. To develop a middle-range theory on the process of evidence-based nursing implementation in Chinese context. A grounded theory study using unstructured in-depth individual interviews was conducted with 56 participants who were involved in 24 evidence-based nursing implementation projects in Mainland China from September 2015 to September 2016. A middle-range grounded theory of 'Taking Root' was developed. The theory describes the evidence implementation process consisting of four components (driving forces, process, outcome, sustainment/regression), three approaches (top-down, bottom-up and outside-in), four implementation strategies (patient-centred, nurses at the heart of change, reaching agreement, collaboration) and two patterns (transformational and adaptive implementation). Certain perspectives may have not been captured, as the retrospective nature of the interviewing technique did not allow for 'real-time' assessment of the actual implementation process. The transferability of the findings requires further exploration as few participants with negative experiences were recruited. This is the first study that explored evidence-based implementation process, strategies, approaches and patterns in the Chinese nursing practice context to inform international nursing and health policymaking. The theory of Taking Root described various approaches to evidence implementation and how the implementation can be transformational for the nurses and the setting in which they work. Nursing educators, managers and researchers should work together to improve nurses' readiness for evidence implementation. Healthcare systems need to optimize internal mechanisms and external collaborations to promote nursing practice in line with evidence and achieve clinical outcomes and sustainability. © 2017 International Council of Nurses.
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["Scrap" as an element of communication in nursing].
Esperidião, E; Medeiros Teixeira, M E; Rodrigues Stacciarini, J M
1996-04-01
Based on the understanding that students and nursing professionals demonstrate difficulties in being a "person" in the profession, we developed a descriptive and exploratory study with a qualitative approach. Then, we offered during the "Iind" II Nursing Congress in the city of Goiania a work-shop called "LEARNING ABOUT NURSE'S ENTITY". Among various processes of work-groups; the "Scrap" was used as a kind of communication. It was a resource utilized in certain dynamics, being the object of our study that has the following goals: to identify the representation of nurse's "entity", to verify the interaction process "man-scrap" during the realization of the work and to verify if the object is represented as it really is. We have seen that there are particularities in the representation of nurse's entity. Regarding "man-scrap" interaction it had the followed sequence: finding strange the material and the proposal of work, manipulating and identifying objects, "scrap" selection and concretion of the job. With respect to the objects, we perceived a clear preference to the ones related to the profession. Finally, we suggest that other studies about the "scrap" communication element, must be developed.
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Involving people with learning disabilities in nurse education: towards an inclusive approach.
Bollard, Martin; Lahiff, John; Parkes, Neville
2012-02-01
There is limited evidence that explores how to effectively include people with learning disabilities in nurse education in the U.K. The majority of reported work relates to mental health nursing and social work training (Morgan and Jones, 2009). This paper specifically reports on the processes and activities undertaken by the authors with people with learning disabilities in the development of a new BSc learning disability nursing programme, a specific branch of nursing in the U.K. In doing so, findings and discussion from two separate projects involving students and people with learning disabilities will be integrated into the paper. EPICURE (Engagement, Processing, Interpretation, Critique, Usefulness, Relevance and Ethics (Stige et al. 2009) is adopted as a qualitative framework throughout the paper to evaluate the reported work that took place between September 2006 and October 2010. Suggestions are therefore made regarding the benefits and challenges of striving towards an inclusive approach to user involvement in nurse education, with particular reference to learning disability. The work presented in the paper demonstrates how through careful involvement of this population, deeper learning opportunities for all nursing students can be created. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Apply creative thinking of decision support in electrical nursing record.
Hao, Angelica Te-Hui; Hsu, Chien-Yeh; Li-Fang, Huang; Jian, Wen-Shan; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Chang, Her-Kung
2006-01-01
The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with.
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Influence of the Nursing Practice Environment on Job Satisfaction and Turnover Intention
Lee, Sang-Yi; Kim, Chul-Woung; Kang, Jeong-Hee; Yoon, Tae-Ho; Kim, Cheoul Sin
2014-01-01
Objectives: To examine whether the nursing practice environment at the hospital-level affects the job satisfaction and turnover intention of hospital nurses. Methods: Among the 11 731 nurses who participated in the Korea Health and Medical Workers’ Union’s educational program, 5654 responded to our survey. Data from 3096 nurses working in 185 general inpatient wards at 60 hospitals were analyzed using multilevel logistic regression modeling. Results: Having a standardized nursing process (odds ratio [OR], 4.21; p<0.001), adequate nurse staffing (OR, 4.21; p<0.01), and good doctor-nurse relationship (OR, 4.15; p<0.01), which are hospital-level variables based on the Korean General Inpatients Unit Nursing Work Index (KGU-NWI), were significantly related to nurses’ job satisfaction. However, no hospital-level variable from the KGU-NWI was significantly related to nurses’ turnover intention. Conclusions: Favorable nursing practice environments are associated with job satisfaction among nurses. In particular, having a standardized nursing process, adequate nurse staffing, and good doctor-nurse relationship were found to positively influence nurses’ job satisfaction. However, the nursing practice environment was not related to nurses’ turnover intention. PMID:25284197
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Developing optimal nurses work schedule using integer programming
NASA Astrophysics Data System (ADS)
Shahidin, Ainon Mardhiyah; Said, Mohd Syazwan Md; Said, Noor Hizwan Mohamad; Sazali, Noor Izatie Amaliena
2017-08-01
Time management is the art of arranging, organizing and scheduling one's time for the purpose of generating more effective work and productivity. Scheduling is the process of deciding how to commit resources between varieties of possible tasks. Thus, it is crucial for every organization to have a good work schedule for their staffs. The job of Ward nurses at hospitals runs for 24 hours every day. Therefore, nurses will be working using shift scheduling. This study is aimed to solve the nurse scheduling problem at an emergency ward of a private hospital. A 7-day work schedule for 7 consecutive weeks satisfying all the constraints set by the hospital will be developed using Integer Programming. The work schedule for the nurses obtained gives an optimal solution where all the constraints are being satisfied successfully.
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Santos, Alda; Castanheira, Filipa; Chambel, Maria José; Amarante, Michael Vieira; Costa, Carlos
2017-07-01
This study validates the Portuguese version of the psychological effects of the relational job characteristics scale among hospital nurses in Portugal and Brazil. Increasing attention has been given to the social dimension of work, following the transition to a service economy. Nevertheless, and despite the unquestionable relational characteristics of nursing work, scarce research has been developed among nurses under a relational job design framework. Moreover, it is important to develop instruments that study the effects of relational job characteristics among nurses. We followed Messick's framework for scale validation, comprising the steps regarding the response process and internal structure, as well as relationships with other variables (work engagement and burnout). Statistical analysis included exploratory factor analysis and confirmatory factor analysis. The psychological effects of the relational job characteristics scale provided evidence of good psychometric properties with Portuguese and Brazilian hospital nurses. Also, the psychological effects of the relational job characteristics are associated with nurses' work-related well-being: positively with work engagement and negatively concerning burnout. Hospitals that foster the relational characteristics of nursing work are contributing to their nurses' work-related well-being, which may be reflected in the quality of care and patient safety. © 2017 John Wiley & Sons Ltd.
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[Interpersonal relationships management in the nursery work process].
Urbanetto, Janete de Souza; Capella, Beatriz Beduschi
2004-01-01
This study deals with the problem of interpersonal relationships in the work process of the nurse and, is supported in the referential of the work process and the evolutionary stages of group relationships. To data collection was used a research-action and documental method, at two university hospitals from the South Region. It has been detected some fragilities faced by the controlling nurse in all the stages of the relationship process, with the presence of inefficacious mechanisms of inclusion of these professionals at work, no differential treatment between the controlling position and other functions, relations with an emphasis in the bipersonal contacts and as inefficient as unsatisfactory mechanisms of work process evaluation.
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Nursing Education Transformation: Promising Practices in Academic Progression.
Gorski, Mary Sue; Farmer, Patricia D; Sroczynski, Maureen; Close, Liz; Wortock, Jean M
2015-09-01
Health care has changed over the past decade; yet, nursing education has not kept pace with social and scientific advances. The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, called for a more highly educated nursing work-force and an improved nursing education system. Since the release of that report, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, has worked with nursing education leaders to better understand existing and evolving nursing education structures. Through a consensus-building process, four overarching promising practice models, with an emphasis on seamless academic progression, emerged to advance the goals of education transformation. Key nurse educators and other stakeholders refined those models through a series of meetings, collaborative partnerships, and focused projects that were held across the United States. This article summarizes that process and provides a description of the models, challenges, common themes, recommendations, and progress to date. Copyright 2015, SLACK Incorporated.
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Lögde, Ann; Rudolfsson, Gudrun; Broberg, Roma Runesson; Rask-Andersen, Anna; Wålinder, Robert; Arakelian, Erebouni
2018-05-01
The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour. Leaving one's job was described as a process and specialist nurses had thought about it for some time. Two main reasons were described; the head nurse manager's dismissive attitude and treatment of their employees and colleagues' mistreatment and colleagues' diminishing behaviour. Increasing knowledge on the role of the head nurse managers in specialist nurses' decision making for leaving their workplace, and creating a friendly, non-violent workplace, may give the opportunity for them to take action before it is too late.
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SOARing Into Strategic Planning: Engaging Nurses to Achieve Significant Outcomes.
Wadsworth, Barbara; Felton, Fiona; Linus, Rita
2016-01-01
In 2013, a new system chief nursing officer engaged the nursing leaders and staff in an Appreciative Inquiry process utilizing strengths, opportunities, aspirations, and results (SOAR), and a Journey of Excellence to assess and understand the current environment. The ultimate goal was to engage all nurses in strategic planning and goal setting to connect their patient care to the system strategic initiatives. This work led to the creation of a nursing vision, a revised professional practice model and greater council alignment, resulting in significant positive change and ongoing advancement throughout the system. The shared decision-making structure was key to the process with a direct connection of each council's goals, leading to the successful achievement of 34 of the 36 goals in 2 years. This article outlines the process, tools, and staff engagement strategies used to achieve system-wide success. This methodology has improved the outcomes across the organization in both small and system-wide work groups. This work can easily be replicated and adapted to help disparate staffs brought together through mergers or acquisitions to become aligned as a new team. This process, model, and framework, provides structure and results in significant outcomes that recognizes and celebrates the work of individual entities while aligning future strategies and goals.
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Van Bogaert, Peter; Kowalski, Christoph; Weeks, Susan Mace; Van Heusden, Danny; Clarke, Sean P
2013-12-01
To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community. Cross-sectional survey. Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N=1201) in two independent hospitals and one hospital group with six hospitals in Belgium. Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses' work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively. The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses' involvement in decision-making process and interdisciplinary teamwork are recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Experiences of Iranian Nurses that Intent to Leave the Clinical Nursing: a Content Analysis
Valizadeh, Leila; Zamanzadeh, Vahid; Habibzadeh, Hosein; Alilu, Leyla; Gillespie, Mark; Shakibi, Ali
2016-01-01
Introduction: Despite the current shortage of nurses, it is important to know the reasons nurses want to leave the clinical setting. The purpose of this study was to explore the experiences of nurses who intend to leave clinical nursing. Methods: In a qualitative content analysis study, data obtained from 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to the Tabriz and Urmia University of Medical Sciences in Iran, selected through purposive sampling. A conventional content analysis was used for data analysis. Results: Four categories and eleven subcategories emerged during data analysis. The extracted categories and sub categories consisted of (I) Entry routes into nursing (implicitly entry, targeted entry), (II) Defects in dignity (lack of professional vision toward the nurses, social status of nurses), (III) Work in non-ideal working environment (lack of support, discrimination, conflict, lack of opportunities for advancement), and (IV) Dissatisfaction with working conditions (heavy workload, lack of power, unusual working hours). Conclusion: The findings of this qualitative study reflect professional turnover as a complex, ongoing, multidimensional process. By identifying the factors responsible, it could be possible to retain nurses in the field. PMID:27354981
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Analyzing the nursing organizational structure and process from a scheduling perspective.
Maenhout, Broos; Vanhoucke, Mario
2013-09-01
The efficient and effective management of nursing personnel is of critical importance in a hospital's environment comprising approximately 25 % of the hospital's operational costs. The nurse organizational structure and the organizational processes highly affect the nurses' working conditions and the provided quality of care. In this paper, we investigate the impact of different nurse organization structures and different organizational processes for a real-life situation in a Belgian university hospital. In order to make accurate nurse staffing decisions, the employed solution methodology incorporates shift scheduling characteristics in order to overcome the deficiencies of the many phase-specific methodologies that are proposed in the academic literature.
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How Home Health Nurses Plan Their Work Schedules: A Qualitative Descriptive Study.
Irani, Elliane; Hirschman, Karen B; Cacchione, Pamela Z; Bowles, Kathryn H
2018-06-12
To describe how home health nurses plan their daily work schedules and what challenges they face during the planning process. Home health nurses are viewed as independent providers and value the nature of their work because of the flexibility and autonomy they hold in developing their work schedules. However, there is limited empirical evidence about how home health nurses plan their work schedules, including the factors they consider during the process and the challenges they face within the dynamic home health setting. Qualitative descriptive design. Semi-structured interviews were conducted with 20 registered nurses who had greater than 2 years of experience in home health and were employed by one of the three participating home health agencies in the mid-Atlantic region of the United States. Data were analyzed using conventional content analysis. Four themes emerged about planning work schedules and daily itineraries: identifying patient needs to prioritize visits accordingly, partnering with patients to accommodate their preferences, coordinating visit timing with other providers to avoid overwhelming patients, and working within agency standards to meet productivity requirements. Scheduling challenges included readjusting the schedule based on patient needs and staffing availability, anticipating longer visits, and maintaining continuity of care with patients. Home health nurses make autonomous decisions regarding their work schedules while considering specific patient and agency factors, and overcome challenges related to the unpredictable nature of providing care in a home health setting. Future research is needed to further explore nurse productivity in home health and improve home health work environments. Home health nurses plan their work schedules to provide high quality care that is patient-centered and timely. The findings also highlight organizational priorities to facilitate continuity of care and support nurses while alleviating the burnout associated with high productivity requirements. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Psychometric properties of the Chinese-version Quality of Nursing Work Life Scale.
Lee, Ya-Wen; Dai, Yu-Tzu; McCreary, Linda L; Yao, Grace; Brooks, Beth A
2014-09-01
In this study, we developed and tested the psychometric properties of the Chinese-version Quality of Nursing Work Life Scale along seven subscales: supportive milieu with security and professional recognition, work arrangement and workload, work/home life balance, head nurse's/supervisor's management style, teamwork and communication, nursing staffing and patient care, and milieu of respect and autonomy. An instrument-development procedure with three phases was conducted in seven hospitals in 2010-2011. Phase I comprised translation and the cultural-adaptation process, phase II comprised a pilot study, and phase III comprised a field-testing process. Purposive sampling was used in the pilot study (n = 150) and the large field study (n = 1254). Five new items were added, and 85.7% of the original items were retained in the 41 item Chinese version. Principal component analysis revealed that a model accounted for 56.6% of the variance with acceptable internal consistency, concurrent validity, and discriminant validity. This study gave evidence of reliability and validity of the 41 item Chinese-version Quality of Nursing Work Life Scale. © 2014 Wiley Publishing Asia Pty Ltd.
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Lopes, M J
1997-01-01
This essay intends to discuss recent transformation both to hospital work and nursing work specifically. Analysis privilege inter and intra relations with multidisciplinary teams which is constituted of practices on the therapeutic process present in hospital space-time.
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Ambiguous meanings of projects as facilitators of sensegiving.
Lunkka, Nina; Suhonen, Marjo
2015-10-01
To describe mid-level nurse managers' experiences of sensegiving in the context of hospital projects. Sensegiving is about shaping and affecting how employees see themselves, their work and issues related to their work. It has been little studied in the context of hospital projects from mid-level nurse managers' point of view. Mid-level nurse managers (n = 10) were interviewed about their experiences of projects from the viewpoint of sensegiving during change processes. Data was analysed using discourse analysis. Three repertoires were constructed from the data: the repertoires of regeneration, control and humane. Projects were considered as appropriate ways for sensegiving in hospitals from the viewpoint of mid-level nurse managers. In order to use projects effectively in hospitals as means for change management mid-level nurse managers ought to enhance their role as interpreters during the change process (i.e. strengthen their visioning, talk and dialogue skills). Training on the nature of change as a social and interactive process could deepen mid-level nurse managers' understanding of the change process in the context of hospital projects. © 2014 John Wiley & Sons Ltd.
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Jourdain, Geneviève; Chênevert, Denis
2010-06-01
The aims of the paper are to examine the role of burnout in the relationship between stress factors related to nurses' work and social environment and intention to leave the profession and to investigate the nature of the relationship between burnout and intention to leave the nursing profession. A postulate of the job demands-resources model is that two distinct yet related processes contribute to the development of burnout. The energetic process originates from demands and is mainly centered on emotional exhaustion; the motivational process originates from resources and is mainly centered on depersonalization. Moreover, we postulated that the two components of burnout are linked indirectly to intention to leave the profession via psychosomatic complaints, associated with the energetic process, and via professional commitment, associated with the motivational process. The research model was tested on cross-sectional data collected in 2005 from 1636 registered nurses working in hospitals who responded to a self-administrated questionnaire. Demands are the most important determinants of emotional exhaustion and indirectly induce depersonalization via emotional exhaustion, whereas resources mainly predict depersonalization. Moreover, emotional exhaustion and depersonalization are linked to psychosomatic complaints and professional commitment, which are in turn associated with intention to leave the profession. The results suggest that a dual strategy is needed in order to retain nurses within the profession: a decrease in job demands, coupled with an increase in available job resources. In particular, nurses' tasks and role should be restructured to reduce work overload and increase the meaning of their work. (c) 2009 Elsevier Ltd. All rights reserved.
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Nursing casualization and communication: a critical ethnography.
Batch, Mary; Windsor, Carol
2015-04-01
The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Critical ethnography. Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008-2009. The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management. © 2014 John Wiley & Sons Ltd.
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Validation of holistic nursing competencies: role-delineation study, 2012.
Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Campbell, Joan A; Brekke, Mary E; Sandor, M Kay
2013-12-01
The American Holistic Nurses Credentialing Corporation (AHNCC), certifying body for nurses practicing within the precepts of holistic nursing, uses a systematic process to guide program development. A previous publication described their early work that distinguished basic and advanced holistic nursing and development of related examinations. A more recent publication described the work of AHNCC from 2004 to 2012, including a role-delineation study (RDS) that was undertaken to identify and validate competencies currently used by holistic nurses. A final report describes the RDS design, methods, and raw data information. This article discusses AHNCC's goals for undertaking the 2012 Holistic Nursing RDS and the implications for the certification programs.
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Mendes, Davidson Passos; Moraes, Geraldo Fabiano de Souza; Mendes, Juliana Cristina de Lima
2012-01-01
Our objective in this study, the analysis of potential fields of risk management in nursing work in psychiatric care to adolescents and children, while settings that go from the relationship between technical and organizational determinants of work activity and the skills of operators. It was established focus on the work process of the Technical and Nursing Assistants to seek for response elements in an attempt to understand the health-disease process experienced by these workers. It was used for analysis and data collection, through the method of Ergonomic Work Analysis (EWA), fifteen workers of nursing staff - T&NA, between effectives and contractors, and the strategies of action and regulation of these workers in relation to the interface that they deal with. The results show that the workers are exposed to all charges in an intense and specific way, causing physical and mental wear, as it approaches the psychological distress, exposure to the psychic pressure, not only through contact with the object of work, but the complexity of these relationships that are involved in nursing staff.
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Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan
2016-01-01
The aim of the study reported in this article was to investigate staff nurses' perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses' involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment.
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Kaunonen, Marja; Salin, Sirpa; Aalto, Pirjo
2015-07-01
To explore factors associated with nursing intensity, work environment intensity and nursing resources that may affect nurse job satisfaction and risk of dissatisfaction in outpatient care at one university hospital in Finland. Much research has been done to study how nursing intensity, work environment intensity and nursing resources are associated with nurse job satisfaction, but not in the context of outpatient care. This research used a cross-sectional design. The data were collected from the hospital information systems of outpatient units (n = 12) in autumn 2010. Management style showed a statistically significant association with job satisfaction. The risk of dissatisfaction increased when nursing staff had no influence over the design of their jobs, when conflicts and contradictions were not addressed in the workplace and when feedback was not processed. Nursing intensity and work environment intensity had no effect on nurse job satisfaction. Nursing resources and patient satisfaction, on the other hand, were important to nurses' job satisfaction. The results indicate that nursing management should involve nursing staff in the development of their jobs and the care delivery model. © 2013 John Wiley & Sons Ltd.
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Hagos, Fisseha; Alemseged, Fessehaye; Balcha, Fikadu; Berhe, Semarya; Aregay, Alemseged
2014-01-01
Background. Nursing process is considered as appropriate method to explain the nursing essence, its scientific bases, technologies and humanist assumptions that encourage critical thinking and creativity, and permits solving problems in professional practice. Objective. To assess the application of nursing process and it's affecting factors in Mekelle Zone Hospitals. Methods. A cross sectional design employing quantitative and qualitative methods was conducted in Mekelle zone hospitals March 2011. Qualitative data was collected from14 head nurses of six hospitals and quantitative was collected from 200 nurses selected by simple random sampling technique from the six hospitals proportional to their size. SPSS version 16.1 and thematic analysis was used for quantitative and qualitative data respectively. Results. Majority 180 (90%) of the respondents have poor knowledge and 99.5% of the respondents have a positive attitude towards the nursing process. All of the respondents said that they did not use the nursing process during provision of care to their patients at the time of the study. Majority (75%) of the respondent said that the nurse to patient ratio was not optimal to apply the nursing process. Conclusion and Recommendation. The nursing process is not yet applied in all of the six hospitals. The finding revealed that the knowledge of nurses on the nursing process is not adequate to put it in to practice and high patient nurse ratio affects its application. The studied hospitals should consider the application of the nursing process critically by motivating nurses and monitor and evaluate its progress. PMID:24649360
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The Social Organization of Nurses' Pain Management Work in Qatar.
Yassin, Khadra; Rankin, Janet; Al-Tawafsheh, Atef
2015-10-01
The purpose of this study was to explore the social organization of nurses' pain management work in Qatar. The research data drew our attention to unacceptable delays in intervening with patients in pain. We describe and analyze delays in opioid administration. Institutional ethnography was the method of inquiry used to guide the study. The main findings of the study reveal that there is a socially organized system of delays built into nurses' work to manage pain. Nurses are subject to time-consuming processes of securing, handling, and administering opioids. This study's innovative approach introduces a promising "alternate" analysis to prior work investigating hospital nurses' pain management practices. Both the method of inquiry and the findings have international relevance for researchers interested in undertreated pain. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
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Maths for medications: an analytical exemplar of the social organization of nurses' knowledge.
Dyjur, Louise; Rankin, Janet; Lane, Annette
2011-07-01
Within the literature that circulates in the discourses organizing nursing education, there are embedded assumptions that link student performance on maths examinations to safe medication practices. These assumptions are rooted historically. They fundamentally shape educational approaches assumed to support safe practice and protect patients from nursing error. Here, we apply an institutional ethnographic lens to the body of literature that both supports and critiques the emphasis on numeracy skills and medication safety. We use this form of inquiry to open an alternate interrogation of these practices. Our main argument posits that numeracy skills serve as powerful distraction for both students and teachers. We suggest that they operate under specious claims of safety and objectivity. As nurse educators, we are captured by taken-for-granted understandings of practices intended to produce safety. We contend that some of these practices are not congruent with how competency actually unfolds in the everyday world of nursing practice. Ontologically grounded in the materiality of work processes, we suggest there is a serious disjuncture between educators' assessment and evaluation work where it links into broad nursing assumptions about medication work. These underlying assumptions and work processes produce contradictory tensions for students, teachers and nurses in direct practice. © 2011 Blackwell Publishing Ltd.
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ERIC Educational Resources Information Center
Pisaniello, Sandra L.; Winefield, Helen R.; Delfabbro, Paul H.
2012-01-01
Nursing is an emotionally complex occupation, requiring performance of both emotional labour (for the benefit of the organisation and professional role) and emotional work (for the benefit of the nurse-patient relationship). According to the Conservation of Resources Theory, such processes can have a significant effect on psychological wellbeing…
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Blood work. Canadian nursing and blood transfusion, 1942-1990.
Toman, C
2001-01-01
The extension of blood transfusion to civilian populations was contingent on the availability of a nursing workforce capable of taking on increasingly responsible roles. Nurses assumed a variety of roles as they incorporated blood work into patient care and, in the process, enabled, embodied, and engendered it as nurses' and women's work. Initially, the student workforce facilitated transfusion through roles that were congruent with nursing's domestic roots. Later, it constrained the expansion of blood work because of its perpetually novice nature. Delegation constituted one strategy by which a limited number of persons could become experienced and autonomous in a particular role. As long as the skill remained limited, nurses shared its associated power and status, which differentiated them within the work culture. A few women were able to shape blood work to their advantage, using their expertise either as job security or as a bargaining point to negotiate better working conditions. However, when the skill was routinized and dispersed among many nurses, it became dirty work. The examination of one specific technology that shifted from medicine into nursing contributes insights to current issues of expanded roles and delegated skills. Nurses need to question seriously what is gained and lost as they take on and let go of technologies. They need to consider what kinds of knowledge will be needed and how best to develop it. Finally, they need to reflect how changes might complicate care giving and nurses' work.
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Resilience and work-life balance in first-line nurse manager.
Kim, Miyoung; Windsor, Carol
2015-03-01
The aim of this study was to explore how first-line nurse managers constructed the meaning of resilience and its relationship to work-life balance for nurses in Korea. Participants were 20 first-line nurse managers working in six university hospitals. Data were collected through in-depth interviews from December 2011 to August 2012, and analyzed using Strauss and Corbin's grounded theory method. Analysis revealed that participants perceived work-life balance and resilience to be shaped by dynamic, reflective processes. The features consisting resilience included "positive thinking", "flexibility", "assuming responsibility", and "separating work and life". This perception of resilience has the potential to facilitate a shift in focus from negative to positive experiences, from rigidity to flexibility, from task-centered to person-centered thinking, and from the organization to life. Recognizing the importance of work-life balance in producing and sustaining resilience in first-line nurse managers could increase retention in the Korean nursing workforce. Copyright © 2015. Published by Elsevier B.V.
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The 'realities' of part-time nursing: a grounded theory study.
Jamieson, Lynn N; Williams, Leonie Mosel; Lauder, William; Dwyer, Trudy
2008-10-01
To develop a theory that explains the 'realities' of part-time nursing. While little is known about the phenomenon of part-time nursing, increasing numbers of nurses work in part-time employment. Grounded theory. The problem that part-time nurses shared was an inability to achieve their personal optimal nursing potential. Motivators to work part-time, employment hours, specialty, individual and organizational factors formed contextual conditions that led to this problem. Part-time nurses responded to the challenges through a process of adaptation and adjustment. Harnessing the full productive potential of part-time nurses requires support to limit the difficulties that they encounter. The developed theory provides a valuable guide to managerial action. Nurse Managers need to consider the developed substantive theory when planning and managing nursing workforces.
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Huang, Fen Fen; Yang, Hsieh Hua
2011-08-17
The main purpose of this study was to discuss the nationality differences of foreign nurse aides and the effect of work stressors influencing work adjustment. And of helping them adapt to Taiwanese society, we summarized the difficulties that foreign nurse aides face in Taiwan. The subjects included 80 foreign nurse aides from the Philippines, Indonesia, and Vietnam who worked in long-term care facilities in Tao Yuan County. We recruited volunteers at the participating facilities to complete the anonymous questionnaires. The return rate of the questionnaire was 88.75%. The validated instruments of Hershenson's (1981) and Schaefer and Moos (1993) were adopted to measure work stressors and work adjustment, respectively. A forward-backward translation process was used in this study. Indonesian foreign nurse aides respect their work, and are better workers than Vietnamese and Filipino nurse aids in many respects, which shows how the nationality of the foreign nurse aides might affect work adjustment. The stress created from patient care tasks influenced the foreign nurse aides' personal relationships at work and also affected their attitude when they performed their tasks. In addition, pressure from their supervisors might have affected their work skills, work habits, personal relationships, self-concepts or work attitudes. Moreover, a heavy workload and improper scheduling might have affected the personal relationships and work attitudes of the foreign nurse aides. It was found that work stressors had a significant correlation with work adjustment. The results of the present study indicate that training programs are important factors for work adjustment among foreign nurse aides. Furthermore, celebration and leisure activities could be provided to release them from work stressors. More effort should be put into improving the working environment, namely providing a more supportive and enriching atmosphere. Based on these findings, we have a better understanding of how to assist foreign nurse aides in the future.
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Automating the self-scheduling process of nurses in Swedish healthcare: a pilot study.
Rönnberg, Elina; Larsson, Torbjörn
2010-03-01
Hospital wards need to be staffed by nurses round the clock, resulting in irregular working hours for many nurses. Over the years, the nurses' influence on the scheduling has been increased in order to improve their working conditions. In Sweden it is common to apply a kind of self-scheduling where each nurse individually proposes a schedule, and then the final schedule is determined through informal negotiations between the nurses. This kind of self-scheduling is very time-consuming and does often lead to conflicts. We present a pilot study which aims at determining if it is possible to create an optimisation tool that automatically delivers a usable schedule based on the schedules proposed by the nurses. The study is performed at a typical Swedish nursing ward, for which we have developed a mathematical model and delivered schedules. The results of this study are very promising and suggest continued work along these lines.
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Nursing Activities Score: nursing work load in a burns Intensive Care Unit1
Camuci, Marcia Bernadete; Martins, Júlia Trevisan; Cardeli, Alexandrina Aparecida Maciel; Robazzi, Maria Lúcia do Carmo Cruz
2014-01-01
Objective to evaluate the nursing work load in a Burns Intensive Care Unit according to the Nursing Activities Score. Method an exploratory, descriptive cross-sectional study with a quantitative approach. The Nursing Activities Score was used for data collection between October 2011 and May 2012, totalling 1,221 measurements, obtained from 50 patients' hospital records. Data for qualitative variables was described in tables; for the quantitative variables, calculations using statistical measurements were used. Results the mean score for the Nursing Activities Score was 70.4% and the median was 70.3%, corresponding to the percentage of the time spent on direct care to the patient in 24 hours. Conclusion the Nursing Activities Score provided information which involves the process of caring for patients hospitalized in a Burns Intensive Care Unit, and indicated that there is a high work load for the nursing team of the sector studied. PMID:26107842
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McGibbon, Elizabeth; Mulaudzi, Fhumulani M; Didham, Paula; Barton, Sylvia; Sochan, Ann
2014-09-01
Although there are notable exceptions, examination of nursing's participation in colonizing processes and practices has not taken hold in nursing's consciousness or political agenda. Critical analyses, based on the examination of politics and power of the structural determinants of health, continue to be marginalized in the profession. The goals of this discussion article are to underscore the urgent need to further articulate postcolonial theory in nursing and to contribute to nursing knowledge about paths to work toward decolonizing the profession. The authors begin with a description of unifying themes in postcolonial theory, with an emphasis on colonized subjectivities and imperialism; the application of a critical social science perspective, including postcolonial feminist theory; and the project of working toward decolonization. Processes involved in the colonization of nursing are described in detail, including colonization of nursing's intellectual development and the white privilege and racism that sustain colonizing thinking and action in nursing. The authors conclude with strategies to increase the counter-narrative to continued colonization, with a focus on critical social justice, human rights and the structural determinants of health. © 2013 John Wiley & Sons Ltd.
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Allan, Julia L; Farquharson, Barbara; Johnston, Derek W; Jones, Martyn C; Choudhary, Carolyn J; Johnston, Marie
2014-05-01
Nurses working for telephone-based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information-processing errors. Nurses who experienced more frequent cognitive failures at work made more conservative decisions, tending to refer patients on to other health professionals more often than other nurses. As stress is associated with cognitive performance decrements in telephone nursing, stress-reduction interventions could improve the quality and safety of care that callers to medical helplines receive. © 2013 The British Psychological Society.
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42 CFR 424.20 - Requirements for posthospital SNF care.
Code of Federal Regulations, 2010 CFR
2010-10-01
... knowledge of the case; or (2) A nurse practitioner or clinical nurse specialist, neither of whom has a... physician. For purposes of this section— (i) Collaboration means a process whereby a nurse practitioner or clinical nurse specialist works with a doctor of medicine or osteopathy to deliver health care services...
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Authentic leadership, organizational culture, and healthy work environments.
Shirey, Maria R
2009-01-01
The purpose of this article is to showcase the relationship among authentic leadership, organizational culture, and healthy work environments using a stress and coping lens. A qualitative descriptive study was conducted to determine what situations contribute to nurse manager stress, what coping strategies they utilize, what health outcomes they report, and what decision-making processes they follow to address stressful situations in their roles. A purposive sample of 21 nurse managers employed at 3 US acute care hospitals completed a demographic questionnaire and 14-question interview incorporating components of the Critical Decision Method. A secondary analysis of the data was conducted to identify differences in nurse manager narratives based upon differences in the organizational cultures where the managers worked. Of the 21 nurse managers studied, differences were evident in the organizational cultures reported. Nurse managers working in the positive organizational cultures (n = 12) generally worked in healthy work environments and engaged in more authentic leadership behaviors. Conversely, nurse managers working in the negative organizational cultures (n = 9) worked in unhealthy work environments and reported less optimism and more challenges engaging in authentic leadership practices. Organizational culture and leadership matter in creating and sustaining healthy work environments. Nurse managers play a pivotal role in creating these environments, yet they need supportive structures and resources to more effectively execute their roles.
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Clausen, Christina; Lavoie-Tremblay, Melanie; Purden, Margaret; Lamothe, Lise; Ezer, Héléne; McVey, Lynne
2017-09-01
The aim of this study was to describe the process of how nurse and physician managers in formalized dyads work together to address clinical management issues in the surgical division of one hospital setting. Nurse and physician managers are uniquely positioned to co-lead and transform healthcare delivery. However, little is known about how this management dyad functions in the healthcare setting. A constructivist grounded theory approach was used to investigate the process of how nurse and physician managers work together in formalized dyads in an urban Canadian university affiliated teaching hospital. Data collection occurred from September 2013-August 2014. Data included participant observation (n = 142 hours) and intensive interviews (n = 36) with nurse-physician manager dyads (12 nurses, 9 physicians) collected in a surgical department. Theoretical sampling was used to elaborate on properties of emerging concepts and categories. A substantive theory on 'intentional partnering' was generated. Nurses' and physicians' professional agendas, which included their interests and purposes for working with each other served as the starting point of 'intentional partnering'. The theory explains how nurse and physician managers align their professional agendas through the processes of 'accepting mutual necessity', 'daring to risk (together)' and 'constructing a shared responsibility'. Being credible, earning trust and safeguarding respect were fundamental to communicating effectively. Intentional partnering elucidates the relational components of working together and the strategizing that occurs as each partner deliberates on what he or she is willing to accept, risk and put into place to reap the benefits of collaborating. © 2017 John Wiley & Sons Ltd.
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Madsen, Wendy
2009-10-01
To investigate the impact of past government policy and legislation on the practice of district nursing in Australia. Nurses have historically been politically passive and have not engaged in the political processes of policy development. However, legislation can have profound impacts on the daily work of nurses as demonstrated in this paper. Historical analysis. The archival records of six district nursing services in Australia were analysed within the political, social and economic context of the 20th century, with particular focus on the 1950s and 1970s. Two pieces of Federal legislation passed in 1956 and 1973, respectively, had critical effects on the work of district nurses. Both resulted in significant expansion of district nursing in Australia; neither was formulated with input from district nursing services. However, together these acts shifted district nursing from being a voluntary, charity based activity to one that was greatly controlled by government. Greater government funding allowed district nursing to expand beyond the capacity possible when funding was locally based, but with government funding came other restrictions related to accountability processes and expectations regarding services provided, and these had profound effects on nursing practice, including excess workloads to the point of unsafe practice. Nurses need to engage with the political processes associated with government policy formulation and implementation if they are to avoid placing themselves and their clients in vulnerable situations as a result of government decisions.
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Spence Laschinger, Heather K; Gilbert, Stephanie; Smith, Lesley M; Leslie, Kate
2010-01-01
The purpose of this theoretical paper is to propose an integrated model of nurse/patient empowerment that could be used as a guide for creating high-quality nursing practice work environments that ensure positive outcomes for both nurses and their patients. There are few integrated theoretical approaches to nurse and patient empowerment in the literature, although nurse empowerment is assumed to positively affect patient outcomes. The constructs described in Kanter's (1993) work empowerment theory are conceptually consistent with the nursing care process and can be logically extended to nurses' interactions with their patients and the outcomes of nursing care. We propose a model of nurse/patient empowerment derived from Kanter's theory that suggests that empowering working conditions increase feelings of psychological empowerment in nurses, resulting in greater use of patient empowerment strategies by nurses, and, ultimately, greater patient empowerment and better health outcomes. Empirical testing of the model is recommended prior to use of the model in clinical practice. We argue that empowered nurses are more likely to empower their patients, which results in better patient and system outcomes. Strategies for managers to empower nurses and for nurses to empower patients are suggested.
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Medication room madness: calming the chaos.
Conrad, Carole; Fields, Willa; McNamara, Tracey; Cone, Maryann; Atkins, Patricia
2010-01-01
Nurses work in stressful environments, encountering interruptions and distractions at almost every turn. The aim of this medication safety project was to improve the physical design and organizational layout of the medication room, reduce nurse interruptions and distractions, and create a standard medication process for enhanced patient safety and efficiency. This successful change improved the medication administration process, decreased medication errors, and enhanced nursing satisfaction.
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Long distance education for croatian nurses with open source software.
Radenovic, Aleksandar; Kalauz, Sonja
2006-01-01
Croatian Nursing Informatics Association (CNIA) has been established as result of continuing work on promoting nursing informatics in Croatia. Main goals of CNIA are promoting nursing informatics and education of nurses about nursing informatics and using information technology in nursing process. CNIA in start of work is developed three courses from nursing informatics all designed with support of long distance education with open source software. Courses are: A - 'From Data to Wisdom', B - 'Introduction to Nursing Informatics' and C - 'Nursing Informatics I'. Courses A and B are obligatory for C course. Technology used to implement these online courses is based on the open source Learning Management System (LMS), Claroline, free online collaborative learning platform. Courses are divided in two modules/days. First module/day participants have classical approach to education and second day with E-learning from home. These courses represent first courses from nursing informatics' and first long distance education for nurses also.
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[Modern nursing work management trends: the case of cooperative companies].
Guimarães, Raphael Mendonça; Muzi, Camila Drumond; Mauro, Maria Yvone Chaves
2004-01-01
This article introduces the issue of nursing work management from a theoretical and conceptual perspective by raising some implications for the management of organizations, as well as its impact on work relationships and, consequently, on the worker's health. The main results about ways and modalities of cooperative companies bring about the consideration that proposals of positive changes in the category run contrary to progress. Indecent work conditions, poor quality assistance and low compensation make up the main negative factors in this work process. Therefore, it is urgent to resume the discussion of what one expects from nursing for the future.
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Fan, Yuying; Zheng, Qiulan; Liu, Shiqing; Li, Qiujie
2016-07-01
To explore the relationships among perceived work environment, psychological empowerment and job engagement of clinical nurses in Harbin, China. Previous studies have focused on organisational factors or nurses' personal characteristics contributing to job engagement. Limited studies have examined the effects of perceived work environment and psychological empowerment on job engagement among Chinese nurses. A cross-sectional quantitative survey with 923 registered nurses at four large university hospitals in China was carried out. Research instruments included the Chinese versions of the perceived nurse work environment scale, the psychological empowerment scale and the job engagement scale. The relationships of the variables were tested using structural equation modelling. Structural equation modelling revealed a good fit of the model, χ(2) /df = 4.46, GFI = 0.936, CFI = 0.957. Perceived work environment was a significant positive direct predictor of psychological empowerment and job engagement. Psychological empowerment was a significant positive direct contributor to job engagement and had a mediating effect on the relationship between perceived work environment and job engagement. Perceived work environment may result in increased job engagement by facilitating the development of psychological empowerment. For nurse managers wishing to increase nurse engagement and to achieve effective management, both perceived work environment and psychological empowerment are factors that need to be well controlled in the process of nurse administration. © 2016 John Wiley & Sons Ltd.
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Nurses' perceptions of the impact of electronic health records on work and patient outcomes.
Kossman, Susan P; Scheidenhelm, Sandra L
2008-01-01
This study addresses community hospital nurses' use of electronic health records and views of the impact of such records on job performance and patient outcomes. Questionnaire, interview, and observation data from 46 nurses in medical-surgical and intensive care units at two community hospitals were analyzed. Nurses preferred electronic health records to paper charts and were comfortable with technology. They reported use of electronic health records enhanced nursing work through increased information access, improved organization and efficiency, and helpful alert screens. They thought use of the records hindered nursing work through impaired critical thinking, decreased interdisciplinary communication, and a high demand on work time (73% reported spending at least half their shift using the records). They thought use of electronic health records enabled them to provide safer care but decreased the quality of care. Administrative implications include involving bedside nurses in system choice, streamlining processes, developing guidelines for consistent documentation quality and location, increasing system speed, choosing hardware that encourages bedside use, and improving system information technology support.
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Voshall, Barbara; Piscotty, Ronald; Lawrence, Jeanette; Targosz, Mary
2013-10-01
Safe medication administration is necessary to ensure quality healthcare. Barcode medication administration systems were developed to reduce drug administration errors and the related costs and improve patient safety. Work-arounds created by nurses in the execution of the required processes can lead to unintended consequences, including errors. This article provides a systematic review of the literature associated with barcoded medication administration and work-arounds and suggests interventions that should be adopted by nurse executives to ensure medication safety.
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Transformational leadership and shared governance: an action study.
Bamford-Wade, Anita; Moss, Cheryle
2010-10-01
The present study demonstrates the practical relevance of the concepts of transformational leadership as a Director of Nursing working with structure (shared governance) and active processes, informed by action research, to achieve the incremental breakthroughs associated with culture change in nursing. Responding to the context of a decade of health reforms in a New Zealand tertiary hospital, the leadership challenge, as a Director of Nursing, was to find ways of transforming the nursing workforce. How could nursing evolve from a relatively disempowered position within the organization (impact of the reforms) and reshape to achieve effectiveness within the new organizational culture? Interwoven with transformational leadership are action processes progressively moving forward through cycles of reconnaissance, planning, implementation and evaluation. The principles of shared governance 'partnership', 'equity', 'accountability' and 'ownership' underpin and work synchronically with the active processes in advancing the effectiveness of nursing. It is leadership for and in action. This study is descriptive and exploratory overall, and more specifically it uses reflective practice and self-reporting as methods. The outcomes of transformational leadership are evident in a confident, competent and committed nursing workforce which embraces continuous learning and expresses a professional respect for each other. The practical inter-weaving of the concepts of transformational leadership, shared governance and action processes provide a framework for sustainable change processes both at a unit and organizational level. It is the interplay between the three concepts that generates a process of creative innovation, questioning and challenging existing structures to try and reach a new level of excellence through the participation and valuing of nurses and nursing practice. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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Prominent attractive qualities of nurses' work in operating room departments: A questionnaire study.
Björn, Catrine; Josephson, Malin; Wadensten, Barbro; Rissén, Dag
2015-01-01
The shortage of nurses in operating room departments (ORs) in Sweden and other countries can lead to reduced capacity and quality in healthcare, as well as more intense work for those on the job. Little is known about what nurses in ORs perceive as crucial for their workplace to be attractive. To capture attractive qualities of nurses' work in Swedish ORs and take a first step in the process of adapting the Attractive Work Questionnaire for use in a health care context. The Attractive Work Questionnaire was completed by 147 (67% ) nurses in four Swedish ORs. Principal Component Analyses (PCA) were performed to determine the underlying structure of the data. Factors contributing to job attractiveness identified in the area "work conditions" were: relations, leadership, equipment, salary, organisation, physical work environment, location, and working hours; in the area "work content": mental work, autonomy and work rate; and in the area "job satisfaction": status and acknowledgement. The PCA showed consistency with the original Attractive Work Questionnaire, Cronbach's alpha varied between 0.57-0.90. Prominent attractive qualities for nurses' work in Swedish ORs were possible to identify through the Attractive Work Questionnaire and the results suggest that the questionnaire can be useful in a health care context.
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Hooker, Leesa; Small, Rhonda; Humphreys, Cathy; Hegarty, Kelsey; Taft, Angela
2015-03-28
In Victoria, Australia, Maternal and Child Health (MCH) services deliver primary health care to families with children 0-6 years, focusing on health promotion, parenting support and early intervention. Family violence (FV) has been identified as a major public health concern, with increased prevalence in the child-bearing years. Victorian Government policy recommends routine FV screening of all women attending MCH services. Using Normalization Process Theory (NPT), we aimed to understand the barriers and facilitators of implementing an enhanced screening model into MCH nurse clinical practice. NPT informed the process evaluation of a pragmatic, cluster randomised controlled trial in eight MCH nurse teams in metropolitan Melbourne, Victoria, Australia. Using mixed methods (surveys and interviews), we explored the views of MCH nurses, MCH nurse team leaders, FV liaison workers and FV managers on implementation of the model. Quantitative data were analysed by comparing proportionate group differences and change within trial arm over time between interim and impact nurse surveys. Qualitative data were inductively coded, thematically analysed and mapped to NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) to enhance our understanding of the outcome evaluation. MCH nurse participation rates for interim and impact surveys were 79% (127/160) and 71% (114/160), respectively. Twenty-three key stakeholder interviews were completed. FV screening work was meaningful and valued by participants; however, the implementation coincided with a significant (government directed) change in clinical practice which impacted on full engagement with the model (coherence and cognitive participation). The use of MCH nurse-designed FV screening/management tools in focussed women's health consultations and links with FV services enhanced the participants' work (collective action). Monitoring of FV work (reflexive monitoring) was limited. The use of theory-based process evaluation helped identify both what inhibited and enhanced intervention effectiveness. Successful implementation of an enhanced FV screening model for MCH nurses occurred in the context of focussed women's health consultations, with the use of a maternal health and wellbeing checklist and greater collaboration with FV services. Improving links with these services and the ongoing appraisal of nurse work would overcome the barriers identified in this study.
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[Perceptions of nurses about leadership].
Amestoy, Simone Coelho; Cestari, Maria Elisabeth; Thofehrn, Maira Buss; Backes, Vânia Marli Schubert; Milbrath, Viviane Marten; Trindade, Letícia de Lima
2009-12-01
This study aimed at ascertaining the perceptions of nurses facing the use of managerial leadership as a tool in their work process. This was a qualitative study of descriptive and exploratory type, conducted with eleven nurses from a large hospital in the southern region of Rio Grande do Sul, Brazil, during the months of February and March 2008. For data collection were used semi-structured interviews and focus group. The content analysis was chosen as a technique for processing the data, resulting in two categories: meanings attributed to the leadership and authority versus authoritarianism. It was noticed that even the leadership offering advantages in nursing work, are still great the difficulties to understand it and, especially, to put it into practice, making it necessary to create programs and strategies to improve the performance of the leadership as a nurses managerial instrument.
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Samadbeik, Mahnaz; Shahrokhi, Nafiseh; Saremian, Marzieh; Garavand, Ali; Birjandi, Mahdi
2017-01-01
In recent years, information technology has been introduced in the nursing departments of many hospitals to support their daily tasks. Nurses are the largest end user group in Hospital Information Systems (HISs). This study was designed to evaluate data processing in the Nursing Information Systems (NISs) utilized in many university hospitals in Iran. This was a cross-sectional study. The population comprised all nurse managers and NIS users of the five training hospitals in Khorramabad city ( N = 71). The nursing subset of HIS-Monitor questionnaire was used to collect the data. Data were analyzed by the descriptive-analytical method and the inductive content analysis. The results indicated that the nurses participating in the study did not take a desirable advantage of paper (2.02) and computerized (2.34) information processing tools to perform nursing tasks. Moreover, the less work experience nurses have, the further they utilize computer tools for processing patient discharge information. The "readability of patient information" and "repetitive and time-consuming documentation" were stated as the most important expectations and problems regarding the HIS by the participating nurses, respectively. The nurses participating in the present study used to utilize paper and computerized information processing tools together to perform nursing practices. Therefore, it is recommended that the nursing process redesign coincides with NIS implementation in the health care centers.
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Good work - how is it recognised by the nurse?
Christiansen, Bjørg
2008-06-01
The aim of this paper is to shed light on how nurses describe situations that reflect achievement and provide confirmation that they have done good work. Nurses' recognition of good work does not seem to have been the object of direct investigation, but is indirectly reflected in studies focusing on nurses' perceptions on work environments and the multifaceted nature of nursing. However, acknowledging high-quality performance in professional nurses can facilitate nurses in maintaining and strengthening the goals and values of the profession. This in turn can help nurses shoulder the multifaceted responsibilities they have to patients and next of kin. This paper is part of the Professional Learning in a Changing Society project, Institute of Educational Research, University of Oslo, funded by the Research Council of Norway. The project involves four professional groups. This paper, however, focuses on a group of 10 nurses, nine of whom work in hospitals and one in an outpatient clinic. A qualitative approach was chosen to gain insight into how nurses, as well as the other professional groups in the project, engage in processes of knowledge production and quality assurance work. Data presented in this paper derive from semi-structured in-depth interviews conducted during spring 2005 and focuses on the recognition of good work. The following themes were identified as essential in confirming that one did good work: securing fundamental needs of patients and next of kin; managing the flow of responsibilities; positive feedback. CONCLUSIONS. Good work seems to be related to specific situations and a sense of achievement by the respondents. Recognition of good work is not only rewarding and enjoyable; it may also serve as a source of consciousness raising for professional and ethical guidelines in the work place.
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Grounding our practice in nursing professional development.
Dickerson, Pamela S
2014-07-01
The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice. Copyright 2014, SLACK Incorporated.
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Engaging clinical nurses in quality and performance improvement activities.
Albanese, Madeline P; Evans, Dietra A; Schantz, Cathy A; Bowen, Margaret; Disbot, Maureen; Moffa, Joseph S; Piesieski, Patricia; Polomano, Rosemary C
2010-01-01
Nursing performance measures are an integral part of quality initiatives in acute care; however, organizations face numerous challenges in developing infrastructures to support quality improvement processes and timely dissemination of outcomes data. At the Hospital of the University of Pennsylvania, a Magnet-designated organization, extensive work has been conducted to incorporate nursing-related outcomes in the organization's quality plan and to integrate roles for clinical nurses into the Department of Nursing and organization's core performance-based programs. Content and strategies that promote active involvement of nurses and prepare them to be competent and confident stakeholders in quality initiatives are presented. Engaging clinical nurses in the work of quality and performance improvement is essential to achieving excellence in clinical care. It is important to have structures and processes in place to bring meaningful data to the bedside; however, it is equally important to incorporate outcomes into practice. When nurses are educated about performance and quality measures, are engaged in identifying outcomes and collecting meaningful data, are active participants in disseminating quality reports, and are able to recognize the value of these activities, data become one with practice.
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Pool, Inge A; Poell, Rob F; Berings, Marjolein G M C; ten Cate, Olle
2015-05-01
A nursing career can last for more than 40 years, during which continuing professional development is essential. Nurses participate in a variety of learning activities that correspond with their developmental motives. Lifespan psychology shows that work-related motives change with age, leading to the expectation that motives for continuing professional development also change. Nevertheless, little is known about nurses' continuing professional development strategies in different age groups. To explore continuing professional development strategies among younger, middle-aged, and older nurses. A qualitative study using semi-structured interviews, from a biographical perspective. Data were analysed using a vertical process aimed at creating individual learning biographies, and a horizontal process directed at discovering differences and similarities between age groups. Twenty-one nurses in three age groups from general and academic hospitals in the Netherlands. In all age groups, daily work was an important trigger for professional development on the ward. Performing extra or new tasks appeared to be an additional trigger for undertaking learning activities external to the ward. Learning experiences in nurses' private lives also contributed to their continuing professional development. Besides these similarities, the data revealed differences in career stages and private lives, which appeared to be related to differences in continuing professional development strategy; 'gaining experience and building a career' held particularly true among younger nurses, 'work-life balance' and 'keeping work interesting and varied' to middle-aged nurses, and 'consistency at work' to older nurses. Professional development strategies can aim at performing daily patient care, extra tasks and other roles. Age differences in these strategies appear to relate to tenure, perspectives on the future, and situations at home. These insights could help hospitals to orientate continuing professional development approaches toward the needs of all age groups. This should be particularly relevant in the face of present demographic changes in the nursing workforce. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Agyeman-Yeboah, Joana; Korsah, Kwadwo Ameyaw; Okrah, Jane
2017-01-01
The nursing process is a tool that is recommended for use by all professional nurses working in Ghana, in order to provide nursing care. However, there is currently a limited use of this tool by nurses in Ghana. The purpose of this research study was to explore the various factors that influence the utilization of this nursing process. An exploratory descriptive qualitative-research design was employed. Ten participants were involved by using the purposive sampling method. A semi-structured interview guide was used to collect the data from the research participants; and the data were analysed by using content analysis. One main theme, with five subthemes, emerged from the analysis. It was found that there are factors, such as nurses not having a better understanding of the nursing process, whilst in school; the absence of the care plan in the ward, as well as the lack of adequate staff, with limited time being available for coping with contributed to the non-usage of the nursing process. We conclude that the clinical utilization of the Nursing process at the clinical setting is influenced by lack of understanding of Nurses on the Nursing process and care plan as well as lack of adequate nurses and time. We recommend that the care-plan form be made officially a part of the admission documents. Furthermore, the nursing administration should put measures in place to provide nurses with the needed resources to implement the nursing process. Additionally, they should ensure that the care-plan forms and other resources needed by the nurses are regularly and adequately provided. Nurses should further see the nursing process as a means of providing comprehensive care to their patients and addressing their specific problems. They should therefore make time despite their busy schedules to use it in order to improve quality of care and the image of nursing in Ghana.
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Estryn-Béhar, Madeleine; Van der Heijden, Beatrice I J M; Ogińska, Halszka; Camerino, Donatella; Le Nézet, Olivier; Conway, Paul Maurice; Fry, Clementine; Hasselhorn, Hans-Martin
2007-10-01
Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL). Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754). Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work-family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries. To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.
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Nurses' reported thinking during medication administration.
Eisenhauer, Laurel A; Hurley, Ann C; Dolan, Nancy
2007-01-01
To document nurses' reported thinking processes during medication administration before and after implementation of point-of-care technology. Semistructured interviews and real-time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US. Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose-time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications. Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the "5 rights."
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Horwitz, Simonne
2011-01-01
This paper charts the history and debates surrounding the introduction of academic, university-based training of nurses in South Africa. This was a process that was drawn out over five decades, beginning in the late 1930s. For nurses, university training was an important part of a process of professionalization; however, for other members of the medical community, nursing was seen as being linked to women's service work. Using the case-study of the University of the Witwatersrand, one of South Africa's premier universities and the place in the country to offer a university-based nursing program, we argue that an historical understanding of the ways in which nursing education was integrated into the university system tells us a great deal about the professionalization of nursing. This paper also recognises, for the first time, the pioneers of this important process. PMID:21994840
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[Work-related musculoskeletal disorders and their association with occupational nursing].
Barboza, Michele Cristiene Nachtigall; Milbrath, Viviane Marten; Bielemann, Valquíria Machado; de Siqueira, Hedi Crecencia Heckler
2008-12-01
Work-related musculoskeletal diseases (MSD) are disorders in the musculoskeletal structures caused by chronic occupational processes. The objective of this study was to get to know scientific papers on MSD related to the nursing profession. A bibliographic research of the last ten years was conducted at Health Virtual Library using the main data bases. Twenty-one summaries were found. Among them, thirteen were selected because they specifically focused on the subject. Three main areas were identified: occupational health nurses in relation to MSDs--their importance in health prevention and promotion; Ergonomics as MSDs prevention method: performed as changes on work consider risk factors; Vulnerability of Nursing staff to MSDs--predisposing factors to disease caused by inappropriate working conditions. The conclusion was that an occupational and ergonomic health service is important to prevent MSDs, especially among the nursing staff.
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Part of the job: the role of physical work conditions in the nurse turnover process.
Vardaman, James M; Cornell, Paul T; Allen, David G; Gondo, Maria B; Muslin, Ivan S; Mobley, Robin N; Brock, Meagan E; Sigmon, Tracy L
2014-01-01
Retention of nursing staff remains an important issue for health care managers. Turnover research has focused primarily on motivational and social factors as keys to retention, whereas the role of the physical work conditions has received considerably less attention. However, work design theory suggests that physical work conditions may be an important factor in fostering retention among nursing staff. The aim of this study was to integrate work design theory with turnover process models to explore the influence of perceptions of physical work conditions on the development of turnover intentions among nursing staff. Drawing on two samples of registered nurses working in cancer units in metropolitan hospitals in the southeastern United States, this study explores the impact of perceptions of physical work conditions on turnover intentions using ordinary least squares regression. Hypotheses are tested in Study 1 and replicated in Study 2. A measure of perceptions of physical work conditions is also developed and validated using exploratory (Study 1) and confirmatory (Study 2) factor analyses. Perceptions of physical work conditions explain variance in turnover intentions above than that explained by motivational and social factors. Specifically, employee perceptions of noisy work conditions are found to significantly increase turnover intentions, whereas perceptions that work conditions facilitate tasks were found to significantly reduce turnover intentions. Perceptions of temperature and health hazard did not show significant effects. Results suggest that health care managers and scholars should re-examine the role of physical work conditions in the turnover process. Investments in upgrades that facilitate tasks may foster retention better than investments that simply improve employee comfort. Negative perceptions of work conditions may have no impact if they are considered a normal "part of the job," although negative perceptions of conditions that are viewed as under the organization's control may be important in creating a desire to leave.
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Caritas, spirituality and religiosity in nurses' coping.
Ekedahl, M A; Wengström, Y
2010-07-01
The purpose of this qualitative study was to investigate registered nurses' coping processes when working with terminally ill and dying cancer patients, with special focus on religious aspects of coping resources. What religious components can be identified as coping resources in oncology nurses' orienting system and what function has religiosity in the nurse's work? The theoretical reference is care philosophy and the psychology of religion and coping. The material consists of interviews with 15 Swedish registered oncology nurses. The results highlight different dynamic aspects of the nurses' life orientation such as caritas, religiosity, spirituality and atheism and demonstrate that religiosity can have a protective function that facilitates coping, as the nurse has something to turn to. Religious coping dominated by basic trust where prayer is used as a coping strategy may support the nurse.
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Cusack, Lynette; Smith, Morgan
2010-09-01
This article explores the power implications of implementing competency-based assessments within the nursing work environment from a manager's perspective. It discusses how the implementation of competency-based assessments for continuing education may affect workplace culture, in particular, the use of power, within the nursing team. The term "managers" for the purpose of this article is defined as "nurses in senior administrative and educational positions within a health care facility." This article adds to the discourse on competency-based models by emphasizing the effect of the nursing work environment on the competency-based assessment process. It concludes by identifying strategies that can be used by nursing management when designing and implementing an effective and fair competency-based assessment for the nursing workplace. Copyright 2010, SLACK Incorporated.
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An Infrastructure to Advance the Scholarly Work of Staff Nurses
Parkosewich, Janet A.
2013-01-01
The traditional role of the acute care staff nurse is changing. The new norm establishes an expectation that staff nurses base their practice on best evidence. When evidence is lacking, nurses are charged with using the research process to generate and disseminate new knowledge. This article describes the critical forces behind the transformation of this role and the organizational mission, culture, and capacity required to support practice that is based on science. The vital role of senior nursing leaders, the nurse researcher, and the nursing research committee within the context of a collaborative governance structure is highlighted. Several well-known, evidence-based practice models are presented. Finally, there is a discussion of the infrastructure created by Yale-New Haven Hospital to advance the scholarly work of the nursing staff. PMID:23482435
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Nelson, Joan M; Cook, Paul F; Raterink, Ginger
2013-01-01
The past several years have seen explosive growth in the number of doctor of nursing practice (DNP) degree programs offered by colleges of nursing in the United States. Through a process of trial and error since 2005, the faculty at the University of Colorado, College of Nursing, have revised the course structure and procedures related to the DNP capstone project to improve the quality and usefulness of these student projects. Efforts have focused on educating and involving all nursing faculty in the DNP capstone process, distinguishing between competencies for our PhD and DNP projects, clearly aligning the DNP capstone project with quality improvement methods rather than with research, working with our campus institutional review board to clarify regulatory review requirements for quality improvement studies, developing a review committee to oversee DNP students' projects, and structuring our sequential course requirements to encourage students' professional presentations and publications. Our current capstone process reflects 7 years of iterative work, which we summarize in this article in hopes that it will help institutions currently in the process of developing a DNP program. Copyright © 2013 Elsevier Inc. All rights reserved.
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Continuous improvement, burnout and job engagement: a study in a Dutch nursing department.
Benders, Jos; Bleijerveld, Hans; Schouteten, Roel
2017-10-01
Continuous improvement (CI) programs are potentially powerful means to improve the quality of care. The more positive nurses perceive these programs' effects, the better they may be expected to cooperate. Crucial to this perception is how nurses' quality of working life is affected. We studied this in a nursing department, using the job demands-resources model. We found that two job demands improved, and none of the job resources. Job engagement did not change significantly, while the burnout risk decreased slightly. Overall, the nurses felt the impact to be small yet the changes were in a positive direction. CI can thus be used to improve nurses' working lives and, by restructuring the work processes, the quality of care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
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Authentic leadership and nurse-assessed adverse patient outcomes.
Wong, Carol A; Giallonardo, Lisa M
2013-07-01
Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses. © 2013 John Wiley & Sons Ltd.
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Adams, Mary; Robert, Glenn; Maben, Jill
2013-07-01
This article examines the importance of some informal work practices among community nurses during a period of significant organizational change. Ethnographic fieldwork in two purposively selected adult community nursing services in England comprised 79 hours of observation of routine practice, 21 interviews with staff and 23 interviews with patients. We identified the informal work practice of 'catching up', informal work conversations between immediate colleagues, as an important but often invisible aspect of satisfying work relationships and of the relational care of patients. Drawing on anthropological literatures on 'communities of practice' the article examines two central issues concerning the practices of 'catching up': (1) how informal learning processes shape community nursing work; (2) how this informal learning is shaped both in relation to the ideals of community nursing work and the wider political and organizational contexts of community nursing practice. Our findings highlight the distinctive value of informal workplace 'catch ups' for nurses to manage the inherent challenges of good home care for patients and to develop a shared ethic of care and professional identity. Our findings also indicate the decline of 'catching up' between nurses along with diminishing time and opportunity for staff to care holistically for patients in present service climates.
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Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Lamothe, Lise; Ritchie, Judith A; Doran, Diane
2013-01-01
This article describes a new conceptual framework for acute care nurse practitioner role enactment, boundary work and perceptions of team effectiveness. Acute care nurse practitioners contribute positively to patient care by enacting an expanded scope of practise. Researchers have found both positive and negative reactions to the introduction of acute care nurse practitioners in healthcare teams. The process of role enactment, shifting role boundaries, and perceptions of team effectiveness has been studied disparately. A framework linking team structures and processes to desirable outcomes is needed. Literature was obtained by searching CINAHL, PsycInfo, MedLine, PubMed, British Nursing Index, Cochrane Library, JSTOR Archive, Web of Science, and Google Scholar from 1985-2010. A descriptive multiple-case study was completed from March 2009-May 2009. A new conceptual framework describing how role enactment and boundary work affect perceptions of team effectiveness was developed by combining theoretical and empirical sources. The framework proposes proximal indicators used by team members to assess their team's performance. The framework identifies the inter-related dimensions and concepts that different stakeholders need to consider when introducing nurse practitioners in healthcare teams. Further study is needed to identify team-level outcomes that reflect the contributions of all providers to quality patient care, and explore the patients' and families' perceptions of team effectiveness following the introduction of acute care nurse practitioners. The new framework can guide decision-making and research related to the structures, processes, and outcomes of nurse practitioner roles in healthcare teams. © 2012 Blackwell Publishing Ltd.
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42 CFR 410.75 - Nurse practitioners' services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... statutory exclusions; and (3) Performs them while working in collaboration with a physician. (i) Collaboration is a process in which a nurse practitioner works with one or more physicians to deliver health... State in which the services are performed. (ii) In the absence of State law governing collaboration...
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Chiovitti, Rosalina F
2008-02-01
The concept of caring is described as intangible, abstract, and invisible in nursing practice. This has translated into a view of caring as a personal choice or natural obligation rather than a deliberate process. While there has been movement to delineate caring within nursing in general, the psychiatric nurse's perspective on caring has been absent from theoretical works and measures constructed to describe nurse's work. To develop a substantive grounded theory of caring from the perspective of Registered Nurses working with patients in three Canadian acute psychiatric hospital settings. The qualitative research design of grounded theory methodology was used to develop a theory of caring. Three urban, acute psychiatric hospital settings in Canada. Two were general hospitals and one was a psychiatric hospital. Registered Nurses (N=17) licensed with the College of Nurses of Ontario. In-depth interviews with Registered Nurses were conducted using theoretical sampling. The data were analysed using constant comparative analysis. Protective empowering is the basic social psychological process that represents Registered Nurses' caring with patients in acute psychiatric hospital settings. Nurses accomplish protective empowering through six main categories of: (1) respecting the patient; (2) not taking the patient's behaviour personally; (3) keeping the patient safe; (4) encouraging the patient's health; (5) authentic relating; and (6) interactive teaching. The six main categories were accomplished through 27 subcategories. In the theory of protective empowering, the goal is to help patients participate in activities contributing to convalescence, health, and/or quality of life. The theory of protective empowering provides six main categories and 27 subcategories that can be transferred to funding formulas, patient health record documentation systems, nurse orientation and education programs, nurse role descriptions, and used in guiding discussions about organizational values of patient-centred care within a collaborative multidisciplinary context.
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Kagan, Ilya; Farkash-Fink, Naomi; Fish, Miri
2016-01-01
How might a tertiary hospital's nursing staff respond to the huge improvement effort required for external accreditation if they are encouraged to lead the change process themselves? This article reports the results of a concurrent evaluation of the nursing work climate at ward level, before and after accreditation by the Joint Commission International. Physician-nurse relations improved; the involvement of social workers, dieticians, and physiotherapists increased; support services responded more quickly to requests; and management-line staff relations became closer.
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[Nurses' subjectivity production and the decision-making in the process of care].
Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa
2013-06-01
This study aimed to understand the relationship between Nurse's production of subjectivity and the decision-making in the process of Nursing care. A qualitative design of research was conducted. The investigation was carried out with twelve nurses who work at the Associação de Caridade Santa Casa do Rio Grande, a hospital located in Rio Grande, RS, Brazil. For data collection, focus group technique was used three meetings were conducted in december 2011. The results were presented in semantic categories: Capitalist System: maintenance of employment bond; Submission System: institutionalized culture and vision of society; Nursing Hierarchical System; and Values System: feeling of guilt and lack of professional recognition. The capitalist system mediates, mainly, the behavior that prevails in the decision-making process in Nursing care.
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Experience of nurses in the process of donation of organs and tissues for transplant.
de Moraes, Edvaldo Leal; dos Santos, Marcelo José; Merighi, Miriam Aparecida Barbosa; Massarollo, Maria Cristina Komatsu Braga
2014-01-01
to investigate the meaning of the action of nurses in the donation process to maintain the viability of organs and tissues for transplantation. this qualitative study with a social phenomenological approach was conducted through individual interviews with ten nurses of three Organ and Tissue Procurement Services of the city of São Paulo. the experience of the nurses in the donation process was represented by the categories: obstacles experienced in the donation process, and interventions performed. The meaning of the action to maintain the viability of organs and tissues for transplantation was described by the categories: to change paradigms, to humanize the donation process, to expand the donation, and to save lives. knowledge of the experience of the nurses in this process is important for healthcare professionals who work in different realities, indicating strategies to optimize the procurement of organs and tissues for transplantation.
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[Emotional labour of nursing care: an evolutionary concept analysis].
Truc, Huynh; Alderson, Marie; Thompson, Mary
2009-06-01
Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, psycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurse adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements : organization (i.e.social norms, social support), nurse (i.e.role identification, professional commitment, work experience and interpersonal skills) and job (i.e.autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions : nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e.productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive) the concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.
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Working Together Toward a Common Goal: A Grounded Theory of Nurse-Physician Collaboration.
Fewster-Thuente, Lori
2015-01-01
Working together toward a common goal is an empirically derived theory that can guide education and practice to improve patient outcomes while saving money and lives. Grounded theory was used to explore nurses' and physicians' experiences with collaboration in order to understand the process intrinsically.
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[Inverse innovation models in the nurse clinic of a Urology Department].
Gamarra, Manuela; López, Maria C; Luján, Marcos; Mora, Jose Ramón
2015-01-01
In the urology clinics there is an important volume of limited-complexity pathology that consumes an important part of resources. Delegating some tasks of this type to Nurses may imply a competitive advantage in economic terms without decrease in the quality of the care given to patients and their level of satisfaction. This is an example of the concept of inverse innovation. In this work we try to make public our experience in the management by nursing staff of features of the urology consultation traditionally reserved to physicians, as well as the design of the related processes. We developed the most frequent processes competence of the nursing staff in the unit: 1) Care of ambulatory urological surgery pathology; 2) Urologic ultrasound; 3) Traditional urologic nurse consultation. During 2013 the nursing staff performed 423 ambulatory urologic surgery pathology clinic visits, 931 urologic ultrasounds and 1019 varied actions corresponding to traditional urological nurse work.We developed stabilization formularies and flow diagrams of the aforementioned processes. We performed a quantification of the amount of money saved in comparison with the costs generated if a nurse or a physician was employed. Such saving was 2,78 and 4,00 Euros in the ambulatory urological surgery pathology and urologic ultrasound, respectively. Total savings in both processes was 4900 Euros. Implication of urological nursing staff in certain care tasks traditionally reserved to the physician is possible without increase in quality defects, obtaining an advantage in terms of economic cost and flexibility in staff organization thanks to the expansion of the competence array.
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Ashghali-Farahani, Mansoureh; Ghaffari, Fatemeh; Hoseini-Esfidarjani, Sara-Sadat; Hadian, Zahra; Qomi, Robabeh; Dargahi, Helen
2018-01-01
Weakness of curriculum development in nursing education results in lack of professional skills in graduates. This study was done on master's students in nursing to evaluate challenges of neonatal intensive care nursing curriculum based on context, input, process, and product (CIPP) evaluation model. This study was conducted with qualitative approach, which was completed according to the CIPP evaluation model. The study was conducted from May 2014 to April 2015. The research community included neonatal intensive care nursing master's students, the graduates, faculty members, neonatologists, nurses working in neonatal intensive care unit (NICU), and mothers of infants who were hospitalized in such wards. Purposeful sampling was applied. The data analysis showed that there were two main categories: "inappropriate infrastructure" and "unknown duties," which influenced the context formation of NICU master's curriculum. The input was formed by five categories, including "biomedical approach," "incomprehensive curriculum," "lack of professional NICU nursing mentors," "inappropriate admission process of NICU students," and "lack of NICU skill labs." Three categories were extracted in the process, including "more emphasize on theoretical education," "the overlap of credits with each other and the inconsistency among the mentors," and "ineffective assessment." Finally, five categories were extracted in the product, including "preferring routine work instead of professional job," "tendency to leave the job," "clinical incompetency of graduates," "the conflict between graduates and nursing staff expectations," and "dissatisfaction of graduates." Some changes are needed in NICU master's curriculum by considering the nursing experts' comments and evaluating the consequences of such program by them.
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Organizational climate and intensive care unit nurses' intention to leave.
Stone, Patricia W; Larson, Elaine L; Mooney-Kane, Cathy; Smolowitz, Janice; Lin, Susan X; Dick, Andrew W
2006-07-01
The purposes of this study were to a) estimate the incidence of intensive care units nurses' intention to leave due to working conditions; and b) identify factors predicting this phenomenon. Cross-sectional design. Hospitals and critical care units. Registered nurses (RNs) employed in adult intensive care units. Organizational climate, nurse demographics, intention to leave, and reason for intending to leave were collected using a self-report survey. Nurses were categorized into two groups: a) those intending to leave due to working conditions; and b) others (e.g., those not leaving or retirees). The measure of organizational climate had seven subscales: professional practice, staffing/resource adequacy, nurse management, nursing process, nurse/physician collaboration, nurse competence, and positive scheduling climate. Setting characteristics came from American Hospital Association data and a survey of chief nursing officers. A total of 2,323 RNs from 66 hospitals and 110 critical care units were surveyed across the nation. On average, the RN was 39.5 yrs old (SD = 9.40), had 15.6 yrs (SD = 9.20) experience in health care, and had worked in his or her current position for 8.0 yrs (SD = 7.50). Seventeen percent (n = 391) of the respondents indicated intending to leave their position in the coming year. Of those, 52% (n = 202) reported that the reason was due to working conditions. Organizational climate factors that had an independent effect on intensive care unit nurse intention to leave due to working conditions were professional practice, nurse competence, and tenure (p < .05). Improving professional practice in the work environment and clinical competence of the nurses as well as supporting new hires may reduce turnover and help ensure a stable and qualified workforce.
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Improvement in self-reported confidence in nurses' professional skills in the emergency department.
Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari
2013-03-05
The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses' education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services.
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The undergraduate research fellows program: a unique model to promote engagement in research.
Vessey, Judith A; DeMarco, Rosanna F
2008-01-01
Well-educated nurses with research expertise are needed to advance evidence-based nursing practice. A primary goal of undergraduate nursing curricula is to create meaningful participatory experiences to help students develop a research skill set that articulates with rapid career advancement of gifted, young graduates interested in nursing research and faculty careers. Three research enrichment models-undergraduate honors programs, research assistant work-for-hire programs, and research work/mentorship programs-to be in conjunction with standard research content are reviewed. The development and implementation of one research work/mentorship program, the Boston College undergraduate research fellows program (UGRF), is explicated. This process included surveying previous UGRFs followed by creating a retreat and seminars to address specific research skill sets. The research skill sets included (a) how to develop a research team, (b) accurate data retrieval, (c) ethical considerations, (d) the research process, (e) data management, (f) successful writing of abstracts, and (g) creating effective poster presentations. Outcomes include evidence of involvement in research productivity and valuing of evidenced-based practice through the UGRF mentorship process with faculty partners.
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Spineli, Vívian Marina Calixto Damasceno; Kurashima, Andrea Yamaguchi; De Gutiérrez, Maria Gaby Rivero
2015-10-01
Our aim was to describe the process of palliative sedation from the point of view of physicians and nurses working in palliative care in Brazil. Ours was a descriptive study conducted between May and December of 2011, with purposeful snowball sampling of 32 physicians and 29 nurses working in facilities in Brazil that have adopted the practice of palliative care. The symptoms prioritized for an indication of palliative sedation were dyspnea, delirium, and pain. Some 65.6% of respondents believed that the survival time of a patient in the final phase was not a determining factor for the indication of this measure, and that the patient, family, and healthcare team should participate in the decision-making process. For 42.6% of these professionals, the opinion of the family was the main barrier to an indication of this therapy. The opinion of the physicians and nurses who participated in this study converged with the principal national and international guidelines on palliative sedation. However, even though it is a therapy that has been adopted in palliative care, it remains a controversial practice.
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Picturing the nurse-person/family/community process in the year 2050.
Mitchell, Gail J
2007-01-01
How will nurses relate with persons in the year 2050? And, how might technology enable or limit the nursing process with persons, families, and communities? These are the questions addressed in this column. Imaging practice in light of the technological imaginings and projections is facilitated by a possible scenario that includes robotics that not only monitor human biological processes, they also emote compassion and caring that may one day be dosed according to the latest diagnostic prescription. Three nurses in this column present their views of how nursing might evolve. Karnick, aligned with the human becoming school of thought, imagines a practice anchored in respect for humanity and quality of life and an accompanying respect for nursing knowledge and nursing work. Senesac and Sato, aligned with Roy's adaptation model, call for nurses to envision and choose the future they want to have. Clear in both perspectives is a reverence for human values and human experience and for the critical role of nursing knowledge as we move toward the not-yet of 2050.
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Kaspar, Roman; Hartig, Johannes
2016-03-01
The care of older people was described as involving substantial emotion-related affordances. Scholars in vocational training and nursing disagree whether emotion-related skills could be conceptualized and assessed as a professional competence. Studies on emotion work and empathy regularly neglect the multidimensionality of these phenomena and their relation to the care process, and are rarely conclusive with respect to nursing behavior in practice. To test the status of emotion-related skills as a facet of client-directed geriatric nursing competence, 402 final-year nursing students from 24 German schools responded to a 62-item computer-based test. 14 items were developed to represent emotion-related affordances. Multi-dimensional IRT modeling was employed to assess a potential subdomain structure. Emotion-related test items did not form a separate subdomain, and were found to be discriminating across the whole competence continuum. Tasks concerning emotion work and empathy are reliable indicators for various levels of client-directed nursing competence. Claims for a distinct emotion-related competence in geriatric nursing, however, appear excessive with a process-oriented perspective.
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Galatsch, Michael; Li, Jian; Derycke, Hanne; Müller, Bernd Hans; Hasselhorn, Hans Martin
2013-12-05
Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule. Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed. The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p <0.001), lowest general health (t1: 63.9, t2: 59.2, p <0.001) and showed the highest decrease in both outcomes. Shift pattern change in line with the nurses' wishes was associated with improved work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health. The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and - to somewhat lesser extent - health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable preventive tool to promote nurses' work ability and - to lesser extent - their perceived health, not least in aging nursing work forces.
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Job satisfaction in nursing: a concept analysis study.
Liu, Y; Aungsuroch, Y; Yunibhand, J
2016-03-01
This study aims to undertake a concept analysis of job satisfaction in the nursing profession. Around current global shortage of nurses, it is important to stabilize the nursing workforce. Nurses' job satisfaction has been found to be related to intention to leave. In the nursing profession, there is a lack of evidence to support the attributes of nurses' job satisfaction. Walker and Avant's approach of concept analysis was used. The main attributes of job satisfaction from this study are (1) fulfillment of desired needs within the work settings, (2) happiness or gratifying emotional responses towards working conditions, and (3) job value or equity. These attributes are influenced by antecedent conditions like demographic, emotional, work characteristics and environmental variables. Additionally, the consequences of nurses' job satisfaction have a significant impact on both nurses and patients. This study integrated both the content and process of motivational theories to generate the attributes of job satisfaction in nursing that overcome the limitation of the previous studies, which looked only at the definitions of nurses' job satisfaction based on content motivational theories. The findings of this study can facilitate both nursing researchers to develop a cultural adaption instrument and policy makers to improve clinical nursing practice. This analysis provides nurse managers with a new perspective to deal with nurses' job satisfaction by taking into account all the attributes that influence it in the nursing field. © 2015 International Council of Nurses.
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Winkelman, Warren J; Halifax, Nancy V Davis
2007-04-01
We present an institutional ethnography of hospital-based psoriasis day treatment in the context of evaluating readiness to supplement services and support with a new web site. Through observation, interviews and a critical consideration of documents, forms and other textually-mediated discourses in the day-to-day work of nurses and physicians, we come to understand how the historical gender-determined power structure of nurses and physicians impacts nurses' work. On the one hand, nurses' work can have certain social benefits that would usually be considered untenable in traditional healthcare: nurses as primary decision-makers, nurses as experts in the treatment of disease, physicians as secondary consultants, and patients as co-facilitators in care delivery processes. However, benefits seem to have come at the nurses' expense, as they are required to maintain a cloak of invisibility for themselves and for their workplace, so that the Centre appears like all other outpatient clinics, and the nurses do not enjoy appropriate economic recognition. Implications for this negotiated invisibility on the implementation of new information systems in healthcare are discussed.
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The N2N instrument to evaluate healthy work environments: an Italian validation.
Palese, Alvisa; Dante, Angelo; Tonzar, Laura; Balboni, Bernardo
2014-02-01
The aims of the study were to (a) validate N2N Healthy Work Environment tool, (b) assess the healthiness of work environments as perceived by nurses themselves and (c) identify the factors associated with Italian nurses' perception of work environment healthiness. The linguistic and cultural adaptation of USA-N2N Healthy Work Environments was achieved through a process of forward/backward translation. Content validity was assessed by three expert nurses. The stability of the instrument was checked with a test/retest evaluation. The instrument psychometric properties, the confirmatory factor analysis as well the healthiness of the work environment and its determinant factors were evaluated with a sample of 294 nurses. The content and face validity of the N2N Healthy Work Environment instrument was confirmed. The instrument demonstrated good internal consistency (α of 0.82), excellent stability values (ρ > 0.70) and high levels of acceptability (response rate: 96.4 %). The confirmatory factor analysis has corroborated the existence of two factors as documented in the original instrument (Mays et al. in J Nurs Manag 19:18-26, 2011). Eighty-seven (29.6 %) nurses perceived the work environment where they work as "healthy". Working under a functional model of care delivery (χ(2) 24.856, p 0.000) and being responsible for one project or more (χ(2) 5.256, p 0.021) were associated with healthy environments. The instrument--valid and reliable, short in the number of items, easy to understand and based on international standards--allows a systematic assessment of the healthiness of the environment and might provide not only the opportunity to evaluate the effects of new organizational models and interventions, but also the possibility to activate a process of self-analysis and a process of ongoing review. The instrument can be used to systematically check the healthiness of Italian working environments, allowing for organizational diagnosis, targeted interventions and international comparisons.
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Why a disaster is not just normal business ramped up: Disaster response among ED nurses.
Hammad, Karen S; Arbon, Paul; Gebbie, Kristine; Hutton, Alison
2017-11-15
The emergency department (ED) is a familiar place for the emergency nurse who spends their working days inside it. A disaster threatens that familiarity and creates changes that make working in the ED during a disaster response different from the everyday experience of working in the ED. This research reports on an aspect of the findings from a larger study about the experience of working as a nurse in the ED during a disaster response. Thirteen nurses from 8 different countries were interviewed about their experience. The findings from this research demonstrate that a disaster event leads to a chain reaction of changes in process, space and practice. Nurses' respond to the news of a disaster event with shock and disbelief. The ED may change as a result of the event requiring nurses to work in an altered environment or a completely different setting. These changes provoke nurses to alter their behaviour and practice and reflect on the experience after the response. Emergency nurses have a high likelihood of participating in disaster response and as such should be adequately prepared. This highlights how disaster response is different and leads to recommendations to enhance training for emergency nurses which will better prepare them Disasterresponse is not normal business ramped up. There are a number of challenges and changes that should be considered when preparing emergency nurses for the realities of disaster response. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.
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The nature nursing quality of work life: an integrative review of literature.
Vagharseyyedin, Seyyed Abolfazl; Vanaki, Zohreh; Mohammadi, Eesa
2011-10-01
Studies that have examined the nursing quality of work life (QWL) have not been systematically reviewed in the recent years. Thus, the current study was aimed to identify the predictors of the nurses' QWL and determine the definitions of QWL for nurses. The authors used an integrative review of the literature and identified six themes as the major predictors of the nurses' QWL: leadership and management style/decision-making latitude, shift working, salary and fringe benefits, relationship with colleagues, demographic characteristics, and workload/job strain. Although different researchers had varied perspectives on the QWL in nursing, most viewed QWL as a subjective phenomenon that is influenced by personal feeling and perceptions. A closer review of definitions of QWL indicated that some authors considered QWL as an "outcome," whereas others saw it as a "process." Further research needs to be conducted to determine the relative importance of QWL predictors, and implementation programs to improve the QWL.
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Selection of student nurses at Bafokeng Nursing College.
Setsoe, G
1992-06-01
Bafokeng Nursing College is a privately owned institution situated at the Impala Mines in Bophuthatswana. It selects and trains student nurses from all parts of Southern Africa in the comprehensive four-year course who at qualifying are free to work for Genmin or anywhere else in the country. The College is affiliated to Medunsa in offering the four-year comprehensive course. Selection is limited because of limited facilities. The old selection process was evaluated in 1985 and the new selection process started functioning in 1986 when the new course was offered for the first time at the College. With the new selection process, the drop-out rate is very low, the pass rate has improved and the quality of nursing care is improving.
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Lancman, S; Barros, J O; Silva, M D; Pereira, A R; Jardim, T A
2017-03-01
Introduction The process of returning to work, especially for individuals with labor restrictions, impacts work teams and interferes with the labor reinsertion process. In this study, we aimed to understand the impact of these situations on a nursing team from both organizational and relational perspectives. Methods We conducted a qualitative research study at a university hospital in the municipality of São Paulo using three strategies: documentary analysis; semi-structured interviews with pairs of workers returning to a labor situation; and a focus group with nursing managers. Results Medical leaves of absence overburden the employees who remain working. Regarding the return to work, the participants reported both positive and negative aspects. One positive aspect reported was that those who return to work contribute to the division of labor, generating solidarity and cooperation. The negative aspects reported were related to the return of workers with labor restrictions who do not fully resume their activities, consequently generating conflicts within the work teams that interfere with the reintegration processes. The supervisors reported difficulties reorganizing work on a broad scale and assessing the workers' diagnoses and symptoms and the workers themselves in terms of the necessity of their leaves and the validity of their labor restrictions. Conclusion The organization of labor and social relationships among peers and supervisors is a significant contributor to the success or failure of the work reintegration process and therefore should be considered. We aimed to address this issue by highlighting the complexity of the return-to-work process among health workers.
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ERIC Educational Resources Information Center
Snyder, Melissa J.
2012-01-01
The purpose of this action research study was two-fold. The first purpose was to examine the process of how nurses engaged in a professional development program that drew upon reading and creative writing related to their lives and work as nurses. Secondly, this study examined the nurses' perspectives on how their involvement in the process…
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Delegation in Correctional Nursing Practice.
Tompkins, Frances
2016-07-01
Correctional nurses face daily challenges as a result of their work environment. Common challenges include availability of resources for appropriate care delivery, negotiating with custody staff for access to patients, adherence to scope of practice standards, and working with a varied staffing mix. Professional correctional nurses must consider the educational backgrounds and competency of other nurses and assistive personnel in planning for care delivery. Budgetary constraints and varied staff preparation can be a challenge for the professional nurse. Adequate care planning requires understanding the educational level and competency of licensed and unlicensed staff. Delegation is the process of assessing patient needs and transferring responsibility for care to appropriately educated and competent staff. Correctional nurses can benefit from increased knowledge about delegation. © The Author(s) 2016.
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Challenges in the nurse's role in rehabilitation contexts.
Christiansen, Bjørg; Feiring, Marte
2017-10-01
To shed light on how nurses perceive particular challenges that they experience in encounters with patients in rehabilitation wards. Rehabilitation is a tailor-made process that allows someone with impairment to live well. Many rehabilitation institutions embrace strong beliefs in patient participation as well as awareness of and listening to the needs and wishes of patients. To our knowledge, few studies have investigated the challenges encountered by nurses from patients in rehabilitation contexts and how these challenges might influence their roles as nurses. This study has a qualitative design that is based on three focus group interviews with nurses working in three rehabilitation wards. A convenience sample of 15 nurses, five from each ward, was recruited to participate in focus group interviews. The participants worked in wards for patients suffering mainly from stroke and head injuries. The analysis is inspired by hermeneutic principles to explore the participants' challenges in their role in rehabilitation contexts. Data analyses identified three main themes surrounding the challenges experienced by nurses: (1) Adjusting patients' and next of kin's expectations, (2) Tailoring support and information, (3) Recognising patients' knowledge. Our results from the three rehabilitation wards indicate that nurses display various educative strategies. There is, however, a need for further empirical work into how knowledgeable patients and next of kin create new challenges with implications for the nurse's role within rehabilitation contexts. The study highlights the educative aspects of the nurse's role in relation to patients and next of kin on rehabilitation wards as significant contributors to recovery processes. © 2016 John Wiley & Sons Ltd.
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How clinical observation enhances recruitment and selection.
Sutherland, Clare
2012-11-01
A survey of nurse managers in Derby Hospitals NHS Foundation Trust in 2010 found 51 practitioners working at an advanced clinical level, but there were variations in titles, pay bands, clinical skills and academic qualifications. This prompted the introduction of a local framework to support the development of the advanced nurse practitioner (ANP) role and a review of the interview process to enable managers to assess applicants' skills, competencies and knowledge. The process is now used in practice, with candidates' clinical skills now observed as part of the ANP selection process. This article describes how the new process works.
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'Working behind the scenes'. An ethical view of mental health nursing and first-episode psychosis.
Moe, Cathrine; Kvig, Erling I; Brinchmann, Beate; Brinchmann, Berit S
2013-08-01
The aim of this study was to explore and reflect upon mental health nursing and first-episode psychosis. Seven multidisciplinary focus group interviews were conducted, and data analysis was influenced by a grounded theory approach. The core category was found to be a process named 'working behind the scenes'. It is presented along with three subcategories: 'keeping the patient in mind', 'invisible care' and 'invisible network contact'. Findings are illuminated with the ethical principles of respect for autonomy and paternalism. Nursing care is dynamic, and clinical work moves along continuums between autonomy and paternalism and between ethical reflective and non-reflective practice. 'Working behind the scenes' is considered to be in a paternalistic area, containing an ethical reflection. Treating and caring for individuals experiencing first-episode psychosis demands an ethical awareness and great vigilance by nurses. The study is a contribution to reflection upon everyday nursing practice, and the conclusion concerns the importance of making invisible work visible.
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The Role of Individual and Collective Mindfulness in Promoting Occupational Safety in Health Care.
Dierynck, Bart; Leroy, Hannes; Savage, Grant T; Choi, Ellen
2017-02-01
Although the importance of safety regulations is highly emphasized in hospitals, nurses frequently work around, or intentionally bypass, safety regulations. We argue that work-arounds occur because adhering to safety regulations usually requires more time and work process design often lacks complementarity with safety regulations. Our main proposition is that mindfulness is associated with a decrease in occupational safety failures through a decrease in work-arounds. First, we propose that individual mindfulness may prevent the depletion of motivational resources caused by worrying about the consequences of time lost when adhering to safety regulations. Second, we argue that collective mindfulness may provide nursing teams with a cognitive infrastructure that facilitates the detection and adaptation of work processes. The results of a multilevel analysis of 580 survey responses from nurses are consistent with our propositions. Our multilevel analytic approach enables us to account for the unique variance in work-arounds that individual and collective mindfulness explain.
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The Experience of China-Educated Nurses Working in Australia: A Symbolic Interactionist Perspective
Zhou, Yunxian
2014-01-01
Background and Purpose Transnational nurse migration is a growing phenomenon. This study explored the experiences of China-educated nurses working in Australia. Design Using a constructivist grounded theory method, 46 in-depth interviews were conducted with 28 China-educated nurses in two major cities in Australia. Results The core category emerged was “reconciling different realities”. Three phases of reconciling were conceptualised: realising, struggling, and reflecting. Realising refers to an awareness of the discrepancies between different realities. Struggling reflects the dilemma of the “middle position” and how being situated as “the other” is experienced. Reflecting is the process of making sense of the experience and rationalising the gains and losses associated with immigration. Conclusions This study produced a theoretical understanding of the experience of China-educated nurses working in Australia. The findings not only inform Chinese nurses who wish to migrate but contribute to the implementation of more effective support services for immigrant nurses. PMID:25229564
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Operationalizing a Nursing Innovation Center Within a Health Care System.
Albert, Nancy M
In nursing, the terms "innovation" and "innovative" are used freely, especially when individuals or groups either develop something new or improve upon current practice. Innovation is often considered adjunct work, not part of foundational work that aims to meet the vision, mission, and values of the organization. Nurse leaders must include innovation as an important theme of this foundational work. Innovation must become a core expectation of all nurses and nursing team members. Team members can provide ideas that lead to innovations. They can also carry out roles that enhance or cultivate ideas, promote prototyping, ensure innovative ideas are efficacious and effective, and facilitate dissemination and diffusion into practice. To ensure that innovation is incorporated as part of nursing practice and then sustained over time, horizontal (elemental) and vertical (global) infrastructure and processes are needed. In this article, operationalization of a Nursing Innovation Center is described and rationale for specific horizontal and vertical services and features is discussed.
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Nursing terminology as a work process instrument of nurses in collective health.
Cavalcante, Marília Daniella Machado Araújo; Larocca, Liliana Müller; Chaves, Maria Marta Nolasco; Cubas, Márcia Regina; Piosiadlo, Laura Christina Macedo; Mazza, Verônica de Azevedo
2016-01-01
To analyze the use of nursing terminology as an instrument of the nursing work process in Collective Health. Exploratory case study. For data collection was conducted a group interview with 24 nurses working in health units of a municipality in south central Paraná, Brazil. Data were analyzed in the light of interdependence between the structural, particular and singular dimensions contained in the Theory of Nursing Praxis Intervention in Collective Health. The situations interfering with improper use were the lack of knowledge about the origin and purpose of terminology, lack of training, and non-mandatory use. Although the nursing terminology is used as an instrument in the nursing work process in collective health, it requires training to be recognized as a classification system. At the same time, institutional policies should be employed to ensure the effective use of these instruments. Analisar a utilização de terminologia de enfermagem como instrumento do processo de trabalho do enfermeiro em Saúde Coletiva. Estudo de caso exploratório. Para coleta de dados foi realizada entrevista em grupo com 24 enfermeiros que atuam nas unidades de saúde de um município no centro-sul do Paraná, Brasil. Os dados foram analisados à luz da interdependência entre as dimensões estrutural, particular e singular contidas na Teoria da Intervenção Práxica de Enfermagem em Saúde Coletiva. As situações que interferiram na utilização inadequada foram o desconhecimento sobre origem e finalidade da terminologia, a falta de treinamento e a não obrigatoriedade de uso. A terminologia de enfermagem, apesar de utilizada como instrumento no processo de trabalho de enfermeiros em Saúde Coletiva, necessita de capacitação para ser reconhecida como sistema classificatório. Ao mesmo tempo, políticas institucionais devem ser empregadas no intuito de garantir a efetiva utilização destes instrumentos.
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Emotional labour underlying caring: an evolutionary concept analysis.
Huynh, Truc; Alderson, Marie; Thompson, Mary
2008-10-01
This paper is a report of a concept analysis of emotional labour. Caring is considered as the essence of nursing. Underpinning caring, the internal regulation of emotions or the emotional labour of nurses is invisible. The concept of emotional labour is relatively underdeveloped in nursing. A literature search using keywords 'emotional labour', 'emotional work' and 'emotions' was performed in CINAHL, PsycINFO and REPERE from 1990 to January 2008. We analysed 72 papers whose main focus of inquiry was on emotional labour. We followed Rodgers' evolutionary method of concept analysis. Emotional labour is a process whereby nurses adopt a 'work persona' to express their autonomous, surface or deep emotions during patient encounters. Antecedents to this adoption of a work persona are events occurring during patient-nurse encounters, and which consist of three elements: organization (i.e. social norms, social support), nurse (i.e. role identification, professional commitment, work experience and interpersonal skills) and job (i.e. autonomy, task routine, degree of emotional demand, interaction frequency and work complexity). The attributes of emotional labour have two dimensions: nurses' autonomous response and their work persona strategies (i.e. surface or deep acts). The consequences of emotional labour include organizational (i.e. productivity, 'cheerful environment') and nurse aspects (i.e. negative or positive). The concept of emotional labour should be introduced into preregistration programmes. Nurses also need to have time and a supportive environment to reflect, understand and discuss their emotional labour in caring for 'difficult' patients to deflate the dominant discourse about 'problem' patients.
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The development of Canadian nursing: professionalization and proletarianization.
Coburn, D
1988-01-01
In this article, the development of nursing in Canada is described in terms of three major time periods: the emergence of lay nursing, including organization and registration, 1870-1930; the move to the hospital, 1930-1950; and unionization and the routinization of health care, 1950 to the present. This development is viewed in the light of the orienting concepts of professionalization, proletarianization, and medical dominance (and gender analysis). This historical trajectory of nursing shows an increasing occupational autonomy but continuing struggles over control of the labor process. Nursing is now using theory, organizational changes in health care, and credentialism to help make nursing "separate from but equal to" medicine and to gain control over the day-to-day work of the nurse. Nursing can thus be viewed as undergoing processes of both professionalization and proletarianization. As nursing seeks to control the labor process, its occupational conflicts are joined to the class struggle of white-collar workers in general. Analysis of nursing indicates the problems involved in sorting out the meaning of concepts that are relevant to occupational or class analysis but which focus on the same empirical phenomenon.
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The nursing shortage: part way down the slippery slope.
Cowin, Leanne; Jacobsson, Denise
2003-07-01
The shortage of nurses has reached a crisis point for health care services. A number of issues including the effects of economic rationalism, generational differences, working conditions and nurse education are revisited in a discussion that aims to refuel the debate on workplace reform for nurses. Economic rationalism has altered the healthcare service landscape. Attempts to balance service delivery with workforce resources have led to possibly unforeseen changes. Highly skilled nurses are required in acute services, however resource allocation may prevent this. The nursing workforce is aging although the current nursing workforce consists of three generations: baby boomers, generation X and generation Y. There are significant ideological and work organisational differences between these generations leading to possible conflict between nurses. The pool of available nurses to fill employment vacancies is finite. Attracting overseas nurses to fill nurse vacancies will leave vacancies elsewhere and is not a long-term solution to the nursing shortage. Moreover, if the workplace has not addressed the reasons why nurses have left the health care workplace then there is a real danger of losing those recently attracted back into the workplace. Working conditions are a critical element within the retention puzzle. Job satisfaction dimensions such as autonomy and professional relationships are key components for improving working conditions. The final issue explored is the question of whether the tertiary education system is the most appropriate place in which to develop and educate nurses. It is suggested that workplace reforms should be the target of retention strategies rather than changes in the educational process of nursing.
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Expanding leadership capacity: educational levels for nurse leaders.
Yoder-Wise, Patricia S; Scott, Elaine S; Sullivan, Dori Taylor
2013-06-01
A master's degree in nursing administration prepares the nurse to lead nursing and interprofessional teams, to create new and innovative approaches to improve care processes and outcomes, as well as traditional management responsibilities related to budgets, human resources, quality and safety, and a healthy work environment. Are we not at a critical juncture in our profession when we should challenge the profession to require a master's degree education for all levels of nursing administration?
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Masoumian Hoseini, S T; Manzari, Z; Khaleghi, I
2015-01-01
Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. To assess ICU nurses' knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses' knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.
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Prison Nursing: Formation of a Stable Professional Identity.
Choudhry, Khurshid; Armstrong, David; Dregan, Alexandru
The aim of this study was to analyze how working within prison environments can influence the self-identity and professional identity of nurses. The prison environment can be a difficult environment for nurses to deliver care within, with nurses having to carry out activities that seem to go against their professional role, while at the same time providing care to prisoners who have greater health needs than the general population. There is a lack of theoretical consideration of how prison nurses carry out their role in the face of such challenges. This study used a review of literature published over the last 11 years exploring nurses' beliefs, thoughts, and feelings toward delivering care within prison environment. With time, nurses working within prison environments develop specific skills to be able to deliver appropriate care to their patients. These skills include adapting to both the prison environment and the prison culture. Ultimately, adaptations lead to a change in identity allowing nurses to work effectively within prison. Providers of prison healthcare should ensure that induction (orientation) processes for new nurses are designed to address specific challenges that nurses face including the potential for cognitive dissonance. They should ensure that nurses receive training to develop and acquire the skills highlighted in this review. Ensuring that this training is in place may increase nurse retention.
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Testing a theoretical model of clinical nurses' intent to stay.
Cowden, Tracy L; Cummings, Greta G
2015-01-01
Published theoretical models of nurses' intent to stay (ITS) report inconsistent outcomes, and not all hypothesized models have been adequately tested. Research has focused on cognitive rather than emotional determinants of nurses' ITS. The aim of this study was to empirically verify a complex theoretical model of nurses' ITS that includes both affective and cognitive determinants and to explore the influence of relational leadership on staff nurses' ITS. The study was a correlational, mixed-method, nonexperimental design. A subsample of the Quality Work Environment Study survey data 2009 (n = 415 nurses) was used to test our theoretical model of clinical nurses' ITS as a structural equation model. The model explained 63% of variance in ITS. Organizational commitment, empowerment, and desire to stay were the model concepts with the strongest effects on nurses' ITS. Leadership practices indirectly influenced ITS. How nurses evaluate and respond to their work environment is both an emotional and rational process. Health care organizations need to be cognizant of the influence that nurses' feelings and views of their work setting have on their intention decisions and integrate that knowledge into the development of retention strategies. Leadership practices play an important role in staff nurses' perceptions of the workplace. Identifying the mechanisms by which leadership influences staff nurses' intentions to stay presents additional focus areas for developing retention strategies.
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Building a values-based culture in nurse education.
Tetley, Josie; Dobson, Fiona; Jack, Kirsten; Pearson, Beryl; Walker, Elaine
2016-01-01
Nurse education has found itself challenged to select and educate nurses who on completion of? of their programme? have: excellent technical skills, an ability to critically analyse care and work compassionately in ways that support the values of care that are important to service users. Recent reports of care suggest that nursing still needs to develop the values base of its student selection and education processes. Against this backdrop, this paper presents two examples from pre registration nurse education that illustrate how a values based approach is used as part of the selection process in one university and used to inform the development of a reflective poetry initiative in another university. Having presented the two examples the authors debate some of the wider benefits and challenges linked to these ways of working. For example, the importance of connecting nurses' personal beliefs, attitudes and assumptions to service user values in recruitment are discussed. The use of poetry as a way of thinking about practice that moves beyond traditional models of reflection in nursing are also considered. However, the authors recognise that if developments in nurse education are to have a real impact on nursing practice and patient care, there is the need for values based initiatives to be more directly connected to the delivery of healthcare. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Bourdieu's theory of practice and its potential in nursing research.
Rhynas, Sarah J
2005-04-01
This paper seeks to consider the utility of Bourdieu's "Theory of Practice" in nursing, and considers specifically its use as a framework for research exploring nurses' conceptualizations of illness and the patients in their care. Bourdieu's work uses the concepts of field, capital and habitus to explain interactions within the social world. This paper describes these concepts and their relationship with nursing is discussed using dementia care as an example. The work of French scholar Pierre Bourdieu has contributed to debates throughout the social sciences, but has had relatively little attention in the nursing literature. Pierre Bourdieu's work developed against a backdrop of change in the academic world. The emergence of the social sciences and the debate around objective and subjective styles of research were influential in the development of his "Theory of Practice". The importance of the conceptualization process is discussed, and the considerable potential influence of conceptualization on patient care is highlighted. Reflexivity is a cornerstone of Bourdieu's work, and is an important feature of nursing research. Examples of health care research using his work as a framework are discussed, and some of the challenges of the approach are outlined. The use of Bourdieu's "Theory of Practice" as a research framework could allow nurse researchers to explore the interactions of nurses with the structures, agents and symbols of illness within the field of care. This work could enhance understanding of how nurses view and react to patients in their care, and promote the development of practice innovations and policy change. The theory may, therefore, have much to offer future nursing research.
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Work ability in nursing: relationship with psychological demands and control over the work.
Prochnow, Andrea; Magnago, Tânia Solange Bosi de Souza; Urbanetto, Janete de Souza; Beck, Carmem Lúcia Colomé; Lima, Suzinara Beatriz Soares de; Greco, Patrícia Bitencourt Toscani
2013-01-01
to evaluate the association between psychological demands, control over the work and the reduction of work ability of nursing professionals. this cross-sectional study involved 498 nursing professionals of a university hospital in the State of Rio Grande do Sul, Brazil. Data collection was carried out in 2009 using the Brazilian versions of the Work Ability Index and Job Stress Scale, with logistic regression models used for the data analysis. the prevalence of 43.3% for reduced work ability and 29.7% for high-strain in the job (high psychological demand and low control) were observed. The chances for professionals presenting reduced work ability under high-strain were higher and significant when compared to those classified as being under low-strain, even after adjusting for potential confounders, except for age and gender. a high prevalence of reduced work ability was observed. This evidence indicates the need for investigation and detailed analysis of the psychosocial aspects of the professionals with regard to the health/disease process of nursing professionals.
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El Hussein, Mohamed; Hirst, Sandra
2016-02-01
To construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognise delirium while caring for older adults in acute care settings. Delirium is often under-recognised in acute care settings; this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' clinical reasoning processes in complex situations such as delirium recognition. Seventeen registered nurses working in acute care settings were interviewed. Concurrent data collection and analysis, constant comparative analysis and theoretical sampling were conducted in 2013-2014. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of registered nurse in acute hospital settings. The core category that emerged from data was 'Tracking the footsteps'. This refers to the common clinical reasoning processes that registered nurses in this study used to recognise delirium in older adults in acute care settings. It depicted the process of continuously trying to catch the state of delirium in older adults. Understanding the clinical reasoning processes that contribute to delirium under-recognition provides a strategy by which this problem can be brought to the forefront of awareness and intervention by registered nurses. Registered nurses could draw from the various processes identified in this research to develop their clinical reasoning practice to enhance their effective assessment strategies. Delirium recognition by registered nurses will contribute to quality care to older adults. © 2016 John Wiley & Sons Ltd.
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Tahghighi, Mozhdeh; Rees, Clare S; Brown, Janie A; Breen, Lauren J; Hegney, Desley
2017-09-01
To synthesize existing research to determine if nurses who work shifts have poorer psychological functioning and resilience than nurses who do not work shifts. Research exploring the impact of shift work on the psychological functioning and resilience of nurses is limited compared with research investigating the impact of shifts on physical outcomes. Integrative literature review. Relevant databases were searched from January 1995-August 2016 using the combination of keywords: nurse, shift work; rotating roster; night shift; resilient; hardiness; coping; well-being; burnout; mental health; occupational stress; compassion fatigue; compassion satisfaction; stress; anxiety; depression. Two authors independently performed the integrative review processes proposed by Whittemore and Knafl and a quality assessment using the mixed-methods appraisal tool by Pluye et al. A total of 37 articles were included in the review (32 quantitative, 4 qualitative and 1 mixed-methods). Approximately half of the studies directly compared nurse shift workers with non-shift workers. Findings were grouped according to the following main outcomes: (1) general psychological well-being/quality of life; (2) Job satisfaction/burnout; (3) Depression, anxiety and stress; and (4) Resilience/coping. We did not find definitive evidence that shift work is associated with poorer psychological functioning in nurses. Overall, the findings suggest that the impact of shift work on nurse psychological functioning is dependent on several contextual and individual factors. More studies are required which directly compare the psychological outcomes and resilience of nurse shift workers with non-shift workers. © 2017 John Wiley & Sons Ltd.
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Expanding the role of nonclinical personnel in the OR.
Hemingway, Maureen; Freehan, Marion; Morrissey, Lisa
2010-06-01
Ideally, quality health care should be accessible, affordable, and equitable. Working toward these goals in the OR necessitates examining and redesigning work processes and nursing workflow to make better use of the education and skills of perioperative nurses and assistive personnel. This article describes a pilot project undertaken in the OR at Massachusetts General Hospital, Boston, to identify tasks that took nurses away from direct patient care and to better incorporate assistive personnel into the workflow to increase nurses' contact with patients. The pilot program resulted in an expanded role for assistive personnel and more direct patient contact for nurses. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.
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Not choosing nursing: work experience and career choice of high academic achieving school leavers.
Neilson, Gavin R; McNally, James G
2010-01-01
Work experience has been a feature of the secondary school curriculum in the United Kingdom for a number of years. Usually requested by the pupil, it aims to provide opportunities for school pupils to enhance their knowledge and understanding of an occupation. The main benefits are claimed to be that it can help pupils develop an insight into the skills and attitudes required for an occupation and an awareness of career opportunities. However the quality and choice of placements are considered to be of great importance in this process and in influencing career choice [Department for Education and Skills (DfES), 2002a. Work Experience: A Guide for Employers. Department for Education and Skills, London]. As university departments of nursing experience a decline in the number of school pupils entering student nurse education programmes, and with the competition for school leavers becoming even greater, it is important to consider whether school pupils have access to appropriate work placements in nursing and what influence their experience has on pursuing nursing as a career choice. This paper is based on interview data from 20 high academic achieving fifth and sixth year school pupils in Scotland, paradigmatic cases from a larger survey sample (n=1062), who had considered nursing as a possible career choice within their career preference cluster, but then later disregarded nursing and decided to pursue medicine or another health care profession. This was partly reported by Neilson and Lauder [Neilson, G.R., Lauder, W., 2008. What do high academic achieving school pupils really think about a career in nursing: analysis of the narrative from paradigmatic case interviews. Nurse Education Today 28(6), 680-690] which examined what high academic achieving school pupils really thought about a career in nursing. However, the data was particularly striking in revealing the poor quality of nursing work experience for the pupils, and also their proposal that there was a need for work experience which was more representative of the reality of nursing. Participants reported that proper work experience in nursing could make it more attractive as a career choice but that there were difficulties and barriers in obtaining an appropriate work experience in nursing. These included unhelpful attitudes of teachers towards work experience in nursing in general and the placements themselves which were typically in a nursing home or a care home. They felt that departments of nursing within universities should have an input into organising more realistic work placements and that their involvement could foster greater interest amongst pupils in nursing as a career.
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Lenzen, Stephanie Anna; Daniëls, Ramon; van Bokhoven, Marloes Amantia; van der Weijden, Trudy; Beurskens, Anna
2018-04-01
Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. To investigate how the approach was implemented and experienced by practice nurses and patients. A process evaluation was conducted using quantitative and qualitative methods. Fifteen female practice nurses (aged between 28 and 55 years), working with people suffering from diabetes, COPD, asthma and/or cardiovascular diseases, participated. Nurses were asked to apply the approach to their chronically ill patients and to recruit patients (n = 10) willing to participate in an interview or an audio-recording of a consultation (n = 13); patients (13 women, 10 men) were aged between 41 and 88 years and suffered from diabetes, COPD or cardiovascular diseases. The approach involved a framework for shared decision making about goals and actions, a tool to explore the patient perspective, a patient profiles model and a training course. Interviews (n = 15) with nurses, a focus group with nurses (n = 9) and interviews with patients (n = 10) were conducted. Nurses filled in a questionnaire about their work routine before, during and after the training course. They were asked to deliver audiotapes of their consultations (n = 13). Overall, nurses felt that the approach supported them to coach patients in shared decision making. Nurses had become more aware of their own attitudes and learning needs and reported to have had more in-depth discussions with patients. The on-the-job coaching was experienced as valuable. However, nurses struggled to integrate the approach in routine care. They experienced the approach as different to their protocol-based routines and expressed the importance of receiving support and the need for integration of the approach into the family physician practice. This study shows that changing practice nurses' role from medical experts to coaches in shared decision making is very complex and requires paying attention to skills and attitudes, as well as to contextual factors. Our results indicate that more time and training might be needed for this role transition. Moreover, it might be worthwhile to focus on organizational learning, in order to increase an organization's capacity to change work routines in a collaborative process. Future research into the development and evaluation of health coaching approaches, focusing on shared decision making, is necessary. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Moral suffering among nurse educators of technical courses in nursing.
Duarte, Carla Godinho; Lunardi, Valéria Lerch; Silveira, Rosemary Silva da; Barlem, Edson Luiz Devos; Dalmolin, Graziele de Lima
2017-04-01
to understand situations of moral suffering experienced at work by nurse educators of technical courses in nursing. a qualitative study with discursive textual analysis by means of semi-structured interviews with ten nurse educators at two professional educational institutions in southern Brazil. two categories were established: lack of commitment on the part of students to the future profession, expressed through disrespect and disregard for the work of nurse educators, with inappropriate behaviors and attitudes; and lack of commitment to the learning-teaching process, expressed by indifference to the professional profile and lack of interest in lessons and care practices associated with learning gaps. these situations have an impact on experiences of moral suffering by nurse educators, and show a need for rethinking their practice, relationships, and educational spaces, and implementing strategies to favor the confrontation of dilemmas and conflicts experienced in educational practice in technical courses in nursing.
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Nurse-police coalition: improves safety in acute psychiatric hospital.
Allen, Diane E; Harris, Frank N; de Nesnera, Alexander
2014-09-01
Although police officers protect and secure the safety of citizens everywhere, nurses are the primary guardians of patient safety within the treatment milieu. At New Hampshire Hospital, both nurses and police officers share ownership of this responsibility, depending on the needs that arise specific to each profession. Psychiatric nurses take pride in their ability to de-escalate agitated and potentially aggressive patients; however, times arise when the best efforts of nurses fail, or when a situation requires intervention from police officers. Nurses and police officers at New Hampshire Hospital have worked together for many years to develop a trusting, respectful alliance. This coalition has resulted in a safe, clear, orderly process for transfer of authority from nurses to police during violent, clinically unmanageable psychiatric emergencies. Nurses and police officers work collaboratively toward the common goal of ensuring safety for patients and staff, while also acknowledging the unique strengths of each profession. Copyright 2014, SLACK Incorporated.
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Nursing Outcomes Classification implementation projects across the care continuum.
Moorhead, S; Clarke, M; Willits, M; Tomsha, K A
1998-06-01
The health care environment in which nurses deliver care is experiencing constant change characterized by decreased lengths of stay in acute care settings, increased use of technology, increasing emphasis on computerized patient records and care planning options, increasing markets dominated by managed care, and an emphasis on outcomes rather than process. These changes dictate that nursing as a profession ensures that the work of nursing is visible in this health care environment and included in the data used to make health policy decisions. This article describes the rich history of a Midwestern hospital's use of standardized nursing languages for the last 25 years. Currently this facility is in the process of implementing the Nursing Outcomes Classification (NOC). Four projects are described that illustrate the ways nurses can use this language with diagnoses from the North American Nursing Diagnoses Association (NANDA) and interventions from the Nursing Interventions Classification (NIC).
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The influence of factors of work environment and burnout syndrome on self-efficacy of medical staff.
Nowakowska, Iwona; Rasińska, Renata; Głowacka, Maria Danuta
2016-06-02
Conditions of a healthy, friendly and safe work environment and proper work organisation increase self-efficacy and decrease or eliminate the factors causing the occurrence of burnout symptoms, all of which have a decisive impact on increasing the quality of work. The aim of the study was to analyse and assess the influence of factors of work environment and burnout syndrome on the self-efficacy of medical staff. The study comprised randomly selected professionally-active nurses working on hospital wards (N=405) on the area of two provinces in Poland. The study used the Generalized Self-Efficacy Scale, Copenhagen Burnout Inventory and a questionnaire concerning the factors that influence the process of work organisation at nursing positions in hospitals. Lower scores for self-efficacy resulted in a worse assessment of development opportunities and promotion prospects (r=-0.11), participation in the decision-making process (r=-0.11) and teamwork (r=-0.10). Lower self-efficacy contributed to the occurrence of burnout symptoms r∈[-0.19 - -0.17]. Properly shaped and used organisational factors are stimulating for professional efficiency and effectiveness, and consequently, for the quality of nursing work. Negative assessment of the factors in the work environment contributes to the occurrence of burnout symptoms and decrease in self-efficacy. Nurses with lower self-efficacy more often experienced symptoms of burnout.
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Ashghali-Farahani, Mansoureh; Ghaffari, Fatemeh; Hoseini-Esfidarjani, Sara-Sadat; Hadian, Zahra; Qomi, Robabeh; Dargahi, Helen
2018-01-01
Background: Weakness of curriculum development in nursing education results in lack of professional skills in graduates. This study was done on master's students in nursing to evaluate challenges of neonatal intensive care nursing curriculum based on context, input, process, and product (CIPP) evaluation model. Materials and Methods: This study was conducted with qualitative approach, which was completed according to the CIPP evaluation model. The study was conducted from May 2014 to April 2015. The research community included neonatal intensive care nursing master's students, the graduates, faculty members, neonatologists, nurses working in neonatal intensive care unit (NICU), and mothers of infants who were hospitalized in such wards. Purposeful sampling was applied. Results: The data analysis showed that there were two main categories: “inappropriate infrastructure” and “unknown duties,” which influenced the context formation of NICU master's curriculum. The input was formed by five categories, including “biomedical approach,” “incomprehensive curriculum,” “lack of professional NICU nursing mentors,” “inappropriate admission process of NICU students,” and “lack of NICU skill labs.” Three categories were extracted in the process, including “more emphasize on theoretical education,” “the overlap of credits with each other and the inconsistency among the mentors,” and “ineffective assessment.” Finally, five categories were extracted in the product, including “preferring routine work instead of professional job,” “tendency to leave the job,” “clinical incompetency of graduates,” “the conflict between graduates and nursing staff expectations,” and “dissatisfaction of graduates.” Conclusions: Some changes are needed in NICU master's curriculum by considering the nursing experts' comments and evaluating the consequences of such program by them. PMID:29628958
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Achury Saldaña, Diana Marcela; Pinilla Alarcón, Maribel; Alvarado Romero, Herly
2015-01-01
To describe aspects facilitating or interfering in the communication process between nursing professionals and patients in critical state. Descriptive study conducted during the second semester of 2013, with the participation of 112 nurses who work in Intensive Care Units of Bogotá (Colombia). To gather the information, the researchers designed a survey. A total of 91.6% of the nursing professionals considers communication important with patients and their families; 75.9% seeks to provide, during the care interventions, physical care and communicate per shift from two to four times with the patient and from one to two times with the family; 50% states feeling afraid to communicate; only 53.7% integrate their emotions in the patient's physical care. Regarding the elements of communication developed during their graduate formation, 42.8% received tools of therapeutic communication during their undergraduate studies and only 33.0% during graduate studies. It is worth to indicate that 80.36% of the Intensive Care Units, where the nursing professionals work, privilege interventions aimed at satisfying physiological needs. The communication process between nurses and patients in critical state is limited by restrictive institutional policies and by the nurse' scarce academic formation. The need exists to start a process of change in relation to models of professional practice deeply rooted in physical care of critical patients to establish models that, during physical care, are centered on communication and the patient-family-professional relationship.
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Governance of professional nursing practice in a hospital setting: a mixed methods study.
dos Santos, José Luís Guedes; Erdmann, Alacoque Lorenzini
2015-01-01
To elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. 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. 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. 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.
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The Level of Professionalism of Nurses Working in a Hospital in Turkey.
Dikmen, Yurdanur; Karataş, Hülya; Arslan, Gülşah Gürol; Ak, Bedriye
2016-01-01
Professionalism is characterized by the degree of dedication displayed by individuals regarding the values and behavioral attributes of a specific career identity. Professionalism indicates attitudes that represent high levels of identification with and commitment to a specific profession. In the process of the professional development of nursing, various factors affect these obstacles which may impede the professional development of nurses and their professional behaviors. This study was carried out with the aim of determining the professional behavior of nurses in a hospital in Turkey. In this descriptive exploratory study a total of 89 nurses working in a public hospital in northwestern of Turkey were participated. Data were collected using a demographic questionnaire and Behavioral Inventory Form for Professionalism in Nursing (BIPN). The result showed that mean scores on the BIPN were 5.07 (3.47). The areas with the highest levels of professional behavior were competence and continuing education 1.88 (0.34). The professionalism levels for nurses were the lowest in the areas of autonomy 0.06 (0.34), publication 0.10 (0.25), and research 0.25 (0.60). There was a statistically significant difference between the total BIPN scores and the education levels of the nurses and the working of nurses. The professional behavior of nurses is at a low level. Since the arrangement of the nurses' working conditions affects their professional behaviors; therefore, development in the field of professional behaviors in nursing must be assessed and supported to increase the quality of patient care.
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Diers, D
1999-01-01
The American Nurses' Association did not embrace the introduction of diagnosis related groups, believing they would not recognise nursing activity nor acuity and would bring about the economic demise of nursing. Australian nurses, by contrast, recognised the window of opportunity that the work towards Australian national diagnosis related groups and funding mechanisms provided to move nursing resources into the political and policy mainstream. This paper reviews the American and Australian nursing experience with casemix, acuity and cost weighting. It uses examples from more recent work to argue for the use of casemix information in new ways, for 'process improvement' or 'evidence-based management'. The paper concludes that the next great leap forward in casemix may require attention to building the information and human infrastructures, so that the valuable clinical-financial information produced by casemix-based information systems can truly inform management and policy.
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Quality improvement: the nurse's role.
Moran, M J; Johnson, J E
1992-06-01
Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment. The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts. Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.
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Bernhart-Just, Alexandra; Hillewerth, Kathrin; Holzer-Pruss, Christina; Paprotny, Monika; Zimmermann Heinrich, Heidi
2009-12-01
The data model developed on behalf of the Nursing Service Commission of the Canton of Zurich (Pflegedienstkommission des Kantons Zürich) is based on the NANDA nursing diagnoses, the Nursing Outcome Classification, and the Nursing Intervention Classification (NNN Classifications). It also includes integrated functions for cost-centered accounting, service recording, and the Swiss Nursing Minimum Data Set. The data model uses the NNN classifications to map a possible form of the nursing process in the electronic patient health record, where the nurse can choose nursing diagnoses, outcomes, and interventions relevant to the patient situation. The nurses' choice is guided both by the different classifications and their linkages, and the use of specific text components pre-defined for each classification and accessible through the respective linkages. This article describes the developed data model and illustrates its clinical application in a specific patient's situation. Preparatory work required for the implementation of NNN classifications in practical nursing such as content filtering and the creation of linkages between the NNN classifications are described. Against the background of documentation of the nursing process based on the DAPEP(1) data model, possible changes and requirements are deduced. The article provides a contribution to the discussion of a change in documentation of the nursing process by implementing nursing classifications in electronic patient records.
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Development of a group work assessment pedagogy using constructive alignment theory.
Croy, Suzanne R
2018-02-01
The purpose of this paper is to explore group work assessment underpinned by constructive alignment theory to develop a new assessment pedagogy. A review was undertaken of an existing module 'Mental Health Nursing 1', with student nurses participating in the BSc (Hons) Nursing Programme. Constructive alignment theory requires teachers to adopt a deep approach to learning where module learning outcomes are aligned with the teaching environment and modes of assessment. As the module progressed, reviewing the Mental Health Nursing 1 module became an excellent opportunity to begin to understand how constructive alignment theory can inform a group work assessment pedagogy. Working using a constructively aligned assessment process became a valuable learning experience for the module leader whilst at the same time revealed a gap in the research around the impact of constructively aligned teaching and group work assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Transforming Care at the Bedside (TCAB): enhancing direct care and value-added care.
Dearmon, Valorie; Roussel, Linda; Buckner, Ellen B; Mulekar, Madhuri; Pomrenke, Becky; Salas, Sheri; Mosley, Aimee; Brown, Stephanie; Brown, Ann
2013-05-01
The purpose of this study was to examine the effectiveness of a Transforming Care at the Bedside initiative from a unit perspective. Improving patient outcomes and nurses' work environments are the goals of Transforming Care at the Bedside. Transforming Care at the Bedside creates programs of change originating at the point of care and directly promoting engagement of nurses to transform work processes and quality of care on medical-surgical units. This descriptive comparative study draws on multiple data sources from two nursing units: a Transforming Care at the Bedside unit where staff tested, adopted and implemented improvement ideas, and a control unit where staff continued traditional practices. Change theory provided the framework for the study. Direct care and value-added care increased on Transforming Care at the Bedside unit compared with the control unit. Transforming Care at the Bedside unit decreased in incidental overtime. Nurses reported that the process challenged old ways of thinking and increased nursing innovations. Hourly rounding, bedside reporting and the use of pain boards were seen as positive innovations. Evidence supported the value-added dimension of the Transforming Care at the Bedside process at the unit level. Nurses recognized the significance of their input into processes of change. Transformational leadership and frontline projects provide a vehicle for innovation through application of human capital. © 2012 Blackwell Publishing Ltd.
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de Medeiros, Ana Lúcia; dos Santos, Sérgio Ribeiro; de Cabral, Rômulo Wanderley Lima
2012-09-01
This study was aimed at understanding, from the nurses' perspective, the experience of going through the Systematization of nursing care (SNC) in an obstetric service unit. We used grounded theory as the theoretical and methodological framework. The subjects of this study consisted of thirteen nurses from a public hospital in the city of João Pessoa, in the state of Paraíba. The data analysis resulted in the following phenomenon. "perceiving SNC as a working method that organizes, directs and improves the quality of care by bringing visibility and providing security for the nursing staff" The nurses expressed the extent of knowledge about the SNC experienced in obstetrics as well as considered the nursing process as a decision-making process, which guides the reasoning of nurses in the planning of nursing care in obstetrics. It was concluded that nurses perceive the SNC as an instrument of theoretical-practical articulation leading to personalized assistance.
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The art and science of political advocacy.
Kosiorowski, Donna
2014-01-01
School nurses throughout the nation, individually and collectively, work to bring about change for the school nursing profession and to safeguard the health of children and the public. School nurses practice amidst education reform, health care reform, changes in society, and medical and technological advancements. School nurses must be active in decisions that affect their daily practice by involvement in the local, state, and federal political process. School nurses must craft the art and develop the science of political advocacy.
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Student Triads: A Collaborative Approach to Practicum Experiences for Master's Nursing Students.
Goodwin, Miki; Jenkins-Weinrub, Edith
2015-01-01
This article presents an approach for a collaborative practicum experience for master's degree nursing students. The students were placed into triads and then assigned as a group to work in a large health care organization. A triad consisted of 1 student from each concentration of study: nursing administration, nursing education, or nursing informatics, and the group was immersed in real-time problem-solving and decision-making processes over the course of the year.
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Van Bogaert, Peter; Peremans, Lieve; Diltour, Nadine; Van heusden, Danny; Dilles, Tinne; Van Rompaey, Bart; Havens, Donna Sullivan
2016-01-01
The aim of the study reported in this article was to investigate staff nurses’ perceptions and experiences about structural empowerment and perceptions regarding the extent to which structural empowerment supports safe quality patient care. To address the complex needs of patients, staff nurse involvement in clinical and organizational decision-making processes within interdisciplinary care settings is crucial. A qualitative study was conducted using individual semi-structured interviews of 11 staff nurses assigned to medical or surgical units in a 600-bed university hospital in Belgium. During the study period, the hospital was going through an organizational transformation process to move from a classic hierarchical and departmental organizational structure to one that was flat and interdisciplinary. Staff nurses reported experiencing structural empowerment and they were willing to be involved in decision-making processes primarily about patient care within the context of their practice unit. However, participants were not always fully aware of the challenges and the effect of empowerment on their daily practice, the quality of care and patient safety. Ongoing hospital change initiatives supported staff nurses’ involvement in decision-making processes for certain matters but for some decisions, a classic hierarchical and departmental process still remained. Nurses perceived relatively high work demands and at times viewed empowerment as presenting additional. Staff nurses recognized the opportunities structural empowerment provided within their daily practice. Nurse managers and unit climate were seen as crucial for success while lack of time and perceived work demands were viewed as barriers to empowerment. PMID:27035457
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ERIC Educational Resources Information Center
Argüelles, Carlos
2016-01-01
This article describes a strategy to integrate information literacy into the curriculum of a nursing program in a community college. The model is articulated in four explained phases: preparatory, planning, implementation, and evaluation. It describes a collaborative process encouraging librarians to work with nursing faculty, driving students to…
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Betz, Cecily L; Cowell, Julia Muennich; Faulkner, Melissa Spezia; Feeg, Veronica D; Greenberg, Cindy Smith; Krajicek, Marilyn J; Lipman, Terri H; Lobo, Marie L; Nehring, Wendy M; Craft-Rosenberg, Martha; Vessey, Judith A
2016-01-01
This article details the process used to develop the revision of the original Guidelines that resulted in the development of the 2014 Health Care Quality and Outcomes Guidelines for Nursing of Children, Adolescents, and Families. Members of the 2014 Guidelines Revision Task Force conducted an extensive process of revision, which included the input and approval of 16 pediatric and child health nursing and affiliated organizational endorsements. The revised Guidelines were presented to and endorsed by the American Academy of Nursing Board. These Guidelines are designed for use by pediatric and child health nurses who work in a range of health care and community-based settings. The Guidelines are proposed to be used as a framework for nurse-directed services and intervention development and testing, as a model for undergraduate and graduate pediatric and child health nursing program curriculum development, and as the theoretical basis for nursing investigations on the care of children, adolescents, and families. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
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Real, Kevin; Bardach, Shoshana H; Bardach, David R
2017-12-01
Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.
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Emotionally intelligent nurse leadership: a literature review study.
Akerjordet, Kristin; Severinsson, Elisabeth
2008-07-01
To establish a synthesis of the literature on the theoretical and empirical basis of emotional intelligence and it's linkage to nurse leadership, focusing on subjective well-being and professional development. Emotional intelligence has been acknowledged in the literature as supporting nurse leadership that fosters a healthy work environment, creating inspiring relationships based on mutual trust. Nurse leaders who exhibit characteristics of emotional intelligence enhance organizational, staff and patient outcomes. A literature search was undertaken using international data bases covering the period January 1997 to December 2007. Eighteen articles were included in this integrative review and were thoroughly reviewed by both authors. Emotional intelligence was associated with positive empowerment processes as well as positive organizational outcomes. Emotionally intelligent nurse leadership characterized by self-awareness and supervisory skills highlights positive empowerment processes, creating a favourable work climate characterized by resilience, innovation and change. Emotional intelligence cannot be considered a general panacea, but it may offer new ways of thinking and being for nurse leaders, as it takes the intelligence of feelings more seriously by continually reflecting, evaluating and improving leadership and supervisory skills.
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Introduction to the Management Process (NS 222): Competency-Based Course Syllabus.
ERIC Educational Resources Information Center
Brady, Marilyn H.
"Introduction to the Management Process" (NS 222) is an associate degree nursing course offered at Chattanooga State Technical Community College to introduce students to basic management concepts, methods of nursing care delivery, patient classification systems, and methods of enacting change and working as a change agent. Upon completion of the…
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Child and adolescent mental health nursing seen through a social constructionist lens.
Rasmussen, Philippa; Muir-Cochrane, Eimear; Henderson, Ann
2015-11-01
To discuss the theoretical framework of social constructivism and justify it s appropriateness for and compatibility with an interpretive approach to child adolescent mental health (CAMH) nursing research. Recent changes to national nursing legislation in Australia have resulted in the removal of the separate register with regulatory authorities that existed for the specialty of mental health nursing. Aspects of mental health nursing age are not easily defined, with some being tacit. CAMH nursing is a sub-specialty area of mental health in which the role and function of these nurses is also not overtly understood. An interpretive research study was designed to develop a deeper understanding of the role and work of CAMH nurses when working in an inpatient setting. REVEW METHODS: An interpretive enquiry methodology was used fro the study, with three sequential stages of data collection: document analysis, focus group interviews and semi-structured individual interviews. Social constructionism was the chosen theoretical framework for this study as it provided a useful lens for interpreting and understanding the work of the CAMH nurse. The social constructionist lens was simpatico with mental health nursing, as they both involved making meaning of or assessing information and understanding of social processes and interactions. IMPLICATIONS FOR REEARCH/PRACTICE: A useful lens for further research into mental health nursing practice.
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Ethical decision-making in hospice care.
Walker, Andreas; Breitsameter, Christof
2015-05-01
Hospices are based on a holistic approach which places the physical, psychological, social and spiritual welfare of their patients at the forefront of their work. Furthermore, they draw up their own mission statements which they are at pains to follow and seek to conduct their work in accordance with codes of ethics and standards of care. Our study researched what form the processes and degrees of latitude in decision-making take in practice when questions of an ethical and ethically relevant nature arise. We used a qualitative approach. Data collection and evaluation was based on the methods of grounded theory. The study was reported to the relevant Ethics Commission who had raised no objections following the submission of the study protocol. The study at the hospices was approved by the directors of the hospices and the nursing teams. The rights of the participants were protected by obtaining informed consent. Medication in the prefinal phase and questions affecting the provision of solids and liquids in the end-of-life phase have an ethical dimension. In the context of these two fields, decisions are taken collectively. A nurse's individual (and ethically relevant) leeway in decision-making processes is restricted to the nurse's own style of administering care. The nurse's decision-making often depends to a far greater degree on her ability to adapt her concept of ideal care to fit the practical realities of her work than to any conceptual framework. An adaptive process is necessary for the nurse because she is required to incorporate the four pillars of hospice care - namely, physical, psychological, social and spiritual care - into the practice of her daily work. Ethically relevant decisions are often characterised by nurses adjusting their aspiration levels to the practical conditions with which they are confronted. © The Author(s) 2014.
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Understanding Race and Racism in Nursing: Insights from Aboriginal Nurses
Vukic, Adele; Jesty, Charlotte; Mathews, Sr. Veronica; Etowa, Josephine
2012-01-01
Purpose. Indigenous Peoples are underrepresented in the health professions. This paper examines indigenous identity and the quality and nature of nursing work-life. The knowledge generated should enhance strategies to increase representation of indigenous peoples in nursing to reduce health inequities. Design. Community-based participatory research employing Grounded Theory as the method was the design for this study. Theoretical sampling and constant comparison guided the data collection and analysis, and a number of validation strategies including member checks were employed to ensure rigor of the research process. Sample. Twenty-two Aboriginal nurses in Atlantic Canada. Findings. Six major themes emerged from the study: Cultural Context of Work-life, Becoming a Nurse, Navigating Nursing, Race Racism and Nursing, Socio-Political Context of Aboriginal Nursing, and Way Forward. Race and racism in nursing and related subthemes are the focus of this paper. Implications. The experiences of Aboriginal nurses as described in this paper illuminate the need to understand the interplay of race and racism in the health care system. Our paper concludes with Aboriginal nurses' suggestions for systemic change at various levels. PMID:22778991
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Addor, Véronique; Jeannin, André; Morin, Diane; Lehmann, Philippe; Jeanneret, Floriane Roulet; Schwendimann, René
2015-03-26
Nursing workforce data are scarce in Switzerland, with no active national registry of nurses. The worldwide nursing shortage is also affecting Switzerland, so that evidence-based results of the nurses at work project on career paths and retention are needed as part of the health care system stewardship; nurses at work is a retrospective cohort study of nurses who graduated in Swiss nursing schools in the last 30 years. Results of the pilot study are presented here (process and feasibility). The objectives are (1) to determine the size and structure of the potential target population by approaching two test-cohorts of nursing graduates (1988 and 1998); (2) to test methods of identifying and reaching them 14 and 24 years after graduation; (3) to compute participation rates, and identify recruitment and participation biases. Graduates' names were retrieved from 26 Swiss nursing schools: 488 nurses from the 1988 cohort and 597 from 1998 were invited to complete a web-based questionnaire. Initial updated addresses (n = 278, seed sample) were found using the Swiss Nursing Association member file. In addition, a snowball method was applied for recruitment, where directly-contacted respondents provided additional names of graduate mates or sent them the invitation. The study was further advertized through the main employers, study partners, and a press release. Participation rate was 26.5% (n = 287), higher for the older cohort of 1988 (29.7%, n = 145) than for 1998 (15.6%, n = 93). Additional nurses (n = 363) not belonging to the test cohorts also answered. All schools were represented among respondents. Only 18 respondents (6%) worked outside nursing or not at all. Among respondents, 94% would 'probably' or 'maybe' agree to participate in the main study. The pilot study demonstrated that targeted nurses could be identified and approached. There is an overwhelming interest in the project from them and from policymakers. Recommendations to increase nurses' participation rate for nurses at work include: (1) to open nurses at work recruitment to all nurses in Switzerland, while recreating cohorts post-hoc for relevant analysis; (2) to define a comprehensive communication strategy with special attention to graduate nurses who are harder to reach.
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[Work reality and the construction process of the nurse's identity].
Netto, Laura Filomena Santos de Araújo; Ramos, Flávia Regina Souza
2002-01-01
This study tries to understand the relation between the reality of the nurse's everyday work and the construction process of this identity, using Agnes Heller's sociological theory of everyday life as the main reference. The possibilities of the worker's expression and fulfillment occur through objective and subjective elements of job reality which comes upon the worker as people who put order and tension in their everyday job; these job determinants imprint and produce impacts, giving sense to the work quality and constructing concrete possibilities to the worker to manifest him/herself as Whole being, guiding the construction of his/her identity.
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Ellis, Julie M; Rawson, Helen
2015-07-01
This article presents findings from a study that explored nurses' and personal care assistants' role in improving the relocation of older people into a nursing home. Suggestions for improving the relocation process for older people moving into a nursing home have been the outcomes of studies that have interviewed residents and their families. However, the views of nurses and personal care assistants working in nursing homes have not been previously explored. An exploratory, descriptive qualitative research design. Individual interviews were conducted with 20 care staff (seven registered nurses, five enrolled nurses and eight personal care assistants) employed at four nursing homes. Using thematic analysis, two key themes were identified: 'What it's like for them' - highlighted staffs' awareness of the advantages, disadvantages and meaning of relocation, and focused on staffing and nursing care; other services provided and the environment. The second theme - 'We can make it better', revealed suggestions for improving the relocation process, and included spending time with new residents and the importance of a person-centred approach to care. Care staff have an important role in improving the relocation process of older people into a nursing home, as well as contributing to the discussion on this important clinical topic. Challenging care staff to acknowledge the importance of their role in helping older people settle into a nursing home is a key requirement of nursing practice in aged care. Nursing practice guidelines, with a focus on person-centred care, on how to manage the relocation process for an older person and their family are required for this aspect of nursing home care. Education of staff on relocation policies and procedures is essential to ensure that residents and their families are supported through this process. © 2015 John Wiley & Sons Ltd.
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Social challenges when implementing information systems in everyday work in a nursing context.
Nilsson, Lina; Eriksén, Sara; Borg, Christel
2014-09-01
Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses' solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.
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Cortese, Claudio G; Colombo, Lara; Ghislieri, Chiara
2010-01-01
The aim of the present study was to develop a research model explaining the causal relationship between certain antecedents (job and emotional charge, supportive management and colleagues), work-family conflict (WFC) and job satisfaction. Many research projects in health organizations have highlighted the link between high WFC and lower levels of job satisfaction. The study of these variables is important in understanding the processes of professional nurse retention. The survey was conducted using a questionnaire administered to 351 professional nurses working in a major North Italian hospital. The questionnaire measures six variables: WFC, job satisfaction, job demand, emotional charge, supportive management and supportive colleagues. The data confirmed the connection between WFC and job satisfaction, and showed the importance of some WFC predictors, such as supportive management, emotional charge and job demand, not only for their connections with WFC but also for their direct associations with job satisfaction. WFC, in health organizations, can contribute to a decrease of nurses' job satisfaction. Nursing management could achieve its aim of reducing WFC through the improvement of support from nurse coordinators, the specific organization of work models, ad hoc family-friendly policies and individual counselling programmes for nurses.
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Müller-Staub, Maria; Stuker-Studer, Ursula
2006-10-01
Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).
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Duncan, Susan M; Thorne, Sally; Van Neste-Kenny, Jocelyne; Tate, Betty
2012-05-01
Academic nursing leaders play a crucial role in the policy context for nursing education. Effectiveness in this role requires that they work together in presenting nursing education issues from a position of strength, informed by a critical analysis of policy pertaining to the delivery of quality nursing education and scholarship. We describe a collective process of dialog and critical analysis whereby nurse leaders in one Canadian province addressed pressing policy issues facing governments, nursing programs, faculty, and students. Consensus among academic nurse leaders, formalized through the development of a policy action framework, has enabled us to take a stand, at times highly contested, in the politicized arena of the nursing shortage. We present the components of a policy action framework for nursing education and share examples of how we have used a critical approach to analyze and frame policy issues in nursing education for inclusion on policy agendas. We believe our work has influenced provincial and national thinking about policy in nursing education is the foundation of our conclusion that political presence and shared strategy among academic nursing leaders is undeniably critical in the global context of nursing today. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
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Using continuous process improvement methodology to standardize nursing handoff communication.
Klee, Kristi; Latta, Linda; Davis-Kirsch, Sallie; Pecchia, Maria
2012-04-01
The purpose of this article was to describe the use of continuous performance improvement (CPI) methodology to standardize nurse shift-to-shift handoff communication. The goals of the process were to standardize the content and process of shift handoff, improve patient safety, increase patient and family involvement in the handoff process, and decrease end-of-shift overtime. This article will describe process changes made over a 4-year period as result of application of the plan-do-check-act procedure, which is an integral part of the CPI methodology, and discuss further work needed to continue to refine this critical nursing care process. Copyright © 2012 Elsevier Inc. All rights reserved.
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Changes Resulting from Reflection Dialogues on Nursing Practice
Okuda, Reiko; Fukada, Mika
2014-01-01
Background Reflection is defined here as a process by which, through self-conversation, one’s self and one’s behavior acquire meaning. However, people have limitations in terms of what they can express and be aware of during reflection. This finding points to the importance of facilitators. The purpose of this study was to determine what changes can be brought about through reflection dialogues on nursing practice. Methods The Participants were 9 nurses who worked at three institutions in City A, each with about 200 beds. Workplace topics were examined through self-reflections and reflection dialogues. The depth of reflection was assessed using the three levels of reflection described by Mezirow—{reflecting on the content}, {reflecting on the process} and {reflecting on the assumptions}. Results In reflecting on nursing practice, the participants were also divided into those who had already reached the highest level, {reflecting on assumptions}, via self-reflection, and those who remained at the level of {reflecting on processes}, despite the use of reflection dialogues. Conclusion The development of reflective thinking on nursing practice was connected not only to the participants’ desire to explore ways of accepting their individual experiences, but may also be connected to whether or not they are able to question themselves about their thoughts and preconceptions about nursing work. PMID:25067874
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The Nursing Diagnosis Disturbed Thought Processes: An Integrative Review.
Escalada-Hermández, Paula; Marín-Fernández, Blanca
2017-09-08
To analyze and synthetize the existing scientific literature in relation to the nursing diagnosis disturbed thought processes (DTPs) (00130). An integrative review was developed, identifying relevant papers through a search of international and Spanish databases and the examination of key manuals. Theoretical papers propose modifications for the nursing diagnosis DTPs. Most of the research papers offer data about its frequency in different clinical settings. There exists an interest in the nursing diagnosis DTPs. However, the available evidence is not very extensive and further work is necessary in order to refine this nursing diagnosis. The re-inclusion of DTPs in the NANDA-I classification will specially contribute to increment its utility in mental healthcare. © 2017 NANDA International, Inc.
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Scott, Linda D; Hwang, Wei-Ting; Rogers, Ann E
2006-02-01
This study describes fatigue and stress among a random sample of full-time hospital staff nurses (n=393) who provide care for aging family members, compares the results to nurses with and without children younger than 18 years living at home, examines differences in sleep duration, and explores the effects on work performance by care giving status during a 4-week period. Little attention has been given to the effects of care giver well-being when individuals assume dual roles as family and professional care givers. Hospital staff nurses recorded daily information concerning their work hours, errors, sleep/wake patterns, perceptions of fatigue, alertness, and stress and periods of drowsiness and sleep episodes while on duty for 28 days. Fatigue and stress levels were significantly higher among nurses caring for both children and elders. However, nurses providing elder care at home were more fatigued, sleep-deprived, and likely to make errors at work. These findings underscore the importance of restorative sleep interventions and fatigue countermeasures for hospital staff nurses involved in dual care giving roles. Limiting overtime and applying circadian principles to hospital scheduling processes would ensure a more alert workforce, minimize health risks for nurses, and maximize the safety of those in their care.
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Developing a social media platform for nurses.
Jackson, Jennifer; Kennedy, Maggie
2015-11-18
Social media tools provide opportunities for nurses to connect with colleagues and patients and to advance personally and professionally. This article describes the process of developing an innovative social media platform at a large, multi-centre teaching hospital, The Ottawa Hospital, Canada, and its benefits for nurses. The platform, TOH Nurses, was developed using a nursing process approach, involving assessment, planning, implementation and evaluation. The aim of this initiative was to address the barriers to communication inherent in the large number of nurses employed by the organisation, the physical size of the multi-centre hospital and the shift-work nature of nursing. The platform was used to provide educational materials for clinical nurses, and to share information about professional practice. The implications of using a social media platform in a healthcare setting were considered carefully during its development and implementation, including concerns regarding privacy and confidentiality.
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Nurse-client interactions in community-based practice: creating common ground.
Kristjanson, L; Chalmers, K
1990-12-01
Although research activity is increasingly aimed at examining health outcomes of community health nursing care, little empirical literature systematically describes the nurse-client interaction. In this pilot study nurse-client interactions were evaluated to describe their detailed elements. Nineteen such interactions occurring in a Canadian public health department were videotaped by a professional filming crew. The clinical situations included home visits, school health interviews and screening, health classes, and clinic work. The audio portion of the nurse-client exchanges were transcribed from the videotapes onto a computer and analyzed using content analysis. Semi-structured interviews were conducted with nurses and clients after the filming to elicit their perceptions of the interactions. Field notes describing nonverbal and contextual data were also collected and analyzed. The central process identified during the interactions was called "creating common ground." This integrating conceptual schema captured the give and take as each participant defined territory and revealed information. The process varied depending on care context, process skills of the nurse, and willingness of the client to engage.
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Crossover of exhaustion between dentists and dental nurses.
Hakanen, Jari J; Perhoniemi, Riku; Bakker, Arnold B
2014-04-01
The aim of this study was to investigate the conditions under which job-related exhaustion may transmit (cross over) from dentists to dental nurses and vice versa. We conducted a cross-sectional survey study among 470 Finnish dentist-dental nurse dyads and used moderated structural equation modelling analyses. We found no support for the direct crossover of exhaustion from one work partner to the other. Instead, we found that exhaustion transferred from dentists to dental nurses only when collaboration was frequent and dental nurses perceived the collaboration as friendly or consisting of mutual feedback. In contrast, dentists were not affected by dental nurses' exhaustion. These results indicate that exhaustion can be contagious in work dyads and may be fuelled by positive and frequent interpersonal relationships when the partner who is higher in the hierarchy has high (versus low) levels of exhaustion. Thus, interpersonal and hierarchical relationships among work partners may play an important role in the crossover process. Limitations and implications are mentioned. © 2013 John Wiley & Sons, Ltd.
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Jormfeldt, Henrika; Svedberg, Petra; Fridlund, Bengt; Arvidsson, Barbro
2007-02-01
A new understanding of the concept of health is needed to meet the goal of mental health nursing, which besides reducing disease is to strengthen the patient's health. The aim of the present study was to describe perceptions of the concept of health among nurses working in mental health services. Twelve Swedish nurses working in mental health services were interviewed and data were analysed with a phenomenographic approach. The nurses expressed 10 perceptions, which constituted three description categories: autonomy, process, and participation. The result showed that health was more than absence of disease. Simultaneously, perceptions were expressed indicating that health was viewed as absence of disease, which implies that the concept is not sufficiently defined. The result emphasizes the need to clarify the concept of health if it is to be used as a goal in mental health nursing and to integrate a clarified definition of health at all hierarchical levels in mental health care services.
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Taxonomy development and knowledge representation of nurses' personal cognitive artifacts.
McLane, Sharon; Turley, James P
2009-11-14
Nurses prepare knowledge representations, or summaries of patient clinical data, each shift. These knowledge representations serve multiple purposes, including support of working memory, workload organization and prioritization, critical thinking, and reflection. This summary is integral to internal knowledge representations, working memory, and decision-making. Study of this nurse knowledge representation resulted in development of a taxonomy of knowledge representations necessary to nursing practice.This paper describes the methods used to elicit the knowledge representations and structures necessary for the work of clinical nurses, described the development of a taxonomy of this knowledge representation, and discusses translation of this methodology to the cognitive artifacts of other disciplines. Understanding the development and purpose of practitioner's knowledge representations provides important direction to informaticists seeking to create information technology alternatives. The outcome of this paper is to suggest a process template for transition of cognitive artifacts to an information system.
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McAllister, Margaret; Davis, Susan; Brien, Donna Lee; Rogers, Irene; Flanagan, Wendy; Howie, Virginia; Dargusch, Jo
2016-12-01
There is a large body of work that documents the history of the nursing profession and the experiences of nurses during significant historical eras such as the First World War. Yet learning about nursing history is commonly a tiny, or absent, component in the undergraduate nursing curriculum. This paper discusses an innovative project that had multiple aims. A primary aim was to engage nursing students and educators in a project that valued nursing history by integrating it into an event to celebrate International Nurses Day. As the paper will explain, other aims were in organising the event so that it capitalised on particular creative arts strengths within the faculty, offering cross-disciplinary connections, engagement and appreciation. A Readers' Theatre event, involving academics and students in nursing, creative arts and education, was conceived, developed and performed for the community. The theme was the experiences of First World War nurses and how they encapsulated values important to nursing today - the 6 Cs - which guide high standards of nursing. The 6 Cs are care, compassion, competence, communication, courage and commitment. We called the Readers' Theatre "The Courage to Care", and this involved a 4month process of script development, event planning and a performance. This process and outcomes were evaluated, prompting a reflection on the strengths and challenges of working in this creative way to engage a wide group of stakeholders to advance the profession of nursing. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Souza, Emilia Jales Simões de; Moreira, Lilian Hortale de Oliveira; Cardoso, Maria Manuela Vila Nova; Ferreira, Rosa Gomes dos Santos; Silva, Thuany Cristine Santos da
2014-09-01
This is an exploratory and descriptive study of a qualitative nature. Its objective is to analyse the formation of strategies for social reintegration of the psychic suffering carrier in the practice of nurses working in hospital psychiatric institutions. For this study, we use, as a basis, the concepts and processes of the formation of strategies presented by Isabel Nicholau, 2001. Twelve nurses with health care experience in hospital psychiatric institutions participated in this study, and data collection occurred through semi-structured interviews in the year 2013. The data revealed that, in addition to human, material, and financial resources, institutional support is needed as is articulation and interaction among professionals and services. The importance of the social dimension and of the negotiation process depicts the development of conception of collective and integrated work. We conclude that strategies are emerging from the daily life of work and are not limited to a rational logic of cost and fundraising, but instead are developed through a negotiated process.
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Mackintosh, Carolyn
2007-08-01
This paper aims to explore and describe how qualified nurses working with in, in-patient surgical areas cope with the daily experiences they are exposed to. It has long been recognised that many aspects of nursing work can result in high levels of stress, with negative consequences for the individual nurse and patient care. Difficulties in coping with nursing work can also result in burnout, as well as raising concerns about cognitive dissonance, emotional labour and the use of emotional barriers. Why some nurses are more prone to experience these phenomena than others, is unclear. A descriptive qualitative approach is taken using a purposive, theoretically congruent sample of 16 qualified registered nurses all of whom participated in a semi-structured interview during 2002. All interviews were tape recorded and transcribed verbatim and then analysed using the four stages outlined by Morse and Field [Morse, J.M., Field, P.A., 1996. Nursing Research: The Application of Qualitative Approaches. Chapman & Hall, London]. Three key themes emerged from analysis; relationships with patients, being a person and the effect of experience. All three interlink to describe a process whereby the individual switches off from the environment around them by adopting a working persona which is different but related to their own personal persona and is beneficially enhanced as a consequence of experience. Working as a nurse results in exposure to potentially distressing and stressful events from which it is important to protect the self. Participants in this study achieve protection by the development of a working persona which facilitates switching off and is beneficially enhanced by experience.
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[Emotion and the nurse-patient relationship].
Chiang, Hsien-Hsien
2008-02-01
The purpose of this study was to examine how emotion affects the nurse-patient relationship. The discussion is derived from a qualitative research study that examined the nurse-patient relationship in humanistic care by observing courses of introduction to nursing and nursing ethics. First, the meaning of the caring relationship is addressed. Secondly, the relationship between empathy and self transcendence is examined. Finally, the nurse's emotion as a tool for healing the other is illustrated. Thoughtful work discussions also seem to identify nurses' awareness of their own emotion as not only promoting self transcendence, but also promoting the healing process.
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Ding, Bao-Fen; Chang, Polun; Wang, Ping; Li, Hai-Ting; Kuo, Ming-Chuan
2017-01-01
With an in-depth analysis of nursing work in 14 hospitals over a period of two years, one unique total nursing information system framework was established where the nursing clinical pathways are used as the main frame and the nursing orders as the nodes on the frame. We used the nursing order concept with the principles of nursing process. A closed-loop management model composed of the nursing orders was set up to solve nursing problems. Based on the principles of traditional Chinese medicine, we further designed an intelligent support module to automatically deduct clinical nursing pathways to promote standardized management and improve the quality of nursing care. The system has successfully been implemented in some facilities since 2015.
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Hooker, Leesa; Small, Rhonda; Taft, Angela
2016-03-01
To investigate factors contributing to the sustained domestic violence screening and support practices of Maternal and Child Health nurses 2 years after a randomized controlled trial. Domestic violence screening by healthcare professionals has been implemented in many primary care settings. Barriers to screening exist and screening rates remain low. Evidence for longer term integration of nurse screening is minimal. Trial outcomes showed sustained safety planning behaviours by intervention group nurses. Process evaluation in 2-year follow-up of a cluster randomized controlled trial. Evaluation included a repeat online nurse survey and 14 interviews (July-September 2013). Survey analysis included comparison of proportionate group difference between arms and between trial baseline and 2 year follow-up surveys. Framework analysis was used to assess qualitative data. Normalization Process Theory informed evaluation design and interpretation of results. Survey response was 77% (n = 123/160). Sustainability of nurse identification of domestic violence appeared to be due to greater nurse discussion and domestic violence disclosure by women, facilitated by use of a maternal health and well-being checklist. Over time, intervention group nurses used the maternal checklist more at specific maternal health visits and found the checklist the most helpful resource assisting their domestic violence work. Nurses' spoke of a degree of 'normalization' to domestic violence screening that will need constant investment to maintain. Sustainable domestic violence screening and support outcomes can be achieved in an environment of comprehensive, nurse designed and theory driven implementation. Continuing training, discussion and monitoring of domestic violence work is needed to retain sustainable practices. © 2015 John Wiley & Sons Ltd.
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Organization of nursing and quality of care for veterans at the end of life.
Kutney-Lee, Ann; Brennan, Caitlin W; Meterko, Mark; Ersek, Mary
2015-03-01
The Veterans Health Administration (VA) has improved the quality of end-of-life (EOL) care over the past several years. Several structural and process variables are associated with better outcomes. Little is known, however, about the relationship between the organization of nursing care and EOL outcomes. To examine the association between the organization of nursing care, including the nurse work environment and nurse staffing levels, and quality of EOL care in VA acute care facilities. Secondary analysis of linked data from the Bereaved Family Survey (BFS), electronic medical record, administrative data, and the VA Nursing Outcomes Database. The sample included 4908 veterans who died in one of 116 VA acute care facilities nationally between October 2010 and September 2011. Unadjusted and adjusted generalized estimating equations were used to examine associations between nursing and BFS outcomes. BFS respondents were 17% more likely to give an excellent overall rating of the quality of EOL care received by the veteran in facilities with better nurse work environments (P ≤ 0.05). The nurse work environment also was a significant predictor of providers listening to concerns and providing desired treatments. Nurse staffing was significantly associated with an excellent overall rating, alerting of the family before death, attention to personal care needs, and the provision of emotional support after the patient's death. Improvement of the nurse work environment and nurse staffing in VA acute care facilities may result in enhanced quality of care received by hospitalized veterans at the EOL. Copyright © 2015 American Academy of Hospice and Palliative Medicine. All rights reserved.
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[Verbal patient information through nurses--a case of stroke patients].
Christmann, Elli; Holle, Regina; Schüssler, Dörte; Beier, Jutta; Dassen, Theo
2004-06-01
The article represents results of a theoretical work in the field of nursing education, with the topic: Verbal Patient Information through Nurses--A Case of Stroke Patients. The literature review and analysis show that there is a shortage in (stroke) patient information generally and a lack of successful concepts and strategies for the verbal (stroke) patient information through nurses in hospitals. The authors have developed a theoretical basis for health information as a nursing intervention and this represents a model of health information as a "communicational teach-and-learn process", which is of general application to all patients. The health information takes place as a separate nursing intervention within a non-public, face-to-face communication situation and in the steps-model of the nursing process. Health information is seen as a learning process for patients and nurses too. We consider learning as information production (constructivism) and information processing (cognitivism). Both processes are influenced by different factors and the illness-situation of patients, personality information content and the environment. For a successful health information output, it is necessary to take care of these aspects and this can be realized through a constructivational understanding of didactics. There is a need for an evaluation study to prove our concept of health information.
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Blackstock, Sheila; Harlos, Karen; Macleod, Martha L P; Hardy, Cindy L
2015-11-01
To examine the impact of organisational factors on bullying among peers (i.e. horizontal) and its effect on turnover intentions among Canadian registered nurses (RNs). Bullying among nurses is an international problem. Few studies have examined factors specific to nursing work environments that may increase exposure to bullying. An Australian model of nurse bullying was tested among Canadian registered nurse coworkers using a web-based survey (n = 103). Three factors - misuse of organisational processes/procedures, organisational tolerance and reward of bullying, and informal organisational alliances - were examined as predictors of horizontal bullying, which in turn was examined as a predictor of turnover intentions. The construct validity of model measures was explored. Informal organisational alliances and misuse of organisational processes/procedures predicted increased horizontal bullying that, in turn, predicted increased turnover intentions. Construct validity of model measures was supported. Negative informal alliances and misuse of organisational processes are antecedents to bullying, which adversely affects employment relationship stability. The results suggest that reforming flawed organisational processes that contribute to registered nurses' bullying experiences may help to reduce chronically high turnover. Nurse leaders and managers need to create workplace processes that foster positive networks, fairness and respect through more transparent and accountable practices. © 2014 John Wiley & Sons Ltd.
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Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René
2015-10-01
To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
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Silva-Costa, Aline; Rotenberg, Lúcia; Griep, Rosane Harter; Fischer, Frida Marina
2011-05-01
This paper is a report of a study on the association between sleep patterns during work nights and recovery from work among nursing workers, considering domestic work hours. Several hospitals allow nursing workers to sleep during the night shift, but this is rarely evaluated from the workers' health perspective. The need for recovery from work concept can be useful for testing the impact of night work on sleep. Recovery is not a problem if workers have enough time to recover between periods of work. Therefore, domestic work would be likely to interfere in the recovery process. This cross-sectional study was carried out at three hospitals in 2005-2006, through a comprehensive questionnaire. All nursing teams engaged in assistance to patients were invited to participate. Analyses included female night workers with no incidence of insomnia. Participants (n = 396) were classified into those who did not sleep during night shifts, those who slept for up to 2 hours and those who slept for 2-3 hours. Binomial logistic regression analysis showed that sleeping on the job for 2-3 hours during night shifts is related to a better recovery from work provided the workers do not undergo long domestic work hours. Being allowed to sleep at work during night shifts seemed to contribute to, but was not enough to guarantee, a good recovery from work in the studied population. Recommendations to deal with sleep-deprivation among night workers should consider the complexity of gender roles on the recovery process. © 2011 Blackwell Publishing Ltd.
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Nursing care of patients during the dying process: a painful professional and human function.
Lopera Betancur, Martha Adiela
2015-01-01
This work sought to describe the care functions of nurses with patients during the dying process. This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. Patient care during dying processes transcends the limits of the nurse' professional functions to become a human obligation.
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Nurse educators and decision making: a female perspective.
Valentine, P E
1992-01-01
Quality of work life issues are major concerns of nurses today. Decision making is one such issue. This article is part of a larger case study of a Canadian hospital school of nursing that asked whether women nurse educators bring unique orientations to the workplace that have relevance for the administration of nursing organizations. The process of decision making, a small part of the larger study, is discussed in this article. The results suggested that women nurse educators used a cooperative, collaborative, highly participatory style of decision making that resulted in decisions based on consensus. The implications this female style of decision making has for nurses and nurse administrators is discussed.
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Nursing care in Tuberculosis patients at a Spanish sanatorium, 1943-19751
Galbany-Estragués, Paola
2014-01-01
Objectives the objective in this study is to identify the profile of the nursing staff, the work conditions and to describe nursing care at a sanatorium located in Barcelona, Spain between 1943 and 1975. Method historical study undertaken between 2008 and 2010, based on oral sources, five direct and one indirect testimonies, and the analysis of written documents. The data from the testimonies were collected through semistructured interviews. Results the nursing staff, mostly religious women, had scarce material and economic resources and no preventive measures to take care of the ill. The nurses undertook activities centered on the basic needs for physical and spiritual wellbeing. Conclusion The study reveals how the nurses, despite working in hostile conditions, attempted to safeguard the wellbeing of the patients and accompany them during the death process. PMID:25029060
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[The nurse's perceptions on administrative actions in their work process].
Vaghetti, Helena; Reis, Daniela; Kerber, Nalú da Costa; Azambuja, Eliana; Fernandes, Geani
2004-01-01
A qualitative, exploratory study carried out from March to December 2002 in a university hospital based in the far south of the country, which aimed at identifying the nurses' perception on the administrative actions exercised in their daily work. Thematic categories emerged from data survey and content analysis in the interviews carried out with 10 nurses. We emphasize Category I: Administrative Actions as a Management Instrument; and Category II: Administrative Actions as Direct/indirect Care. In the first one, administrative actions are perceived as planning, coordination, leadership, control, information retention, and organization; the second one depicts administrative actions as an integral part of nursing care. It has been observed that many administrative actions exercised by nurses are inherent to their role, in keeping with the Nurse's Professional Exercise Code, and they are critical for care.
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A qualitative study of experienced nurses' voluntary turnover: learning from their perspectives.
Hayward, Dana; Bungay, Vicky; Wolff, Angela C; MacDonald, Valerie
2016-05-01
The purpose of this research was to critically examine the factors that contribute to turnover of experienced nurses' including their decision to leave practice settings and seek alternate nursing employment. In this study, we explore experienced nurses' decision-making processes and examine the personal and environmental factors that influenced their decision to leave. Nursing turnover remains a pressing problem for healthcare delivery. Turnover contributes to increased recruitment and orientation cost, reduced quality patient care and the loss of mentorship for new nurses. A qualitative, interpretive descriptive approach was used to guide the study. Interviews were conducted with 12 registered nurses, averaging 16 years in practice. Participants were equally represented from an array of acute care inpatient settings. The sample drew on perspectives from point-of-care nurses and nurses in leadership roles, primarily charge nurses and clinical nurse educators. Nurses' decisions to leave practice were influenced by several interrelated work environment and personal factors: higher patient acuity, increased workload demands, ineffective working relationships among nurses and with physicians, gaps in leadership support and negative impacts on nurses' health and well-being. Ineffective working relationships with other nurses and lack of leadership support led nurses to feel dissatisfied and ill equipped to perform their job. The impact of high stress was evident on the health and emotional well-being of nurses. It is vital that healthcare organisations learn to minimise turnover and retain the wealth of experienced nurses in acute care settings to maintain quality patient care and contain costs. This study highlights the need for healthcare leaders to re-examine how they promote collaborative practice, enhance supportive leadership behaviours, and reduce nurses' workplace stressors to retain the skills and knowledge of experienced nurses at the point-of-care. © 2016 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
McNutt, Jana; Clowers, Pat; Collum, Lara; Canton, Dixie; Comfort, Sherri; Kron, Maxine; Mahaffey, Elizabeth; Hancock, Jane; Waldrup, Sandra; Walker, Sherri; Pearson, Lisa; Miller, Kelly; Cooper, Patti; Bedwell, Susan
2008-01-01
As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…
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'Struggling to be an insider': a phenomenological design of new nurses' transition.
Lee, Huei Ying; Hsu, Min-Tao; Li, Pei-Ling; Sloan, Rebecca S
2013-03-01
To obtain a comprehensive understanding of the transition process of new nurses in Taiwan. Background. The transition period for new nurses can be a daunting and traumatic experience. The large number of newly graduated Taiwanese nurses who resign from their jobs within three months indicates that this process can be complicated. However, the problems associated with the experiences of new nurses have not yet been recognised. We adopted a phenomenological design using focus group interviews. Sixteen new nurses (less than one year working experience) participated in eight weekly group interviews lasting two hours each to grasp their experience of 'being new'. Interview data were analysed according to Sloan's (2002) three moments, and the whole process of analysis followed the suggestions of Agar (1986), which was performed in a close collaboration between researchers until the consensus about the findings could be reached. The overarching pattern of the transition process of new nurses becoming experienced members of the clinical nursing team was revealed as a journey of 'struggling to be an insider'. This phenomenon was characterised by four themes, including (1) 'being new as being weak', (2) 'masking myself', (3) 'internalising the unreasonable' and (4) 'transforming myself to get a position'. While Western culture view abusive indoctrination of new nurses as toxic behaviour, under the Chinese traditions of yield, tolerance and self-oppression, following the power hierarchy and seeking harmony, the transition of new nurses is interpreted differently. Recognition of the journey of 'struggling to be an insider' helps nurse administrators to (1) gain a better understanding of what new nurses encounter in their transition process, (2) help new nurses without harm, (3) improve in-service training programmes and (4) retain future nurses. © 2012 Blackwell Publishing Ltd.
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Al-Hussami, Mahmoud; Hamad, Sawsan; Darawad, Muhammad; Maharmeh, Mahmoud
2017-10-02
Purpose This paper aims to set a leadership guidance program that can promote nurses' knowledge of leadership and, at the same time, to enhance their leadership competencies and quality of work to promote their readiness for change in healthcare organizations. Design/methodology/approach A pre-experimental, one-group pretest-posttest design was utilized. Out of 90 invited to participate in this study, 61 nurses were accepted to participate. Findings The statistical analyses suggested several significant differences between pre- and in-service nurse managers about leadership competencies, quality of work and readiness for change. Yet, findings from the background characteristics were not found to be significant and had no effects on the perceived readiness for change. Research limitations/implications The present study highlights the importance of leadership competencies and quality of work that healthcare policymakers identify for the success of organizational change efforts. Practical implications Healthcare policymakers, including directors of nursing, should focus on applications that increase leadership competencies and overall satisfaction of the nurse managers to support the changes in hospitals and supporting learning organization. Hence, they should establish policies that decrease the possible negative impact of planned change efforts. Originality/value Competent nurse managers enhance their readiness for change, which in turn helps nurses in constructive change processes. A leadership guidance program should be set for nurse managers. This study has important implications for hospital administrators and directors of nursing.
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Engagement of nurses in their profession. Qualitative study on engagement.
García-Sierra, Rosa; Fernández-Castro, Jordi; Martínez-Zaragoza, Fermín
To identify common issues of nurses with high engagement to enable us to develop the construct as it applies to nursing in more depth. Based on the constructivist paradigm and with a phenomenological approach, a qualitative content analysis was conducted using an inductive approach. Participants were nurses working in direct care in different healthcare areas. The sample size was determined by data saturation and 15 participants were interviewed. The units of meaning were grouped into 11 subcategories, and then into 7 categories termed vigour, dedication, reward, autonomy, social support, conciliation and attributes of nurses. Then these categories were grouped into 3 major themes: job characteristics, characteristics of organizations, and individual characteristics. Having high engagement does not mean ignoring the negative aspects of work and organizations. Nurses who maintain high engagement are also affected by the negative aspects, however the assessment of positive aspects such as enjoying the work, the meaning of being a nurse, reward and autonomy enable the process of depletion of engagement to be overcome. In view of the findings, we propose reconceptualising the construct, taking the features of nursing into account. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
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[The work of the intensive care nurse: a study on the social representations structure].
Silva, Iranete Almeida Sousa; da Cruz, Enêde Andrade
2008-09-01
This study aims at characterizing the social representations of the nurse in the intensive care unit (ICU) by identifying the central core and the peripheral system. It was carried out in five ICUs from both public and philanthropic teaching, research and assistance hospitals in Salvador (Bahia, Brazil). Data were gathered from ninety nurses by means of free evocation from the phrase: nurse's work in an ICU and then processed with the EVOC software. Analysis was performed by building a four-digit chart based on the structural approach to the theory of social representations. Results point out stress, responsibility, integral care and gratification as the core elements. The peripheral system comprised personal and professional attitudes deemed necessary to perform the work. Therefore, it could be concluded that stress and responsible work are relieved by the gratifying feeling of providing integral care, which demands a range of personal and professional attitudes.
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The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.
Schoonover, Heather
The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.
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Brazilian nursing history on the shoulders of giants.
Oguisso, T; de Freitas, G F
2015-03-01
This study describes the route followed by nursing in Brazil, through the foundation of nursing organizations and the emergence of nursing leaders and pioneers. To present the origins of modern nursing in Brazil, identifying the main nurse-leaders and analysing their performance for the creation and consolidation of the nursing organizations. It is a historical and social study with descriptive approach, to describe the process of Brazilian nursing professionalization and leadership through a literature review. The oldest nursing organization is the Brazilian Nursing Association that holds scientific and cultural activities. There are also nurses' unions and nursing specialty associations, such as the Brazilian Academy for the History of Nursing, and the Federal Nursing Council. The latter has compulsory membership for controlling nursing services according to the qualifications of the personnel. The very first school for nurses in the Nightingale system was created in São Paulo, 1894, at the Samaritan Hospital, and by the government in 1923, in Rio de Janeiro, for which American nurses, led by Ethel Parsons, sponsored by the Rockefeller Foundation, were essential for the creation of the Anna Nery Nursing School, still in operation within a federal university. Some nurses pioneered these works such as Edith Fraenkel, Maria Rosa Pinheiro, Amalia Carvalho and others. The work done by nursing leaders has brought to the profession a better status and made it more recognized by the society. © 2014 International Council of Nurses.
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Murray, Marry Ellen; Douglas, Stephen; Girdley, Diana; Jarzemsky, Paula
2010-08-01
Practicing nurses are required to engage in quality improvement work as a part of their clinical practice, but few undergraduate nursing education programs offer course work and applied experience in this area. This article presents a description of class content and teaching strategies, assignments, and evaluation strategies designed to achieve the Quality and Safety Education in Nursing competencies related to quality improvement and interdisciplinary teams. Students demonstrate their application of the quality improvement process by designing and implementing a small-scale quality improvement project that they report in storyboard format on a virtual conference Web site.
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A Qualitative Study of the Work Environments of Mexican Nurses
Squires, Allison; Juarez, Adrian
2012-01-01
Background Studies of the nursing work environment are increasingly common in developed countries, but few exist in developing countries. Because of resource differences between the two contexts, researchers need to clarify what aspects of the work environments are similar and different. Objectives To study the perspectives of Mexican nurses about their work environments to determine similarities and differences to results from developed world studies. Design A secondary, directed content analysis of qualitative data from 46 Spanish language interviews using workplace-oriented themes Setting Purposively selected Mexican states from four regions of the country that reflect the country’s socioeconomic differences. Participants Practicing Mexican nurses with at least one year of clinical experience and currently working in nursing. Participants were recruited through convenience and snowball sampling techniques. Methods Initial data collection occurred in 2006 and 2008 during a broader study about professionalization processes that occurred in Mexican nursing between 1980 and 2005. The secondary, directed content analysis focused on an in-depth exploration of a central theme that emerged from the two original studies: The Workplace. The directed content analysis used themes from the global nursing work environment literature to structure the analysis: Professional relationships, organizational administrative practices, and quality of care and services. Results The three themes from the global literature were relevant for the Mexican context and a new one emerged related to hiring practices. By category, the same factors that created positive or negative perceptions of the work environment matched findings from other international studies conducted in developed countries. The descriptors of the category, however, had different conceptual meanings that illustrate the health system challenges in Mexico. Conclusions Findings from this study suggest that studies that seek to measure nursing work environments will most likely apply in Mexico and other Latin American or middle-income countries. Instruments designed to measure the work environment of nurses in these countries may prove relevant in those contexts, but require careful adaptation and systematic translations to ensure it. PMID:22386989
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Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivère, Michel; Rukholm, Ellen; Belanger-Gardner, Diane
2015-12-01
The purpose of this study was to examine the relationship nursing personal and workplace system factors (work disability) and work ability index scores in Ontario, Canada. A total of 111 registered nurses were randomly selected from the total number of registered nurses on staff in the labor, delivery, recovery, and postpartum areas of four northeastern Ontario hospitals. Using a stratified random design approach, 51 participants were randomly selected in four northeastern Ontario cities. A total of 51 (45.9% response rate) online questionnaires were returned and another 60 (54.1% response rate) were completed using the paper format. The obstetric workforce in northeastern Ontario was predominately female (94.6%) with a mean age of 41.9 (standard deviation = 10.2). In the personal systems model, three variables: marital status (p = 0.025), respondent ethnicity (p = 0.026), and mean number of patients per shift (p = 0.049) were significantly contributed to the variance in work ability scores. In the workplace system model, job and career satisfaction (p = 0.026) had a positive influence on work ability scores, while work absenteeism (p = 0.023) demonstrated an inverse relationship with work ability scores. In the combined model, all the predictors were significantly related to work ability scores. Work ability is closely related to job and career satisfaction, and perceived control at work among obstetric nursing. In order to improve work ability, nurses need to work in environments that support them and allow them to be engaged in the decision-making processes.
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N²E: Envisioning a process to support transition from nurse to educator.
McAllister, Margaret; Oprescu, Florin; Jones, Christian
2014-01-01
Rising health inequities, continuing nursing shortages, and overlooked professional development needs of nurse educators are three important issues facing nursing in Australia. This paper argues for an innovative and proactive strategy that could transform the nurse education workforce into one that is repopulated, reinvigorated and refocused. The problem facing nurse educators, and subsequently affecting nurses' preparation for practice and longevity in the profession, was identified by drawing on findings from the literature, extensive educational experience, and an exploratory study of nurse educators working in universities, colleges and health services. A solution has been devised by drawing together the tenets of critical social theory, transformative learning, communities of practice and social media. Nursing educators, refocused around a social justice agenda, may be the remedy that the Australian Health Care System requires to embark on effective action that can benefit everyone, from the health service staff to our most vulnerable groups in society. This refocusing can be achieved in a structured and strategic process that builds confidence and professional capabilities.
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N2E: Envisioning a process to support transition from nurse to educator.
McAllister, Margaret; Oprescu, Florin; Jones, Christian
2013-11-21
Abstract Rising health inequities, continuing nursing shortages, and overlooked professional development needs of nurse educators are three important issues facing nursing in Australia. This paper argues for an innovative and proactive strategy that could transform the nurse education workforce into one that is repopulated, reinvigorated and refocused. The problem facing nurse educators, and subsequently affecting nurses' preparation for practice and longevity in the profession, was identified by drawing on findings from the literature, extensive educational experience, and an exploratory study of nurse educators working in universities, colleges and health services. A solution has been devised by drawing together the tenets of critical social theory, transformative learning, communities of practice and social media. Nursing educators, refocused around a social justice agenda, may be the remedy that the Australian Health Care System requires to embark on effective action that can benefit everyone, from the health service staff to our most vulnerable groups in society. This refocusing can be achieved in a structured and strategic process that builds confidence and professional capabilities.
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Factors that affect the development of nurses' competencies: a systematic review.
Rizany, Ichsan; Hariyati, Rr Tutik Sri; Handayani, Hanny
2018-02-01
To investigate factors affecting the development of nursing competency based on a review of the literature. A systematic review was utilized. The articles were taken from the databases of Pro-Quest, ScienceDirect, SpringerLink, and Scopus. They were retrieved using the following keywords: nursing competence, nurse competencies and clinical competence. Twenty-one papers were selected. Competence development is a continuous process of improving knowledge, attitudes and skills, and is influenced by a myriad of factors. Six factors were identified that affected the development of nursing competence in our systematic review: (1) work experience, (2) type of nursing environment, (3) educational level achieved, (4) adherence to professionalism, (5) critical thinking, and (6) personal factors. Work experience and education were shown to significantly influence the development of competency of nurses. Nurse managers need to support staffing competence through ongoing education, mentoring-preceptorship training, and case-reflection-discussion teaching programs. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
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Calculus formation: nurses' decision-making in abortion-related care.
McLemore, Monica R; Kools, Susan; Levi, Amy J
2015-06-01
Nurses routinely provide care to patients in ethically challenging situations. To explore the continuum between conscientious objectors and designated staff in the provision of care to women seeking abortions, the aim of this study was to thickly describe decision-making, using abortion as the clinical context to elucidate how nurses approach ethically challenging work. A purposive sample of 25 nurses who worked in abortion clinics, emergency departments, intensive care units, labor, and delivery, operating rooms, and post anesthesia care units were interviewed. Qualitative description and thematic analysis were used to identify the cognitive, emotional, and behavioral processes in nurses' decisions to care for women needing abortions. Nurses developed and used multifaceted, real-time calculi when making decisions about their participation in emergent or routine abortion care. Nurses tacked back and forth between the personal and professional and/or held multiple contradictory positions simultaneously. Nurses weighed the role and opinion of others to determine if they know how to or know why they would provide abortion care to women, particularly in the elective abortion context. The parameters of the nurse-patient relationship were complex and specific to the experiences of both the nurse and patient. Findings from this study further develop the science of ethically challenging decision-making and expand our understanding of factors that influence how nurses develop relationships to ethically challenging work. © 2015 Wiley Periodicals, Inc.
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Mediating toxic emotions in the workplace--the impact of abusive supervision.
Chu, Li-Chuan
2014-11-01
This study explores whether abusive supervision can effectively predict employees' counterproductive work behaviour (CWB) and organisational citizenship behaviour (OCB) and the role of toxic emotions at work as a potential mediator of these relationships in nursing settings. Workplace bullying is widespread in nursing. Despite the growing literature on abusive supervision and employees' counterproductive work behaviour and organisational citizenship behaviour, few studies have examined the relationships between abusive supervision and these work behaviours from the viewpoint of the victimed employee's emotion process. This study adopted a two-stage survey of 212 nurses, all of whom were employed by hospitals in Taiwan. Hypotheses were tested through the use of hierarchical multiple regression. The results showed that abusive supervision was positively associated with toxic emotions. Moreover, toxic emotions could effectively predict nurses' counterproductive work behaviour and organisational citizenship behaviour. Finally, it was found that toxic emotions partially mediated the negative effects of abusive supervision on both work behaviours. Toxic emotions at work are a critical mediating variable between abusive supervision and both counterproductive work behaviour and organisational citizenship behaviour. Hospital administrators can implement policies designed to manage events effectively that can spark toxic emotions in their employees. Work empowerment may be an effective way to reduce counterproductive work behaviour and to enhance organisational citizenship behaviour among nurses when supervisors do not promote a healthy work environment for them. © 2013 John Wiley & Sons Ltd.
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The Level of Professionalism of Nurses Working in a Hospital in Turkey
Dikmen, Yurdanur; Karataş, Hülya; Arslan, Gülşah Gürol; Ak, Bedriye
2016-01-01
Introduction: Professionalism is characterized by the degree of dedication displayed by individuals regarding the values and behavioral attributes of a specific career identity. Professionalism indicates attitudes that represent high levels of identification with and commitment to a specific profession. In the process of the professional development of nursing, various factors affect these obstacles which may impede the professional development of nurses and their professional behaviors. This study was carried out with the aim of determining the professional behavior of nurses in a hospital in Turkey. Methods: In this descriptive exploratory study a total of 89 nurses working in a public hospital in northwestern of Turkey were participated. Data were collected using a demographic questionnaire and Behavioral Inventory Form for Professionalism in Nursing (BIPN). Results: The result showed that mean scores on the BIPN were 5.07 (3.47). The areas with the highest levels of professional behavior were competence and continuing education 1.88 (0.34). The professionalism levels for nurses were the lowest in the areas of autonomy 0.06 (0.34), publication 0.10 (0.25), and research 0.25 (0.60). There was a statistically significant difference between the total BIPN scores and the education levels of the nurses and the working of nurses. Conclusion: The professional behavior of nurses is at a low level. Since the arrangement of the nurses’ working conditions affects their professional behaviors; therefore, development in the field of professional behaviors in nursing must be assessed and supported to increase the quality of patient care. PMID:27354973
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Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika
2017-12-28
Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision-making with the patient. These factors fostered an in-depth knowledge of the patients and acted as a foundation for the nurses' reasoning process. Nurses' reasoning frequently advanced beyond the computerised decision support system recommendations. Future studies are warranted to develop more accurate algorithms, increase system maturity, and improve the integration of the digital clinical information with clinical experiences, to support telemedicine nurses' reasoning process.
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Tomietto, Marco; Rappogliosi, Cristina Maria; Sartori, Riccardo; Battistelli, Adalgisa
2014-01-01
In the first years of nursing profession, new-graduate nurses' turnover intention is a relevant issue due to both the tangible and intangible costs it generates to health care organizations, such as selection and recruitment costs, ward team burden in the onboarding process and the possibility to enhance ward team stability in order to provide an effective and safe nusing care. Organizational socialization is the main factor involved in these dynamics of turnover intention in the first years of nursing profession. This study aims to identify the main factors involved in the organizational socialization process to reduce turnover intention in the first 3 years of nursing profession. 101 new-graduate nurses have been enrolled within the first three years of nursing profession. They have been stratified looking at tenure and years in nursing. Organizational Socialization Inventory scale has been used to assess the onboarding process and 4 items to assess turnover intention. Turnover intention is of 23% in the first year in nursing, and it's over the 26% starting from the second year. The onboarding process explains over the 26% of the variance in turnover intention, and over the 36% in the sub-sample with a stable tenure. Unstable tenured nurses prefer to acquire those competences useful to perform their work, while stable tenure nurses aim to search for professional growth opportunities and integration in the ward-team, in order to reduce turnover intention. Turnover intention is relevant in the first three years of nursing profession. According to the different tenure, different strategies are necessary to plan an effective onboarding process and enhance nursing retention.
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Fernet, Claude; Trépanier, Sarah-Geneviève; Demers, Mireille; Austin, Stéphanie
Staff turnover is a major issue for health care systems. In a time of labor shortage, it is critical to understand the motivational factors that underlie turnover intention in newly licensed nurses. To examine whether different forms of motivation (the reasons for which nurses engage in their work) predict intention to quit the occupation and organization through distinct forms (affective and continuance) and targets (occupation and organization) of commitment. Cross-sectional data were collected from a sample of 572 French-Canadian newly registered nurses working in public health care in the province of Quebec, Canada. The hypothesized model was tested by structural equation modeling. Autonomous motivation (nurses accomplish their work primarily out of a sense of pleasure and satisfaction or because they personally endorse the importance or value of their work) negatively predicts intention to quit the profession and organization through target-specific affective commitment. However, although controlled motivation (nurses accomplish their work mainly because of internal or external pressure) is positively associated with continuance commitment to the occupation and organization, it directly predicts, positively so, intention to quit the occupation and organization. These results highlight the complexity of the motivational processes at play in the turnover intention of novice nurses, revealing distinct forms of commitment that explain how motivation quality is related simultaneously to intention to quit the occupation and organization. Health care organizations are advised to promote autonomous over controlled motivation to retain newly recruited nurses and sustain the future of the nursing workforce. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
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Dawson, Angela J; Stasa, Helen; Roche, Michael A; Homer, Caroline S E; Duffield, Christine
2014-04-08
This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.
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Bern-Klug, Mercedes; Connolly, Robert; Downes, Deirdre; Galambos, Colleen; Kusmaul, Nancy; Kane, Rosalie; Hector, Paige; Beaulieu, Elise
2016-01-01
In July of 2015, the Federal Register published for public comment proposed rule changes for nursing homes certified to receive Medicare and/or Medicaid. If the final rules are similar to the proposed rules, they will represent the largest change in federal rules governing nursing homes since the Nursing Home Reform Act which was part of OBRA 1987. The proposed changes have the potential to enhance the quality of care and quality of life of nursing home residents. Many of the proposed changes would directly affect the practice of social work and would likely expand the role for nursing home social workers. This article discusses the role that members of the National Nursing Home Social Work Network (NNHSW Network) played in developing and submitting a response to CMS. The article provides the context for the publication of the proposed rules, describes the process used by the NNHSW Network to develop and build support for comments on these rules, and also includes the actual comments submitted to CMS. Social work education programs and continuing education programs throughout the country will continue to have an important role to play in helping to prepare social work students and practitioners for a career in long-term care.
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Finding our Place: Making the Connection Toward Faith Integration.
Astle, Barbara; Gibson, Deborah
At the onset, the unfamiliarity of faith integration for nurse educators working within a faith-based university can be challenging. Two nurse educators describe the process they took to learn and navigate faith integration, while teaching undergraduate nursing students. Over the course of one year, various approaches toward faith integration with students were implemented, leading to an authentic relational interconnectedness.
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[Higher education in nursing: the faculty work process in different institutional contexts].
Leonello, Valéria Marli; Oliveira, Maria Amélia de Campos
2014-12-01
To analyze the characteristics of faculty work in nursing higher education. An exploratory qualitative study with a theoretical-methodological framework of dialectical and historical materialism. The faculty work process was adopted as the analytical category, grounded on conceptions of work and professionalism. Semi-structured interviews were conducted with 24 faculty members from three higher education institutions in the city of São Paulo, classified according to the typology of institutional contexts. The faculty members at these higher education institutions are a heterogeneous group, under different working conditions. Intensification and precarious conditions of the faculty work is common to all three contexts, although there are important distinctions in the practices related to teaching, research and extension. Faculty professionalization can be the starting point for analyzing and coping with such a distinct reality of faculty work and practice.
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Pioneering the psychiatric nurse role in foster care.
Bertram, Julie E; Narendorf, Sarah Carter; McMillen, J Curtis
2013-12-01
Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse's work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. © 2013.
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Bellandi, Tommaso; Cerri, Alessandro; Carreras, Giulia; Walter, Scott; Mengozzi, Cipriana; Albolino, Sara; Mastrominico, Eleonora; Renzetti, Fernando; Tartaglia, Riccardo; Westbrook, Johanna
2018-01-01
The aim of this study was to obtain baseline data on doctors' and nurses' work activities and rates of interruptions and multitasking to improve work organisation and processes. Data were collected in six surgical units with the WOMBAT (Work Observation Method by Activity Timing) tool. Results show that doctors and nurses received approximately 13 interruptions per hour, or one interruption every 4.5 min. Compared to doctors, nurses were more prone to interruptions in most activities, while doctors performed multitasking (33.47% of their time, 95% CI 31.84-35.17%) more than nurses (15.23%, 95% CI 14.24-16.25%). Overall, the time dedicated to patient care is relatively limited for both professions (37.21%, 95% CI 34.95-39.60% for doctors, 27.22%, 95% CI 25.18-29.60% for nurses) compared to the time spent for registration of data and professional communication, that accounts for two-thirds of doctors' time and nearly half of nurses' time. Further investigation is needed on strategies to manage job demands and professional communications. Practitioner Summary: This study offers further findings on the characteristics and frequency of multitasking and interruptions in surgery, with a comparison of how they affect doctors and nurses. Further investigation is needed to improve the management of job demands and communications according to the results.
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ERIC Educational Resources Information Center
Alghenaimi, Said
2012-01-01
In healthcare institutions, work must continue 24 hours a day, 7 days a week. A team of nurses is needed to provide around-the-clock patient care, and this process requires transfer of patient care responsibilities, a process known as a "handoff." The present study explored the role of electronic health records in structuring handoff…
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ERIC Educational Resources Information Center
Gallagher Gordon, Mary
2012-01-01
This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model,…
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Adams, Jeffrey M; Natarajan, Sudha
2016-01-01
Acquiring influence, and knowing how to use it, is a required competency for nurse leaders, yet the concept of influence and how it works is not well described in the nursing literature. In this article, the authors examine what is known about influence and present an influence model specific to nurse leaders. The Adams Influence Model was developed through an iterative process and is based on a comprehensive review of the influence literature, expert commentary, multiple pilot studies, evaluation of nursing theories, and validation by an external data source. Rather than defining "how to" influence, the model serves as a guide for personal reflection, helping nurse leaders understand and reflect on the influence process and factors, tactics, and strategies they can use when seeking to influence others.
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[Gender mainstreaming and nursing].
Wang, Hsiu-Hung
2011-12-01
Gender mainstreaming is one of the most important strategies in promoting global gender equality. The Taiwan government launched policies on gender mainstreaming and gender impact assessment in 2007 in response to strong public and academic advocacy work. With rising awareness of gender issues, nursing professionals in Taiwan should keep pace with global trends and become actively involved in advancing gender-mainstreaming policies. This article shows that nursing professionals should prepare themselves by cultivating gender competence, understanding gender-related regulations, recognizing the importance of gender impact assessment implementation, integrating gender issues into nursing education, conducting gender-related research and participating in decision-making processes that promote gender mainstreaming. Nursing professionals should enhance their knowledge and understanding of gender mainstreaming-related issues and get involved in the gender-related decision-making process in order to enhance gender awareness and women's health and further the professional development of nurses.
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Strangers in a strange land: work experiences of foreign nurses in Parma's territory.
Vesperoni, Pietro; Masera, Giuliana
2015-03-13
The purpose of this research is to explore, investigate and describe experiences and points of view of foreign nurses working in the area of Parma. We focalize particularly on two areas of interest: negativities and positivities in experiences related to the process of integration into the new working environment. The literature search has revealed that the phenomenon of "nursing immigration" is numerically significant in Italy and more particularly in Emilia Romagna. From studies conducted in other countries (UK, USA, Canada, Australia and Iceland) there are two categories of factors which influence the process of integration of foreign nurses in the new working environment, facilitators and barriers. For this study we followed the phenomenological method . A total of twelve foreign nurses were interviewed in the months of October and November 2013 in the territory of Parma working in various professional fields (medicine, critical care and surgery). We did not impose any structure to interviews so that respondents were free to express their lived experiences spontaneously. All interviews were recorded, transcribed verbatim and analyzed by the method of Giorgi (1970). Results obtained from the analysis of interviews revealed seven themes, divided in positivities and negativities. Positivities are psycho-social support (Italian colleagues, fellow countrymen, patients), opportunities of cultural enrichment, positive work ethic. negativities are difficulty of language and communication, and inequalities racial prejudice, differences in care practices and inadequate opportunities for professional growth related to the Italian working environment. The study concludes by pointing out the importance of the role that foreign nurses can play in our health care system and how the results of this search can help all professionals in the health sector to have a greater understanding of their experiences. This knowledge can make a contribution to the development of new quantitative research in the same area and then to the formation of new strategies for hospitality and support.
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Funkesson, Kajsa Helena; Anbäcken, Els-Marie; Ek, Anna-Christina
2007-09-01
Nurses' clinical reasoning is of great importance for the delivery of safe and efficient care. Pressure ulcer prevention allows a variety of aspects within nursing to be viewed. The aim of this study was to describe both the process and the content of nurses' reasoning during care planning at different nursing homes, using pressure ulcer prevention as an example. A qualitative research design was chosen. Seven different nursing homes within one community were included. Eleven registered nurses were interviewed. The methods used were think-aloud technique, protocol analysis and qualitative content analysis. Client simulation illustrating transition was used. The case used for care planning was in three parts covering the transition from hospital until 3 weeks in the nursing home. Most nurses in this study conducted direct and indirect reasoning in a wide range of areas in connection with pressure ulcer prevention. The reasoning focused different parts of the nursing process depending on part of the case. Complex assertations as well as strategies aiming to reduce cognitive strain were rare. Nurses involved in direct nursing care held a broader reasoning than consultant nurses. Both explanations and actions based on older ideas and traditions occurred. Reasoning concerning pressure ulcer prevention while care planning was dominated by routine thinking. Knowing the person over a period of time made a more complex reasoning possible. The nurses' experience, knowledge together with how close to the elderly the nurses work seem to be important factors that affect the content of reasoning.
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Complaints against nurses: a reflection of 'the new managerialism' and consumerism in health care?
Beardwood, B; Walters, V; Eyles, J; French, S
1999-02-01
This paper discusses the effects of restructuring on nursing as a profession through an examination of the issue of complaints in Ontario. It argues that new managerialist techniques and associated changes in the nature of work are reducing the autonomy of nurses and making it difficult for them to meet the standards of their profession. Simultaneously, the Ontario government has increased the power of the public in the disciplinary process and the College of Nurses of Ontario is encouraging patients to register their complaints. The growth of consumerism in health care, coupled with the disciplinary process, individualizes complaints and deemphasizes their relationship to restructuring. Moreover, in response to the increasing number of complaints - complaints which more often come from the public - nursing organizations have encouraged the legalization of the disciplinary process, thus fostering the individualization of the issues.
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ERIC Educational Resources Information Center
Sims, Addie; Burch, Brenda; River, Jayne; Hull, Jennifer; Williams, Judy; Cross, Ella; Lowe, Pam
2005-01-01
As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…
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ERIC Educational Resources Information Center
Jackson, Jennifer; Sims, Addie
2010-01-01
As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…
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2014-01-01
Background This study aimed to reveal nurses’ experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Method A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Results Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Conclusion Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover. PMID:24708565
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Conducting Nursing Research to Advance and Inform Health Policy.
Ellenbecker, Carol Hall; Edward, Jean
2016-11-01
The primary roles of nurse scientists in conducting health policy research are to increase knowledge in the discipline and provide evidence for informing and advancing health policies with the goal of improving the health outcomes of society. Health policy research informs, characterizes, explains, or tests hypotheses by employing a variety of research designs. Health policy research focuses on improving the access to care, the quality and cost of care, and the efficiency with which care is delivered. In this article, we explain how nurses might envision their research in a policy process framework, describe research designs that nurse researchers might use to inform and advance health policies, and provide examples of research conducted by nurse researchers to explicate key concepts in the policy process framework. Health policies are well informed and advanced when nurse researchers have a good understanding of the political process. The policy process framework provides a context for improving the focus and design of research and better explicating the connection between research evidence and policy. Nurses should focus their research on addressing problems of importance that are on the healthcare agenda, work with interdisciplinary teams of researchers, synthesize, and widely disseminate results.
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Nursing practice in stroke rehabilitation: systematic review and meta-ethnography.
Clarke, David J
2014-05-01
To identify and synthesise the available research evidence in order to generate an explanatory framework for nursing practice in stroke rehabilitation. Although nurses are the largest professional group working with stroke survivors, there is limited understanding of nursing practice in stroke units. In particular, there is currently very little evidence in respect of nurses' involvement in poststroke rehabilitation. Meta-ethnography. A systematic review was undertaken. The review question was: 'What is the nature of nursing practice in the care and rehabilitation of inpatient stroke survivors?' Searches of 12 electronic databases identified 14,655 publications, and after screening, 778 remained; 137 papers were obtained and 54 retained for mapping. Sixteen qualitative studies were included in the meta-ethnography. Nurses' involvement in poststroke rehabilitation was limited. Contextual factors impacted on nurses' perceptions and practice. Nurses' integration of rehabilitation skills was perceived to be contingent on adequate nurse staffing levels and management of demands on nurses' time. Team working practices and use of the built environment indicated separation of nursing and therapy work. Physical care and monitoring were prioritised. Stroke-specific education and training was evident, but not consistent in content or approach. Stroke survivors and families needed help to understand nurses' role in rehabilitation. The review provides compelling evidence that there is an need to re-examine the role of nurses in contributing to poststroke rehabilitation, including clarifying when this process can safely begin and specifying the techniques that can be integrated in nurses' practice. Integrating stroke-specific rehabilitation skills in nurses' practice could contribute substantially to improving outcomes for stroke survivors. The explanatory framework developed from the review findings identifies issues which will need to be addressed in order to maximise nurses' contribution to the rehabilitation of stroke survivors. © 2013 John Wiley & Sons Ltd.
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Li, Yan; Turale, Sue; Stone, Teresa E; Petrini, Marcia
2015-09-01
While Asia has the dubious distinction of being the world's most natural disaster-prone area, disaster nursing education and training are sparse in many Asian countries, especially China where this study took place. To explore the earthquake disaster experiences of Chinese nurses and develop a substantive theory of earthquake disaster nursing that will help inform future development of disaster nursing education. A qualitative study employing grounded theory, informed by symbolic interactionism. Fifteen Chinese registered nurses from five hospitals in Jiangxi Province who undertook relief efforts after the 2008 Wenchuan Earthquake. Data were collected in 2012-2013 in digitally-recorded, semi-structured, in-depth interviews and reflective field notes, and analyzed using Glaser's grounded theory method. Participants were unprepared educationally and psychologically for their disaster work. Supporting the emergent theory of "working in that terrible environment", was the core category of "turning into a strong nurse", a process of three stages: "going to the disaster"; "immersing in the disaster"; and "trying to let disaster experiences fade away". The participants found themselves thrust in "terrible" scenes of destruction, experienced personal dangers and ethical dilemmas, and tried the best they could to help survivors, communities and themselves, with limited resources and confronting professional work. Our rich findings confirm those of other studies in China and elsewhere, that attention must be paid to disaster education and training for nurses, as well as the mental health of nurses who work in disaster areas. Emergent theory helps to inform nurse educators, researchers, leaders and policy makers in China, and elsewhere in developing strategies to better prepare nurses for future disasters, and assist communities to prepare for and recover after earthquake disasters. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Important interactional strategies for everyday public health nursing practice.
Porr, Caroline J
2015-01-01
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. © 2013 Wiley Periodicals, Inc.
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Collaborative testing as a learning strategy in nursing education: a review of the literature.
Sandahl, Sheryl S
2009-01-01
Nurses are important members of a patient's interprofessional health care team. A primary goal of nursing education is to prepare nursing professionals who can work collaboratively with other team members for the benefit of the patient. Collaborative learning strategies provide students with opportunities to learn and practice collaboration. Collaborative testing is a collaborative learning strategy used to foster knowledge development, critical thinking in decision-making, and group processing skills. This article reviews the theoretical basis for collaborative learning and research on collaborative testing in nursing education.
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Whitley, T W; Benson, N H; Allison, E J; Revicki, D A
1989-07-01
A mail survey of members of the National Flight Nurses Association was conducted to assess occupational stress and job satisfaction. In addition to scales measuring stress and job satisfaction, the questionnaire requested demographic information and included a depression scale. The anticipated direct relationship between stress and depression was observed (r = .56, p .0001), as were the expected inverse relationships between stress and job satisfaction (r = .54, p less than .0001), and between depression and job satisfaction (r = -.45, p .0001). Responses to statements on the stress scale indicated that work interference with family life and failure to receive recognition were important sources of stress, while avoidance behaviors such as tardiness and daydreaming were used infrequently to cope with stress. Inadequate recognition, particularly by administrators and supervisors, and lack of involvement in decision-making processes surfaced as sources of dissatisfaction, as did inadequate feedback about job performance. The tasks performed by flight nurses and being members of cohesive work groups were important sources of job satisfaction. The results indicate that although flight nurses basically are satisfied with their jobs and enjoy working in air medical transport, they want to know that they are performing well. They also want to be involved in decision-making processes and to be recognized for the stressful jobs they perform.
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Factors influencing nurse supervisor competence: a critical incident analysis study.
Arvidsson, Barbro; Fridlund, Bengt
2005-05-01
The aim of the study was to identify factors related to critical incidents that influence the competence of nurse supervisors. Nurse supervisors require considerable competence in order to help supervisees to reflect on their clinical work and to interpret the needs of the patient. A qualitative approach involving the critical incident technique was used. Critical incidents were collected by means of self-reports from 25 nurse supervisors. Two main areas emerged: a professional and a personal stance. The professional stance described the nurse supervisors' awareness of the importance of creating a secure learning environment and facilitating reflection. The supervisors structured the material and created awareness of fundamental nursing values. The second main area, personal stance, described the nurse supervisors' behaviour when they gave the participating nurses the opportunity to work through the experiences gained in the daily provision of nursing care. Although they experienced lack of self-assurance during the supervision session, they also expressed security regarding their own performance as nurse supervisors. Nurse supervisors need to include more nursing theory and focus on the nursing process as well as being aware of their own shortcomings and resources. One way for the supervisor to scrutinize his/her actions is to discuss and examine them with a more experienced nurse supervisor colleague.
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The Staff Nurse Clinical Leader at the Bedside: Swedish Registered Nurses' Perceptions.
Larsson, Inga E; Sahlsten, Monika J M
2016-01-01
Registered nurses at the bedside are accountable for and oversee completion of patient care as well as directly leading and managing the provision of safe patient care. These nurses have an informal leadership role that is not associated with any given position. Leadership is a complex and multifaceted concept and its meaning is unclear, especially in the staff nurse context. The aim was to describe registered nurses' perceptions of what it entails to be the leader at the bedside in inpatient physical care. A phenomenographic approach was employed. Interviews were performed with Swedish registered nurses ( n = 15). Five descriptive categories were identified: demonstrating clinical knowledge, establishing a good atmosphere of collaboration, consciously structuring the work in order to ensure patients' best possible nursing care, customized presence in the practical work with patients according to predetermined prerequisites, and monitoring coworkers' professional practice. Registered nurses informal role as leader necessitates a social process of deliberate effort to attain and maintain leader status and authority. Participants used deliberate communicative approaches and interactive procedures. Leader principles grounded in the core values of the nursing profession that ensure nursing values and person-centered attributes were a key aspect.
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Dawber, Chris
2013-04-01
In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
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The international migration of nurses in long-term care.
Redfoot, Donald L; Houser, Ari N
2008-01-01
This article describes five major factors that are affecting patterns of international migration among nurses who work in long-term care settings: DEMOGRAPHIC DRIVERS: The aging of the populations in developed countries and the low to negative growth in the working-age population will increase the demand for international workers to provide long-term care services. GENDER AND RACE: A dual labor market of long-term care workers, increasingly made up of women of color, is becoming internationalized by the employment of migrating nurses from developing countries. CREDENTIALING: The process of credentialing skilled workers creates barriers to entry for migrating nurses and leads to "decredentialing" where registered nurses work as licensed practical nurses or aides. COLONIAL HISTORY AND GEOGRAPHY: The colonial histories of many European countries and the United States have increased migration from former colonies in developing countries to former colonial powers. WORKER RECRUITMENT: Efforts to limit the recruitment of health care workers from some developing countries have had little effect on migration, in part because much of the recruitment comes through informal channels of family and friends.
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Pryse, Yvette; McDaniel, Anna; Schafer, John
2014-08-01
Those in nursing have been charged with practicing to the full extent of their education and training by the Institute of Medicine. Therefore, evidence-based practice (EBP) has never been more important to nursing than in the current healthcare environment. Frequently the burden of EBP is the responsibility of the bedside practitioner, but has been found to be a process that requires leadership and organizational support. A key underlying component of a strong EBP environment includes effective communications and collaboration among staff and nursing leadership. Developing measurement tools that examine the milieu and nursing leadership in which the staff nurse practices is an important component of understanding the factors that support or hinder EBP. The aim of this study is to report on the development and analysis of two new scales designed to explore leadership and organizational support for EBP. The EBP Nursing Leadership Scale (10 items) examines the staff nurses perception of support provided by the nurse manager for EBP, and the EBP Work Environment Scale (8 items) examines organizational support for EBP. Staff nurses who worked at least .5 FTE in direct patient care, from two inner city hospitals (n = 422) completed the scales. The scales were evaluated for internal consistency reliability with the Cronbach alpha technique, content validity using a panel of experts, and construct validity by The content validity index computed from expert rankings was .78 to 1.0 with an average of.96. Cronbach's alpha was .96 (n = 422) for the EBP Nursing Leadership Scale and .86 (n = 422) for the EBP Work Environment Scale. Factor analysis confirmed that each scale measured a unidimensional construct (p < .000). The EBP Nursing Leadership Scale and the EBP Work Environment Scale are psychometrically sound instruments to examine organizational influences on EBP. © 2014 Sigma Theta Tau International.
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Social Interaction and Collaboration among Oncology Nurses.
Moore, Jane; Prentice, Dawn; McQuestion, Maurene
2015-01-01
Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.
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Measuring the impact of a team model of nursing practice using work sampling.
Walker, Kim; Donoghue, Judith; Mitten-Lewis, Suzanne
2007-02-01
The increasing number of inexperienced graduates, as well as other levels of nurse such as the enrolled nurse and assistant-in-nursing, requires health service and nursing managers in the acute care sector to rethink the long-preferred "patient allocation" model of care provision. As well, the escalating shortage of registered nurses and subsequent low morale among those remaining in the workforce require hospitals to re-examine skills mix and staffing ratios. This paper presents the results of two work-sampling studies conducted in a major metropolitan private hospital, the first of which was to provide a rationale for changing from the patient allocation model to a team model of care. The second study aimed to evaluate and provide data on the impact of the change. Staff were heavily involved in both studies as well as the change process. The findings highlight how effective the new model has been in redistributing certain aspects of care to make better use of each nurse level's knowledge and skills.
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Groff-Paris, Lisa; Terhaar, Mary
2010-12-07
The strongest predictor of nurse job dissatisfaction and intent to leave is that of stress in the practice environment. Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment have been found to increase nurse satisfaction and decrease turnover. In this article we share our experience of developing a rapid-design process to change the approach to performance improvement so as to increase engagement, empowerment, effectiveness, and the quality of the professional practice environment. Meal and non-meal breaks were identified as the target area for improvement. Qualitative and quantitative data support the success of this project. We begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow's theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators Survey. We then describe our performance improvement project and share our conclusion and recommendations.
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Winter, Peggi
2016-01-01
Nursing professional practice models continue to shape how we practice nursing by putting families and members at the heart of everything we do. Faced with enormous challenges around healthcare reform, models create frameworks for practice by unifying, uniting, and guiding our nurses. The Kaiser Permanente Practice model was developed to ensure consistency for nursing practice across the continuum. Four key pillars support this practice model and the work of nursing: quality and safety, leadership, professional development, and research/evidence-based practice. These four pillars form the foundation that makes transformational practice possible and aligns nursing with Kaiser Permanente's mission. The purpose of this article is to discuss the pillar of professional development and the components of the Nursing Professional Development: Scope and Standards of Practice model (American Nurses Association & National Nursing Staff Development Organization, 2010) and place them in a five-level development framework. This process allowed us to identify the current organizational level of practice, prioritize each nursing professional development component, and design an operational strategy to move nursing professional development toward a level of high performance. This process is suggested for nursing professional development specialists.
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Nowrouzi, Behdin; Lightfoot, Nancy; Carter, Lorraine; Larivère, Michel; Rukholm, Ellen; Belanger-Gardner, Diane
2015-01-01
Background The purpose of this study was to examine the relationship nursing personal and workplace system factors (work disability) and work ability index scores in Ontario, Canada. Methods A total of 111 registered nurses were randomly selected from the total number of registered nurses on staff in the labor, delivery, recovery, and postpartum areas of four northeastern Ontario hospitals. Using a stratified random design approach, 51 participants were randomly selected in four northeastern Ontario cities. Results A total of 51 (45.9% response rate) online questionnaires were returned and another 60 (54.1% response rate) were completed using the paper format. The obstetric workforce in northeastern Ontario was predominately female (94.6%) with a mean age of 41.9 (standard deviation = 10.2). In the personal systems model, three variables: marital status (p = 0.025), respondent ethnicity (p = 0.026), and mean number of patients per shift (p = 0.049) were significantly contributed to the variance in work ability scores. In the workplace system model, job and career satisfaction (p = 0.026) had a positive influence on work ability scores, while work absenteeism (p = 0.023) demonstrated an inverse relationship with work ability scores. In the combined model, all the predictors were significantly related to work ability scores. Conclusion Work ability is closely related to job and career satisfaction, and perceived control at work among obstetric nursing. In order to improve work ability, nurses need to work in environments that support them and allow them to be engaged in the decision-making processes. PMID:26929842
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[Enhancement of quality by employing qualification-oriented staff and team-oriented cooperation].
Meyenburg-Altwarg, Iris; Tecklenburg, Andreas
2010-01-01
Taking three practical examples from a university hospital the present article describes how quality can be improved by linking deployment of qualification-oriented staff with team-oriented cooperation, especially with regard to the professional groups of physicians and nurses. In the first example, a cross-professional work group defined tasks which--in a legally acceptable manner--allow selected activities to be transferred from physicians to nurses, improving the work processes of all persons concerned. Work and duty profiles, training and modified work processes were created and implemented according to the PDCA circle-based process. The first evaluation took place after nine months using interviews, questionnaires (patients, physicians, and nurses) as well as CIRS. In the second example, emphasis was placed on offers of supplementary services for private patients resulting in a lightening of the workload on the nursing staff. These supplementary services are intended to enhance the wellbeing of the patients. Special external-service staff provide high standard hotel services. These services consistently receive high ratings from the patients. The methods used for introduction and evaluation are analogous to those used in the first example. The third example is concerned with the extension of nursing care and patient empowerment beyond the boundaries of ward and hospital. The guidelines were the implementation of the national expert standard for discharge management according to the DNQP. The methods of introduction were analogous to those used in example 1. For the evaluation interviews were conducted with all participating groups. In all examples actual quantitative measures (key ratios) are not yet available; however, the data collected from the interviews and questionnaires of all the participants are promising.
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The competencies of Registered Nurses working in care homes: a modified Delphi study.
Stanyon, Miriam Ruth; Goldberg, Sarah Elizabeth; Astle, Anita; Griffiths, Amanda; Gordon, Adam Lee
2017-07-01
registered Nurses (RNs) working in UK care homes receive most of their training in acute hospitals. At present the role of care home nursing is underdeveloped and it is seen as a low status career. We describe here research to define core competencies for RNs working in UK care homes. a two-stage process was adopted. A systematic literature review and focus groups with stakeholders provided an initial list of competencies. The competency list was modified over three rounds of a Delphi process with a multi-disciplinary expert panel of 28 members. twenty-two competencies entered the consensus process, all competencies were amended and six split. Thirty-one competencies were scored in round two, eight were agreed as essential, one competency was split into two. Twenty-four competencies were submitted for scoring in round three. In total, 22 competencies were agreed as essential for RNs working in care homes. A further 10 competencies did not reach consensus. the output of this study is an expert-consensus list of competencies for RNs working in care homes. This would be a firm basis on which to build a curriculum for this staff group. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com
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Professional ethics: beyond the clinical competency.
Vanaki, Zohreh; Memarian, Robabeh
2009-01-01
Assessment of clinical competency in professional roles especially in crucial situations can improve the nursing profession. This qualitative research was conducted to determine the process of acquiring clinical competency by nurses in its cultural context and within the health care delivery system in Iran. This study, using grounded theory methodology, took place in universities and hospitals in Tehran. Nurses (36) included nurse managers, tutors, practitioners, and members of the Iranian Nursing Organization. Simultaneous data collection and analysis took place using participant semistructured interviews. Three categories emerged: (a) personal characteristics such as philanthropy, strong conscience, being attentive, accepting responsibility, being committed to and respecting self and others; (b) care environment including appropriate management systems, in-service training provision, employment laws, and control mechanisms, suitable and adequate equipment; and (c) provision of productive work practices including love of the profession, critical thinking, nursing knowledge, and professional expertise. Professional ethics has emerged as the core variable that embodies concepts such as commitment, responsibility, and accountability. Professional ethics guarantees clinical competency and leads to the application of specialized knowledge and skill by nurses. The results can be used to form the basis of guiding the process of acquiring clinical competency by nurses using a systematic process.
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ERIC Educational Resources Information Center
Matsuda, Yui; Azaiza, Khitam; Salani, Deborah
2017-01-01
The flipped classroom approach is an innovative teaching method to promote students' active learning. It has been used in nursing education and has showed positive results. The purpose of this article is to describe the process of developing a flipped classroom approach for an undergraduate evidence-based nursing practice course and discuss…
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Improvement in self-reported confidence in nurses’ professional skills in the emergency department
2013-01-01
Background The aim of this study was to assess nurses’ self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Methods Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software. During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses’ skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Results Nurses’ self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (p<0.05). Conclusions During an extensive reform of emergency services, we noted a significant improvement in the professional skills of nurses. This improvement was especially consistent among nurses working in the ED during the whole transition process. Nurses’ education and training program in the ED may be successfully put into practice when based on co-operation between nurses and physicians dedicated to emergency services. PMID:23497683
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Breaking the silence: nurses' understandings of change in clinical practice.
Copnell, Beverley; Bruni, Nina
2006-08-01
This paper reports a study exploring critical care nurses' understandings of change in their practice. In contemporary nursing literature, change in clinical nursing practice is generally understood to be a rational process, synonymous with progress. It is seen as invariably contested, and hence difficult to achieve. It is represented as occurring infrequently. This literature effectively silences clinicians as this discourse of change does not recognize or incorporate their views or practices. This study was informed by a Foucauldian poststructuralist framework. The participants were 12 critical care nurses who engaged in three individual in-depth, focused interviews. The transcripts were deconstructed to reveal participants' discourses of change and the implications of these discourses for nursing work. The data were generated between 1996 and 1998 as part of a study whose in-depth analysis was completed in 2003. Change was revealed as a highly complex phenomenon, closely intertwined with understandings of clinical nursing work. Participants showed difficulty in identifying or recalling clinical changes. Several dichotomies shaped their understandings of change, including change/stasis, formal/informal and dramatic/subtle. Their experiences of change frequently conflicted with prevailing dominant understandings, but they did not openly challenge them. Rather, they employed dichotomies, such as abstract/concrete and other/self, to enable them to work with these conflicts. As a result, they engaged in practices such as naming other nurses as 'irrational'. The data provide new understandings of change in clinical nursing practice, some of which challenge many widely held views (for example, that such change is a rare occurrence). It is argued that a lack of open challenge by clinical nurses contributes to their silencing, promotes disharmony amongst nurses and, hence, works against a collaborative approach to decisions about clinical practice.
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Using Cognitive Work Analysis to Fit Decision Support Tools to Nurse Managers’ Work Flow
Brewer, Barbara B.; Logue, Melanie D.; Gephart, Sheila; Verran, Joyce A.
2011-01-01
Purpose To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager’s work domain. Methods Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in 3 Arizona hospitals. The WDA described the nurse manager’s environment in terms of the constraints it imposes on the nurse manager’s ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. Results The results highlight the competing priorities, and external and internal constraints that today’s nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering “what if” questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogenous sample and the reliance on interview data targeting safety and quality. PMID:21862397
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Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow.
Effken, Judith A; Brewer, Barbara B; Logue, Melanie D; Gephart, Sheila M; Verran, Joyce A
2011-10-01
To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager's work domain. Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in three Arizona hospitals. The WDA described the nurse manager's environment in terms of the constraints it imposes on the nurse manager's ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. The results highlight the competing priorities, and external and internal constraints that today's nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering "what if" questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogeneous sample and the reliance on interview data targeting safety and quality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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Technology Implementation and Workarounds in the Nursing Home
Vogelsmeier, Amy A.; Halbesleben, Jonathon R.B.; Scott-Cawiezell, Jill R.
2008-01-01
Objective This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes. Design As a part of a larger study, this qualitative evaluation was conducted to identify workarounds associated with the implementation of an electronic medication administration record. Data were collected using multimethods including direct observation, process mapping, key informant interviews, and review of field notes from medication safety team meetings. Measurements Open and axial coding techniques were used to identify and categorize types of workarounds in relation to work flow blocks. Results Workarounds presented in two distinct patterns, those related to work flow blocks introduced by technology and those related to organizational processes not reengineered to effectively integrate with the technology. Workarounds such as safety alert overrides and shortcuts to documentation resulted from first-order problem solving of immediate blocks. Nursing home staff as individuals frequently used first-order problem solving instead of the more sophisticated second-order problem solving approach used by the medication safety team. Conclusion This study provides important practical examples of how nursing home staff work around work flow blocks encountered during the implementation of technology. Understanding these workarounds as a means of first-order problem solving is an important consideration to understanding risk to medication safety. PMID:17947626
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Electronic health record tools' support of nurses' clinical judgment and team communication.
Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin
2013-11-01
Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.
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[The constitution of competences in mental health nursing education and practice].
Lucchese, Roselma; Barros, Sônia
2009-03-01
This qualitative study had the purpose to increase the discussions about the constitution of competences in the education of nurses so that they can work in the mental healthcare area. to analyze the representations of the research subjects about mental healthcare competences. qualitative research. The nursing department in a public university in the state of São Paulo. Professors and healthcare nurses working in the same area. The mobilization of testimonies happened in focus groups, followed by discourse analysis. The building of competences and promotion of complex situations in the students' learning process were discussed, and the discourse analysis yielded the following empirical categories: The concept of competence, What is a complex situation, Which knowledge is necessary to manage complex situations in psychiatric nursing and mental healthcare, Competence: knowing how to manage a complex situation.
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Vehko, Tuulikki; Jolanki, Outi; Aalto, Anna-Mari; Sinervo, Timo
2018-06-01
To assess how health care professionals outline the management of care and explore which health or social care professionals were involved in the patient's treatment. A survey with a patient vignette for general practitioners (n = 31) and registered nurses (n = 31) working daily in Finnish health centres located in four cities. Respondents answered structural questions and explained in detail the care process that they tailored for the patient. The care process was examined using content analysis. A physician-nurse working pair was declared to be in charge of the care process by 27% of respondents, a registered nurse by 9% and a general practitioner by 11%. However, 53% reported that no single person or working pair was in charge of the care process (response rate 72%). The concluding result of the analyses of the presented process was that both treatment practices and the professionals participating in the patient's treatment varied. Collaboration with social services was occasional, and few care processes included referrals to social services. For the patient who needs both health and social care services, the management of care is a challenge. To improve the chances of patients being actively involved in making treatment plans at least three factors need to be addressed. Firstly, a written treatment plan should explicate the care process. Second, collaboration and interaction between health and social care services should be strengthened, and third, a contact person should be named to avoid care gaps in primary health care. Next-step data from patients need to be collected to get their views on care management and compare these with those from general practitioners and registered nurses.
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Eliopoulos, Charlotte
2013-01-01
A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.
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Role, perspective and knowledge of Iranian critical care nurses about breaking bad news.
Imanipour, Masoomeh; Karim, Zahra; Bahrani, Naser
2016-05-01
Given the issue of caring critically ill patients, nurses are involved in the process of breaking bad news in critical care units, while little research has been conducted on this challenging issue. The purpose of this study was to determine the role, perspective and knowledge of Iranian critical care nurses regarding breaking bad news. This descriptive study was conducted on a sample of 160 nurses working in critical care units of hospitals affiliated to Tehran University of Medical Sciences. Stratified and quota sampling methods were used. The data collection tool was a four-part questionnaire with validity and reliability confirmed via content validity and test-retest, respectively. The study showed that most critical care nurses were involved in breaking bad news, with different roles. The majority of participants (91.2%) had a positive attitude towards involvement of nurses in breaking bad news. In this study, 78.8% of nurses had moderate knowledge about how to break bad news, and only a few had good level of knowledge (16.2%). According to the findings, while critical care nurses took different roles in the process of breaking bad news and they had positive attitude towards participation in this process, yet their knowledge about this process was inadequate. Thus, designing educational programmes to enhance critical care nurses' knowledge and skills in this area seems necessary. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
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Time management strategies in nursing practice.
Waterworth, Susan
2003-09-01
With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. To explore how nurses organize and manage their time. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995-1999. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Ignoring the influence of 'others', the team and the organization perpetuates a rather individualistic and self-critical perspective of time management. This may lead to a failure to address problems in the organizing of work, and the co-ordinating of care involving other health care workers.
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Collaborative learning using nursing student dyads in the clinical setting.
Austria, Mary Jean; Baraki, Katie; Doig, Alexa K
2013-05-04
Formal pairing of student nurses to work collaboratively on one patient assignment is a strategy for improving the quality and efficiency of clinical instruction while better utilizing the limited resources at clinical agencies. The aim of this qualitative study was to explore the student nurse and patient experiences of collaborative learning when peer dyads are used in clinical nursing education. Interviews were conducted with 11 students and 9 patients. Students described the process of collaborative learning as information sharing, cross-checking when making clinical decisions, and group processing when assessing the outcomes of nursing interventions. Positive outcomes reported by students and patients included reduced student anxiety, increased confidence and task efficiency. Students' primary concern was reduced opportunity to perform hands-on skills which had to be negotiated within each dyad. Meeting the present and future challenges of educating nurses will require innovative models of clinical instruction such as collaborative learning using student peer dyads.
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Assertiveness process of Iranian nurse leaders: a grounded theory study.
Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim
2009-06-01
The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.
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Establishing a program of global initiatives for nursing education.
Kulage, Kristine M; Hickey, Kathleen T; Honig, Judy C; Johnson, Mary P; Larson, Elaine L
2014-07-01
In the global nursing community, schools of nursing are increasingly developing initiatives and networks across national boundaries. This article describes the process undertaken at a school of nursing to determine its global health priorities and develop a program of global initiatives for nursing education. A series of meetings were held to determine faculty global activities and gauge interest in designing a 5-year strategic plan for the program. A volunteer Strategic Planning Work-group was convened to formalize a mission, vision, and strategic plan for the program, which were presented to, refined by, and vetted by an advisory board and the faculty at large. We recommend this process to schools committed to developing or expanding a program dedicated to global initiatives and a global perspective in educational planning. Involving stakeholders, building on current strengths, and aligning with mission and vision are essential elements for developing a meaningful program of global initiatives for nursing education. Copyright 2014, SLACK Incorporated.
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An emancipatory study of contemporary nursing practice.
Jacobs, Barbara Bennett; Fontana, Joyce S; Kehoe, Maryanne Hidalgo; Matarese, Colette; Chinn, Peggy L
2005-01-01
Changes in health care facilities have created the necessity for individual nurses to change, eg, change jobs, pursue additional education, become independent entrepreneurs. There is a shortage of nurses that places stress on those who remain to care for an increasing number of persons with too few resources. The purposes of this study were to explore nurses' perceptions of the circumstances of their work lives and to describe the processes by which they can create change in these circumstances. The methodology was an emancipatory design combining tenets of critical inquiry and feminist research. The method used was a dialectical process of reflection and action (praxis). Three diverse groups of nurses met weekly over 6-10 weeks. Using the group process method, each group reflected on, discussed, and analyzed the phenomenon of practicing nursing today. The outcome of an emancipatory study is reflected in the power of the process. The group interaction increased awareness, promoted reflection on the status quo, and energized the groups to derive possible solutions to changing that status quo. It is not the solutions themselves that are as relevant as is the obvious cogency of the process to achieve individual and group emancipation. Six codifications reflected the themes that emerged and 5 processes for exploring untested feasibilities for change were identified. The participants perceived themselves more as subjects in their history than objects to be manipulated, capable of transforming a rather dismal situation of nursing practice into one that was critical, creative, and freer from constraints. The implication of this study is that nurses are encouraged to adopt and adapt this process of group interaction because of its demonstrated credibility to empower and validate the role that nurses have to derive and implement solutions to change their unsatisfactory status quo.
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Developing an Addictions Nursing Competency Framework Within a Canadian Context.
Ling, Sara; Watson, Alison; Gehrs, Margaret
Clients with substance use disorders access care in all areas of the health care system, yet the Canadian nursing literature lacks content on the knowledge, skills, and judgment needed by nurses who work with this population. To address this literature gap, two Advanced Practice Nurses adapted the Canadian Centre on Substance Abuse's Technical Competencies for Canada's Substance Abuse Workforce to include nursing content and theory. This article describes the adaptation process and validation method used by the Advanced Practice Nurses at a large, Canadian urban teaching hospital and includes discussion about actual and potential opportunities for practical application of the adapted framework.
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Brownie, Sharon M; Hunter, Lyndal H; Aqtash, Salah; Day, Gary E
2015-01-01
In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care-particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. © The Author(s) 2015.
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Hunter, Lyndal H.; Aqtash, Salah; Day, Gary E.
2015-01-01
In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care—particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, policy makers, and regulators who are reviewing or developing nursing regulatory processes and advancing nursing workforce capacity building activities; and nurse educators and nurses wishing to work in the UAE. PMID:25944674
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International Nursing: How Much Power Do Nurse Managers Have?
Trus, Marija; Martinkenas, Arvydas; Suominen, Tarja
This study was conducted to explore issues of nurse managers' power and empowerment. Data were collected from nurse managers by way of a questionnaire consisting of background factors, work-related questions, and power-related questions at the unit and organization levels. The degree of empowerment was evaluated using 2 established instruments (CWEQ-II and Work Empowerment Questionnaire). The overall level of managers' personal power within their own units was relatively high. Nurse managers' perception of their power at an organizational level was found to be at a moderate level. Several factors related to an individual's professional background were correlated to power issues, both at the unit and organizational levels. Structural and psychological empowerment correlated with the overall level of power at a unit level and the overall level of power at an organizational level. Nurse managers self-reported their own general power at a unit level as high, which offers them possibilities to lead the development of nursing care in their units. Organizations may benefit more from nurse managers' leadership by more fully integrating them in the development processes of the entire organization.
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Nursing's next advance: an internal classification for nursing practice.
Clark, J; Lang, N
1992-01-01
An International Classification of Nursing Practice (ICNP) is needed to support the processes of nursing practice and advance the knowledge necessary for cost-effective delivery of quality nursing care. Below, the authors present their case for developing such a system that will provide nursing with a nomenclature, a language and a classification that can be used to describe and organize nursing data. It is their belief that this landmark project is achievable and that ICN should lead the work in collaboration with its member associations, the World Health Organization and key national, international, governmental and nongovernmental groups. But to ensure that the system will be adaptable across borders, nurses and organizations are being encouraged to share their ideas and research on such a system.
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Kang, Jiyeon; Jeong, Yeon Jin; Kong, Kyoung Ran
2018-02-01
This qualitative study aimed to explore the experience of incivility among nursing students. Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments. © 2018 Korean Society of Nursing Science.
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Hutchinson, Marie; Vickers, Margaret H; Jackson, Debra; Wilkes, Lesley
2006-05-01
This paper reports some of the findings from the first qualitative stage of a large national study of bullying in the nursing workplace currently being undertaken in Australia. The findings reported here reveal how relationships between bullies were embedded within informal organizational alliances, enabling bullies to control work teams and use emotional abuse and psychological violence as a means of enforcing bully-defined 'rules of work'. Within nursing teams, bullies controlled work roles, tasks, and status in the nursing hierarchy through enforcing their 'rules'. Bullies enforced these rules through a process of ritual indoctrination, destroying the self-confidence and self-image of those targeted, and forcing them to eventually resign their position or acquiesce to survive. The merciless, calculated and deliberate nature of the bullying resulted in profound harm for many of those targeted. The findings of this research have implications for the understanding and management of workplace bullying.
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[Translation and validation in italian of the Moral Distress Scale for psychiatric nurses (MDS-P)].
Canciani, Eleonora; Spotti, Daniela; Bonetti, Loris
2016-01-01
Moral distress (MD) is a painful feeling and/or psychological disequilibrium, which may lead to negative consequences into the wellness of a nurse's working life. Nurses who work in psychiatry are more likely to experience a different type of MD compared with nurses of other contexts. In Italy a tool to evaluate MD in nurses who work in psychiatry doesn't exist. The aim of this study is to validate the Moral Distress Scale for Psychiatric Nurses (MDS-P) in Italian language. For translation the forward and back-translation has been used; the effectiveness regarding content and face validity of the translated scale has been analyzed through a focus group with experts of the field. In order to check the reliability of the scale the test-retest method has been used, by means of the determination of Spearman's correlation coefficient, Intraclass Correlation Coefficient (ICC) and Cronbach's alpha. The forward and back-translation process was successful. During the focus group analysis, 8 items were added to the 15 items of the original scale, due to experts suggestions. 32 nurses took part in the test-retest phase. Spearman's correlation coefficient resulted to be 0,91, ICC > 0,9, Cronbach's alpha calculated on test and retest, was always >0,9. The Italian version of the MDS-P proves to be an effective, appropriate and reliable instrument to measure the MD phenomenon within the population of nurses who work in the psychia- tric field in Italy.
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[Pleasure in nursing technicians working at an emergency unit of a public university hospital].
Garcia, Alessandra Bassalobre; Dellaroza, Mara Solange Gomes; Haddad, Maria do Carmo Lourenço; Pachemshy, Luiza Rita
2012-06-01
This study aimed to reveal the main aspects of the work process and feelings of pleasure experienced by nursing technicians who work at an emergency unit in Paraná, Brazil. The theoretical basis is the psychodynamics of work. This is a qualitative and descriptive study. Data were collected and analyzed using a semi-structured interview and the content analysis technique. Subjects were selected using a snowball sampling. Important aspects of the work process were revealed such as the unpredictability of working in an emergency unit, the impact of team work, and the comprehensive care model as a precursor to humanized care. Pleasure originates from the acknowledgement of their work either by the working subject him/herself by patients or society; and from the team work, realized by the cooperation among professionals. Feelings of pleasure are linked to the acknowledgment of their work, which should be valued since gratification contributes to the psychological health of workers.
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Kudo, Yasushi; Kono, Keiko; Kume, Ryuko; Matsuhashi, Ayako; Tsutsumi, Akizumi
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
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Nurse overtime, working conditions, and the presence of mandatory nurse overtime regulations.
Bae, Sung-Heui
2012-05-01
Although more states have regulated mandatory nurse overtime, limited research has examined the impact of these regulations on the actual time nurses work and their working conditions. The purpose of this study was to compare nurse overtime and working conditions between states with and states without regulations limiting mandatory nurse overtime. Data were collected from registered nurses working in hospitals located in states with and without mandatory nurse overtime regulations; the final sample consisted of 219 nurses. No difference was found in overtime worked between nurses who worked in states with regulations or without. Those nurses working in states with regulations cared for more patients per shift and experienced more chronic nursing shortages on their nursing units than those working in states without regulation. Continuous efforts are needed to improve the implementation of regulations to reduce nurse mandatory overtime and long work hours. Copyright 2012, SLACK Incorporated.
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A European curriculum for nurses working in haemophilia.
Harrington, C; Bedford, M; Andritschke, K; Barrie, A; Elfvinge, P; Grønhaug, S; Mueller-Kagi, E; Leenders, B; Schrijvers, L H
2016-01-01
Currently, there is no consensus on education required to develop haemophilia nursing. The aim was to develop a curriculum for haemophilia nurses that could be used as a resource in Europe. This could form a basis for continuous professional development and used in the preparation of specialized educational programmes. The EAHAD nurses working group set out to describe the skills and knowledge needed for a nurse to work in this specialty. This was considered at two levels: basic requirements and at a more advanced level. The working group acted as a focus group for this project drawing on existing specialist training, national role definitions, competencies and results of the EAHAD Nurses survey (2012). A template was populated with the knowledge base and the skills required. Themes were analysed and information generated organized into domains: content of curriculum; learning outcomes, defined in terms of knowledge, skills, behaviour and attitudes; and suggestions for teaching methods. For curriculum content the following domains were identified: Applied biological science; treatment and management of haemophilia and associated disorders; genetic practice; care management of affected carriers and women; the impact of living with bleeding disorders; evidence base and applied research in haemophilia practice; and, the specialist role of the haemophilia nurse. Examples are given for teaching and learning process. This curriculum is intended for use as a strategic resource to outline education for the haemophilia nurse and contribute to the standardization and benchmarking of haemophilia nursing care and thus to improvement in the quality of patient care. © 2015 John Wiley & Sons Ltd.
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Authentic leadership, performance, and job satisfaction: the mediating role of empowerment.
Wong, Carol A; Laschinger, Heather K S
2013-04-01
To report a study conducted to test a model linking authentic leadership of managers with nurses' perceptions of structural empowerment, performance, and job satisfaction. Authentic leadership has been proposed as the root element of effective leadership needed to build healthier work environments because there is special attention to the development of empowering leader-follower relationships. Although the influence of leadership style and empowerment on job satisfaction is well documented, there are few studies examining the influence of authentic leadership on nurses' empowerment and work outcomes. A non-experimental, predictive survey. In 2008, a random sample of 600 Registered Nurses working in acute care hospitals across Ontario in Canada was surveyed. The final sample consisted of 280 (48% response rate) nurses. Variables were measured using the Authentic Leadership Questionnaire, Conditions of Work Effectiveness Questionnaire, Global Job Satisfaction Survey, and General Performance scale. The theoretical model was tested using structural equation modelling. The final model fit the data acceptably. Authentic leadership significantly and positively influenced staff nurses' structural empowerment, which in turn increased job satisfaction and self-rated performance. The results suggest that the more managers are seen as authentic, by emphasizing transparency, balanced processing, self-awareness and high ethical standards, the more nurses perceive they have access to workplace empowerment structures, are satisfied with their work, and report higher performance. © 2012 Blackwell Publishing Ltd.
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The classification systems of nursing practice--the historical and practical perspective.
Górajek-Jóźwik, Jolanta
2003-01-01
The contribution into activities connected with the development of the quality of nursing care is closely combined with the process of systematic recording of accumulated data, of undertaken activities and achieved results. This in turn constitutes the essence of the 31st Aim of WHO which speaks not only about the need to continue the rational contribution towards the increase in the nursing care quality but also the application of adequate computer technologies to improve this quality. The aim of this work is to demonstrate the scope and character of the activities that have been over years undertaken by the nursing community towards the development of the classification systems which are comparable with those used in medicine. The focus has been specifically put on the taxonomy of diagnosis used by the North American Nursing Diagnosis Association (NANDA) and the European International Classification of Nursing Practice (ICNP). The analysis of the reference sources constitutes the methodological foundation applied in this work. It has allowed to show the pioneering contribution of the American Nursing Association (ANA) into the process of recording and coding of the data that are essential in care delivery as well as their value for the development of ICNP. The latter one is a systematic and multi-axial structure which uses unified terminology and numeric codes for the three categories of variables: the recognized conditions, the undertaken activities and the achieved results.
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Strategies to address the nursing shortage in Saudi Arabia.
Aboshaiqah, A
2016-09-01
To investigate the nursing shortage in Saudi Arabia and specifically the shortage of Saudi nurses in the healthcare workforce and to propose solutions. Literature published from 1993 to 2013 providing relevant information on the nursing shortage, cultural traditions and beliefs, and nursing education and policies in Saudi was accessed from multiple sources including Medline, CINAHL Plus and Google Scholar and from official Saudi government document and was reviewed. Saudi Arabia depends largely on an expatriate workforce, and this applies to nursing. Saudi Arabia is experiencing a nursing shortage in common with most countries in the world and a shortage of Saudi nationals, especially women, in the healthcare workforce. The world shortage of nursing is extrinsic to Saudi, but intrinsic factors include a poor image of the nursing profession in the country that is exacerbated by cultural factors. With the call for the Saudization of the workforce to replace the imported workforce by Saudi nationals, including nurses, through the 1992 Royal Decree, Saudi Arabia faces a problem in attracting and retaining Saudi nationals in the nursing workforce. Solutions are suggested that are aimed at improving the public image of nursing through education and the use of the media and improvements in the workplace by addressing working processes such as teamwork, ensuring adequate staffing levels and addressing some aspects of culture which may make working in nursing more compatible with being a Saudi national. © 2016 International Council of Nurses.
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Manual for monitoring the quality of nursing home care records.
Barbosa, Silvia Freitas; Tronchin, Daisy Maria Rizatto
2015-01-01
to build and validate an instrument aimed at monitoring the quality of nursing records in the Home Care Program (HCP) of a university hospital. methodological study involving the elaboration of a manual, whose content was later submitted to six experts for validation, reaching a ≥ 80% consensus. The data collection process was carried out in 2012 by means of a questionnaire comprised of the following issues: nursing evolution, nursing diagnosis, and nursing prescription, and standards for the nursing team recommended by the Regional Nursing Council of São Paulo and by the assessed institution. Manual items were judged according to the following variables: relevance, pertinence, clarity and simplicity. of the 39 propositions, 100% achieved ≥ 80% agreement in the relevance, pertinence and clarity variables; 92.3% in the simplicity variable. Sleep/rest, Mobility and Check-out variables did not reach a favorable minimum consensus in the prescribed activities and were improved following suggestions from the experts. we believe that the instrument will enable the improvement of the HCP's work process.
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Two theories/a sharper lens: the staff nurse voice in the workplace.
DeMarco, Rosanna
2002-06-01
This paper (1) introduces the two theoretical frameworks, Silencing the Self and the Framework of Systemic Organization (2) describes the design and findings briefly of a study exploring spillover in nurses utilizing the frameworks, and (3) discusses the process and value of theory triangulation when conducting research in the context of complex nursing systems phenomena where gender, professional work, and gender identity merge. A research study was designed to analyse the actual workplace behaviours of nurses in the context of their lives at work and outside work. An exploration of theoretical frameworks that could direct the measurement of the phenomena in question led to the use of two frameworks, the Framework of Systemic Organization (Friedemann 1995) and the Silencing the Self Theory (Jack 1991), and the creation of a valid and reliable summative rating instrument (the Staff Nurse Workplace Behaviours Scale, SNWBS). A descriptive correlational design was used to measure behaviours between work and home. There were statistically significant relationships found between workplace behaviours, family behaviours, and silencing behaviours as measured by the two separate scales measuring framework concepts. Although both theories had different origins and philosophical tenets, the findings of a research study created an opportunity to integrate the concepts of each and unexpectedly increase and broaden the understanding of spillover for women who are often nurses.
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Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet
2016-06-01
We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the inclusion of nursing-related standard operating procedures in certification/accreditation standards. © 2016 International Council of Nurses.
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Thompson, Juliana; Cook, Glenda; Duschinsky, Robbie
2018-03-01
To explore nursing home nurses' experiences and views of work identity. Nursing home nurses are in a unique position as they work at the interface of health and social care. Little is known about nursing home nurses' perceptions and experiences of working within this context. Evidence suggests that using the concept of work identity can support understanding of how workers make sense of their work. Hermeneutic phenomenological study. The study was carried out in seven nursing homes in North East England. Findings are based upon literary analysis of multiple episodic interviews with 13 nursing home nurses. Participants' responses suggested that nursing "residents" is different to nursing "patients," and nursing home nurses are required to modify their care activities to account for these differences. Participants also proposed that they are isolated and excluded from the rest of the healthcare workforce group. These issues led participants to feel uncertain about work identity. Many participants attempted to strengthen their work identity by aligning their role with what they perceived the "nurse identity" to be. Nurses' work activities and professional group identity influence their work identity. When work activities and professional group identity do not align with role expectations, as can be the case for nursing home nurses, work identity may be compromised. These nurses may attempt to change work practices to strengthen their work identity. Health- and social care providers need to account for work identity factors in the organisation of care, and planning and implementation of integrated health- and social care initiatives. © 2017 John Wiley & Sons Ltd.
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Mentor relationship as a tool of professional development of student nurses in clinical practice.
Saarikoski, Mikko
2003-09-01
This is a condensed version of a research project relating to the design and the development of a research instrument concerning 'Mentor Relationship as a Tool of Professional Development of Student Nurses in Clinical Practice'. This short research paper is taken from and reproduces the research work undertaken by Saarikoski (2002). The main themes refer to: (1) Evaluation scale to assess the quality of clinical learning environment and (2) Supervision of student nurses during their clinical placements. Parts one and two are taken from the main research study and include the following (i) developing and testing an evaluation tool (ii) describing how nursing students experience their clinical learning environment and (iii) the supervision given by qualified staff nurses working in a hospital setting. This abridged report discusses the methodology approaches undertaken by the author and includes: (a) comparative phased twin centred study (b) a pilot scheme and (c) a primary research instrument that was developed into an extensively validated assessment-measuring tool. This report strongly suggests that there is clear evidence in this research report that the supervisory relationship is the most important single element of pedagogical activities of staff nurses. The total satisfaction of students correlated most clearly with the method of supervision and that those satisfied students had a successful mentor relationship and frequently enough access to private supervision sessions with mentor. In the sample of this empirical study (n = 279 student nurses in Finland) individualized supervision system was most common on psychiatric wards. All nurse educators and clinical practitioners working across Europe and around the World in clinical learning environments will find this paper very useful in helping them to improve and quantify the supervisory process. This study starts bridging the gap between using and integrating both at a National and European level qualitative assessment systems that relate to the learning and supervisory process. The study encourages the need for professionals to test these new instruments in other nursing cultures and reflects upon the need for further research work in this area.
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ERIC Educational Resources Information Center
Nuuyoma, Vistolina
2017-01-01
Group-based assessments used in the Bachelor of Nursing Science (clinical) Honours programme at a public university in Namibia are usually in the form of assignments and projects. Completing tasks in groups helps students to develop important skills like critical thinking and debating. In addition, it prepares them to work in the health-care…
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Masoumian Hoseini, S. T.; Manzari, Z.; Khaleghi, I.
2015-01-01
Background: Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. Objective: To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. Methods: In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. Results: 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Conclusion: Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process. PMID:26306156
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The process of whistleblowing in a Japanese psychiatric hospital.
Ohnishi, Kayoko; Hayama, Yumiko; Asai, Atsushi; Kosugi, Shinji
2008-09-01
This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after whistleblowing, wavering emotions were observed, consisting of a guilty conscience, fear of retribution, and pride, which subsequently transformed to stable emotions containing a sense of relief and regret for delayed action. It is necessary for nurses to recognize that their professional responsibility is primarily to patients, not to organizations. Nurses should also have professional judgment about appropriate allegiance and actions.
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[Stress in the nursing team of an emergency medical service].
Panizzon, Cristiane; Luz, Anna Maria Hecker; Fensterseifer, Lísia Maria
2008-09-01
This exploratory study aimed at determining stress levels and stressors, verifying the association between stress and studied variables, and identifying the predictive stress factors in an emergency nursing team. Data were collected using a social-demographic questionnaire and a scale of labor pressure sources applied with 98 workers. Chi-square test and Spearman correlation test results showed a high stress level, and identified work load as the main stressor. All pressure sources at work had a positive significant correlation with stress leve, and the following predictors were identified: work load, problems related to the client, and organizational processes and structure. The results indicate the need of management changes in the emergency unit in order to reduce the stress of the nursing team.
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Axtell, Sara A; Avery, Melissa; Westra, Bonnie
2010-04-01
Health professionals are reorienting workforce education to better prepare students for working with increasingly diverse populations. The authors describe a community-based curriculum deliberation process in which community leaders and health workers deliberated with faculty and students to make recommendations about a graduate nursing curriculum. There were five areas of competencies recommended for graduate nursing to improve care of diverse populations: self-awareness, basic knowledge of culture and identity, attitudes that promote cross-cultural communication, cross-cultural clinical skills, and advocacy skills. The school now is in the process of phasing in recommendations gained from the deliberation.
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Thinking strategies used by Registered Nurses during emergency department triage.
Göransson, Katarina E; Ehnfors, Margareta; Fonteyn, Marsha E; Ehrenberg, Anna
2008-01-01
This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.
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Clinical intuition in the nursing process and decision-making-A mixed-studies review.
Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda
2017-12-01
To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision-making that supports safe patient care, and is a validated component of nursing clinical care expertise. © 2017 John Wiley & Sons Ltd.
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Association of the nurse work environment with nurse incivility in hospitals.
Smith, Jessica G; Morin, Karen H; Lake, Eileen T
2018-03-01
To determine whether nurse coworker incivility is associated with the nurse work environment, defined as organisational characteristics that promote nurse autonomy. Workplace incivility can negatively affect nurses, hospitals and patients. Plentiful evidence documents that nurses working in better nurse work environments have improved job and health outcomes. There is minimal knowledge about how nurse coworker incivility relates to the United States nurse work environment. Quantitative, cross-sectional. Data were collected through online surveys of registered nurses in a southwestern United States health system. The survey content included the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index and the Workplace Incivility Scale. Data analyses were descriptive and correlational. Mean levels of incivility were low in this sample of 233 staff nurses. Incivility occurred 'sporadically' (mean = 0.58; range 0.00-5.29). The nurse work environment was rated highly (mean = 3.10; range of 1.00-4.00). The nurse work environment was significantly inversely associated with coworker incivility. The nurse manager qualities were the principal factor of the nurse work environment associated with incivility. Supportive nurse managers reduce coworker incivility. Nurse managers can shape nurse work environments to prevent nurse incivility. © 2017 John Wiley & Sons Ltd.
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Dittman, Patricia W
2015-01-01
Chemical use and dependency is a prevalent problem in society and among the members of the nursing profession. Nursing students, as the novice representatives of the profession, may be particularly vulnerable to chemical use. Nursing leaders in both educational institutions and practice settings must recognize highly vulnerable individuals, which nursing activities are most vulnerable, and interventions to assist and support the vulnerable individual while assuring a safe practice environment. As nurses, it is our responsibility, both ethically and legally, to provide a safe working environment not only for our patients but also for ourselves by reporting the behaviors of nurses who may be impaired through the proper channels according to your state's Nurse Practice Act. Through a united approach, nurse leaders from both the academic and practice environments should provide a safe and effective rehabilitation approach.
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Jangland, Eva; Yngman Uhlin, Pia; Arakelian, Erebouni
2016-11-01
The position of Nurse Practitioner is a new role in Nordic countries. The transition from a registered nurse to the Nurse Practitioner role has been reported to be a personal challenge. This study, guided by the Nordic theoretical model for use in the education of advanced practice nurses, represents a unique opportunity to describe this transition for newly graduated Nurse Practitioners in an interprofessional surgical care team in Sweden. The aim was to explore how the first Nurse Practitioners in surgical care experienced the transition into a new role and what competences they used in the team. Eight new Nurse Practitioners with parallel work in clinical practice were interviewed twice around the time of their graduation. The qualitative analyses show that the participants integrated several central competences, but the focus in this early stage in their new role was on direct clinical praxis, consultation, cooperation, case management, and coaching. Transition from the role of clinical nurse specialist to nurse practitioner was a challenging process in which the positive response from patients was a driving force for the new Nurse Practitioners. The participants felt prepared for and determined to solve the challenging situations they approached working in the interprofessional team. Copyright © 2016 Elsevier Ltd. All rights reserved.
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High school students' perceptions of nursing as a career choice.
Kohler, P A; Edwards, T A
1990-01-01
Declining enrollments in nursing programs, coupled with the current shortage of practicing registered nurses, prompted this investigation of 306 high school students' beliefs about nurses and nursing. The study also identifies potential numbers of future nursing students from high school populations and their primary source of information about nursing. Using an investigator questionnaire, subjects responded to statements about educational requirements for registered nurses along with their working conditions, earning power, and social status. Findings reveal a projected continuing shortage of nurses based on the very small percentage of subjects even considering nursing as a career. Additional findings show that whereas some perceptions about nursing seem congruent with those of nurses themselves, other beliefs held by high school students are not consistent with the realities of professional nursing today. Results of this study can be used by nurse recruiters to correct misconceptions about nursing and to help high school students perceive the profession in a more positive way. Expanding the informational sources about nursing can facilitate the recruitment process.
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Group work: Facilitating the learning of international and domestic undergraduate nursing students.
Shaw, Julie; Mitchell, Creina; Del Fabbro, Letitia
2015-01-01
Devising innovative strategies to address internationalization is a contemporary challenge for universities. A Participatory Action Research (PAR) project was undertaken to identify issues for international nursing students and their teachers. The findings identified group work as a teaching strategy potentially useful to facilitate international student learning. The educational intervention of structured group work was planned and implemented in one subject of a Nursing degree. Groups of four to five students were formed with one or two international students per group. Structural support was provided by the teacher until the student was learning independently, the traditional view of scaffolding. The group work also encouraged students to learn from one another, a contemporary understanding of scaffolding. Evaluation of the group work teaching strategy occurred via anonymous, self-completed student surveys. The student experience data were analysed using descriptive statistical techniques, and free text comments were analysed using content analysis. Over 85% of respondents positively rated the group work experience. Overwhelmingly, students reported that class discussions and sharing nursing experiences positively influenced their learning and facilitated exchange of knowledge about nursing issues from an international perspective. This evaluation of a structured group work process supports the use of group work in engaging students in learning, adding to our understanding of purposeful scaffolding as a pathway to enhance learning for both international and domestic students. By explicitly using group work within the curriculum, educators can promote student learning, a scholarly approach to teaching and internationalization of the curriculum.
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Burnout syndrome and its prevalence in primary care nursing: a systematic review and meta-analysis.
Monsalve-Reyes, Carolina S; San Luis-Costas, Concepción; Gómez-Urquiza, Jose L; Albendín-García, Luis; Aguayo, Raimundo; Cañadas-De la Fuente, Guillermo A
2018-05-10
burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. The aim of the study was to estimate the prevalence of emotional exhaustion, depersonalization and low personal accomplishment in primary care nurses. We performed a meta-analysis. We searched Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN and LILACS databases up to September 2017 to identify cross-sectional studies assessing primary care nurses' burnout with the Maslach Burnout Inventory were included. The search was done in September 2017. After the search process, n = 8 studies were included in the meta-analysis, representing a total sample of n = 1110 primary care nurses. High emotional exhaustion prevalence was 28% (95% Confidence Interval = 22-34%), high depersonalization was 15% (95% Confidence Interval = 9-23%) and 31% (95% Confidence Interval = 6-66%) for low personal accomplishment. Problems such as emotional exhaustion and low personal accomplishment are very common among primary care nurses, while depersonalization is less prevalent. Primary care nurses are a burnout risk group.
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Nurses and stress: recognizing causes and seeking solutions.
Happell, Brenda; Dwyer, Trudy; Reid-Searl, Kerry; Burke, Karena J; Caperchione, Cristina M; Gaskin, Cadeyrn J
2013-05-01
To identify, from the perspectives of nurses, occupational stressors and ways in which they may be reduced. Nurses commonly experience high levels of occupational stress, with negative consequences for their physical and psychological health, health-care organisations and community. There is minimal research on reducing occupational stress. Six focus groups were conducted with 38 registered nurses using a qualitative exploratory approach. Participants were asked to identify sources of occupational stress and possible workplace initiatives to reduce stress. Sources of occupational stress were: high workloads, unavailability of doctors, unsupportive management, human resource issues, interpersonal issues, patients' relatives, shift work, car parking, handover procedures, no common area for nurses, not progressing at work and patient mental health. Suggestions for reduction included: workload modification, non-ward-based initiatives, changing shift hours, forwarding suggestions for change, music, special events, organisational development, ensuring nurses get breaks, massage therapists, acknowledgement from management and leadership within wards. The findings highlight the need to understand local perspectives and the importance of involving nurses in identifying initiatives to reduce occupational stress. Health-care environments can be enhanced through local understanding of the occupational stressors and productively engaging nurses in developing stress reduction initiatives. Nurse managers must facilitate such processes. © 2013 Blackwell Publishing Ltd.
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The working experiences of novice psychiatric nurses in Taiwanese culture: a phenomenological study.
Hung, B J; Huang, X Y; Cheng, J F; Wei, S J; Lin, M J
2014-08-01
Novice psychiatric nurses experience heavy workloads, insufficient training and support in Taiwan. The aim of this study was to understand the working experiences of novice psychiatric nurses during their first year in a clinical setting. A qualitative phenomenological approach, using semi-structured face-to-face interviews was used. Narratives were analyzed using Colaizzi's seven-step method. Data saturation was reached after interviews were conducted with 15 nurses based on the purposive sampling. Four themes and eight sub-themes were identified: struggling (lacking a sense of security and competency), emulating (learning the process of interaction with clients and families, learning an appropriate role from nursing staff), prevailing (developing core competency, creating a therapeutic environment) and belonging (coping with the job, becoming a part of the psychiatric nursing staff). The findings from this study demonstrate that nurses are often inadequately prepared for psychiatric nursing. They have little understanding of mental illness, are unable to communicate appropriately with clients and struggle to cope with the conditions. Our study supports the importance for helping nurses to improve their essential knowledge and skills for coping with the job and providing good quality care, particularly in the first year. © 2014 John Wiley & Sons Ltd.
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Technology and medication errors: impact in nursing homes.
Baril, Chantal; Gascon, Viviane; St-Pierre, Liette; Lagacé, Denis
2014-01-01
The purpose of this paper is to study a medication distribution technology's (MDT) impact on medication errors reported in public nursing homes in Québec Province. The work was carried out in six nursing homes (800 patients). Medication error data were collected from nursing staff through a voluntary reporting process before and after MDT was implemented. The errors were analysed using: totals errors; medication error type; severity and patient consequences. A statistical analysis verified whether there was a significant difference between the variables before and after introducing MDT. The results show that the MDT detected medication errors. The authors' analysis also indicates that errors are detected more rapidly resulting in less severe consequences for patients. MDT is a step towards safer and more efficient medication processes. Our findings should convince healthcare administrators to implement technology such as electronic prescriber or bar code medication administration systems to improve medication processes and to provide better healthcare to patients. Few studies have been carried out in long-term healthcare facilities such as nursing homes. The authors' study extends what is known about MDT's impact on medication errors in nursing homes.
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Quality of nursing documentation: Paper-based health records versus electronic-based health records.
Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam
2018-02-01
To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.
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[Reflections on stress and burnout and their relationship with nursing].
Murofuse, Neide Tiemi; Abranches, Sueli Soldati; Napoleão, Anamaria Alves
2005-01-01
This bibliographic review aimed to differentiate between stress and Burnout and to establish their relationship with nursing work to support the understanding of psychical suffering at work. The study was based on the analysis and interpretation of articles, thesis and dissertations produced between 1990 and 2001. Although there is a consensus among the individuals on the existence of stress and burnout, there are several controversies surrounding these terms. These theories were created in the context of capitalist production increase. Stress refers to a personal tiring that interferes in the life of the person but not necessarily in his/her relationship with the work. Burnout is a syndrome involving negative attitudes and behaviors towards users, clients, organization and work. It is a gradual process of subjective experiences that result in practical and emotional problems to workers and organizations. Nursing work facilitates stress and burnout and causes suffering and illness among workers.
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Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha
2015-08-12
The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha
2015-01-01
Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff. PMID:26270947
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Pop, Marcel; Hollós, Sándor; Vingender, István; Mészáros, Judit
2009-03-08
Our paper is presenting a new initiative regarding an international cooperation willing to develop a dual degree program in nursing, the so-called Transatlantic Curriculum in Nursing. The candidates--after successful completion of their studies--will get a European and an American partner diploma in nursing. The objective is to prepare an internationally and culturally competent workforce; develop the practice of nursing students' exchange programs; process the model of dual degree independent of geographical, political or cultural borders; spread the evidence-based nursing standards in the daily practice. The partners in this initiative are Semmelweis University in Budapest, Hungary, Nazareth College of Rochester, NY, USA and Laurea University in Tikkurila, Finland. The planned activities in the framework of the program: mutual student and staff mobility, joint curriculum development and teaching process, determining joint standards. The expected outcomes are: to develop a standardised model for the enhancement and implementation of international educational programs in nursing; to improve institutional work culture; to improve professional terminology and cultural abilities; to create the model of a new type of nursing professional having a high level of cultural and language competence which are indispensable for participating in global programs.
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The Influence of Nurse Manager Leadership Style on Staff Nurse Work Engagement.
Manning, Jennifer
2016-09-01
Nursing literature supports the importance of an engaged nursing workforce as a means to positively influence performance. Nurse manager leadership style plays a critical role in engaging staff nurses. These relationships have been minimally studied in nurse managers and staff nurses. The aim of this study is to evaluate the influence of nurse manager leadership style factors on staff nurse work engagement. Using a descriptive correlational research design, 441 staff nurses working in 3 acute care hospitals were surveyed. Survey instruments included the Utrecht Work Engagement Scale and the Multifactorial Leadership Questionnaire 5X short form. Transactional and transformational leadership styles in nurse managers positively influenced staff nurse work engagement. Passive-avoidant leadership style in nurse managers negatively influenced staff nurse work engagement. Nurse managers who provide support and communication through transformational and transactional leadership styles can have a positive impact on staff nurse work engagement and ultimately improve organizational outcomes.
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[High-quality nursing health care environment: the patient safety perspective].
Tu, Yu-Ching; Wang, Ruey-Hsia
2011-06-01
Patient safety is regarded as an important indicator of nursing care quality, and nurses hold frontline responsibility to maintain patient safety. Many countries now face healthcare provider shortfalls, and recognize a close correlation between adequate manpower and patient safety. Many healthcare organizations work to foster positive work environments in order to improve health service quality. The active participation and "buy in" of nurses, patients and policymakers are critical to maximize healthcare environment quality and improve patient safety. This article adopts Donabedian's theoretical "Structure-Process-Outcome" model of quality (Donabedian, 1988) and presumes all high-quality healthcare environment indicators to be linked to patient safety. In addition to raising public awareness regarding the influence of healthcare environment quality on patient safety, this research suggests certain indicators for tracking and assessing healthcare environment quality. Future research may design an empirical study based on these indicators to help further enhance healthcare environment quality and the professional development of nurses.
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Confronting 'reality': nursing, science and the micro-politics of representation.
Walker, K
1994-11-01
In an age where previous frames of reference lose their certainty nurses are finding themselves rethinking their relations to the 'real'. In this paper I interrogate an empirical 'text' of a local nursing cultural practice through a poststructural critique of the ways in which language, discourses, representation and experience intersect to construct 'reality' for us with specific consequences. I do this in an attempt to disclose the micro-politics at work in the processes of signifying and thus representing nursing to a world of potential students. The discourses of science and caring find themselves exposed in particular representational technologies and practices that mark nursing's collusion with the 'truths' of science at the expense of those we loosely name 'caring'. This cultural theoretical work constitutes a provisional and historical fragment of analysis designed to trouble the relations we often unwittingly sustain with dominant 'regimes of truth'.
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2013-01-01
In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Specialized nurses with an autonomous role in patient care had comparable outcomes to physicians alone (Model 1) based on moderate quality evidence, with consistent results among a subgroup analysis of patients with diabetes based on low quality evidence. Model 2 showed an overall improvement in appropriate process measures, disease-specific measures, and patient satisfaction based on low to moderate quality evidence. There was low quality evidence that nurses working under Model 2 may reduce hospitalizations for patients with coronary artery disease. The specific role of the nurse in supplementing or substituting physician care was unclear, making it difficult to determine the impact on efficiency. Nurses with additional skills, training, or scope of practice may help improve the primary care of patients with chronic diseases. This review found that specialized nurses working on their own could achieve health outcomes that were similar to those of doctors. It also found that specialized nurses who worked with doctors could reduce hospital visits and improve certain patient outcomes related to diabetes, coronary artery disease, or heart failure. Patients who had nurse-led care were more satisfied and tended to receive more tests and medications. It is unclear whether specialized nurses improve quality of life or doctor workload.
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A theoretical framework for psychiatric nursing practice.
Onega, L L
1991-01-01
Traditionally, specific theoretical frameworks which are congruent with psychiatric nursing practice have been poorly articulated. The purpose of this paper is to identify and discuss a philosophical base, a theoretical framework, application to psychiatric nursing, and issues related to psychiatric nursing knowledge development and practice. A philosophical framework that is likely to be congruent with psychiatric nursing, which is based on the nature of human beings, health, psychiatric nursing and reality, is identified. Aaron Antonovsky's Salutogenic Model is discussed and applied to psychiatric nursing. This model provides a helpful way for psychiatric nurses to organize their thinking processes and ultimately improve the health care services that they offer to their clients. Goal setting and nursing interventions using this model are discussed. Additionally, application of the use of Antonovsky's model is made to nursing research areas such as hardiness, uncertainty, suffering, empathy and literary works. Finally, specific issues related to psychiatric nursing are addressed.
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Manenti, Simone Alexandra; Ciampone, Maria Helena Trench; Mira, Vera Lucia; Minami, Lígia Fumiko; Soares, Jaqueline Maria Sousa
2012-06-01
The objective of this study was to construct a profile of managerial competencies, based on the consensus of nurse coordinators in the field. This study was developed in a philanthropic hospital in São Paulo, following the research-action model, and included 13 nurse coordinators as participants. The data collection was performed using the focal group technique. Data analysis was performed using the theoretical frameworks related to the working process and managerial competencies. The results identified the greater emphasis assigned to the competencies related to the mentor, coordinator and director roles. It was, therefore, possible to construct a professional development plan that is based on competencies in the technical, ethical-political, and communicative domains, as well as the development of citizenship. The analysis of the managerial working process and the study of the competencies within the managerial environment were shown to be important, because they highlighted the professionals' need to improve, thus fulfilling personal, professional, and organizational demands.
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Dingel-Stewart, Sylvia; LaCoste, Janice
2004-01-01
Lacking political stewardship, healthcare in America is shaped primarily by rapidly changing market forces seeking to stem the tide of rising healthcare costs. However, nursing's voice in this process is fragmented and unfocused. Staff nurses' focus and commitment are to quality care rendered at the bedside and in interactions with the patient. With this narrow focus, staff nurses are paralyzed by the constant change and unable to move to a broader, more integrative view of healthcare-one that encompasses quality care, policymaking, and healthcare finance. Using the theory of transformative learning, nurse administrators and managers can influence nurses' frames of reference and expand their view to be more inclusive. Nurses who are successful in this transformation process will emerge with a new view of self-visible and empowered. These newly transformed nurses see themselves more as healthcare engineers than as technicians coordinating care across the continuum, and creating fluid working relationships to prevent the dis-continuum of care of patients falling through the cracks of the current healthcare system.
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Mancia, J R; Burlamaque, C S
2001-01-01
This work is a description of the most relevant facts of the branch of the Brazilian Association of Nursing (ABEn) in Rio Grande do Sul federal state, along its fifty years of work. The data was collected in primary sources such as records of the association, newspaper articles, congress minutes, reports from ABEn's members, and pictures. The study contextualizes nursing in the period, which precedes the creation of this branch. It presents biographical aspects of the first directors of the association. Reports the trajectory of this branch, focusing on its struggle to legitimate the nursing profession as a profession that demands higher education and to include it in the career plans of public and private organizations. Describes the efforts of the association to meet the demands of the professional and educational legislation. Presents the work done to strengthen ABEn-Rio Grande do Sul through the organization of campaigns, scientific events and the event Semana da Enfermagem (congress of nursing). It also acknowledges the decisive role of ABEn-RS in the creation and consolidation of the Syndicate of Nursing and of the Federal/Regional Board of Nursing. Finally the study demonstrates that, although it defends specific professional interests, it also has a profound commitment with the quality of the health service provided in Brazil.
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Nursing practices in the primary health care context: a scoping review 1
Barbiani, Rosangela; Nora, Carlise Rigon Dalla; Schaefer, Rafaela
2016-01-01
ABSTRACT Objective: to identify and categorize the practices performed by nurses working in Primary Health Care and Family Health Strategy Units in light of responsibilities established by the profession's legal and programmatic frameworks and by the Brazilian Unified Health System. Method: a scoping review was conducted in the following databases: LILACS, IBECS, BDENF, CINAHL and MEDLINE, and the Cochrane and SciELO libraries. Original research papers written by nurses addressing nursing practices in the primary health care context were included. Results: the review comprised 30 studies published between 2005 and 2014. Three categories emerged from the analysis: practices in the service; practices in the community; and management and education practices. Conclusion: the challenges faced by nurses are complex, as care should be centered on the population's health needs, which requires actions at other levels of clinical and health responsibility. Brazilian nursing has achieved important advancements since the implementation of policies intended to reorganize work. There is, however, a need to shift work processes from being focused on individual procedures to being focused on patients so that an enlarged clinic is the ethical-political imperative guiding the organization of services and professional intervention. PMID:27579928
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Bergh, Anne-Louise; Karlsson, Jan; Persson, Eva; Friberg, Febe
2012-09-01
To describe nurses' perceptions of conditions for patient education, focusing on organisational, environmental and professional cooperation aspects, and to determine any differences between primary, municipal and hospital care. Although patient education is an important part of daily nursing practice, the conditions for this work are unclear and require clarification. A stratified random sample of 701 (83%) nurses working in primary, municipal and hospital care completed a 60-item questionnaire. The study is part of a larger project. The study items relating to organisation, environment and professional cooperation were analysed using descriptive statistics, non-parametric tests and content analysis. Conditions for patient education differ. Nurses in primary care had better conditions and more managerial support, for example in the allocation of undisturbed time. Conditions related to organisation, environment and cooperation need to be developed further. In this process, managerial support is important, and nurses must ask for better conditions in order to carry through patient education. Managerial support for the development of visible patient education routines (e.g. allocation of time, place and guidelines) is required. One recommendation is to designate a person to oversee educational work. © 2012 Blackwell Publishing Ltd.
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Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L
2016-02-01
To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote safe and efficient communication. Nurses should empower patients to address concerns directly with providers through use of devices including health passports. © 2016 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
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Sociotechnical analysis of nurses' use of personal mobile phones at work.
Bautista, John Robert; Lin, Trisha T C
2016-11-01
Nurses' use of personal mobiles phones at work is a growing trend in healthcare organizations. Although recent studies have explored the positive and negative implications of nurses using personal mobile phones at work, none has yet analyzed the interactions of sociotechnical components (users, technology and policy) on nurses' use of personal mobile phones at work. Identify sociotechnical interactions by analyzing each sociotechnical component (users, technology and policy) that affects nurses' use of personal mobile phones at work. In-depth interviews were conducted with 30 nurses employed in 13 hospitals in the Philippines. The respondents include staff nurses (n=23), charge nurses (n=4), and nurse managers (n=3). Staff nurses were asked on their use of personal mobile phones at work, while charge and nurse managers were asked on their observations regarding staff nurses' use of personal mobile phones at work. Responses were analyzed qualitatively using sociotechnical analysis. Sociotechnical analysis indicated that staff nurses used their personal mobile phones at work in various ways because its use helped in their nursing work, but inevitably altered a few of their routines. Although most hospitals had policies that prohibit the use of mobile phones, staff nurses justified their use of personal mobile phones by using it for work purposes and for the benefit of their patients. Staff nurses highlighted the absence of hospital-provided mobile phones as a key reason for using personal mobile phones at work. Charge nurses and nurse managers also influenced staff nurses' use of personal mobile phones at work. Nurses could use their personal mobile phones at work for work purposes to enhance their clinical performance and improve patient care. Hospital administrators can leverage on nurses' use of personal mobile phones at work by formulating policies that consider both the benefits and potential drawbacks of mobile phone usage. Recommendations are made for the formulation of hospital policies to optimize the use of personal mobile phones of nurses at work. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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Sbaih, L
1997-04-01
An ethnomethodological study was undertaken to explore the work of Accident and Emergency (A & E) nurses; the aim of which was to analyse the ordinary, taken for granted, everyday work of those practising A & E nursing. In this second paper on the work of A & E nurses, the specific rules or maxims of nursing work in A & E are introduced. From the analysis of materials gained: fieldwork notes, observations of nurses at work and conversations, a number of maxims of A & E nursing work were identified. Maxims direct, instruct and make nurses accountable for their work and the ways in which it gets done. That is, the presence of maxims underpinning A & E nursing work ensure that A & E nursing is seen and heard as a specific type of work with its own unique approach to talk and organization. Being aware of the maxims of A & E nursing work is not the concern of the nurse practising A & E nursing on a daily basis. Implicit and explicit reference to the maxims when talking about and doing the work provides nurses with impressions of who can do the job. Non-adherence by some nurses to the maxims of A & E nursing work often leads their colleagues to question their commitment to their choice of work setting. Maxims of A & E nursing account for the ways in which the work is seen, heard and talked about. Maxims direct the organization of work and its development within the A & E setting.
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Cognitive abilities of preschool children: implications for nurses working with young children.
Hauck, M R
1991-08-01
To effectively care for well or ill children, nurses must know something about how children think and what they are capable of comprehending. Nurses have traditionally based assumptions about children's cognitive abilities on a surface knowledge of Piaget's theory of cognitive development. Many recent researchers in the field of cognitive development have pointed out limitations in Piaget's theory and offer new ways of conceptualizing the way children think. In this article, I will identify limitations of Piaget's theory as it applies to preschool-aged children. Ideas of researchers using an information processing approach to understanding children's thinking will be described as alternative approaches to the understanding of preschool thought. I prescriptively postulate how research findings concerning cognition have implications for nurses working with young children.
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[Nursing staff absenteeism rates as a personnel management indicator].
Sancinetti, Tânia Regina; Soares, Alda Valéria Neves; Lima, Antonio Fernandes Costa; Santos, Nanci Cristiano; Melleiro, Marta Maria; Fugulin, Fernanda Maria Togeiro; Gaidzinski, Raquel Rapone
2011-08-01
Absenteeism in nursing is a difficult problem for health organizations; hence it is an indicator that must be monitored. The objective of this study was to analyze the absenteeism rate of nursing professionals in a public hospital. Absenteeism data were collected monthly, from January to July 2008, and calculated by means of an electronic program. The mean absenteeism index for nurses varied from 5.6% to 9.7% for technicians/nursing aides. Sick leaves were the most prevalent reason for absences. The data revealed the major cause of absenteeism and pointed at the need to change policies for hiring nursing professionals, in addition to reviewing the working processes in order to improve the workers' health conditions.
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Exploring nurses' reactions to a novel technology to support acute health care delivery.
Kent, Bridie; Redley, Bernice; Wickramasinghe, Nilmini; Nguyen, Lemai; Taylor, Nyree J; Moghimi, Hoda; Botti, Mari
2015-08-01
To explore nurses' reactions to new novel technology for acute health care. Past failures of technology developers to deliver products that meet nurses' needs have led to resistance and reluctance in the technology adoption process. Thus, involving nurses in a collaborative process from early conceptualisation serves to inform design reflective upon current clinical practice, facilitating the cementing of 'vision' and expectations of the technology. An exploratory descriptive design to capture nurses' immediate impressions. Four focus groups (52 nurses from medical and surgical wards at two hospitals in Australia; one private and one public). Nursing reactions towards the new technology illustrated a variance in barrier and enabler comments across multiple domains of the Theoretical Domains Framework. Most challenging for nurses were the perceived threat to their clinical skill, and the potential capability of the novel technology to capture their clinical workflow. Enabling reactions included visions that this could help integrate care between departments; help management and support of nursing processes; and coordinating their patients care between clinicians. Nurses' reactions differed across hospital sites, influenced by their experiences of using technology. For example, Site 1 nurses reported wide variability in their distribution of barrier and enabling comments and nurses at Site 2, where technology was prevalent, reported mostly positive responses. This early involvement offered nursing input and facilitated understanding of the potential capabilities of novel technology to support nursing work, particularly the characteristics seen as potentially beneficial (enabling technology) and those conflicting (barrier technology) with the delivery of both safe and effective patient care. Collaborative involvement of nurses from the early conceptualisation of technology development brings benefits that increase the likelihood of successful use of a tool intended to support the delivery of safe and efficient patient care. © 2015 John Wiley & Sons Ltd.
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Farzandipour, Mehrdad; Meidani, Zahra; Riazi, Hossein; Sadeqi Jabali, Monireh
2016-12-01
Considering the integral role of understanding users' requirements in information system success, this research aimed to determine functional requirements of nursing information systems through a national survey. Delphi technique method was applied to conduct this study through three phases: focus group method modified Delphi technique and classic Delphi technique. A cross-sectional study was conducted to evaluate the proposed requirements within 15 general hospitals in Iran. Forty-three of 76 approved requirements were clinical, and 33 were administrative ones. Nurses' mean agreements for clinical requirements were higher than those of administrative requirements; minimum and maximum means of clinical requirements were 3.3 and 3.88, respectively. Minimum and maximum means of administrative requirements were 3.1 and 3.47, respectively. Research findings indicated that those information system requirements that support nurses in doing tasks including direct care, medicine prescription, patient treatment management, and patient safety have been the target of special attention. As nurses' requirements deal directly with patient outcome and patient safety, nursing information systems requirements should not only address automation but also nurses' tasks and work processes based on work analysis.
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Enhancing team learning in nursing teams through beliefs about interpersonal context.
Ortega, Aída; Sánchez-Manzanares, Miriam; Gil, Francisco; Rico, Ramón
2013-01-01
This article is a report of a study that examines the relationship between team-level learning and performance in nursing teams, and the role of beliefs about the interpersonal context in this relationship. Over recent years, there has been an increasing interest in the learning processes of work teams. Researchers have investigated the impact of team learning on team performance, and the enabling conditions for this learning. However, team learning in nursing teams has been largely ignored. A cross-sectional field survey design was used. The sample comprises a total of 468 healthcare professionals working in 89 nursing teams at different public hospitals throughout Spain. Members of nursing teams participated voluntarily by completing a confidential individual questionnaire. Team supervisors evaluated nursing teams' performance. Data were collected over 2007-2008. The results show a mediating effect of team learning on the relationship between beliefs about interpersonal context (psychological safety, perceived task interdependence, and group potency) and team performance. Our findings suggest that beliefs about interpersonal context and team learning are important to effective nursing team performance. © 2012 Blackwell Publishing Ltd.
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The work setting of diabetes nursing specialists in the Netherlands: a questionnaire survey.
van den Berg, Tilja I J; Vrijhoef, Hubertus J M; Tummers, Gladys; Landeweerd, Jan A; van Merode, Godefridus G
2008-10-01
The aim of this study is to explore whether the work organisation of diabetes specialist nurses (DSNs) differs significantly from nurses working in hospital and nursing home and if so, does this difference result in positive or negative consequences regarding work and health. In traditional health care settings, nurses exhibit a high level of environmental uncertainty and low decision-making authority, which has a negative effect on psychological reactions towards work. In professional nursing, specialisation, e.g. diabetic nursing, is a current trend in many countries. Therefore, insight into the determinants of the work situation of nursing specialists is becoming increasingly relevant. Comparisons were made between 3 different samples: 1204 nurses employed by 15 hospitals, 1058 nurses employed by 14 nursing homes, and 350 diabetes nurses working in other health care settings throughout the Netherlands. Data concerning organisation, work aspects, and psychological reactions were measured via questionnaires. Variances between the groups were analysed with ANCOVA, besides hierarchical multiple regression analysis was applied. Environmental uncertainty scored lower amongst diabetes nurses when compared to nurses working in the other two types of health care settings. Social support and role conflict scored low for diabetes nursing specialists who simultaneously perceived autonomy and role ambiguity highest. Diabetes nursing specialists also scored highest on intrinsic work motivation and job satisfaction and lowest for psychosomatic health. Except for social support and role ambiguity, diabetic nurses rate their [work] organisation, [work] aspects and psychological [work] reactions more positively than nurses employed in other health care settings.
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Nursing diagnoses in pemphigus vulgaris: a case study.
Pena, Silvana B; Guimarães, Heloísa C Q C P; Bassoli, Sidinéia R B; Casarin, Santina N A; Herdman, Trace Heather; de Barros, Alba L B L
2013-10-01
This case study illustrates the use of the nursing process based upon the standardized nursing diagnoses approved by NANDA International (NANDA-I), and using the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC) in the care of a patient with pemphigus vulgaris (PV). The published literature on PV and the experience and expertise of the authors in working with people with impaired skin integrity and PV were used to develop this case study. The accuracy of nursing diagnoses and appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. Impaired skin integrity is a human response diagnosed by nurses, and early treatment is important due to the vulnerability of these patients. The case study contributes to nursing knowledge for professionals who care for patients with PV. © 2013 NANDA International.
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Choi, Sandy Pin-Pin; Pang, Samantha Mei-Che; Cheung, Kin; Wong, Thomas Kwok-Shing
2011-10-01
The nursing work environment, which provides the context of care delivery, has been gaining increasing attention in recent years. A growing body of evidence points to an inseparable link between attributes of the nursing work environment and nurse and patient outcomes. While most studies have adopted a survey design to examine the workforce and work environment issues, this study employed a phenomenological approach to provide empirical evidence regarding nurses' perceptions of their work and work environment. The aim of this study was to advance our understanding of the phenomenon of increasing nurse turnover through exploring frontline registered nurses' lived experiences of working in Hong Kong public hospitals. A modified version of Van Kaam's controlled explication method was adopted. Individual semi-structured interviews were conducted with 26 frontline nurses recruited from ten acute regional, district and non-acute public hospitals in Hong Kong. Their perspectives in regard to their work and work environment, such as workload, manpower demand and professional values, were extensively examined, and a hypothetical description relating the nursing work environment with nurses' turnover intention was posited. Contemplation of nurses' experiences revealed the vulnerable aspects of nursing work and six essential constituents of the nursing work environment, namely staffing level, work responsibility, management, co-worker relationships, job, and professional incentives. These essential constituents have contributed to two sets of forces, stabilizing and destabilizing forces, which originate from the attributes of the nursing work environment. Nurses viewed harmonious co-worker relationships, recognition and professional development as the crucial retaining factors. However, nurses working in an unfavorable environment were overwhelmed by destabilizing forces; they expressed frustration and demonstrated an intention to leave their work environment. The nursing work environment is a complex entity comprising multiple constituents; its attributes affect nurses' perceptions of their work and work environment, which warrant special attention in addressing the phenomenon of increasing nurse turnover. Copyright © 2011 Elsevier Ltd. All rights reserved.
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Bae, Sung-Heui; Yoon, Jangho
2014-10-01
To examine the degree to which states' work hour regulations for nurses-policies regarding mandatory overtime and consecutive work hours-decrease mandatory overtime practice and hours of work among registered nurses. We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. © Health Research and Educational Trust.
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Zaghini, F; Biagioli, Valentina; Prandi, Cesarina; Fida, Roberta; Sili, A
2015-11-22
Workers engaging in Organizational Citizenship Behaviour (OCB) can benefit colleagues, organization and stakeholders. Such behavior is vital to the efficacy of health care organizations as they can have a positive effect on the quality of care and users' satisfaction. Therefore, it is important to assess such behaviour with a valid and reliable instrument. The purpose of this study was to test, from a confirmatory perspective, the dimensionality of the Italian version of the Podsakoff et al. OCB scale in a large sample of nurses, and at the same time to evaluate the differences in nurses' OCB considering socio-demographic and job characteristics. The study included 886 nurses from different health organizations in Italy. The psychometric characteristics of the Italian OCB scale were tested through confirmatory factor analysis (CFA). The differences in nurses' OCB, according to several socio-demographic and job characteristics, were evaluated through a series of correlations and analysis of variance. The CFA of the Italian OCB scale confirmed the hypothesized factor structure, consisting of three dimensions: altruism, civic virtue and conscientiousness. Nurses' gender and professional training were positively correlated with OCB, while the amount of extra work was negatively correlated. In regard to clinical work settings, palliative care nurses engaged in OCB more than nurses working in other areas. The Italian OCB scale is a valid and reliable instrument. Its use can support all individuals involved in the promotion of workers' organizational well-being in implementing processes aimed at fostering nurses' OCB.
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"The pure hard slog that nursing is . . .": a qualitative analysis of nursing work.
Bogossian, Fiona; Winters-Chang, Peta; Tuckett, Anthony
2014-09-01
To explore nurses' perceptions of the nature of nursing work as a factor that contributes to attrition from the profession. A nonpurposive sample of nurses from the Nurses and Midwives e-cohort Study in Australia, New Zealand, and the United Kingdom provided electronic responses about reasons for leaving the profession. Data were then subjected to qualitative content analysis. Nurses at the "coal face," that is, those who actually do the work of nursing, in real working conditions, express dissatisfaction in relation to hygiene factors relating to the nature of nursing work and attribute these to nurses leaving the profession: workload, shift work, violence, and financial remuneration. Nurses' satisfaction with work and motivation to work are being sorely tested. There is manifest tension between the core concepts of nursing-compassion and care-and a system of work that actively precludes nurses from being able to exhibit these virtues and fails to reward them. Workload, shift work, violence, and financial remuneration are drivers of attrition and need to be addressed. Implications from this study are fourfold: determination of nursing workload, mitigating the impact of shift work, providing safe work environments, and adequate financial remuneration. © 2014 Sigma Theta Tau International.
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Clinical management of "entitled" clients.
Kerr, Norine
2002-12-01
As this process occurs, the painful affects become toned down for the clients. By exploring the source of clients' painful affects, wounded self-esteem, fearful projections, and dysfunctional defenses, misguided entitlement can be undermined. Much of this work will occur in a formal psychotherapy process, but nurses can create healthy object relatedness. To do so, they must see beyond the provocative and offensive behaviors to the vulnerable individual within who desperately needs compassionate and intelligent nursing care.
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Marino, Miguel; Killerby, Marie; Lee, Soomi; Klein, Laura Cousino; Moen, Phyllis; Olson, Ryan; Kossek, Ellen Ernst; King, Rosalind; Erickson, Leslie; Berkman, Lisa F; Buxton, Orfeu M
2016-12-01
To evaluate the effects of a workplace-based intervention on actigraphic and self-reported sleep outcomes in an extended care setting. Cluster randomized trial. Extended-care (nursing) facilities. US employees and managers at nursing homes. Nursing homes were randomly selected to intervention or control settings. The Work, Family and Health Study developed an intervention aimed at reducing work-family conflict within a 4-month work-family organizational change process. Employees participated in interactive sessions with facilitated discussions, role-playing, and games designed to increase control over work processes and work time. Managers completed training in family-supportive supervision. Primary actigraphic outcomes included: total sleep duration, wake after sleep onset, nighttime sleep, variation in nighttime sleep, nap duration, and number of naps. Secondary survey outcomes included work-to-family conflict, sleep insufficiency, insomnia symptoms and sleep quality. Measures were obtained at baseline, 6-months and 12-months post-intervention. A total of 1,522 employees and 184 managers provided survey data at baseline. Managers and employees in the intervention arm showed no significant difference in sleep outcomes over time compared to control participants. Sleep outcomes were not moderated by work-to-family conflict or presence of children in the household for managers or employees. Age significantly moderated an intervention effect on nighttime sleep among employees (p=0.040), where younger employees benefited more from the intervention. In the context of an extended-care nursing home workplace, the intervention did not significantly alter sleep outcomes in either managers or employees. Moderating effects of age were identified where younger employees' sleep outcomes benefited more from the intervention.
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Marino, Miguel; Killerby, Marie; Lee, Soomi; Klein, Laura Cousino; Moen, Phyllis; Olson, Ryan; Kossek, Ellen Ernst; King, Rosalind; Erickson, Leslie; Berkman, Lisa F.; Buxton, Orfeu M.
2016-01-01
Objectives To evaluate the effects of a workplace-based intervention on actigraphic and self-reported sleep outcomes in an extended care setting. Design Cluster randomized trial. Setting Extended-care (nursing) facilities. Participants US employees and managers at nursing homes. Nursing homes were randomly selected to intervention or control settings. Intervention The Work, Family and Health Study developed an intervention aimed at reducing work-family conflict within a 4-month work-family organizational change process. Employees participated in interactive sessions with facilitated discussions, role-playing, and games designed to increase control over work processes and work time. Managers completed training in family-supportive supervision. Measurements Primary actigraphic outcomes included: total sleep duration, wake after sleep onset, nighttime sleep, variation in nighttime sleep, nap duration, and number of naps. Secondary survey outcomes included work-to-family conflict, sleep insufficiency, insomnia symptoms and sleep quality. Measures were obtained at baseline, 6-months and 12-months post-intervention. Results A total of 1,522 employees and 184 managers provided survey data at baseline. Managers and employees in the intervention arm showed no significant difference in sleep outcomes over time compared to control participants. Sleep outcomes were not moderated by work-to-family conflict or presence of children in the household for managers or employees. Age significantly moderated an intervention effect on nighttime sleep among employees (p=0.040), where younger employees benefited more from the intervention. Conclusion In the context of an extended-care nursing home workplace, the intervention did not significantly alter sleep outcomes in either managers or employees. Moderating effects of age were identified where younger employees’ sleep outcomes benefited more from the intervention. PMID:28239635
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Naruse, Takashi; Sakai, Mahiro; Nagata, Satoko
2016-04-01
Home-visiting nursing agencies are required to foster staff nurse's work engagement; thus, the factors related to work engagement require identification. This study examined relational coordination among colleagues and agency span of control on the work engagement of home-visiting nurses. Cross-sectional data from 93 staff nurses in 31 home-visiting nursing agencies were collected via a survey and analyzed using mixed linear regression. There was no significant main effect of relational coordination among nurse colleagues on work engagement. In large agencies with a large span of control, relational coordination among nursing colleagues predicted work engagement. Nursing managers' relational coordination was found to be positively associated with staff nurse work engagement. Agency span of control is a moderating factor on the positive effect of relational coordination with nursing colleagues on staff nurse work engagement. © 2016 Japan Academy of Nursing Science.
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The Development Process of eHealth Strategy for Nurses in Finland.
Ahonen, Outi; Kouri, Pirkko; Kinnunen, Ulla-Mari; Junttila, Kristiina; Liljamo, Pia; Arifulla, Dinah; Saranto, Kaija
2016-01-01
Growing use of information and communication technology (ICT) demands have caused a need for nursing to strengthen the knowledge, skills and competences related to ICT in health (eHealth) and define its versatile roles. The Finnish Nurses Association (FNA) named a group of eHealth experts from various professional fields that are closely connected to nursing e.g. nursing practice, higher education, nursing research and administration. The main purpose was to describe nurses' contribution to the national strategy concerning eHealth development and implementation in health and social care. The group searched for answers, discussed strategic issues, wrote drafts, and sent texts for open commentary circles. The chosen themes of the eHealth strategies deal with the role of the client, nursing practice, ethical aspects education and eHealth competences, nursing leadership, knowledge management and research and development. The article describes the strategic work and the structure of eHealth strategy of nurses in Finland.
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Jongudomkarn, Darunee; Macduff, Colin
2014-01-01
Cancer and non-communicable diseases are a major issue not only for the developed but also developing countries. Public health and primary care nursing offer great potential for primary and secondary prevention of these diseases through community and family-based approaches. Within Thailand there are related established educational curricula but less is known about how graduate practitioners enact ideas in practice and how these can influence policy at local levels. The aim of this inquiry was to develop family nursing practice in primary care settings in the Isaan region or Northeastern Thailand and to distill what worked well into a nursing model to guide practice. An appreciative inquiry approach involving analysis of written reports, focus group discussions and individual interviews was used to synthesize what worked well for fourteen family nurses involved in primary care delivery and to build the related model. Three main strategies were seen to offer a basis for optimal care delivery, namely: enacting a participatory action approach mobilizing families' social capital; using family nursing process; and implementing action strategies within communities. These were distilled into a new conceptual model. The model has some features in common with related community partnership models and the World Health Organization Europe Family Health Nurse model, but highlights practical strategies for family nursing enactment. The model offers a basis not only for planning and implementing family care to help prevent cancer and other diseases but also for education of nurses and health care providers working in communities. This articulation of what works in this culture also offers possible transference to different contexts internationally, with related potential to inform health and social care policies, and international development of care models.
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Framing nursing practice within a forensic outpatient service.
Encinares, M; Lorbergs, K A
2001-09-01
The role of the outpatient forensic nurse is evolving as a specialized area of nursing practice in the community. Nurses must have comprehensive knowledge of the patients, keen intuition, and sound judgment in the continuous clinical assessment of the criminogenic factors that help determine the patients' level of risk. In addition, it is crucial to know and understand the court system, the process of the ORB, and the implications of the disposition order. The comprehensive, client-centered care provided by the Forensic Outpatient Service encompasses multifunctional and complex roles and responsibilities and clearly demonstrates the importance of the forensic outpatient nurse in working with this group of patients.
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Hurley, John; Lakeman, Richard
2011-01-01
Identity studies are well established across the social science literature with mental health nursing beginning to offer evidenced insights into what may, or may not, constitute key identity performances. For mental health nursing these performances remain contested, both from within the profession and from international contexts that favour generic constructions of mental health. This paper offers findings from a qualitative study that focused upon the process of how mental health nursing identity development is influenced, rather than what that identity may or may not be. These findings highlight that mental health nurses (MHNs) not only form their identity around service user centred education and training, but that many also use the education as a means to leave the profession. Through highlighting the impact of informal education (i.e., through work), formal education, and training upon the formation of mental health nursing identity, nurses are potentially alerted to the importance of clinically focussed mental health being prominent within curricula, rewarding mental health nursing skills specialisation, and the importance of the role of the service user in mental health nurse education and, hence, identity formation.
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Nurse managers and the sandwich support model.
Chisengantambu, Christine; Robinson, Guy M; Evans, Nina
2018-03-01
To explore the interplay between the work of nurse managers and the support they receive and provide. Support is the cornerstone of management practices and is pivotal in employees feeling committed to an organisation. Support for nurse managers is integral to effective health sector management; its characteristics merit more attention. The experiences of 15 nurse managers in rural health institutions in South Australia were explored using structured interviews, observation and document review. Effective decision making requires adequate support, which influences the perceptions and performance of nurse managers, creating an environment in which they feel appreciated and valued. An ideal support system is proposed, the "sandwich support model," to promote effective functioning and desirable patient outcomes via support "from above" and "from below." The need to support nurse managers effectively is crucial to how they function. The sandwich support model can improve management practices, more effectively assisting nurse managers. Organisations should revisit and strengthen support processes for nurse managers to maximize efficiencies. This paper contributes to understanding the importance of supporting nurse managers, identifying the processes used and the type of support offered. It highlights challenges and issues affecting support practices within the health sector. © 2017 John Wiley & Sons Ltd.
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Introducing students to clinical audit.
Parkes, Jacqueline; O'Dell, Cindy
2015-11-01
It is more than a decade since the UK Central Council for Nursing Midwifery and Health Visiting said that engaging with clinical audit is 'the business of every registered practitioner', yet there appears to be little evidence that nursing has embraced the process. To address this issue, Northampton General Hospital and the University of Northampton implemented a pilot project in which two third-year adult nursing students worked on a 'real life' audit. Supported by the hospital's audit department, and supervised by academic tutors with the relevant experience, the students worked on a pressure-ulcer care audit for their final year dissertation. This article describes the process undertaken by the hospital audit team and the university academic team to develop the pilot project and support the students. Based on the positive evaluations, the university has extended the project to a second phase, incorporating two new partner organisations.
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Liu, Justina Y W
2014-05-01
To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. This is a descriptive, exploratory qualitative study. Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. © 2013 John Wiley & Sons Ltd.
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Allen, Davina
2014-10-01
Over the last forty years, nursing's claim to professional expertise has been expressed in terms of its care-giving function. Informed by a distinctive 'holistic' approach, models of nursing identify therapeutic relationships as the cornerstone of practice. While 'knowing the patient' has been central to clinicians' occupational identity, research reveals that nurses not only experience significant material constraints in realising these ideals, their contribution to healthcare extends far beyond direct work with patients. Amidst growing concern about healthcare quality, a body of critical commentary has emerged proposing that the contemporary nursing mandate, with its exclusive focus on care-giving, is no longer serving the interests of the profession or the public. Drawing on an ethnographic study of UK hospital nurses' 'organising work' and insights from practice-based approaches and actor network theory, this paper lays the foundations for a re-conceptualisation of holism within the nursing mandate centred on organisational rather than therapeutic relationships. Nurses can be understood as obligatory passage points in health systems and through myriad processes of 'translational mobilisation' sustain the networks through which care is organised. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Field-Richards, Sarah E; Arthur, Antony
2012-12-01
To explore the nurse-volunteer relationship in a day hospice. Underpinned by an interpretive approach, face-to-face semistructured interviews were conducted with 12 day hospice volunteers. The nature and dynamics of the relationship between nursing staff and volunteers within the day hospice were characterized by increasing formality and changes in the division of labor, which challenged smooth working relationships. Volunteers see their role as becoming increasingly formalized partly as a response to increasing administrative demands on hospice nurses. The willingness of volunteers to take on new roles is variable. For volunteers to feel secure and valued and working relationships to remain strong, the process of how boundaries between paid and unpaid workers are negotiated needs to be transparent.
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Saito, Yumiko; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Takai, Yukari; Yamamoto-Mitani, Noriko
2018-05-01
To examine burnout and work engagement among nurses in Japanese long-term care hospitals and their relation to nurses' and organisational work values, and nurse-organisation congruence of such values. Nursing managers must help improve nurses' well-being; however, no research has considered strategies to improve staff outcomes in long-term care hospitals. We propose that individual nurse's work values and the congruence of these values with those of their organisations may influence burnout and work engagement. We conducted a cross-sectional survey of nurses in long-term care hospitals. Multiple regression analyses were conducted to examine the effects of nurses' work values and nurse-organisation congruence in these values on burnout and work engagement. Higher individual intrinsic and altruistic work values were associated with improvements in nurses' burnout and work engagement. Nurse-organisation non-congruence in altruistic values was associated with lower work engagement, whereas that of intrinsic work values was not associated with either outcome variable. Promoting intrinsic and altruistic work values among nurses could be effective for improving both burnout and work engagement. Opportunities such as case conferences could foster intrinsic and altruistic work values through the review of good care practices and communication between managers/colleagues about feelings and thoughts. © 2018 John Wiley & Sons Ltd.
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Yang, Y; Koh, D; Ng, V; Lee, C; Chan, G; Dong, F; Goh, S; Anantharaman, V; Chia, S
2002-01-01
Aims: To assess and compare the self perceived work related stress among emergency department (ED) and general ward (GW) nurses, and to investigate its relation with salivary IgA and lysozyme. Methods: One hundred and thirty two of 208 (63.5%) registered female ED and GW nurses participated in the study. A modified mental health professional stress scale (PSS) was used to measure self perceived stress. ELISA methods were used to determine the salivary IgA and lysozyme levels. Results: On PSS, ED nurses had higher scores (mean 1.51) than GW nurses (1.30). The scores of PSS subscales such as organisational structure and processes (OS), lack of resources (RES), and conflict with other professionals (COF) were higher in ED than in GW nurses. ED nurses had lower secretion rates of IgA (geometric mean (GM) 49.1 µg/min) and lysozyme (GM 20.0 µg/min) than GW nurses (68.2 µg/min, 30.5 µg/min). Significant correlations were observed between PSS and log IgA and lysozyme secretion rates. OS, RES, and COF were correlated with log IgA and lysozyme levels. Conclusion: ED nurses, who reported a higher level of professional stress, showed significantly lower secretion rates of salivary IgA and lysozyme compared to GW nurses. Salivary IgA and lysozyme were inversely correlated with self perceived work related stress. As these salivary biomarkers are reflective of the mucosal immunity, results support the inverse relation between stress and mucosal immunity. PMID:12468751
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Humpty Dumpty: reflection and reflective nursing practice.
Richardson, R
1995-06-01
The recent increase in the amount of published work relating reflection and reflective practice to nurses and nursing practice suggests that nurses value the opportunities which this approach is believed to provide. There also appears to be an underlying assumption that we all share the same concepts, hence the association with Humpty Dumpty. Indications of attempts to mechanize the processes and to endow the perceived skills with an élitism are becoming evident. In contrast, there are other attempts to foster the notion of accepting uncertainty, unpredictability and the opportunity for increased understanding to emerge. In this paper, the roots of some of these concepts are traced. The appropriateness of traditional values and assumptions, based on natural science perspectives, in relation to reflective processes and the practice of nursing is questioned. The development of a multi-faceted approach which takes account of differing contexts and the factors which influence them is suggested.
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Behrends, Marianne; Kupka, Thomas; Schmeer, Regina; Meyenburg-Altwarg, Iris; Marschollek, Michael
2016-01-01
The goal of the project Witra Care was to investigate how far the use of mobile technology is suitable to collect experience-based knowledge of nurses. Nine new employees and seven experienced nurses received for six weeks a mobile phone or a tablet pc with a mobile application that allowed them to collect learning object as pictures, videos, audio files or notes. In Witra Care the nurses created 303 learning objects. They have found the collecting of learning experiences was helpful for their learning processes. The learning objects demonstrate various aspects of daily routines in nursing. The results of Witra Care show that the documentation of learning experiences with mobile devices helps to gather information about the practical knowledge in the daily work of nurses, identifies individual learning needs of the employees and supports them in their personal learning processes.
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Lillibridge, Jennifer
2007-01-01
The preceptor model of clinical education uses nurses to fulfill the role of 'teacher' in a one-on-one relationship with students. The current nursing shortage, however, places increased demands on nurses and threatens their continuation in this role. The purpose of this qualitative descriptive study was to gain a better understanding of the nurse preceptor's experience. Five themes evolved during data analysis: (1) making it worthwhile for the nurse, (2) making a difference, (3) engaging in the process, (4) "I love being a preceptor, but..., and (5) accepting the role, taking responsibility. Making it worthwhile for the nurse included how nurses saw personal and professional rewards and benefits in precepting. Making a difference described how nurses felt they made a difference in student learning. Engaging in the process described how nurses created learning opportunities for students by being a good role model and protecting students from negative experiences. "I love being a preceptor, but..." identified aspects of the precepting role that were difficult. Accepting the role, taking responsibility identified the different people involved in the complex precepting experience; the preceptor, nursing faculty, students, and the nurse manager that all had to work together if students were to have a good experience. Findings can be used to develop better support for preceptors as well as more structured and consistent orientation to the role.
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Zhang, Yuan; Punnett, Laura; Gore, Rebecca
2014-02-01
Employee turnover is a large and expensive problem in the long-term care environment. Stated intention to leave is a reliable indicator of likely turnover, but actual predictors, especially for nursing assistants, have been incompletely investigated. This quantitative study identifies the relationships among employees' working conditions, mental health, and intention to leave. Self-administered questionnaires were collected with 1,589 employees in 18 for-profit nursing homes. A working condition index for the number of beneficial job features was constructed. Poisson regression modeling found that employees who reported four positive features were 77% less likely to state strong intention to leave (PR = 0.23, p < .001). The strength of relationship between working conditions and intention to leave was slightly mediated by employee mental health. Effective workplace intervention programs must address work organization features to reduce employee intention to leave. Healthy workplaces should build better interpersonal relationships, show respect for employee work, and involve employees in decision-making processes.
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Renolen, Åste; Høye, Sevald; Hjälmhult, Esther; Danbolt, Lars Johan; Kirkevold, Marit
2018-01-01
Evidence-based practice is considered a foundation for the provision of quality care and one way to integrate scientific knowledge into clinical problem-solving. Despite the extensive amount of research that has been conducted to evaluate evidence-based practice implementation and research utilization, these practices have not been sufficiently incorporated into nursing practice. Thus, additional research regarding the challenges clinical nurses face when integrating evidence-based practice into their daily work and the manner in which these challenges are approached is needed. The aim of this study was to generate a theory about the general patterns of behaviour that are discovered when clinical nurses attempt to integrate evidence-based practice into their daily work. We used Glaser's classical grounded theory methodology to generate a substantive theory. The study was conducted in two different medical wards in a large Norwegian hospital. In one ward, nurses and nursing assistants were developing and implementing new evidence-based procedures, and in the other ward, evidence-based huddle boards for risk assessment were being implemented. A total of 54 registered nurses and 9 assistant nurses were observed during their patient care and daily activities. Of these individuals, thirteen registered nurses and five assistant nurses participated in focus groups. These participants were selected through theoretical sampling. Data were collected during 90h of observation and 4 focus groups conducted from 2014 to 2015. Each focus group session included four to five participants and lasted between 55 and 65min. Data collection and analysis were performed concurrently, and the data were analysed using the constant comparative method. "Keeping on track" emerged as an explanatory theory for the processes through which the nurses handled their main concern: the risk of losing the workflow. The following three strategies were used by nurses when attempting to integrate evidence-based practices into their daily work: "task juggling", "pausing for considering" and "struggling along with quality improvement". The "keeping on track" theory contributes to the body of knowledge regarding clinical nurses' experiences with evidence-based practice integration. The nurses endeavoured to minimize workflow interruptions to avoid decreasing the quality of patient care provided, and evidence-based practices were seen as a consideration that was outside of their ordinary work duties. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Teaching the process of delegation.
Adams, D
1995-12-01
Registered nurses can no longer expect to perform all patient care activities in this age of decentralization, shared governance, and redefining of work duties to include nurse extenders. Delegation is a much needed skill for hospital nurses, because it can free them to deal with professional activities of care, if it is learned and practiced over time. Practitioners of delegation must learn how to assess readiness for delegation in the extender and must recognize that delegation should be a planned process, not an act of desperation. Clear communication is critical at all stages of the process, and evaluation is necessary to be sure that the delegated tasks were completed accurately and promptly. The benefits of delegating far outweigh the loss of control and potential as a result of inconsistency.
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Learning organizations, internal marketing, and organizational commitment in hospitals.
Tsai, Yafang
2014-04-04
Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new 'learning organization' and using effective internal marketing. A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling. A significant positive correlation was found between the existence of a 'learning organization', internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment. Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses.
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Expanding horizons. Integrating environmental health in occupational health nursing.
Rogers, B; Cox, A R
1998-01-01
1. Environmental hazards are ubiquitous. Many exist in the workplace or occur as a result of work process exposures. 2. Environmental health is a natural component of the expanding practice of occupational health nursing. 3. AAOHN's vision for occupational and environmental health will continue to set the standard and provide leadership in the specialty.
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Choi, Sandy Pin-Pin; Cheung, Kin; Pang, Samantha Mei-Che
2013-04-01
To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice. © 2012 Blackwell Publishing Ltd.
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Effects of work environment on patient and nurse outcomes.
Copanitsanou, Panagiota; Fotos, Nikolaos; Brokalaki, Hero
2017-02-09
Several parameters of the nurse's work environment lead to fewer patient complications and lower nurse burnout. The aim of this systematic review was the analysis of research data related to the effect of nurses' work environments on outcomes for both patients and nurses. Medline was searched by using keywords: 'working conditions', 'work environment', 'nurses', 'nursing staff', 'patients', 'outcomes'. In total, 10 studies were included, of which 4 were cross-sectional and the remaining were descriptive correlational studies. Patients who were hospitalised in units with good work environments for the nurses were more satisfied with the nursing care than the patients in units with poor work environments. Nurses who perceived their work environment to be good experienced higher job satisfaction and lower rates of burnout syndrome. A good work environment constitutes a determinant factor for high care quality and, at the same time, relates to improved outcomes for the nurses.
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Defining the paramedic process.
Carter, Holly; Thompson, James
2015-01-01
The use of a 'process of care' is well established in several health professions, most evidently within the field of nursing. Now ingrained within methods of care delivery, it offers a logical approach to problem solving and ensures an appropriate delivery of interventions that are specifically suited to the individual patient. Paramedicine is a rapidly advancing profession despite a wide acknowledgement of limited research provisions. This frequently results in the borrowing of evidence from other disciplines. While this has often been useful, there are many concerns relating to the acceptable limit of evidence transcription between professions. To date, there is no formally recognised 'process of care'-defining activity within the pre-hospital arena. With much current focus on the professional classification of paramedic work, it is considered timely to formally define a formula that underpins other professional roles such as nursing. It is hypothesised that defined processes of care, particularly the nursing process, may have features that would readily translate to pre-hospital practice. The literature analysed was obtained through systematic searches of a range of databases, including Ovid MEDLINE, Cumulative Index to Nursing and Allied Health. The results demonstrated that the defined process of care provides nursing with more than just a structure for practice, but also has implications for education, clinical governance and professional standing. The current nursing process does not directly articulate to the complex and often unstructured role of the paramedic; however, it has many principles that offer value to the paramedic in their practice. Expanding the nursing process model to include the stages of Dispatch Considerations, Scene Assessment, First Impressions, Patient History, Physical Examination, Clinical Decision-Making, Interventions, Re-evaluation, Transport Decisions, Handover and Reflection would provide an appropriate model for pre-hospital practices.
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Tjoflåt, Ingrid; Karlsen, Bjørg; Saetre Hansen, Britt
2016-06-01
To describe how Norwegian expatriate nurses engaged in humanitarian assignments overseas experience working with the local nurses promoting nursing care in the hospital ward. Western countries have a long tradition of providing nurses with expert knowledge in nursing care for humanitarian projects and international work overseas. Studies from humanitarian mission revealed that health workers rarely acknowledge or use the local knowledge. However, there is a lack of studies highlighting expatriate nurses' experiences working with local nurses to promote nursing care in the hospital ward. This study applies a descriptive explorative qualitative design. The data were collected in 2013 by means of seven semi-structured interviews and analysed using qualitative content analysis. The data analyses revealed three themes related to the expatriate nurses' experiences of working with the local nurses to promote nursing care in the hospital ward: (1) Breaking the code, (2) Colliding worlds and (3) Challenges in sharing knowledge. The findings reflect different challenges when working with the local nurses. Findings indicate valuable knowledge gained about local nursing care and the local health and educational system. They also demonstrate challenges for the expatriate nurses related to the local nursing standard in the wards and using the local nurses' experiences and knowledge when working together. The findings can inform nurses, humanitarian organisations and institutions working overseas regarding the recruitment and the preparation of nurses who want to work cross- culturally or in humanitarian missions overseas. © 2016 John Wiley & Sons Ltd.
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Desmedt, M; De Geest, S; Schubert, M; Schwendimann, R; Ausserhofer, D
2012-12-21
Magnet hospitals share nurse work environment characteristics associated with superior patient, nurse and financial outcomes. In Switzerland, however, it is uncertain how nurses appraise their work environments. To describe the quality of the nurse work environment in 35 Swiss acute care hospitals and to benchmark findings based on international Magnet hospital research. This study used two data sources: (1) the Swiss arm of the RN4CAST study; and (2) a structured literature review. Hospitals were categorised based on Magnet and non-Magnet data. Our outcome variable of interest was the quality of nurse work environment measured with the Practice Environment Scale of the Nurse Work Index (PES-NWI). We reviewed 13 American, Canadian, and Australian studies of acute-care hospitals. Three provided Magnet hospitals' nurse work environment data, and all included non-Magnet hospitals' data. Swiss hospitals' evaluations on nurse work environment quality varied widely, but 25% achieved scores indicating "Magnet nurse work environments". Swiss hospitals' average "Nursing manager ability" subscale scores fulfilled Magnet hospital criteria, although "Nurse participation in hospital affairs" and "Nursing staffing and resource adequacy" scores neared non-Magnet levels. On average, our results indicated high quality nurse work environments in Swiss hospitals. Implementing Magnet model organisational principles might be a valuable approach for Swiss acute-care hospitals to both improve mixed and unfavourable nurse work environments and to improve nurse and patient outcomes. National benchmarking of nurse work environments and other nurse-sensitive indicators may facilitate evaluating the impact of current developments in Swiss healthcare.
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Bae, Sung-Heui; Yoon, Jangho
2014-01-01
Objectives To examine the degree to which states’ work hour regulations for nurses—policies regarding mandatory overtime and consecutive work hours—decrease mandatory overtime practice and hours of work among registered nurses. Methods We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. Principal Findings The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. Conclusions State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. PMID:24779701
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Trinchero, Elisabetta; Brunetto, Yvonne; Borgonovi, Elio
2013-09-01
This paper used Social Exchange Theory to empirically examine whether perceived organisational support, satisfaction with training and development and perception of discretionary power are antecedents of engagement for registered nurses working in Italian public and private hospitals (n = 827). According to Social Exchange Theory, effective workplace relationships support employees and encourage nurses to use training to enhance their workplace outcomes. This research used a cross-sectional design. Data were collected from registered nurses working in six Italian hospitals using a survey-based, self-report strategy. Regression analysis found that the variance of process-oriented supervision accounted for 6.9% of Italian registered nurse's perception of engagement, training and development accounted for 26.8% and discretionary power accounted for 2.1%. Workplace relationships enhance autonomy and engagement. Effective workplace relationship impacts positively on nurses' outcome. This paper confirms the relevance of training to enhance engagement of nurses. It also confirms the importance of workplace relationships in enhancing autonomy and engagement. Previous research has identified the importance of nurses' autonomy in an environment where there are shortages of nurses. This study confirms a similar situation for Italian nurses. The findings underline the relevance of investments in continuous professional development to enhance nurses' engagement in private and public health-care settings. © 2013 John Wiley & Sons Ltd.
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Saber, Deborah A; Strout, Kelley; Caruso, Lisa Swanson; Ingwell-Spolan, Charlene; Koplovsky, Aiden
2017-10-01
Many natural and man-made disasters require the assistance from teams of health care professionals. Knowing that continuing education about disaster simulation training is essential to nursing students, nurses, and emergency first responders (e.g., emergency medical technicians, firefighters, police officers), a university in the northeastern United States planned and implemented an interprofessional mass casualty incident (MCI) disaster simulation using the Project Management Body of Knowledge (PMBOK) management framework. The school of nursing and University Volunteer Ambulance Corps (UVAC) worked together to simulate a bus crash with disaster victim actors to provide continued education for community first responders and train nursing students on the MCI process. This article explains the simulation activity, planning process, and achieved outcomes. J Contin Educ Nurs. 2017;48(10):447-453. Copyright 2017, SLACK Incorporated.
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Kyrkjebø, J M; Hanssen, T A; Haugland, B Ø
2001-12-01
To evaluate a programme introducing quality improvement (QI) in nursing education. Betanien College of Nursing and clinical practices at hospitals in Bergen. 52 nursing students from a second year class working in 16 groups undertaking hospital based practical studies. Second year nursing students were assigned to follow a patient during a day's work and to record the processes of care from the patient's perspective. Data collected included waiting times, patient information, people in contact with the patient, investigations, and procedures performed. Students also identified aspects of practice that could be improved. They then attended a 2 day theoretical introductory course in QI and each group produced flow charts, cause/effect diagrams, and outlines of quality goals using structure, process, and results criteria to describe potential improvements. Each group produced a report of their findings. Main measures-A two-part questionnaire completed by the students before and after the intervention was used to assess the development of their understanding of QI. Evidence that students could apply a range of QI tools and techniques in the specific setting of a hospital ward was assessed from the final reports of their clinical attachments. The students had a significantly better knowledge of QI after the introductory course and group work than before it, and most students indicated that they considered the topic highly relevant for their later career. They reported that it was quite useful to observe one patient throughout one shift and, to some extent, they learned something new. Students found the introductory course and working in groups useful, and most thought the programme should be included in the curriculum for other nursing students. They considered it important for nurses in general to have knowledge about QI, indicating a high perceived relevance of the course. All 16 groups delivered reports of their group work which were approved by the tutors. Through the reports, all the groups demonstrated knowledge and ability to apply tools and techniques in their practical studies in a hospital setting. The introduction of a short experience-based programme into the practical studies of second year nursing students enabled them to learn about the concepts, tools, and techniques of continuous QI in a way that should provide them with the skills to undertake it as part of routine practice.
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Salma, Jordana; Hegadoren, Kathleen M; Ogilvie, Linda
2012-01-01
The number of internationally educated nurses is increasing in the Canadian workforce. Recruitment of internationally educated nurses is often seen as a solution to ongoing nursing shortages. However, international recruitment needs to be accompanied by strategies to ensure long-term retention. One of the criteria for successful retention is the availability and accessibility of career advancement and educational opportunities. Little research exists on the opportunities for career advancement and education for internationally educated nurses in Canada. This interpretive descriptive study was conducted to look at the perceptions of internationally educated nurses regarding career advancement and educational opportunities in Alberta, Canada. Eleven internationally educated nurses, working as registered nurses in Alberta, were interviewed using semi-structured interviews. Five themes were identified: motherhood as a priority, communication and cultural challenges, process of skill recognition, perceptions of opportunity and need for mentorship.
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Warshawsky, Nora E; Havens, Donna S; Knafl, George
2012-09-01
This study tested the effects of interpersonal relationships on nurse managers' work engagement and proactive work behavior. An engaged workforce may help healthcare organizations improve performance. In healthcare, nurse managers are responsible for creating motivating work environments. They also need to be engaged, yet little is known about what influences nurse managers' performance. A self-administered electronic survey was used to collect data from 323 nurse managers working in acute care hospitals. Instruments included the Relational Coordination Scale, Utrecht Work Engagement Scale, and Proactive Work Behavior Scale. Interpersonal relationships with nurse administrators were most predictive of nurse managers' work engagement. Interpersonal relationships with physicians were most predictive of nurse managers' proactive work behavior. Organizational cultures that foster quality interpersonal relationships will support the job performance of nurse managers.
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The professional competence profile of Finnish nurses practising in a forensic setting.
Koskinen, L; Likitalo, H; Aho, J; Vuorio, O; Meretoja, R
2014-05-01
Forensic nurses in Finland work in the two state-maintained forensic hospitals. The main function of these hospitals is to perform forensic psychiatric evaluation and provide treatment for two groups of patients: violent offenders found not guilty by reason of insanity, and those too dangerous or difficult to be treated in regional hospitals. Although the forensic nurses work with the most challenging psychiatric patients, they do not have any preparatory special education for the work. This paper describes the development of nurses who participated in a 1-year further education programme that was tailored to them. The nurses experienced that the 1-year education had a significant impact on their overall competence level. They found that their skills for observing, helping, teaching and caring for their patients had increased during the education. Conversely, it was found that the nurses collaborated little with their patients' family members. They were also not familiar with utilizing research findings in improving their care of patients. Forensic nursing is a global and relatively young profession that combines nursing care and juridical processes. There are, however, significant differences in the qualifications of forensic nurses internationally. The aim of the study was to describe the professional competence profile of practising forensic nurses in Finland and to explore the effects of a 1-year further education programme on that competence profile. The data were collected in 2011-2012 using the Nurse Competence Scale comprising seven competence categories, and analysed using the software package SPSS version 19.0 (SPSS, Inc., Armonk, NY, USA). The participants were 19 forensic nurses and their 15 head nurses. The assessed overall scores from both informant groups indicated a high level of competence across the seven categories. The nurses felt that the overall competence level had increased during the education programme. The increase seen by the head nurses was smaller. The less frequent competence items included utilization of research and involvement of family in care. It can be stated that the 1-year further education programme was effective in developing the nurses' competence profile and, in particular, affected their professional self-confidence. It will, however, be essential to strengthen their skills for working with families and their awareness of evidence-based forensic nursing. © 2013 John Wiley & Sons Ltd.
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Black, Lisa; Spetz, Joanne; Harrington, Charlene
2010-01-01
Registered nurses (RNs) who work outside of nursing have seldom been examined. This aim of this study was to compare the 122,178 (4%) of RNs who are employed outside of nursing to those who work in nursing jobs in terms of sociodemographic, market, and political variables to determine if these groups are substantively different from one another. Using a logit regression model, wages were a significant predictor of working outside of nursing for unmarried nurses but not for married nurses. Married and unmarried male nurses were more likely to work outside of nursing. Baccalaureate education, children under age 6, higher family income, and years since graduation increased the odds of working outside of nursing for married nurses. Ultimately, identifying characteristics on which these groups differ may inform future policy directions that could target nurses who may leave nursing at a time when retention efforts might be effective to alter their trajectory away from the profession.
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Bragadóttir, Helga; Gunnarsdóttir, Sigrún; Ingason, Helgi T
2013-05-01
This paper describes the development and piloting of electronic standardized measures on nursing work (e-SMNW) for rich data gathering on the work and work environment of registered nurses (RNs) and practical nurses (PNs). Efficient and valid methods are needed to measure nursing work to enhance the optimal use of the nursing workforce for safe patient care. The study combined human factors engineering (HFE) and nursing knowledge to develop electronic standardized measures for observational studies on nursing work in acute care. The work and work environment of RNs and PNs in acute care medical and surgical inpatient units was successfully measured using e-SMNW. With predetermined items of work activities and influencing factors in the work of nurses, and full use of computer technology, multi-layered rich standardized data were gathered, analysed and displayed. The combination of nursing knowledge, HFE and computer technology enables observational data collection for a rich picture of the complex work of nursing. Information collected by standardized and multi-layered measures makes it easier to identify potential improvements, with regard to influencing factors and management of the work and work environment of nurses. Further use of computer technology in health services research is encouraged. © 2012 Blackwell Publishing Ltd.
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Nurses' work environment: indicators of satisfaction.
Suliman, Mohammad; Aljezawi, Maen
2018-01-10
This study aimed to investigate nurses' perceptions of the nursing work environment in Jordanian hospitals. Previous research has indicated a strong relationship between nurses' work environment and their satisfaction at work. However, little is known about the situation in Jordan. A cross-sectional and descriptive design was used. A sample of 500 nurses was recruited. The study was conducted using the Individual Workload Perception Revised scale (IWPS-R). A sum of 382 out of 500 nurses from three health care sectors in Jordan responded to the questionnaires (response rate = 76.4%). The results indicate that nurses working in the public hospitals had significantly better perceptions about their work environment than nurses working in private and university hospitals. Older nurses with lower academic qualifications are more likely to be satisfied with their work. Furthermore, nurses who have good perceptions of support from their manager and peers, and a manageable workload are more likely to stay in their jobs. The public hospitals are currently considered a more suitable milieu for nurses in Jordan. Other health care sectors should work to enhance nurses' working conditions. Providing a supportive work environment with a manageable workload will encourage nurses to stay in their hospitals. © 2018 John Wiley & Sons Ltd.
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Halbesleben, Jonathon R B; Savage, Grant T; Wakefield, Douglas S; Wakefield, Bonnie J
2010-01-01
Health care organizations have redesigned existing and implemented new work processes intended to improve patient safety. As a consequence of these process changes, there are now intentionally designed "blocks" or barriers that limit how specific work actions, such as ordering and administering medication, are to be carried out. Health care professionals encountering these designed barriers can choose to either follow the new process, engage in workarounds to get past the block, or potentially repeat work (rework). Unfortunately, these workarounds and rework may lead to other safety concerns. The aim of this study was to examine rework and workarounds in hospital medication administration processes. Observations and semistructured interviews were conducted with 58 nurses from four hospital intensive care units focusing on the medication administration process. Using the constant comparative method, we analyzed the observation and interview data to develop themes regarding rework and workarounds. From this analysis, we developed an integrated process map of the medication administration process depicting blocks. A total of 12 blocks were reported by the participants. Based on the analysis, we categorized them as related to information exchange, information entry, and internal supply chain issues. Whereas information exchange and entry blocks tended to lead to rework, internal supply chain issues were more likely to lead to workarounds. A decentralized pharmacist on the unit may reduce work flow blocks (and, thus, workarounds and rework). Work process redesign may further address the problems of workarounds and rework.
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Nurses' extended work hours: Patient, nurse and organizational outcomes.
Kunaviktikul, W; Wichaikhum, O; Nantsupawat, A; Nantsupawat, R; Chontawan, R; Klunklin, A; Roongruangsri, S; Nantachaipan, P; Supamanee, T; Chitpakdee, B; Akkadechanunt, T; Sirakamon, S
2015-09-01
Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems. Policymakers need to be aware of the issues regarding nurses' extended work hours, which has been found to contribute to burnout. Urgently, nurse and health administrators need to develop and implement appropriate nursing overtime policies and strategies to help reduce this phenomenon, including measures to overcome the nursing shortage. © 2015 International Council of Nurses.
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Teamwork in perioperative nursing. Understanding team development, effectiveness, evaluation.
Farley, M J
1991-03-01
Teams are an essential part of perioperative nursing practice. Nurses who have a knowledge of teamwork and experience in working on teams have a greater understanding of the processes and problems involved as teams develop from new, immature teams to those that are mature and effective. This understanding will assist nurses in helping their teams achieve a higher level of productivity, and members will be more satisfied with team efforts. Team development progresses through several stages. Each stage has certain characteristics and desired outcomes. At each stage, team members and leaders have certain responsibilities. Team growth does not take place automatically and inevitably, but as a consequence of conscious and unconscious efforts of its leader and members to solve problems and satisfy needs. Building and maintaining a team is certainly work, but work that brings a great deal of satisfaction and feelings of pride in accomplishment. According to I Tenzer, RN, MS, teamwork "is not a panacea; it is a viable approach to developing a hospital's most valuable resource--people."
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Gifkins, Jane; Loudoun, Rebecca; Johnston, Amy
2017-12-01
The aim of this investigation was to compare perceptions of nurses exposed to short or longer term shift work and their experiences working under this type of scheduling. Shift work is a crucial component of nurses' working lives, ensuring continuous care for patients. This study fills a research gap around the personal experiences of shift working nurses and the strategies used to manage the impacts of shift work. Qualitative case study design. Constructivist methodology, including in-depth semi-structured interviews conducted in 2015, was used for the study. Iterative review and inductive analysis of transcripts from nine recently graduated nurses and twelve experienced nurses enabled identification and verification of key themes. Three main areas of difference between new and experienced nurses relating to shift work challenges in a nursing environment emerged: perceptions about the utility of working in shifts, coping strategies and social support at home and work. Most experienced nurses found shift work advantageous, especially those with dependents. Coping strategies included flexible shift arrangements in both groups. Experienced nurses detailed the importance of support from family and friends while inexperienced nurses described feeling disconnected from social supports. Experienced nurses cited a lack of support from nursing managers as problematic. Findings suggest shift selection mitigated challenges of shift work for both inexperienced and experienced nurses, indicating autonomous roster selection is critical. Similarly, social support at work from senior nurses and management and at home played an important role in nurses' coping. © 2017 John Wiley & Sons Ltd.
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"To be a nurse": a professional choice and the construction of identity processes in the 1970s.
Teodosio, Sheila Saint-Clair; Padilha, Maria Itayra
2016-06-01
to analyze the factors that influenced the choice for nursing made by graduates from the first class of the Undergraduate Nursing and Obstetrics Course of the Federal University of Rio Grande do Norte in the 1970s and to understand the senses and meanings of being a nurse when choosing this profession. a qualitative socio-historical study was performed, using oral history to collect data. the analysis generated the following categories: "To be a nurse: a professional choice" and "The ideal of being a nurse: senses and meanings". The senses of "being a nurse" are associated with graduates' perspective of this profession and the meanings included the traditional conceptions that have historically affected it. professional choice was influenced by family and work expectations and the nursing course had an effect on the construction of nurses' professional identity.
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Wang, Panfeng; Zhang, Hongjun; Li, Baohua; Lin, Keke
2016-01-01
The aims of this study were to develop a nursing information system (NIS), enhance the visibility of patient risk, and identify challenges and facilitators to adoption of the NIS risk assessment system for nurse leaders. This article describes the function of a nursing risk assessment information system, and the results of a survey on the risk assessment system. The results suggested that quality of information processing in nursing significantly improved patient safety. Nurses surveyed demonstrated a high degree of satisfaction, with saving time and improving safety. The nursing document information system described was introduced to improve patient safety and decrease risk. The application of the system has greatly enhanced the efficiency of nursing work, and guides the nurses to make an accurate, comprehensive and objective assessment of patient information, contributing significantly to further improvement in care standards and care decisions.
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Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.
Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A
2018-06-01
This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.
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Conflict coaching training for nurse managers: a case study of a two-hospital health system.
Brinkert, Ross
2011-01-01
This study evaluated the application of the Comprehensive Conflict Coaching model in a hospital environment. Conflict coaching involves a coach working with a client to improve the client's conflict understanding, interaction strategies and/or interaction skills. The training of nurse managers as conflict coaches is an innovative continuing education programme that partially addresses conflict-related concerns in nursing. Twenty nurse managers trained as conflict coaches and each coached a supervisee. Qualitative data were gathered from nurse managers, supervisees and senior nursing leaders over an 8-month period and organized using standard programme evaluation themes. Benefits included supervisor conflict coaching competency and enhanced conflict communication competency for nurse managers and supervisees facing specific conflict situations. Challenges included the management of programme tensions. Additional benefits and challenges are discussed, along with study limitations. Conflict coaching was a practical and effective means of developing the conflict communication competencies of nurse managers and supervisees. Additional research is needed. Conflict is common in nursing. Conflict coaching is a new conflict communication and supervision intervention that demonstrates initial promise. Conflict coaching seems to work best when supported by a positive conflict culture and integrated with other conflict intervention processes. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
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Human Resources for Health Challenges in Nigeria and Nurse Migration.
Salami, Bukola; Dada, Foluke O; Adelakun, Folake E
2016-05-01
The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.
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The nurse work environment, job satisfaction and turnover rates in rural and urban nursing units.
Baernholdt, Marianne; Mark, Barbara A
2009-12-01
The aim of the present study was to determine whether there are differences in hospital characteristics, nursing unit characteristics, the nurse work environment, job satisfaction and turnover rates in rural and urban nursing units. Research in urban hospitals has found an association between the nurse work environment and job satisfaction and turnover rates, but this association has not been examined in rural hospitals. Rural and urban nursing units were compared in a national random sample of 97 United States hospitals (194 nursing units) with between 99 and 450 beds. Significant differences were found between hospital and nursing unit characteristics and the nurse work environment in rural and urban nursing units. Both nursing unit characteristics and the work environment were found to have a significant influence on nurse job satisfaction and turnover rates. Job satisfaction and turnover rates in rural and urban nursing units are associated with both nursing unit characteristics and the work environment. Both rural and urban hospitals can improve nurse job satisfaction and turnover rates by changing unit characteristics, such as creating better support services and a work environment that supports autonomous nursing practice. Rural hospitals can also improve the work environment by providing nurses with more educational opportunities.
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Practices for caring in nursing: Brazilian research groups.
Erdmann, A L; de Andrade, S R; de Mello, A L Ferreira; Klock, P; do Nascimento, K C; Koerich, M Santos; Backes, D Stein
2011-09-01
The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distributed in sample groups, were interviewed. The core phenomenon 'research groups of administration and management in nursing: arrangements and interactions in the system of caring in nursing' was derived from the categories: conceptual bases and contexts of the research groups; experiencing interactions in the research groups; functionality of the research groups; and outputs of the research groups. The research groups are integrated in the system of caring in nursing. The activities of the Brazilian administration and management in nursing research groups are process oriented and in a process of constant renovation, socially relevant, operate in a complex scenario and contribute to the advancement of the organizations of the system of caring in nursing through strengthening the connection among academia, service and community. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.
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Mahomed, Rosemary; St John, Winsome; Patterson, Elizabeth
2012-11-01
To investigate the process of patient satisfaction with nurse-led chronic disease management in Australian general practice. Nurses working in the primary care context of general practice, referred to as practice nurses, are expanding their role in chronic disease management; this is relatively new to Australia. Therefore, determining patient satisfaction with this trend is pragmatically and ethically important. However, the concept of patient satisfaction is not well understood particularly in relation to care provided by practice nurses. A grounded theory study underpinned by a relativist ontological position and a relativist epistemology. Grounded theory was used to develop a theory from data collected through in-depth interviews with 38 participants between November 2007-April 2009. Participants were drawn from a larger project that trialled a practice nurse-led, collaborative model of chronic disease management in three Australian general practices. Theoretical sampling, data collection, and analysis were conducted concurrently consistent with grounded theory methods. Patients undergo a cyclical process of Navigating Care involving three stages, Determining Care Needs, Forming Relationship, and Having Confidence. The latter two processes are inter-related and a feedback loop from them informs subsequent cycles of Determining Care Needs. If any of these steps fails to develop adequately, patients are likely to opt out of nurse-led care. Navigating Care explains how and why time, communication, continuity, and trust in general practitioners and nurses are important to patient satisfaction. It can be used in identifying suitable patients for practice nurse-led care and to inform the practice and organization of practice nurse-led care to enhance patient satisfaction. © 2012 Blackwell Publishing Ltd.
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Health disparities, social injustice, and the culture of nursing.
Giddings, Lynne S
2005-01-01
Nurses are well positioned to challenge institutionalized social injustices that lead to health disparities. The aim of this cross-cultural study was to collect stories of difference and fairness within nursing. The study used a life history methodology informed by feminist theory and critical social theory. Life story interviews were conducted with 26 women nurses of varying racial, cultural, sexual identity, and specialty backgrounds in the United States (n = 13) and Aotearoa New Zealand (n = 13). Participants reported having some understanding of social justice issues. They were asked to reflect on their experience of difference and fairness in their lives and specifically within nursing. Their stories were analyzed using a life history immersion method. Nursing remains attached to the ideological construction of the "White good nurse." Taken-for-granted ideals privilege those who fit in and marginalize those who do not. The nurses experienced discrimination and unfairness, survived by living in two worlds, learned to live in contradiction, and worked surreptitiously for social justice. For nurses to contribute to changing the systems and structures that maintain health disparities, the privilege of not seeing difference and the processes of mainstream violence that support the construction of the "White good nurse" must be challenged. Nurses need skills to deconstruct the marginalizing social processes that sustain inequalities in nursing and healthcare. These hidden realities--racism, sexism, heterosexism, and other forms of discrimination--will then be made visible and open to challenge.
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Timmons, Stephen; Evans, Catrin; Nair, Sreelekha
2016-10-01
In the paper, we are looking at the relationship between globalisation and the professional project, using nursing in Kerala as an exemplar. Our focus is on the intersection of the professional project, gender and globalisation processes. Included in our analysis are the ways in which gender affects the professional project in the global south, and the development of a professional project which it is closely tied to global markets and global migration, revealing the political-economic, historical, and cultural factors that influence the shape and consequences of nurse migration. The phenomenon that enabled our analysis, by showing these forces at work in a particular time and place, was an outbreak of strikes by nurses working in private hospitals in Kerala in 2011-2012. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Hall, Katherine C; Diffenderfer, Sandy K; Stidham, April; Mullins, Christine M
2018-04-19
In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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Pioneering the Psychiatric Nurse Role in Foster Care (*)
Bertram, Julie E.; Narendorf, Sarah Carter; McMillen, J. Curtis
2013-01-01
Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse’s work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. PMID:24238008
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Chang, Yu-San; Wu, Yu-Hsuan; Lu, Mei Rou; Hsu, Chung-Yao; Liu, Ching-Kuan; Hsu, Chin
2015-05-01
Shift workers frequently experience acute sleep deprivation on first night shift. This study compared the efficacy of 30-min nap (between 2 and 3 a.m.) on the visual attention ability of the nurses working at first 8-h night shift at the time of maximum fatigue (between 3 and 4 a.m.). In addition, we measured cognitive function (between 9 and 10 a.m.) in nurses working on daytime shift, which we defined as baseline wakefulness. The results showed that working on the night shift groups was associated with sleep loss, leading to a decrease in visual attention performance compared to the daytime shift group. There was no statistically significant difference in the visual attention performance between those taking and not taking a nap during the night shift, however the effect size was medium in the information process. It was still needed increase sample size to draw the conclusion regarding a 30-min nap break have positive benefits on perceptual speed during the first night shift. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.
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Evaluating and improving a model of nursing care delivery: a process of partnership.
Hall, Catherine; McCutcheon, Helen; Deuter, Kate; Matricciani, Lisa
2012-01-01
Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Researchers conducted non-participant observations (n = 9) of two hours duration across the 24 h period. Focus groups (n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008-2009. Two main problem areas were identified as impeding the nurses' ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.
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Nurses' views on their involvement in euthanasia: a qualitative study in Flanders (Belgium)
de Casterlé, B Dierckx; Verpoort, C; De Bal, N; Gastmans, C
2006-01-01
Background Although nurses worldwide are confronted with euthanasia requests from patients, the views of palliative care nurses on their involvement in euthanasia remain unclear. Objectives In depth exploration of the views of palliative care nurses on their involvement in the entire care process surrounding euthanasia. Design A qualitative Grounded Theory strategy was used. Setting and participants In anticipation of new Belgian legislation on euthanasia, we conducted semistructured interviews with 12 nurses working in a palliative care setting in the province of Vlaams‐Brabant (Belgium). Results Palliative care nurses believed unanimously that they have an important role in the process of caring for a patient who requests euthanasia, a role that is not limited to assisting the physician when he is administering life terminating drugs. Nurses' involvement starts when the patient requests euthanasia and ends with supporting the patient's relatives and healthcare colleagues after the potential life terminating act. Nurses stressed the importance of having an open mind and of using palliative techniques, also offering a contextual understanding of the patient's request in the decision making process. Concerning the actual act of performing euthanasia, palliative care nurses saw their role primarily as assisting the patient, the patient's family, and the physician by being present, even if they could not reconcile themselves with actually performing euthanasia. Conclusions Based on their professional nursing expertise and unique relationship with the patient, nurses participating as full members of the interdisciplinary expert team are in a key position to provide valuable care to patients requesting euthanasia. PMID:16574869
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Healthy work environments for the ageing nursing workforce.
Stichler, Jaynelle F
2013-10-01
The aim of this article is to describe the physical challenges that ageing nurses experience and the facility design features that can promote healthy work environments to motivate nurses to continue working. Older nurses are working longer and beyond the usual retirement age. They often experience chronic fatigue and the usual physical and cognitive changes associated with aging. Nursing is a physically demanding profession and many older nurses work in pain while providing direct patient care. The literature is replete with studies focusing on the organisational factors that retain older nurses, but little research addresses design factors that facilitate nurses working longer and more safely in direct patient care. Electronic databases in medicine, nursing, psychology, and architecture were searched and evidence-based, non-evidence-based, and review articles and government and organisational newsletters were evaluated. Hospital design can help address the physical work challenges that older nurses experience. Older nurses have a wealth of knowledge and expertise, and the design of nursing units can optimize their work experience. Nurse Managers must participate in design efforts and advocate designs that support aging nurses. © 2013 John Wiley & Sons Ltd.
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Lantta, Tella; Anttila, Minna; Kontio, Raija; Adams, Clive E; Välimäki, Maritta
2016-01-01
Patient violence against nurses in their work environments is a widespread global concern, particularly in the field of mental health care. A high prevalence of violent events impacts the well-being of nurses and may also impair overall ward climate. However, it has been proposed that nurses' use limited techniques to prevent patient violence, and, therefore, more comprehensive methods for dealing with patient violence are needed. There is still restricted understanding of the ward climate during the occurrence of a violent event as well as how these incidents could be more effectively prevented. This study aimed to explore nurses' experiences of violent events in psychiatric wards, give insight into ward climates and examine suggestions for violence prevention. This study employed a descriptive, exploratory design including focus groups (n = 5) and open-ended questions. The participants were registered and enrolled nurses (n = 22) working on three closed psychiatric in-patient wards in one Finnish hospital district. Focus groups were tape-recorded, transcribed and analyzed with inductive content analysis. Nurses' experiences of violent events included a variety of warning signs and high-risk situations which helped them to predict forthcoming violence. Patient-instigated violent events were described as complicated situations involving both nurses and patients. When the wards were overloaded with work or emotions, or if nurses had become cynical from dealing with such events, well-being of nurses was impaired and nursing care was complicated. Suggestions for violence prevention were identified, and included, for example, more skilled interaction between nurses and patients and an increase in contact between nurses and patients on the ward. This study revealed the complexity of violent events on psychiatric wards as well as the implications of these events on clinical practice development and training, administration and policy. A routine process is needed through which nurses' experiences and ideas concerning prevention of violent events are acknowledged.
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Gormley, Denise K
2011-01-01
The purpose was to examine differences in perceptions of work environment and quality of care between nurse managers and staff nurses, and the relationship between nurses' perceptions of the work environment and intention to leave. It is important for managers to understand how staff nurses perceive the work environment as these perceptions may affect nurses' intention to leave the organization. Few studies have examined the perceptions of nurses compared with nurse manager/directors regarding the organizational influences on intention to leave. This study was a cross-sectional, non-experimental design. A total of 336 nurses and managers participated from two Midwestern hospitals. Participants completed the Perceived Nurse Work Environment Scale (PNWE), Anticipated Turnover Scale (ATS), and a researcher developed perception of quality scale. Data were analysed for descriptive statistics, Analysis of Variance, and Pearson's correlation. Significant differences were found between nurses and managers on perceptions of work environment. Managers rated work environment higher than staff on all subscales. Work environment was related to anticipated turnover. Managers and staff nurses are 'not on the same page' in perceptions of work environment. Nurse managers need to understand the organizational influences that may affect nurses' intention to leave. Strategies to improve the work environment are necessary to meet the needs of the staff nurse. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.
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Specialized Nursing Practice for Chronic Disease Management in the Primary Care Setting
2013-01-01
Background In response to the increasing demand for better chronic disease management and improved health care efficiency in Ontario, nursing roles have expanded in the primary health care setting. Objectives To determine the effectiveness of specialized nurses who have a clinical role in patient care in optimizing chronic disease management among adults in the primary health care setting. Data Sources and Review Methods A literature search was performed using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database. Results were limited to randomized controlled trials and systematic reviews and were divided into 2 models: Model 1 (nurse alone versus physician alone) and Model 2 (nurse and physician versus physician alone). Effectiveness was determined by comparable outcomes between groups in Model 1, or improved outcomes or efficiency in Model 2. Results Six studies were included. In Model 1, there were no significant differences in health resource use, disease-specific measures, quality of life, or patient satisfaction. In Model 2, there was a reduction in hospitalizations and improved management of blood pressure and lipids among patients with coronary artery disease. Among patients with diabetes, there was a reduction in hemoglobin A1c but no difference in other disease-specific measures. There was a trend toward improved process measures, including medication prescribing and clinical assessments. Results related to quality of life were inconsistent, but patient satisfaction with the nurse-physician team was improved. Overall, there were more and longer visits to the nurse, and physician workload did not change. Limitations There was heterogeneity across patient populations, and in the titles, roles, and scope of practice of the specialized nurses. Conclusions Specialized nurses with an autonomous role in patient care had comparable outcomes to physicians alone (Model 1) based on moderate quality evidence, with consistent results among a subgroup analysis of patients with diabetes based on low quality evidence. Model 2 showed an overall improvement in appropriate process measures, disease-specific measures, and patient satisfaction based on low to moderate quality evidence. There was low quality evidence that nurses working under Model 2 may reduce hospitalizations for patients with coronary artery disease. The specific role of the nurse in supplementing or substituting physician care was unclear, making it difficult to determine the impact on efficiency. Plain Language Summary Nurses with additional skills, training, or scope of practice may help improve the primary care of patients with chronic diseases. This review found that specialized nurses working on their own could achieve health outcomes that were similar to those of doctors. It also found that specialized nurses who worked with doctors could reduce hospital visits and improve certain patient outcomes related to diabetes, coronary artery disease, or heart failure. Patients who had nurse-led care were more satisfied and tended to receive more tests and medications. It is unclear whether specialized nurses improve quality of life or doctor workload. PMID:24194798
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Working Conditions and Mental Health of Nursing Staff in Nursing Homes
Zhang, Yuan; Punnett, Laura; Mawn, Barbara; Gore, Rebecca
2018-01-01
Nursing staff in nursing homes suffer from poor mental health, probably associated with stressful working conditions. Working conditions may distribute differently among nursing assistants, licensed practical nurses, and registered nurses due to their different levels in the organizational hierarchy. The objectives of this study were to evaluate the association between working conditions and mental health among different nursing groups, and examine the potential moderating effect of job group on this association. Self-administered questionnaires were collected with 1,129 nursing staff in 15 for-profit non-unionized nursing homes. Working conditions included both physical and psychosocial domains. Multivariate linear regression modeling found that mental health was associated with different working conditions in different nursing groups: physical safety (β = 2.37, p < 0.05) and work-family conflict (β = –2.44, p < 0.01) in NAs; work-family conflict (β = –4.17, p < 0.01) in LPNs; and physical demands (β = 10.54, p < 0.05) in RNs. Job group did not moderate the association between working conditions and mental health. Future workplace interventions to improve mental health should reach to nursing staff at different levels and consider tailored working condition interventions in different nursing groups. PMID:27104634
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Working Conditions and Mental Health of Nursing Staff in Nursing Homes.
Zhang, Yuan; Punnett, Laura; Mawn, Barbara; Gore, Rebecca
2016-07-01
Nursing staff in nursing homes suffer from poor mental health, probably associated with stressful working conditions. Working conditions may distribute differently among nursing assistants, licensed practical nurses, and registered nurses due to their different levels in the organizational hierarchy. The objectives of this study were to evaluate the association between working conditions and mental health among different nursing groups, and examine the potential moderating effect of job group on this association. Self-administered questionnaires were collected with 1,129 nursing staff in 15 for-profit non-unionized nursing homes. Working conditions included both physical and psychosocial domains. Multivariate linear regression modeling found that mental health was associated with different working conditions in different nursing groups: physical safety (β = 2.37, p < 0.05) and work-family conflict (β = -2.44, p < 0.01) in NAs; work-family conflict (β = -4.17, p < 0.01) in LPNs; and physical demands (β = 10.54, p < 0.05) in RNs. Job group did not moderate the association between working conditions and mental health. Future workplace interventions to improve mental health should reach to nursing staff at different levels and consider tailored working condition interventions in different nursing groups.
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Advancing adolescent maternal development: a grounded theory.
Atkinson, Leah D; Peden-McAlpine, Cynthia J
2014-01-01
This paper reports a substantive grounded theory called the theory of Advancing Adolescent Maternal Development. A grounded theory approach was used. Thirty public health nurses working with adolescent clients in a state public health nurse home visiting program volunteered to participate in this study. The basic social psychological problem that emerged from the data was incomplete and at risk adolescent maternal development. Social support and public health nursing interventions are central in the problem resolution process which occurs in stages. Study results can be used to inform the nursing care of pregnant and parenting adolescents. © 2014.
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Building a vision for the future: strategic planning in a shared governance nursing organization.
Baker, C; Beglinger, J E; Bowles, K; Brandt, C; Brennan, K M; Engelbaugh, S; Hallock, T; LaHam, M
2000-06-01
Today's health care delivery environment is marked by extreme turbulence and ever-increasing complexity. Now, more than ever, an organization's strategic plan must do more than outline a business plan. Rather, the strategic plan is a fundamental tool for building and sustaining an organizational vision for the future. The strong, dynamic strategic plan (1) represents a long-range vision for improving organizational performance, (2) provides a model for planning and implementing structures and processes for the management of outcomes, (3) reflects and shapes the organizational culture and customer focus, (4) provides decision support for difficult operational choices made day to day, and (5) integrates and aligns the work of the organization. This article describes the development, implementation, and evaluation of a methodology for strategic planning within a shared governance nursing organization. Built upon the strategic plan of the hospital, the process undertaken by the nursing organization reflects the following commitments: (1) to develop a strategic plan that is meaningful and part of daily work life at all levels of the nursing organization, (2) to make the plan practical and realistic through incremental building, (3) to locate and articulate accountability for each step, and (4) to build in a process for checking progress toward goal achievement and readjusting the plan as necessary.
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ERIC Educational Resources Information Center
Calhoun, Shawn P.
2012-01-01
Information literacy is a complex knowledge domain. Cognitive processing theory describes the effects an instructional subject and the learning environment have on working memory. Essential processing is one component of cognitive processing theory that explains the inherent complexity of knowledge domains such as information literacy. Prior…
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Yamaguchi, Yoshiko; Inoue, Takahiro; Harada, Hiroko; Oike, Miyako
2016-12-01
The shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses' intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors' levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes. This study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables' levels and effect size on nurses' intention to leave their organization or profession between these care settings. The research design was cross-sectional. Participating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses' intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%). The level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables' effect on nurses' intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses' intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively. Interventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses' work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses' job control will increase nurse retention. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Politics of change: the discourses that inform organizational change and their capacity to silence.
McMillan, Kim
2016-09-01
Changes in healthcare organizations are inevitable and occurring at unprecedented rates. Such changes greatly impact nurses and their work, yet these experiences are rarely explored. Organizational change discourses remain grounded in perspectives that explore and explain systems, often not the people within them. Change processes in healthcare organizations informed by such organizational discourses validate only certain perspectives and forms of knowledge. This fosters exclusionary practices, limiting the capacity of certain individuals or groups of individuals to effectively contribute to change discourses and processes. The reliance on mainstream organizational discourses in healthcare organizations has left little room for the exploration of diverse perspectives on the subject of organizational change, particularly those of nurses. Michel Foucault's work challenges dominant discourse and suggest that strong reliance's on specific discourses effectively disqualify certain forms of knowledge. Foucault's writings on disqualified knowledge and parrhesia (truth telling and frank speech) facilitate the critical exploration of discourses that inform change in healthcare organizations and nurses capacities to contribute to organizational discourses. This paper explores the capacity of nurses to speak their truths within rapidly and continuously changing healthcare organizations when such changes are often driven by discourses not derived from nursing knowledge or experience. © 2016 John Wiley & Sons Ltd.
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Taylor, Christine; Angel, Liz; Nyanga, Lucy; Dickson, Cathy
2017-10-01
To describe the process and challenges from a project that aimed to develop processes, source new placements and place students primarily in the discipline of nursing, but also occupational therapy, physiotherapy, podiatry, social work, and speech therapy. Clinical experience in health facilities is an essential element of health professional education, yet globally, there is a lack of clinical placements to meet demands. Educational providers are seeking placements in nontraditional facilities, yet little has been reported on the challenges in the process of procuring clinical placements. The project used a descriptive approach within a quality implementation framework. The project was guided by the quality implementation framework that included four critical steps: considerations of the host setting, structuring the implementation, supporting the implementation and improving future applications. A total of 115 new student placements were finalised across six health disciplines, including elderly care, nongovernment organisations and general practice. Sixty-two nursing students were placed in the new placements during the project. Challenges included communication, the time-consuming nature of the process and 'gatekeeping' blocks to obtaining placements. Recommendations included the importance of personal interaction in developing and maintaining relationships, and the need for clear communication processes and documentation. Potential areas for research are also given. There is great potential for growth in establishing new placements outside the traditional placement facilities for nursing and allied health and for expanding already existing nonhospital placements. Clinical professional experiences are essential to any nursing or allied health programme. There is an increasing demand for, and global lack of, clinical placements for nursing and allied health students. The results provide nursing and allied health educators and managers a framework for planning clinical placement procurement, and assisting in decision-making and developing strategies and processes for practice. © 2016 John Wiley & Sons Ltd.
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Vargas, Mara Ambrosina de O; Meyer, Dagmar Estermann
2005-06-01
This study discusses the human being-machine relationship in the process called "cyborgzation" of the nurse who works in intensive care, based on post-structuralist Cultural Studies and highlighting Haraway's concept of cyborg. In it, manuals used by nurses in Intensive Care Units have been examined as cultural texts. This cultural analysis tries to decode the various senses of "human" and "machine", with the aim of recognizing processes that turn nurses into cyborgs. The argument is that intensive care nurses fall into a process of "technology embodiment" that turns the body-professional into a hybrid that makes possible to disqualify, at the same time, notions such as machine and body "proper", since it is the hybridization between one and the other that counts there. Like cyborgs, intensive care nurses learn to "be with" the machine, and this connection limits the specificity of their actions. It is suggested that processes of "cyborgzation" such as this are useful for questioning - and to deal with in different ways - the senses of "human" and "humanity" that support a major part of knowledge/action in health.
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Orientation and transition programme component predictors of new graduate workplace integration.
Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert; Ghement, Isabella R
2015-03-01
To examine the relationships between selected components of new graduate nurse transition programmes and transition experiences. Transition support for new graduates is growing increasingly multifaceted; however, an investigation of the effectiveness of the constituent components of the transition process is lacking. An online survey was disseminated to new graduates working in acute care settings and included questions related to new graduate transition programmes. The Casey Fink Graduate Nurse Experience Survey was used to quantify the transition experience. New graduate nurses who participated in a formal new graduate (NG) transition programme had significantly higher total transition scores than non-programme nurses. The orientation length and the average number of hours worked in a two week period were significant predictors of transition; the percentage of preceptored shifts was statistically insignificant. New graduate transition is enhanced with participation in a formal transition programme. Orientation should be at least four weeks in length, and new graduates should work at least 49 hours in a two week period. Nurse managers are in key positions to advocate for new graduate nurse transition programmes with adequate resources to support a four week orientation phase and shift scheduling to ensure an adequate number of hours over two week periods to facilitate transition. © 2013 John Wiley & Sons Ltd.
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Role stressors and coping strategies among nurse managers.
Udod, Sonia; Cummings, Greta G; Care, W Dean; Jenkins, Megan
2017-02-06
Purpose The purpose of this paper is to share preliminary evidence about nurse managers' (NMs) role stressors and coping strategies in acute health-care facilities in Western Canada. Design/methodology/approach A qualitative exploratory inquiry provides deeper insight into NMs' perceptions of their role stressors, coping strategies and factors and practices in the organizational context that facilitate and hinder their work. A purposeful sample of 17 NMs participated in this study. Data were collected through individual interviews and a focus group interview. Braun and Clarke's (2006) six phase approach to thematic analysis guided data analysis. Findings Evidence demonstrates that individual factors, organizational practices and structures affect NMs stress creating an evolving role with unrealistic expectations, responding to continuous organizational change, a fragmented ability to effectively process decisions because of work overload, shifting organizational priorities and being at risk for stress-related ill health. Practical implications These findings have implications for organizational support, intervention programs that enhance leadership approaches, address individual factors and work processes and redesigning the role in consideration of the role stress and work complexity affecting NMs health. Originality/value It is anticipated that health-care leaders would find these results concerning and inspire them to take action to support NMs to do meaningful work as a way to retain existing managers and attract front line nurses to positions of leadership.
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[A new vision of nursing: the evolution and development of evidence-based nursing].
Chiang, Li-Chi
2014-08-01
The concept and principles of evidence-based medicine (EBM), first introduced in 1996 in the UK and Canada, have greatly impacted healthcare worldwide. Evidence-based care is a new approach to healthcare that works to reduce the gap between evidence and practice in order to further the scientific credentials and practices of the nursing profession. The revolution in healthcare has perhaps most noticeably impacted the nursing sciences. Today, new methodologies are increasingly synthesizing knowledge, while expanded access to publication resources is creating a new era in evidence-based nursing. Therefore, we expect to see in Taiwan the increased sharing of innovative implementations of evidence-based nursing practice and promotion campaigns and the exploration of a new evidence-based nursing paradigm for incorporating evidence-based concepts into the policymaking process, nursing practice, and nursing education. All scientists in clinical care, education, and research are responsible to establish scientific nursing knowledge in support of the evidence-based nursing practice.
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Should I stay or should I go? Nurses' wishes to leave nursing homes and home nursing.
Bratt, Christopher; Gautun, Heidi
2018-04-30
This study investigates the prevalence of nurses' wishes to leave work in elderly care services and aims to explain differences between younger and older nurses. Health-and-care services, and specifically elderly care services, experience problems recruiting and retaining nurses. A nationwide survey among nurses in Norway with 4,945 nurses aged 20-73 (mean age = 41.8), 95% female. Structural equation modelling was used, analysing the whole sample as well as analysing younger and older nurses as separate groups. Of the nurses surveyed, 25% wanted to work outside elderly care services and 25% were uncertain. The wish to leave was much more frequent among younger nurses. Reported working conditions were a strong predictor of the wish to leave, and a much stronger predictor among younger nurses than older nurses in nursing homes. Working conditions are a major predictor of nurses' wishes to leave elderly care services, especially among younger nurses in nursing homes. Attempts to reduce turnover in elderly care services need to address the working conditions for younger nurses, for instance by reducing the time young nurses work in isolation. © 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.
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Effects of nurse work environment on job dissatisfaction, burnout, intention to leave.
Nantsupawat, A; Kunaviktikul, W; Nantsupawat, R; Wichaikhum, O-A; Thienthong, H; Poghosyan, L
2017-03-01
The nursing shortage is a critical issue in many countries. High turnover rates among nurses is contributing to the shortage, and job dissatisfaction, intention to leave, and burnout have been identified as some of the predictors of nurse turnover. A well-established body of evidence demonstrates that the work environment for nurses influences nurse job dissatisfaction, intention to leave, and burnout, but there never has been a study undertaken in Thailand to investigate this relationship. To investigate how work environment affects job dissatisfaction, burnout, and intention to leave among nurses in Thailand. The study used a cross-sectional survey to collect data from 1351 nurses working in 43 inpatient units in five university hospitals across Thailand. The participants completed the Practice Environment Scale of the Nursing Work Index, the Maslach Burnout Inventory, and measures of job dissatisfaction and intention to leave. Logistical regression models assessed the association between work environment and nurse-reported job dissatisfaction, burnout, and intent to leave. Nurses working in university hospitals with better work environments had significantly less job dissatisfaction, intention to leave, and burnout. The nurse work environment is a significant feature contributing to nurse retention in Thai university hospitals. Improving the work environment for nurses may lead to lower levels of job dissatisfaction, intention to leave, and burnout. Focusing on these nurse outcomes can be used as a strategy to retain nurses in the healthcare system. Addressing the challenges of poor work environments requires coordinated action from policymakers and health managers. © 2016 International Council of Nurses.
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Recruitment and retention strategies for expert nurses in abortion care provision.
McLemore, Monica R; Levi, Amy; James, E Angel
2015-06-01
The purpose of this thematic analysis is to describe recruitment, retention and career development strategies for expert nurses in abortion care provision. Thematic analysis influenced by grounded theory methods were used to analyze interviews, which examined cognitive, emotional, and behavioral processes associated with how nurses make decisions about participation in abortion care provision. The purposive sample consisted of 16 nurses, who were interviewed between November 2012 and August 2013, who work (or have worked) with women seeking abortions in abortion clinics, emergency departments, labor and delivery units and post anesthesia care units. Several themes emerged from the broad categories that contribute to successful nurse recruitment, retention, and career development in abortion care provision. All areas were significantly influenced by engagement in leadership activities and professional society membership. The most notable theme specific to recruitment was exposure to abortion through education as a student, or through an employer. Retention is most influenced by flexibility in practice, including: advocating for patients, translating one's skill set, believing that nursing is shared work, and juggling multiple roles. Lastly, providing on the job training opportunities for knowledge and skill advancement best enables career development. Clear mechanisms exist to develop expert nurses in abortion care provision. The findings from our study should encourage employers to provide exposure opportunities, develop activities to recruit and retain nurses, and to support career development in abortion care provision. Additionally, future workforce development efforts should include and engage nursing education institutions and employers to design structured support for this trajectory. Copyright © 2015 Elsevier Inc. All rights reserved.
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Eriksson, Irene; Nilsson, Kerstin
2008-09-01
To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension. Trust has been found to be an important aspect of the patient-nurse relationship. Little research has focused on how trust is formed in patient-nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension. Qualitative study. Qualitative data were collected through open-ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews. The first theme that emerged from the analysis, the nurses' competence, describes the nurses' consciousness of their method of expression, both oral and non-verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse-led clinics for this patient group.
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The weekend matters: exploring when and how nurses best recover from work stress.
Drach-Zahavy, Anat; Marzuq, Nabil
2013-03-01
This article is a report of a comparative study examining nurses' levels of emotional exhaustion and vigour after a short respite taken on weekends as compared with two midweek days taken off. Recovery from work stress - a respite experience that generates replenishing of psychological and physical resources that have been depleted by meeting effortful demands - is crucial to offset future deleterious consequences to mental and physical health. Longitudinal panel survey. Nurses (n = 400) completed questionnaires during 2010-2011 on three occasions: (1) Before the respite (weekend or midweek), we measured the timing of the respite and emotional exhaustion and vigour; (2) during the respite we measured respite experiences; and (3) after the respite we re-measured emotional exhaustion and vigour. Nurses' emotional exhaustion was significantly lower and their vigour significantly higher after a short weekend respite than after two-midweek-days taken off. Specific experiences during the respite can compensate for the inferior recovery process on weekdays compared with weekends: emotional exhaustion levels of nurses who experienced high relaxation during their respite did not differ whether the respite was at the midweek or weekend. Vigour levels of nurses who experienced control during their respite did not differ whether their respite was midweek or at the weekend. Insights gained on leisure experiences carry important practical implications for nurses and nursing managers. Staff nurses and their managers should be educated in how to recover from work during leisure time, including preferring weekend on midweek respites and engagement in relaxation and control experiences as much as possible. © 2012 Blackwell Publishing Ltd.
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[The Role and Function of Informatics Nurses in Information Technology Decision-Making].
Lee, Tso-Ying
2017-08-01
The medical environment has changed greatly with the coming of the information age, and, increasingly, the operating procedures for medical services have been altered in keeping with the trend toward mobile, paperless services. Informatization has the potential to improve the working efficiency of medical personnel, enhance patient care safety, and give medical organizations a positive image. Informatics nurses play an important role in the decision-making processes that accompany informatization. As one of the decision-making links in the information technology lifecycle, this role affects the success of the development and operation of information systems. The present paper examines the functions and professional knowledge that informatics nurses must possess during the technology lifecycle, the four stages of which include: planning, analysis, design/development/revision, and implementation/assessment/support/maintenance. The present paper further examines the decision-making shortcomings and errors that an informatics nurses may make during the decision-making process. We hope that this paper will serve as an effective and useful reference for informatics nurses during the informatization decision-making process.
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Career transitions of inactive nurses: a registration database analysis (1993-2006).
Alameddine, Mohamad; Baumann, Andrea; Onate, Kanecy; Deber, Raisa
2011-02-01
One important strategy to address nursing shortages is to tap into the pool of licensed nurses who are not currently working in nursing and induce them to return to the nursing labour market. However, there is a paucity of research examining their likelihood of return to the active labour market. Analyze the career transitions of nurses registered with the College of Nurses Ontario but not working in the province's nursing labour market to determine the proportion of these nurses rejoining the active nursing workforce and examine the variation by inactive sub-category and age group. Quantitative analysis of a linked longitudinal database for all those registered with the College of Nurses of Ontario for the years 1993-2006. Registration records of all 215,687 nurses registered at any time in those years were merged by their unique registration number. Each nurse was placed for each year into an employment category. Two groups of nurses were defined: active (registered, working in nursing in Ontario) and inactive (registered, not working in nursing in Ontario). Inactive nurses were then sub-categorized into five mutually exclusive sub-categories: 'not working and seeking nursing employment', 'working in non-nursing and seeking nursing employment', 'not working and not seeking nursing employment', 'working in non-nursing and not seeking nursing employment' and 'working outside Ontario'. One-year career movements of nurses were tracked by generating 13 year-to-year transition matrixes. In the short-term, inactive nurses seeking a nursing job had the highest average rate of return to the active workforce (27.3-30.8%), though they might become high risk of leaving the profession if they do not find employment in a timely manner. Inactive nurses not seeking nursing employment are a heterogeneous group, and include nurses on leave who are likely to subsequently rejoin the active workforce should appropriate opportunities arise. The proportion of nurses rejoining the active workforce decreased with age. Because 'inactive' nurses are a heterogeneous group, their optimal reintegration to the nursing workforce requires governments, professional associations and employers to work collaboratively to design targeted and timely recruitment strategies to avoid the permanent loss of skilled nursing resources. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.
Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine
2011-12-01
The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices. © 2011 Blackwell Publishing Ltd.
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Cho, Hyeonmi; Han, Kihye
2018-05-14
This study aimed to determine the relationships among the unit-level nursing work environment and individual-level health-promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. This study used a cross-sectional design. Data were collected using self-reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health-promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile-II, respectively. Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse-physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health-promotion interventions for spiritual growth and health responsibility are needed. Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses' responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes. © 2018 Sigma Theta Tau International.
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Factors that impact on emergency nurses' ethical decision-making ability.
Alba, Barbara
2016-11-10
Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.
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RN work engagement in generational cohorts: the view from rural US hospitals.
Sullivan Havens, Donna; Warshawsky, Nora E; Vasey, Joseph
2013-10-01
To describe staff nurse work engagement, identify predictors by generational cohort, present implications for nurse managers and suggest future research. A global nurse shortage looms. While an adequate supply of nurses is needed to ensure access to care, access to quality care may be enhanced by an adequate supply of highly engaged nurses-those who are dedicated, energized, and absorbed. Nurses have long reported the presence of energy depleting practice environments. Nurses practicing in professional practice environments may be more engaged. A non-experimental survey design was executed. Direct care Registered Nurses (n = 747) working in five rural acute care hospitals completed questionnaires to assess work engagement (Utrecht Work Engagement Scale-9), decisional involvement (Decisional Involvement Scale), relational coordination (Relational Coordination Survey) and the nursing practice environment (Practice Environment Scale of the Nursing Work Index). Descriptive, correlational and regression analyses examined work engagement and predictors by generational cohort. With the exception of the absorption component, no statistically significant differences in engagement emerged across generational cohorts. Predictors of engagement differed by cohort, however across all cohorts, professional nursing practice environments predicted nurse work engagement. Professional nursing practice environments are significantly associated with nurse work engagement. Enhancing nurse work engagement is a complex challenge. Generational cohorts may respond to different strategies to enhance engagement. © 2013 John Wiley & Sons Ltd.
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Identifying research priorities with nurses at a tertiary children's hospital in the United Kingdom.
Williams, A; Sell, D; Oulton, K; Wilson, N; Wray, J; Gibson, F
2017-03-01
The objective of this study was to undertake a research priority setting exercise with the aim of maximizing efficiency and impact in research activity undertaken by nurses at one children's tertiary healthcare institution by ensuring the clinical staff directly shaped a coherent, transparent and consensus driven nurse-led research agenda. In Round 1, the research topics of 147 nurses were elicited using a modified nominal group technique as the consensus method. The number of participants in the 24 separate discussions ranged from 3 to 21, generating lists of between 6 and 23 topics. In Round 2, nurses from the clinical areas ranked topics of importance resulting in a set of four to five priorities. In Round 3, the divisional heads of nursing consulted with staff in all of their clinical areas to each finalize their five divisional priorities. The Nursing Research Working Group discussed and refined the divisions' priorities and voted on the final list to agree the top five research priorities for the organization. A total of 269 research topics were initially generated. Following three rounds of ranking and prioritizing, five priorities were agreed at Divisional level, and from these, the five top organizational priorities were selected. These were (i) understanding and improving all aspects of the patient journey through the hospital system; (ii) play; (iii) staff wellbeing, patient care and productivity; (iv) team work - linking to a more efficient service; and (v) supporting parents/parent pathway. Divisional priorities have been disseminated widely to clinical teams to inform a patient-specific nurse-led research agenda. Organizational priorities agreed upon have been disseminated through management structures and processes to ensure engagement at all levels. A subgroup of the Nursing Research Working Group has been delegated to take this work forward so that the agreed priorities continue to contribute towards shaping nurse-led research activity, thereby going some way to inform and embed an evidence-based culture of inquiry. © 2016 John Wiley & Sons Ltd.
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The politics of nursing care: correcting deviance in accordance with the social contract.
O'Byrne, Patrick; Holmes, Dave
2009-05-01
Despite numerous theories, models, and philosophies describing what nurses are and what they do, nursing care is often presented as an apolitical process which primarily focuses on patient needs and priorities. However, it is our position that nursing practice-in all regards-is political. To support this argument, we have drawn on works describing of soft/hard power, pastoral power, stigma, deviance, and governmentality, in addition to explaining our institutional social contract conceptualization of politics. In using these concepts, our political perspective reframes nursing practice as a means by which an individual's potential or actual deviance (meaning a deviation from social norms) can be identified and then corrected.
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Succeeding in the first year of practice: heed the wisdom of novice nurses.
Chandler, Genevieve Elizabeth
2012-01-01
The transition from student to nurse has been described as traumatic, confusing, and shocking. The difficulties encountered by the graduates have led to the premature termination of their first position, and sometimes they leave nursing altogether. To coach new nurses in preparation for their first year of practice using an appreciative inquiry framework, this study focused on the new graduates' perspective of the processes that enabled them to successfully integrate into their new role. From the analysis of 36 interviews, three themes were identified: "They were there for me," "There are no stupid questions," and "Nurturing the seeds." New nurses know what works for them; educators need to heed their wisdom.
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Evaluation of Acceptance of Nursing Information System in a German and American Hospital.
Vollmer, Anne-Maria; Prokosch, Hans-Ulrich; Evans, Scott; Kuttler, Kathryn
2016-01-01
Nursing Information Systems (NIS) are not well-adopted and accepted in Germany. The evaluation of a NIS deployment in a German University Hospital supports this assumption. A second side study in the US should point out the differences regarding the technical and organizational differences. We use a questionnaire including standardized instruments like the Unified Theory of Acceptance (UTAUT). Results indicated that nurses in Germany compared to in the US do not use nursing process documentation to the same extent. The main reasons behind the low usage in comparison with the US are deficits in ease-of-use, system performance and the high expenditure of time and paper work for charting nursing plans.
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Recognizing and responding to uncertainty: a grounded theory of nurses' uncertainty.
Cranley, Lisa A; Doran, Diane M; Tourangeau, Ann E; Kushniruk, Andre; Nagle, Lynn
2012-08-01
There has been little research to date exploring nurses' uncertainty in their practice. Understanding nurses' uncertainty is important because it has potential implications for how care is delivered. The purpose of this study is to develop a substantive theory to explain how staff nurses experience and respond to uncertainty in their practice. Between 2006 and 2008, a grounded theory study was conducted that included in-depth semi-structured interviews. Fourteen staff nurses working in adult medical-surgical intensive care units at two teaching hospitals in Ontario, Canada, participated in the study. The theory recognizing and responding to uncertainty characterizes the processes through which nurses' uncertainty manifested and how it was managed. Recognizing uncertainty involved the processes of assessing, reflecting, questioning, and/or being unable to predict aspects of the patient situation. Nurses' responses to uncertainty highlighted the cognitive-affective strategies used to manage uncertainty. Study findings highlight the importance of acknowledging uncertainty and having collegial support to manage uncertainty. The theory adds to our understanding the processes involved in recognizing uncertainty, strategies and outcomes of managing uncertainty, and influencing factors. Tailored nursing education programs should be developed to assist nurses in developing skills in articulating and managing their uncertainty. Further research is needed to extend, test and refine the theory of recognizing and responding to uncertainty to develop strategies for managing uncertainty. This theory advances the nursing perspective of uncertainty in clinical practice. The theory is relevant to nurses who are faced with uncertainty and complex clinical decisions, to managers who support nurses in their clinical decision-making, and to researchers who investigate ways to improve decision-making and care delivery. ©2012 Sigma Theta Tau International.
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Skaalvik, Mari Wolff; Normann, Hans Ketil; Henriksen, Nils
2011-08-01
To measure nursing students' experiences and satisfaction with their clinical learning environments. The primary interest was to compare the results between students with respect to clinical practice in nursing homes and hospital wards. Clinical learning environments are important for the learning processes of nursing students and for preferences for future workplaces. Working with older people is the least preferred area of practice among nursing students in Norway. A cross-sectional design. A validated questionnaire was distributed to all nursing students from five non-randomly selected university colleges in Norway. A total of 511 nursing students completed a Norwegian version of the questionnaire, Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale in 2009. Data including descriptive statistics were analysed using the Statistical Program for the Social Sciences. Factor structure was analysed by principal component analysis. Differences across sub-groups were tested with chi-square tests and Mann-Whitney U test for categorical variables and t-tests for continuous variables. Ordinal logistic regression analysis of perceptions of the ward as a good learning environment was performed with supervisory relationships and institutional contexts as independent variables, controlling for age, sex and study year. The participating nursing students with clinical placements in nursing homes assessed their clinical learning environment significantly more negatively than those with hospital placements on nearby all sub-dimensions. The evidence found in this study indicates that measures should be taken to strengthen nursing homes as learning environments for nursing students. To recruit more graduated nurses to work in nursing homes, actions to improve the learning environment are needed. © 2011 Blackwell Publishing Ltd.
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Galatsch, Michael; Iskenius, Mario; Schlarmann, Jörg Grosse; Schmidt, Sascha G; Müller, Bernd Hans; Hasselhorn, Hans Martin
2013-11-01
Aggressive behavior and violence in patients, residents or clients are growing challenges in nursing. Aggressive behavior can have both, physical and psychological consequences for nurses and can lead to a reduced performance at work, demotivation, sickness absence and the premature exit from the nursing profession. To develop purposive strategies and to deal with aggressive behavior and health promotion programs, it is crucial to know more about the prevalence of aggressive behavior from patients and the effect on the work ability of nurses in different types of institutions. Data of 1735 German nurses was derived from the European NEXT-Study. Description and analysis of variance for each working area (hospital ward, Intensive Care Unit, psychiatric ward, nursing home and home care) were conducted. The work ability was measured with the Work Ability Index (WAI). The aggressive behavior was measured by one item developed by the NEXT Study Group. Linear regression models were applied to analyze the effect of aggressive behavior on the work ability of nurses in a comparison of the five different working areas. A total of 84.9 percent of the nurses were "sometimes" or "often/always" confronted with aggressive behavior from patients. In the comparison of the five working areas, nurses were exposed to different levels of aggressive behavior, while differences in the work ability of nurses were also observed. It was found that aggressive behavior from patients was associated with reduced work ability in nurses working in hospital wards, nursing homes and home care, but not nurses working in ICUs and psychiatric wards. The findings indicate that many nurses in Germany are exposed to aggressive behavior from patients, which has negative effect on the nurses' work ability. However, it is assumed that strategies to deal with aggressive behavior could play a buffer role between aggressive behavior and work ability of nurses, highlighting one possibility of intervention in future.
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Hospital nurses' work environment, quality of care provided and career plans.
Hinno, S; Partanen, P; Vehviläinen-Julkunen, K
2011-06-01
In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.
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Fruits without labour: the implications of Friedrich Nietzsche's ideas for the caring professions.
Nolan, P W; Brown, B; Crawford, P
1998-08-01
Seldom is the work of philosophers invoked by health professionals when examining aspects of care from a philosophical perspective. Instead, students of health care, especially nurses, have been introduced to 'philosophies' which are often superficially examined and poorly understood. This practice fails to develop in students an appreciation of the work of philosophers or to acquire the art of critical thinking. The introduction of models and theories of nursing in the past three decades has alerted nurses to the importance of possessing critical skills in order to identify sound theory and implement good practice. This paper goes beyond mere philosophising and examines aspects of mental health care from the perspectives of one of nineteenth century Europe's most notable philosophers, Friedrich Nietzsche. It argues that understanding his work can enhance one's ability to reflect on nursing practice, as well as bringing a new dimension to how we analyse 'mental health' problems. His work provides many insights into how we can improve our understanding of the effect of mental illness and mental health care on the individual, and how we conceptualise the process of care. This paper provides an overview of his life's work, his impact on the history of ideas and develops some of the more provocative implications of his work for mental health care.
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Work environment, job satisfaction, stress and burnout among haemodialysis nurses.
Hayes, Bronwyn; Douglas, Clint; Bonner, Ann
2015-07-01
To examine the relationships among nurse and work characteristics, job satisfaction, stress, burnout and the work environment of haemodialysis nurses. Haemodialysis nursing is characterised by frequent and intense contact with patients in a complex and intense environment. A cross-sectional online survey of 417 haemodialysis nurses that included nurse and work characteristics, the Brisbane Practice Environment Measure, Index of Work Satisfaction, Nursing Stress Scale and the Maslach Burnout Inventory. Haemodialysis nurses reported an acceptable level of job satisfaction and perceived their work environment positively, although high levels of burnout were found. Nurses who were older and had worked in haemodialysis the longest had higher satisfaction levels, experienced less stress and lower levels of burnout than younger nurses. The in-centre type of haemodialysis unit had greater levels of stress and burnout than home training units. Greater satisfaction with the work environment was strongly correlated with job satisfaction, lower job stress and emotional exhaustion. Haemodialysis nurses experienced high levels of burnout even though their work environment was favourable and they had acceptable levels of job satisfaction. Targeted strategies are required to retain and avoid burnout in younger and less experienced nurses in this highly specialised field of nursing. © 2013 John Wiley & Sons Ltd.
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Association of the Nurse Work Environment, Collective Efficacy, and Missed Care.
Smith, Jessica G; Morin, Karen H; Wallace, Leigh E; Lake, Eileen T
2018-06-01
Missed nursing care is a significant threat to quality patient care. Promoting collective efficacy within nurse work environments could decrease missed care. The purpose was to understand how missed care is associated with nurse work environments and collective efficacy of hospital staff nurses. A cross-sectional, convenience sample was obtained through online surveys from registered nurses working at five southwestern U.S. hospitals. Descriptive, correlational, regression, and path analyses were conducted ( N = 233). The percentage of nurses who reported that at least one care activity was missed frequently or always was 94%. Mouth care (36.0% of nurses) and ambulation (35.3%) were missed frequently or always. Nurse work environments and collective efficacy were moderately, positively correlated. Nurse work environments and collective efficacy were associated with less missed care (χ 2 = 10.714, p = .0054). Fostering collective efficacy in the nurse work environment could reduce missed care and improve patient outcomes.
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The health care work environment and adverse health and safety consequences for nurses.
Geiger-Brown, Jeanne; Lipscomb, Jane
2010-01-01
Nurses' working conditions are inextricably linked to the quality of care that is provided to patients and patients' safety. These same working conditions are associated with health and safety outcomes for nurses and other health care providers. This chapter describes aspects of the nursing work environment that have been linked to hazards and adverse exposures for nurses, as well as the most common health and safety outcomes of nursing work. We include studies from 2000 to the present by nurse researchers, studies of nurses as subjects, and studies of workers under similar working conditions that could translate to nurses' work environment. We explore a number of work organization factors including shift work and extended work hours, safety climate and culture, teamwork, and communication. We also describe environmental hazards, including chemical hazards (e.g., waste anesthetics, hazardous drugs, cleaning compounds) and airborne and bloodborne pathogen exposure. Nurses' health and safety outcomes include physical (e.g., musculoskeletal disorders, gastrointestinal, slips, trips and falls, physical assault) and psychosocial outcomes (e.g., burnout, work-family conflict). Finally, we present recommendations for future research to further protect nurses and all health care workers from a range of hazardous working conditions.
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Workplace Violence: An Extensive Issue for Nurses in Pakistan-: A Qualitative Investigation.
Shahzad, Asif; Malik, R K
2014-07-01
The objective of the present study was to examine the incidences of violence during nurses' careers and their impacts on their work life in the Islamic Republic of Pakistan. The current article highlights workplace violence toward nurses as a serious issue in Pakistan, which is almost an unexplored area as data are scarce. Individual interviews were conducted, applying a qualitative approach for getting the in-depth knowledge about the subject. Grounded theory method was used for data analysis and NVIVO-10 was used for information processing. Majority of the nurses experienced violence in the previous 6 months of their career. Nurses also confirmed that verbal abuse was witnessed and although experienced frequently, they did not report it, as they believed that reporting was useless and no action would be taken. Most nurses reported that due to violence, they experience stress, low work performance, low job satisfaction, high absenteeism, and high turnover intentions. The results illustrated a clear trend of an increasing number of violence incidents toward nurses. The findings of the present study possibly will assist hospital administration to manage and reduce violence at workplace. © The Author(s) 2014.
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Ambiguity in knowledge transfer: The role of theory-practice gap.
Cheraghi, Mohammad Ali; Salsali, Mahvash; Safari, Mahmoud
2010-01-01
In spite of much literature written about the theory-practice gap in the international nursing journals, there is evidence that indicates this subject has not been probed comprehensively since nursing education was transferred to universities in Iran. In the recent years, the public and the government have criticized Iranian nurses because of poor quality of patient care. Although this subject has been lamented by some researchers, there is no comprehensive work on how this gap resulted. In the process of a larger study on "nursing knowledge translation to practice", of one PhD thesis, this process was explored. Using grounded theory analysis, indepth interviews were undertaken with a purposive sample of 29 nurses, with different levels of experience, from the school of nursing in Tehran University of Medical Sciences in 2006 from January to August. Data were analyzed using the constant comparative method. Three main themes emerging from this study included clinical behavior structure, paradoxical knowledge and practice, and divergent nursing organization. It seems that nursing education with some praxis and paradoxes in the realm of nursing knowledge and practice, along with divergent organizational structure have decreased nurses' ability in applying their professional knowledge and skills in order to bridge the gap between theory and practice. Moreover, in spite of increased academic input into nursing education, clinical behaviors of both education and practice settings was perceived as "traditional routine-based".
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[Integration of the nursing process in the electronic health record in an university hospital].
Guadarrama-Ortega, D; Delgado-Sánchez, P; Martínez-Piedrola, M; López-Poves, E M; Acevedo-García, M; Noguera-Quijada, C; Camacho-Pastor, J L
To describe the process of implementation of Individualized Care Plan in the Electronic Health Record and its impact on the University Hospital Alcorcón Foundation. Working groups of staff nurses who analyzed activities usually performed to create a catalog of diagnoses, outcomes and interventions. A group of referents that refined the catalog to make it manageable was created. A training plan, nursing assessment forms and the Nursing Discharge Report were designed. In February 2016 the new methodology was implemented in inpatient units of adults. Between 74.86 and 88.18% of the patients underwent a care plan with the new methodology. Between 69.41 and 76.25% of patients are discharged with a Nursing Discharge Report accordance with regulations. An increase of 24.1% of patients with Nursing Discharge Report after implantation is observed (P=.000; RR: 1.46; 95% CI 1.36-1.56). A total of 116 nurses has been trained. In the study conditions, the use of nursing taxonomies has generated thinking skills and allowed nurses to issue judgments, ensure quality of care, and implementing interventions with a planned results. The nursing taxonomy and care plan in the Electronic Health Record have increased interprofessional communication to improve continuity of care through improved Nursing Discharge Report. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
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Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael
2018-05-01
Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with sufficient information (β 0.403 [95%-CI: 0.03-0.77) and adapted treatment and care (β 0.462 [95%-CI: 0.04-0.88]). Furthermore, higher levels of implicit rationing of nursing care were associated with lower levels of patient-centered care, e.g., adapted treatment and care (β -0.912 [95%-CI: -1.50-0.33]). Our study shows a negative association between implicit rationing of nursing care and patient-centered care: i.e.the lower the level of implicit rationing of nursing care, the better patients understood nurses, felt sufficiently informed and recognized that they were receiving highly individualized treatment. To improve patient-centered care, the nurse work environment and the level of implicit rationing of nursing care should be taken into consideration. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Dierckx de Casterlé, Bernadette; Willemse, An; Verschueren, Marc; Milisen, Koen
2008-09-01
This study explored the dynamics related to a leadership development programme and their impact on the clinical leader, the nursing team and the care-giving process. While there is a growing conviction about the need to invest in transformational leadership in nursing, further insight into the true complexity of leadership development and, more specifically, how leadership can make a difference in nursing and patient outcomes is essential. A single instrumental case study was conducted in a unit of a large academic hospital where a Clinical Leadership development Project (CLP) was implemented successfully. We used mixed methods with multiple sources of data to capture the complexity of leadership development. Data were collected through individual interviews, focus groups and observation of participants. A purposive sample of 17 participants representing a wide variety of team members has permitted data saturation. The data were categorized and conceptualized and finally organized into a framework describing leadership development on the unit and its impact on the leader, the nursing team and the care-giving process. Leadership development is an ongoing, interactive process between the clinical leader and the co-workers. The head nurse became more effective in areas of self-awareness, communication skills, performance and vision. The nursing team benefited because more effective leadership promoted effective communication, greater responsibility, empowerment and job clarity. Improved clinical leadership seemed also to influence patient-centred communication, continuity of care and interdisciplinary collaboration. The results of the study give more insight into the processes underlying the leader's progress towards attaining a transformational leadership style and its impact on the team members. The impact of leadership on the care-giving process, however, remains difficult to describe. The interactive nature of leadership development makes CLP a challenge for the leader as well for the team members. Through its impact on the leader and the nursing team, CLP is a valuable instrument for improving work environments of nurses, contributing positively to patient-centred care.
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Introduction and development of NCP using ICNP in Pakistan.
Rukanuddin, R J
2005-12-01
Traditionally, nursing care has been described as performing nursing tasks and often focused on nurses carrying out doctors' orders. In many countries of the world, including Pakistan, nurses do not document care in a standardized manner. Because of this limitation many health administrators, policy makers, and consumers make inadequate assumptions about nursing work, often regarding nurses as any other 'health care technician' who can be easily replaced by more economical health care workers. To overcome this problem, standardized documentation is being introduced into the Aga Khan University School of Nursing and hospital, Aga Khan Health Services, Public Health School in Karachi, and government colleges of nursing, using the International Classification for Nursing Practice (ICNP). The purpose of this paper is to highlight the process of introducing and developing standardized nursing care plans (NCP) using ICNP in Pakistan. The process for introducing ICNP consists of four components, including administrative planning, development, teaching and training, and testing. Subsets of the ICNP for (i) maternity: antenatal, postnatal and natal care; and (ii) cardiology were developed using standardized NCPs. The subsets were developed by nurse experts and introduced at the testing sites. The testing will be conducted as a pilot project. Findings from the pilot will be used to continue and expand standardized nursing documentation using the ICNP across Pakistan. Through this project, nurses, midwives and lady health visitors (midwives, vaccinator and health educators) will test standardization of documentation and begin to evaluate efficiency and effectiveness of clinical practice.
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Nursing Home Work Practices and Nursing Assistants' Job Satisfaction
ERIC Educational Resources Information Center
Bishop, Christine E.; Squillace, Marie R.; Meagher, Jennifer; Anderson, Wayne L.; Wiener, Joshua M.
2009-01-01
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,…
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da Cruz, Andrea de Mello Pereira; Almeida, Miriam de Abreu
2010-12-01
This is a qualitative, exploratory and descriptive study whose general objective was to learn, considering the perspective of the nursing technician who works in school hospitals, the competencies developed during their educational process to implement the Nursing Care Systematization (NCS). Data collection and analysis were carried out through a focal group, with content analysis and nursing technicians. Two thematic categories emerged: The participation of the nursing technician in the NCS and The competencies in the education of the nursing technician. Each one received two subcategories: Conception of the NCS and (De)valuation of the NCS, Technical-scientific competency and Competency in the interpersonal relationship, respectively. It was observed that the NCS must be shared, discussed and made public among nursing professionals, so that they may acknowledge themselves as the leading actors of their methodology and be aware that their practices determine the results.
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Ballangrud, Randi; Hall-Lord, Marie Louise; Persenius, Mona; Hedelin, Birgitta
2014-08-01
To describe intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care. Failures in team processes are found to be contributory factors to incidents in an intensive care environment. Simulation-based training is recommended as a method to make health-care personnel aware of the importance of team working and to improve their competencies. The study uses a qualitative descriptive design. Individual qualitative interviews were conducted with 18 intensive care nurses from May to December 2009, all of which had attended a simulation-based team training programme. The interviews were analysed by qualitative content analysis. One main category emerged to illuminate the intensive care nurse perception: "training increases awareness of clinical practice and acknowledges the importance of structured work in teams". Three generic categories were found: "realistic training contributes to safe care", "reflection and openness motivates learning" and "finding a common understanding of team performance". Simulation-based team training makes intensive care nurses more prepared to care for severely ill patients. Team training creates a common understanding of how to work in teams with regard to patient safety. Copyright © 2014 Elsevier Ltd. All rights reserved.
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McCready, Jason S
2010-07-01
Abstract Nursing is frequently described as practical or pragmatic and there are many parallels between nursing and pragmatism, the school of thought. Pragmatism is often glancingly referenced by nursing authors, but few have conducted in-depth discussions about its applicability to nursing; and few have identified it as a significant theoretical basis for nursing research. William James's pragmatism has not been discussed substantially in the nursing context, despite obvious complementarities. James's theme of pluralism fits with nursing's diversity and plurality; his emphasis on social conscience in our actions matches nursing's fundamental purpose of improving the lives of others; his continuous testing of pluralistic truths in critically reflective practice pairs well with nursing's focus on developing best-available, holistic evidence; and his conceptualization of truth as being born in practice and becoming an instrument in practice is entirely compatible with nursing's theory-practice identity. The oft-discussed theory-practice gap is seen to hinder the development of nursing knowledge. If nursing is to find its identity in knowledge development and potentiate the knowledge developed, it is imperative to identify and address that which is impeding progress. By way of the pragmatic tenets of William James, I will argue that a significant part of the theory-practice gap lies in how nursing knowledge development is operationalized, creating a false dichotomy between practice and research. I will also argue that the research-practice schism has been widened by continued philosophical and methodological infighting in the research community. I will describe how Jamesian pragmatism can be 'what works' for rebuilding relationships and supporting an engaged plurality within nursing research and bring research and practice together into a collaborative and iterative process of developing nursing knowledge.
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Psychological contracts and commitment amongst nurses and nurse managers: a discourse analysis.
McCabe, T J; Sambrook, Sally
2013-07-01
Few studies explore the link between the psychological contracts and the commitment of nursing professionals in the healthcare sector, and how perceived breaches of the psychological contract can impact on nurses' commitment levels. This study explores the connections between the psychological contracts and organisational and professional commitment of nurses and nurse managers. Semi-structured interviews were conducted with nurses and nurse managers, to explore the connections between their psychological contracts and organisational and professional commitment. Large acute and small community organisation within the British National Health Service. 28 nurses and 11 nurse managers working within an acute and a community sector organisation - 20 and 19 in each organisation. Participants were selected through a process of purposive sampling, reflecting variations in terms of age, grade, ward and tenure. A discourse analysis was conducted on the qualitative data from the thirty nine semi-structured interviews. Two overall themes emerged, professional and managerial values. Professional values included the sub-themes: professional recognition; immediate work environment - leadership and peer support; professional development and progression. Sub-themes under managerial values included: involvement; general management; resource management. The findings suggest that nurses and nurse managers are governed by relational psychological contracts, underpinned by an affective and to a lesser extent normative commitment towards the nursing profession. They emphasise 'professional values', and professional commitment, as the basis for positive psychological contracts amongst nursing professionals. There was anecdotal evidence of relational psychological contract breach, with decreasing job satisfaction as the outcome of perceived psychological contract breach. Positive psychological contracts and commitment levels amongst nursing professionals can be supported by managers been aware and sensitive to nursing discourses, and managing their expectations through greater involvement and leadership development. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Van Bogaert, Peter; van Heusden, Danny; Timmermans, Olaf; Franck, Erik
2014-01-01
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. 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. Cross-sectional survey. 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. 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. 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.
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Putting Safety in the Frame: Nurses' Sensemaking at Work.
O'Keeffe, Valerie Jean; Thompson, Kirrilly Rebecca; Tuckey, Michelle Rae; Blewett, Verna Lesley
2015-01-01
Current patient safety policy focuses nursing on patient care goals, often overriding nurses' safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used "frames" built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses' decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses' frames question current policy and practice by challenging how nurses' safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.
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[Parents and nursing staff's expectations regarding the nurse's work in a NICU].
Kamada, Ivone; Rocha, Semíramis Melani Melo
2006-09-01
The general purpose of this investigation was to identify parent and nursing staff expectations regarding the nurse's role in Neonatal Intensive Care Units (NICU). A descriptive study was carried out using a qualitative approach and interviews were conducted at a NICU in the interior of the State of São Paulo. Results showed new expectations on the part of parents and professionals regarding the role of NICU nurses. The knowledge identified as necessary were a family-centered approach, interpersonal relations techniques, and differentiation between technology and scientific knowledge. The conclusion is that NICU nurses need to play a more incisive role in the nursing care process, adjusting the use of technological advances to human knowledge, particularly in the area of interpersonal relationships between family members and staff, which includes activities of continuing education, such as specialization courses.
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Wosinski, Jacqueline; Belcher, Anne E; Dürrenberger, Yvan; Allin, Anne-Claude; Stormacq, Coraline; Gerson, Linda
2018-01-01
The purpose of this study was to identify and synthesize the best available evidence on the perspective of undergraduate nursing students on facilitating elements that contribute to their success with PBL. a qualitative systematic review of the literature according to meta-aggregative methodology using the JBI SUMARI system was conducted. Data was collected across CINAHL, Medline, Embase, Eric, Teacher Reference Center and reference lists. Out of 378 articles, 101 were retrieved for examination and eight were retained after methodological analysis. 51 findings, matched with a verbatim, were extracted and aggregated in five categories: 1) in PBL, the nursing tutor models clinical reasoning and leadership skills; 2) the quality of group interactions is critical to the success of nursing students with PBL; 3) nursing students go through the process of learning with PBL; 4) through PBL, nursing students acquire skills that foster clinical reasoning; and 5) when the PBL method is used as intended, nursing students understand its purpose and process. These categories were aggregated in two syntheses worded as recommendation for practice. The synthesized recommendations are: 1) tutors should be trained to effectively guide the team work of undergraduate nursing students along the PBL process in order for them to achieve its goal; and 2) nursing students should be securely introduced to PBL and experience the development of their clinical reasoning through PBL. Future research should focus on the strategies undergraduate nursing students use to succeed with PBL and the effectiveness of PBL in enhancing critical thinking and collaboration skills. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
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Does daily nurse staffing match ward workload variability? Three hospitals' experiences.
Gabbay, Uri; Bukchin, Michael
2009-01-01
Nurse shortage and rising healthcare resource burdens mean that appropriate workforce use is imperative. This paper aims to evaluate whether daily nursing staffing meets ward workload needs. Nurse attendance and daily nurses' workload capacity in three hospitals were evaluated. Statistical process control was used to evaluate intra-ward nurse workload capacity and day-to-day variations. Statistical process control is a statistics-based method for process monitoring that uses charts with predefined target measure and control limits. Standardization was performed for inter-ward analysis by converting ward-specific crude measures to ward-specific relative measures by dividing observed/expected. Two charts: acceptable and tolerable daily nurse workload intensity, were defined. Appropriate staffing indicators were defined as those exceeding predefined rates within acceptable and tolerable limits (50 percent and 80 percent respectively). A total of 42 percent of the overall days fell within acceptable control limits and 71 percent within tolerable control limits. Appropriate staffing indicators were met in only 33 percent of wards regarding acceptable nurse workload intensity and in only 45 percent of wards regarding tolerable workloads. The study work did not differentiate crude nurse attendance and it did not take into account patient severity since crude bed occupancy was used. Double statistical process control charts and certain staffing indicators were used, which is open to debate. Wards that met appropriate staffing indicators prove the method's feasibility. Wards that did not meet appropriate staffing indicators prove the importance and the need for process evaluations and monitoring. Methods presented for monitoring daily staffing appropriateness are simple to implement either for intra-ward day-to-day variation by using nurse workload capacity statistical process control charts or for inter-ward evaluation using standardized measure of nurse workload intensity. The real challenge will be to develop planning systems and implement corrective interventions such as dynamic and flexible daily staffing, which will face difficulties and barriers. The paper fulfils the need for workforce utilization evaluation. A simple method using available data for daily staffing appropriateness evaluation, which is easy to implement and operate, is presented. The statistical process control method enables intra-ward evaluation, while standardization by converting crude into relative measures enables inter-ward analysis. The staffing indicator definitions enable performance evaluation. This original study uses statistical process control to develop simple standardization methods and applies straightforward statistical tools. This method is not limited to crude measures, rather it uses weighted workload measures such as nursing acuity or weighted nurse level (i.e. grade/band).
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Social networks in nursing work processes: an integrative literature review.
Mesquita, Ana Cláudia; Zamarioli, Cristina Mara; Fulquini, Francine Lima; Carvalho, Emilia Campos de; Angerami, Emilia Luigia Saporiti
2017-03-20
To identify and analyze the available evidence in the literature on the use of social networks in nursing work processes. An integrative review of the literature conducted in PubMed, CINAHL, EMBASE and LILACS databases in January 2016, using the descriptors social media, social networking, nursing, enfermagem, redes sociais, mídias sociais, and the keyword nursing practice, without year restriction. The sample consisted of 27 international articles which were published between 2011 and 2016. The social networks used were Facebook (66.5%), Twitter (30%) and WhatsApp (3.5%). In 70.5% of the studies, social networks were used for research purposes, in 18.5% they were used as a tool aimed to assist students in academic activities, and in 11% for executing interventions via the internet. Nurses have used social networks in their work processes such as Facebook, Twitter and WhatsApp to research, teach and watch. The articles show several benefits in using such tools in the nursing profession; however, ethical considerations regarding the use of social networks deserve further discussion. Identificar e analisar as evidências disponíveis na literatura sobre a utilização de redes sociais nos processos de trabalho em enfermagem. Revisão integrativa da literatura realizada em janeiro de 2016, nas bases de dados PubMed, CINAHL, EMBASE e LILACS, com os descritores social media, social networking, nursing, enfermagem, redes sociais, mídias sociais e a palavra-chave nursing practice, sem restrição de ano. A amostra foi composta por 27 artigos, os quais foram publicados entre 2011 e 2016, todos internacionais. As redes sociais utilizadas foram o Facebook (66,5%), o Twitter (30%) e o WhatsApp (3,5%). Em 70,5% dos estudos as redes sociais foram utilizadas para fins de pesquisa, em 18,5% como ferramenta para auxiliar estudantes nas atividades acadêmicas, e em 11% para a realização de intervenções via internet. Em seus processos de trabalho, os enfermeiros têm utilizado as redes sociais Facebook, Twitter e WhatsApp para pesquisar, ensinar e assistir. Os artigos evidenciam diversos benefícios sobre o uso de tais ferramentas na profissão de enfermagem, entretanto, as considerações éticas a respeito da utilização das redes sociais merecem maior discussão.
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Gillet, Nicolas; Fouquereau, Evelyne; Bonnaud-Antignac, Angélique; Mokounkolo, René; Colombat, Philippe
2013-10-01
The importance of transformational leadership for nurses' well-being is increasingly acknowledged. However, there is a paucity of research examining the mechanisms that may explain the relationships between transformational leadership and nurses' quality of work life. First, to examine two possible psychological mechanisms that link transformational leadership behaviors to nurses' quality of work life. Second, to study the relationship between nurses' quality of work life and their work engagement. Cross-sectional study design. The study took place in 47 different hematology, oncology, and hematology/oncology units in France. Participants were nurses and auxiliary nurses. 343 nurses completed the questionnaire. Surveys were sent to all nurses working in the units. 95% were female, the average age was 36.30 years. Nurses were asked to rate their supervisor's transformational leadership style and their perceptions of distributive and interactional justice in the unit. They were also asked to evaluate their own level of quality of work life and their work engagement. Distributive justice and interactional justice were found to fully mediate the relationship between transformational leadership and nurses' quality of work life. In addition, nurses' quality of work life positively related to their work engagement. Transformational leaders may help ensure nurses' quality of work life which in turn increases their work engagement. These leadership practices are thus beneficial for both employees and organization. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Gyllensten, Kristina; Andersson, Gunnar; Muller, Helena
2017-01-01
There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work-family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses' and assistant nurses' job satisfaction, work-life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nurses and assistant nurses in order to improve the working situation. The aim of the study was to investigate the experiences of reduced work hours and no lunch breaks among nurses and assistant nurses at an orthopaedic surgery department at a hospital in Sweden, with a particular focus on recovery and psychosocial working environment. A qualitative design was used in the study. Eleven nurses and assistant nurses working at the particular orthopaedic department took part in the study, and semi-structured interviews were used to collect data. The interviews were analysed by interpretative phenomenological analysis. Four main themes were developed in the analysis of the data: A more sustainable working situation, Improved work-life balance, Consequences of being part of a project, and Improved quality of care. Each theme consisted of subthemes. Overall, reduced work hours appeared to have many, mainly positive, effects for the participants in both work and home life.
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Liu, Yi; Wu, Li-Min; Chou, Pi-Ling; Chen, Mei-Hsin; Yang, Li-Chien; Hsu, Hsin-Tien
2016-01-01
This study aimed to (a) test the fit of the hypothesized model for new nurses' intent to leave and (b) determine the extent to which personal characteristics, work conditions, and work-related fatigue predict intent to leave among new nurses. This study was a cross-sectional survey study. A total of 162 new nurses were recruited. A hypothesized model was proposed for model testing. Structural equation modelling was used for data analysis. Work conditions only had an effect through work-related fatigue on new nurses' intent to leave. Personal characteristics did not have a significant effect on new nurses' intent to leave. The final model showed a good fit. Work-related fatigue, work conditions, and health explained 65% of the variance in new nurses' intent to leave. Work-related fatigue was a major determinant of new nurses' intent to leave. More attention should be paid to fatigue reduction strategies among new nurses. Work-related fatigue should be monitored, particularly for new nurses who work more than 10 hr per day and who have greater workloads. © 2015 Sigma Theta Tau International.
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Shared Governance and Work Engagement in Emergency Nurses.
Siller, Jennifer; Dolansky, Mary A; Clavelle, Joanne T; Fitzpatrick, Joyce J
2016-07-01
Lack of work engagement in emergency nurses has been linked to increased job turnover, burnout, and lack of job satisfaction. Shared governance is a vehicle that can be used by emergency nursing leaders to increase work engagement among emergency nurses. Research is lacking about the relationship between perceptions of shared governance and work engagement in emergency nurses. In this study we examined the relationship between ED nurses' perceptions of shared governance and work engagement. A descriptive correlation design was used with a convenience sample of 43 emergency nurses recruited through the ENA Web site. Participants completed a demographic questionnaire, the Index of Professional Nursing Governance Tool, and the Utrecht Work Engagement Scale. The mean total work engagement score indicated average engagement (M = 4.4, standard deviation = 1.2). A significant positive relationship was found between shared governance and work engagement, indicating that as perceptions of shared governance increase, work engagement increases (r (41) = 0.62, P < .001). The study provides beginning evidence on the relationship of shared governance and work engagement in emergency nurses. Understanding the relationship between perceptions of shared governance and work engagement in emergency nurses may assist emergency nursing leaders in developing and testing interventions to enhance it. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
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Strategies for Pursuing a Master's Degree.
Thomas, Cynthia M; McIntosh, Constance E; Mensik, Jennifer S
2016-01-01
Health care has become very complex and is in a constant state of change. As a result of the evolving change and increasing complexity, a more educated nursing workforce is needed (Dracup K. Master's nursing programs. American Association of Colleges of Nursing. 2015; Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. 2010). It is now becoming necessary for registered nurses to earn an advanced degree to work at the highest level of their practice authority (Dracup K. Master's nursing programs. American Association of Colleges of Nursing. 2015; Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. 2010.). Preparing to reenter college may be an overwhelming prospect for some registered nurses seeking an advanced degree. However, there are some simple strategies that may help sort out the many degree options, financial obligations, decisions about brick and mortar versus online learning, commitment to degree completion, and changing career paths. This article will provide the registered nurse valuable information that will assist in the exciting process of returning to college.
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Learning organizations, internal marketing, and organizational commitment in hospitals
2014-01-01
Background Knowledge capital is becoming more important to healthcare establishments, especially for hospitals that are facing changing societal and industrial patterns. Hospital staff must engage in a process of continual learning to improve their healthcare skills and provide a superior service to their patients. Internal marketing helps hospital administrators to improve the quality of service provided by nursing staff to their patients and allows hospitals to build a learning culture and enhance the organizational commitment of its nursing staff. Our empirical study provides nursing managers with a tool to allow them to initiate a change in the attitudes of nurses towards work, by constructing a new ‘learning organization’ and using effective internal marketing. Methods A cross-sectional design was employed. Two hundred questionnaires were distributed to nurses working in either a medical centre or a regional hospital in Taichung City, Taiwan, and 114 valid questionnaires were returned (response rate: 57%). The entire process of distribution and returns was completed between 1 October and 31 October 2009. Hypothesis testing was conducted using structural equation modelling. Results A significant positive correlation was found between the existence of a ‘learning organization’, internal marketing, and organizational commitment. Internal marketing was a mediator between creating a learning organization and organizational commitment. Conclusion Nursing managers may be able to apply the creation of a learning organization to strategies that can strengthen employee organizational commitment. Further, when promoting the creation of a learning organization, managers can coordinate their internal marketing practices to enhance the organizational commitment of nurses. PMID:24708601
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Rationalisation of nursing education in Limpopo province : nurse educators' perspectives.
Makhuvha, T R; Davhana-Maselesele, M; Netshandama, V O
2007-12-01
Nursing education institutions are facing a challenge of realigning its functioning according to the changes that are taking place within the country. The intention of the government post apartheid was to correct the imbalances which were brought about by the apartheid government and the following regulations and policies influenced the change in nursing education, that is, Reconstruction and Development Programme (RDP), White Paper on Higher Education (WPHE), and the National Qualification Framework (NQF) (South Africa, 1995:6). In 1996 the government introduced the first democratic constitution of the Republic of South Africa (RSA) according toAct 108 of 1996. In the light of those increasing changes in nursing education, led by political change, the experiences of nurse educators is a critical issue facing nursing campuses. The purpose of this study was two-fold; namely: to explore and describe the experiences of nurse educators with regard to the rationalisation of nursing education and to use information obtained to describe guidelines for the effective rationalisation of a nursing college in the Limpopo Province. A qualitative, exploratory, descriptive and contextual research design was used. Qualitative interviews were conducted with nurse educators who worked in nursing colleges before and after 1994. Measures to ensure trustworthiness were applied and ethical issues were adhered to throughout the research process. Data was analysed following Tesch's method (Creswell 1994:154-155). The research established that nurse educators experienced dissatisfaction in several areas relating to the rationalization of nursing education. Support was also expected from bureaucracy at higher level. This study developed guidelines to policy makers and nurse educators to ensure effective rationalisation process.
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Shift Work in Nurses: Contribution of Phenotypes and Genotypes to Adaptation
Gamble, Karen L.; Motsinger-Reif, Alison A.; Hida, Akiko; Borsetti, Hugo M.; Servick, Stein V.; Ciarleglio, Christopher M.; Robbins, Sam; Hicks, Jennifer; Carver, Krista; Hamilton, Nalo; Wells, Nancy; Summar, Marshall L.; McMahon, Douglas G.; Johnson, Carl Hirschie
2011-01-01
Background Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work. Methods Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses. Results Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25%) were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work). Conclusions Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental “stress” to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy. PMID:21533241
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Liu, Ke; You, Li-Ming; Chen, Shao-Xian; Hao, Yuan-Tao; Zhu, Xiao-Wen; Zhang, Li-Feng; Aiken, Linda H
2012-05-01
This study examines the relationship between hospital work environments and job satisfaction, job-related burnout and intention to leave among nurses in Guangdong province, China. The nursing shortage is an urgent global problem and also of concern in China. Studies in Western countries have shown that better work environments are associated with higher nurse satisfaction and lower burnout, thereby improving retention and lowering turnover rates. However, there is little research on the relationship between nurse work environments and nurse outcomes in China. This is a cross-sectional study. Survey data were collected from 1104 bedside nurses in 89 medical, surgical and intensive care units in 21 hospitals across the Guangdong province in China. Stratified convenience sampling was used to select hospitals, and systematic sampling was used to select units. All staff nurses working on participating units were surveyed. The China Hospital Nurse Survey, including the Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory, was employed to collect data from nurses. Statistical significance level was set at 0·05. Thirty-seven per cent of the nurses experienced high burnout, and 54% were dissatisfied with their jobs. Improving nurses' work environments from poor to better was associated with a 50% decrease in job dissatisfaction and a 33% decrease in job-related burnout among nurses. Burnout and job dissatisfaction are high among hospital nurses in Guangdong province, China. Better work environments for nurses were associated with decreased job dissatisfaction and job-related burnout, which may successfully address the nursing shortage in China. The findings of this study indicate that improving work environments is essential to deal with the nursing shortage; the findings provide motivation for nurse managers and policy makers to improve work environments of hospital nurses in China. © 2012 Blackwell Publishing Ltd.
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The impact of long work hours and shift work on cognitive errors in nurses.
Rhéaume, Ann; Mullen, Jane
2018-01-01
Pilot study to examine the impact of long work hours and shift work on cognitive errors in nurses. Twelve-hour shifts are more commonly used in hospital settings and there is growing concern over the impact that extended and irregular work hours have on nurses' well-being and performance. Twenty-eight nurses working different shifts (8-hr days and 12-hr rotation) participated in this study. Nurses were assessed at the beginning of four consecutive shifts using actigraphy, a sleep diary and an after work questionnaire. Nurses working 12-hr rotations had less total sleep time and less sleep efficiency than 8-hr day nurses. Twelve-hour rotation nurses also napped more than their counterparts. There were no differences between the two groups with respect to cognitive errors. Twelve-hour rotations have a negative effect on nurses' sleep patterns. There is no evidence indicating 12-hr rotations increased errors. Nurse managers can implement specific strategies, such as greater shift work flexibility and designated quiet time, to reduce the effects of disturbed sleep patterns in nurses. © 2017 John Wiley & Sons Ltd.
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Hospital nurses' lived experience of power.
Fackler, Carol A; Chambers, Angelina N; Bourbonniere, Meg
2015-05-01
The purpose of this study was to explore hospital nurses' lived experience of power. A hermeneutic phenomenological approach informed by Merleau-Ponty's philosophy of the phenomenology of perception was used to further an understanding of nurses' embodiment of power. Fourteen hospital clinical nurses employed in intensive care units and on medical floors in two major medical centers in the northeastern United States participated in 1-hr semistructured interviews about their lived experience of power. A hermeneutic analytic approach and reflexive (cultural) bracketing produced three relational themes of power: (a) knowing my patients and speaking up for them; (b) working to build relationships that benefit patients; and (c) identifying my powerful self. Hospital clinical nurses develop a sense of power. Nurses believe power develops through acquisition of knowledge, experience, and self-confidence; this process is enhanced by exposure to good mentors. Nurses use their power to build relationships and advocate for patients. They consciously use power to improve patient care. Nurses' voices need to be heard and acknowledged. To do this in the clinical setting and beyond, hospital nurses must invite themselves or find ways to be invited into the authoritative discourse of hospital organizations. Nurses use their power to advocate for positive outcomes for patients and families. The satisfaction that comes from these positive relationships may improve nurses' perceptions of their work environment. Nurses' understanding and use of sociopolitical knowing needs further study, so that nurses may understand how to participate in current and future debates and decisions about our changing healthcare delivery systems and services. © 2015 Sigma Theta Tau International.
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Caribbean nurses migrating to the UK: a gender-focused literature review.
Jones, A D; Bifulco, A; Gabe, J
2009-09-01
International nurse recruitment is an integral part of government health care strategy in many countries. However, the gendered implications of nurse migration have been little explored despite the fact that the nursing workforce is predominantly made up of women. Based on the migration of nurses from the English-speaking Caribbean region to the UK, this paper explores the significance of gender at both the macro and micro levels. Four strands of inquiry were explored: nurse migration, impact on development, work experiences and family life. Key terms were used to search the electronic databases SSCI, EBSCO and JSTOR. An interpretative framework based on the feminist theory of intersectionality was used to systematically review the 15 studies that met the inclusion criteria. Gender issues are significant across all aspects of the migratory process. Migrant nurses contribute to social progress through remittances and knowledge gained abroad although overall, nurse migration negatively impacts development and there are hidden implications for women. For some Caribbean nurses, migration reflects increased economic freedom; however, for others, gender inequality lies at the centre of the decision to relocate. Gender inequality also permeates the lives of many migrant nurses even in countries where economic and work conditions are improved. The ramifications of nurse migration cannot be fully understood without attention to gender inequalities and the specific socio-economic contexts in which they exist. There is need for a gender-centred approach to international nursing recruitment policy that takes account not only of the impact on developing countries, but also of the well-being of migrant nurses themselves.
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Naruse, Takashi; Sakai, Mahiro; Watai, Izumi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Murashima, Sachiyo
2013-12-01
The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.
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Borhani, Fariba; Arbabisarjou, Azizollah; Kianian, Toktam; Saber, Saman
2016-10-01
Despite the existence of a large community of nurses, specific mechanisms have not been developed yet to consider their needs and the quality of their work life. Moreover, few studies have been conducted to analyze the nature of nursing, nursing places or nurses' quality of work life. In this regard, the present study aimed to assess predictable productivity of nurses working in Kerman University of Medical Sciences' teaching hospitals via the dimensions of Quality of Work Life. The present descriptive-correlational study was conducted to assess predictable productivity of nurses via the dimensions of Quality of Work Life. The study's population consisted of all nurses working in different wards of teaching hospitals associated with Kerman University of Medical Sciences. Out of the whole population, 266 nurses were selected based on the simple random sampling method. To collect data, the questionnaires of 'Quality of Nursing Work Life' and 'Productivity' were used after confirming their reliability (test-retest) and content validity. Finally, the collected data were analyzed through the SPSS software (version 16). Although the quality of work life for nurses was average and their productivity was low but the results showed that quality of life is directly related to nurses' productivity. Quality of life and its dimensions are predictive factors in the in the nurses' productivity. It can conclude that by recognizing the nurses' quality of work life situation, it can realize this group productivity and their values to the efficiency of the health system. For the quality of working life improvement and increasing nurses' productivity more efforts are needed by authorities. The findings can be applied by managers of hospitals and nursing services along with head nurses to enhance the quality of health services and nursing profession in general.