Nursing process: from literature to practice. What are we actually doing?

Development and psychometric testing of a competency of nursing process questionnaire

Objectives

This study aimed to develop and evaluate a competency of nursing process questionnaire (CNPQ) for registered nurses in Cambodia.

Methods

Guided by the nursing process, an initial questionnaire was generated through focus group discussion, literature review, and the expert consultation. Finally, the validity and reliability of the questionnaire were validated through a questionnaire survey online of 260 registered nurses selected from Complimentary Package Activities 1, 2, 3, and national hospitals from January to February 2022 in five geographic areas of Cambodia.

Results

The content validity index was 1.00. The Cronbach's α coefficient for the whole questionnaire was 0.963, and the range for the five dimensions was 0.963-0.964, which shows that the questions were consistent. The test-retest reliability was 0.769. The exploratory factor analysis led to a list of 24 items that were grouped into five dimensions: assessment, diagnosis, planning, implementation, and evaluation. The cumulative variance contribution rate was 70.08%.

Conclusions

The CNPQ developed in this study showed good reliability and validity and can be used to assess the competency of registered nurses by themselves and help nursing managers to develop the relevant policies.

Qualitative exploration of the challenges and the benefits of the nursing process in clinical practice: A study among registered nurses in a municipal hospital in Ghana

AIM

This study aims to explore the challenges and benefits of using the nursing process in a Ghanaian Hospital.

DESIGN

The study employed a qualitative descriptive design to explore the challenges and the benefits of the utilization of the nursing process.

METHODS

Twelve (12) Registered Nurses were recruited for the study using purposive sampling. Recorded in-depth interviews were conducted and data were analysed using thematic analysis.

RESULTS

The study found a low nurse-to-patient ratio, inadequate knowledge, apathy, inadequate logistics, poor supervision as challenges. However, quality and cost-effective care improved nurse-patient relationships, and job satisfaction was found to be the benefits of nursing process use. Interventions to improve its utilization should be targeted towards improving the nurse-to-patient ratio, provision of adequate resources and inclusion of the nursing care plan in patient folders.

Evaluation of Nurses' Perceptions of Nursing Diagnoses and Their Opinions Regarding the Application of Nursing Process

AIM

This study aimed to evaluate nurses’ perception of nursing diagnoses and their opinions regarding the application of nursing process and to determine the factors affecting them.

METHOD

This was a descriptive cross-sectional study. The sample consisted of 320 nurses who worked at a foundation university hospital between October and December 2017. The Nurse’s Information Form and Nursing Diagnoses Perception Scale were used to collect the research data. The scale included expressions reflecting nurses’ perceptions about the use, usefulness, aims, results, objectives, and limitations of nursing diagnoses.

RESULTS

A total of 51.2% of the nurses participating in the study had a bachelor’s degree, and the average age was 25.36 ± 4.83 years. More than half of the nurses (50.9%) stated that they had difficulty in the assessment stage of the nursing process and that they diagnosed the risk of infection most frequently (74.4%). The nurses’ mean total score on the survey was 2.68 ± 0.44 (2–4). There was a statistically significant relationship between the total mean score of the scale with the sex, education level, and the belief that the nursing process should be used (p < .001; p < .001; p < .05).

CONCLUSION

The nurses’ perception of nursing diagnoses was at a moderate level. Positive perception of nursing diagnoses could improve nursing quality by enabling nurses to focus on care.

Barriers to implementation of nursing process in South Gondar Zone Governmental hospitals, Ethiopia

Background

The nursing process is a global concept, which forms the foundation of nursing as a profession. The use of the nursing process in most hospitals is lagging despite all the efforts of nursing professionals to implement it. The nursing process is dynamic and it is used in clinical practice worldwide to deliver quality-individualized care to patients.

Objective

This study assessed barriers to the implementation of the nursing process among nurses working at South Gondar Zone Governmental Hospitals, North Central Ethiopia, 2019.

Methods

Institutional based cross-sectional study was carried out. By using Census about N = 249 nurses were recruited. Data was collected through self-administered questionnaires. The data were entered into Epi data version 3.1 and analyzed using statistical package for social sciences (SPSS) version 23.0. Descriptive statistics such as measurements of central tendency and inferential statistics multiple logistic regression, 95% CI, and p-value ≤ 0.05 was used. The study was approved by Debre Tabor University college of health sciences ethics and research committee.

Results

A total of N = 249 study subjects participated with the response rate of 241 (96.4%). The mean age (SD±) of respondents' was 29.9 ± 7.2. About two-third of 146 (60%) nurses had poor knowledge of nursing process implementation. Three fourth 180 (74.7%) of nurses were implementing the nursing process. Nurses with sufficient information to NP were 2.45, nurses who have adequate skills to NP were 2.43, and nurses who have good knowledge were 2.24 times more likely to implement the nursing process than the opposite. No enough motivation to use NP 137 (56.8%), no follow-up by authority 141 (58.5%), no enough time for applying NP 145 (60.2%), no specific training for applying NP 173 (71.8%) and shortage of nurse staffs for nursing NP implementation 187 (77.6%) are also factors which affects nursing process implementation.

Conclusion

Based on this study only three fourth of the nurses were implementing the nursing process. For poor and non-implementation of nursing process different hindering factors were identified. Such as; shortage of time, lack of training, lack of knowledge, unrecognized by authority, no enough motivation, lack of cooperation b/n professionals, engaging in other manual tasks and unrelated tasks, unclear and poor job descriptions, work overload and poor payment for the profession were the major barriers for NP implementation. Therefore, there need to be strengthen national policy frameworks and interventions aimed at improving nursing process training and implementationin in the clinical settings.

Impact of Nursing Methodology Training Sessions on Completion of the Virginia Henderson Assessment Record

The Virginia Henderson model, integrated in the computer application GACELA Care, helps to standardise the nursing assessment and establish precise and personalised nursing diagnoses. The aim was to determine the extent of completion of the initial patient assessment record after nurses following a training programme on nursing methodology. A quasi-experimental, retrospective, randomised, observational, single-group study was performed in two stages: pre-training and post-training. Voluntary training sessions were held for the nurses that work with GACELA Care. The completion of the initial patient assessment using the needs of Virginia Henderson and the Norton scale was evaluated before and after the training sessions. Completion of the needs of Virginia Henderson in the initial patient assessment increased from 94.2% to 100% (p = 0.014). Completion of “hygiene/skin” increased significantly from 83.3% to 95.8% (pre-training and post-training, respectively). The remaining needs did not show statistical significance. Recording of the Norton scale increased from 63.13% to 92.5% (p < 0.001). The training sessions on nursing methodology have improved the completion of records and inclusion of normal characteristics, defining characteristics and risk factors, and improving pressure ulcer risk assessment through the Norton scale.

Implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia

BACKGROUND

The nursing process was initially adopted from the general system theory, and was developed and implemented in the field of education. There is a demand to implement the nursing process in practical care in every health institution, but the perception remains that it is time-consuming and impractical. If the nursing process is not valued and not used, nurses may continue to intervene on the basis of a medical diagnosis rather than on the basis of a rational nursing Process steps. In any of the steps, oversight or omission can result in less than optimal nursing care. The purpose of this study was to assess implementation and factors affecting the nursing process among nurses working in selected government hospitals in Southwest Ethiopia.

METHODS

An institution-based cross-sectional descriptive study was conducted from March 10 to April 1, 2015 in three hospitals in southwest Ethiopia using self-administered questionnaires. This study included a total of 138 nurses using simple random sampling. Data were classified, coded and entered into epidemiological information version 3.5.3, and exported to the statistical package for social science version 20 for analysis, descriptive statistics were used to describe the variables, bivariable and multivariable logistic regression were used to see the effect of each variable on the dependent variable.

RESULT

The nursing process was found to be 73.9% implemented. Compared to a Bachelor of Science nurses', the likelihood of implementing the nursing process was less likely among diploma nurses. Nurses working in administratively supported hospitals implemented the nursing process more compared to those without administrative support. The nursing process had been implemented higher by trained nurses compared to untrained nurses.

CONCLUSION

The implementation of nursing process was good where; nearly seven in every ten nurses implemented the nursing process. Low educational qualification, lack of training, and non-supportive hospital administration were predictors of the nursing process implementation. The health service management, in collaboration with Ethiopian nursing/professional associations and international governmental and non-governmental organizations should give continuous on the job professional development education, and develop nursing practice guidelines.

Implementation of Nursing Process and Its Association with Working Environment and Knowledge in Ethiopia: A Systematic Review and Meta-Analysis

Background

The nursing process is a scientific problem-solving approach, which directs nursing care and potentially improves quality of health care service. The national pooled implementation of the nursing process in Ethiopia remains unknown. Hence, this review and meta-analysis aimed to estimate the overall implementation of the nursing process and its association with the working environment and knowledge in Ethiopia.

Methods

PubMed, Scopus, Cochrane Library, Google Scholar, PsycINFO, and CINAHL were searched and complemented by manual searches. The DerSimonian and Laird random effects model was applied to estimate the pooled effect size, odds ratios, and 95% confidence interval across studies. The I² statistic was used to check heterogeneity between the studies. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. Publication bias was examined using funnel plot and Egger's regression test statistic. Analysis was performed using STATA™ Version 14 software.

Results

Seven studies comprised of 1,268 study participants were included in this meta-analysis. The estimated pooled implementation of the nursing process in Ethiopia was 42.44% (95% CI: 36.91, 47.97%). Based on subgroup analysis, methods of outcome measurement showed that the highest overall implementation of the nursing process was observed from studies conducted using self-report technique 42.95% (95% CI: 35.76, 50.15). Nurses working in stressful environment were 81% less likely to implement the nursing process (OR 0.19, 95% CI: 0.04, 0.76), and nurses having good knowledge were 8 times more likely to implement nursing process (OR 8.38, 95% CI: 2.82, 24.86).

Conclusion

The overall implementation of the nursing process in Ethiopia was relatively low. Good knowledge of nurse had paramount benefits to improve implementation of the nursing process. Therefore, nurse can be educated on the imperative of knowledge in order to enhance the nursing process implementation and to improve the overall quality of healthcare services. Furthermore, policymakers and other concerned bodies should give special attention to improving the implementation of the nursing process.

A concept analysis of burn care in nursing

BACKGROUND

Burn is a life-threatening injury that requires long-term treatment and concomitant hospital stay. Relevant clinical studies in burns have been accomplished and published in the literature. However, none of these studies reported the concept analysis of burn care in nursing. Therefore, analysing the concept of burn care acts as an imperative strategy to provide comprehensive management of burn injury.

OBJECTIVE

The study aims to describe the concept of burn care in nursing.

METHOD

Walker and Avant's method (2013) was used to achieve the objective of the study.

FINDINGS

A model of burn care in nursing was generated that consists of assessment and diagnosis, intervention and evaluation. In addition, the biopsychosocial model developed by George L. Engel (1977) was also integrated to examine how these aspects play a significant role in burn care.

CONCLUSION

Implementing the concept of burn care will improve the quality of nursing care, cosmetic outcomes and vice versa, reduce the comorbidities on burn injury.

Outpatient nursing care implementations in Indonesian regional public hospitals

OBJECTIVE

This study aimed to describe the nursing care implementations in the outpatient installations of several hospitals.

METHOD

A descriptive study design was used with purposive random sampling. A total of 292 patients were included based on the following criteria: treated at the internal, neurological, ear, nose, and throat, pulmonary, surgical, skin, sex, and heart disease polyclinics, able to read and write, and attended more than one visit. This study was conducted in three central referral hospitals in the Bogor, Depok, and Jakarta areas of Indonesia.

RESULTS

The outpatient care implementation was not optimal in the three regional public hospitals (56.8%). The nurses minimally performed the outpatient nursing processes, namely diagnosis enforcement (63.7%) and implementation (62%).

CONCLUSION

The implementation of care that is not optimal can result in a decrease in patient satisfaction and safety. The support of hospital management is needed to facilitate the availability of adequate nursing resources (both quantity and quality) and to provide equipment, facilities, and logistics to optimize nursing care.

Determinants of Nursing Process Implementation in North East Ethiopia: Cross-Sectional Study

Nursing process is a framework used to provide an effective, coordinated, and organized quality care for patients. Effective implementation of this framework leads to improved quality of care and decreases potential complication, hospital length of stay, and the cost of care. To assess implementation of nursing process and its hindering factors, a quantitative cross-sectional study was conducted among nurses in Afar region hospitals from October 2016 to December 2016. The data were collected from 102 nurses using primary Brooking's ward nurses' self-report questionnaire and with some newly prepared questions. The collected data were entered using Epi-Data version 3.1 and analyzed by SPSS version 20 and then presented by tables, graphs, and figures. Forty-three (42.1%) nurses were implementing nursing process at the time of data collection. Assessment and diagnosis were carried out by 57 (56.9%) nurses, planning by 46% of nurses, implementation by 38.2% of nurses, and evaluation by 36.2% of nurses in Afar region. Among the hindering factors towards nursing process implementation, lack of preparedness or knowledge about the nursing process or some part of it (83.3%) and absence of in-service training pertinent to nursing process (75.5%) were the most mentioned ones. Generally, nursing process was poorly implemented in Afar region mainly due to lack of knowledge and absence of in service training. Therefore, giving emphasis for cognitive parts of students about nursing process during their school time and refreshing nurse staffs with continuous training will definitively improve level of nursing process implementation.

Nurses' knowledge and practices in the face of the challenge of using the systematization of nursing care as an instrument of assistance in a first aid in Brazil

To analyze the performance of nurses in the implementation of nursing care systematization (NCS). This study is a descriptive research developed from a qualitative approach. The content analysis (CA) must be developed through 3 chronological poles allowing the researcher to construct an analysis structure that corresponds to the needs of the research and the objectives of the proposed research; The chronological poles of CA are described as: Phase 1-preanalysis, phase 2-exploration of the material: phase 3-treatment of the results obtained and interpretation. Only a semistructured interview will be conducted with the research subjects who meet the inclusion criteria of the study, preserving the identity of the individuals and guaranteeing the right to quit the research at any time during the interview. The Research Ethics Committee of Hospital of the clinics of Acre, Brazil (Amazon region) under the opinion no. 1.460.960 approved this protocol. The clinical protocol was registered in the "Brazilian Registry of Clinical Trials" validated by the World Health Organization, and received clinical trials "RBR-882rg2."

A cross sectional study on nursing process implementation and associated factors among nurses working in selected hospitals of Central and Northwest zones, Tigray Region, Ethiopia

BACKGROUND

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.

METHOD

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.

RESULT

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.

CONCLUSION

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.

Factors that influence the clinical utilization of the nursing process at a hospital in Accra, Ghana

Background

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.

Method

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.

Results

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.

Conclusions

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.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-017-0228-0) contains supplementary material, which is available to authorized users.

Ongoing nursing training influence on the completion of electronic pressure ulcer records

INTRODUCTION

Pressure ulcer (PU) care in nursing at the Hospital Clínico Universitario de Valladolid (HCUV) in Spain includes basic care and its registration through the electronic GACELA Care tool. To assess and evaluate the nursing intervention in PU evolution, a training programme was carried out to unify criteria on PU assessment, treatment, evaluation and monitoring.

OBJECTIVE

To assess the influence of training on the completion of PU records in the GACELA Care application, and identify the level of satisfaction of the nurses after its use.

MATERIALS AND METHODS

A quasi-experimental prospective study consisting of a specific training programme assessed pre- and post-training was carried out on the records of PU documentation at the HCUV. The PU records included in the study were collected using the electronic nursing healthcare management computer tool GACELA Care and belonged to patients admitted for >48h, excluding venous, arterial and stage I PUs. The pre-training sample consisted of 65 records collected between 1 April and 30 June 2014, and there were 57 post-training records, completed from 1 January to 31 March 2015. The training programme consisted of thirty-minute theoretical and practice training sessions. The study variables were ulcer type, location, stage, length and diameter, perilesional skin, cure type, products used and cure frequency, in addition to the number of actions taken in the records in correlation to the days of hospitalisation. To identify the nurses' opinions, a satisfaction survey about the management platform of ongoing Castilla y León training was administered.

RESULTS

The variations from the pre- to the post-training PU-sample completion rates were the following: from 23% to 40% for PU diameter, from 11% to 38% for PU length and from 57% to 79% for perilesional skin condition records. There was also a significant increase in the number of form updates after the training activity. The nurses' level of satisfaction with the training activity showed a positive outcome, with an average score of 8.84 over 10.

CONCLUSION

The training activity improved PU record completion significantly and was deemed positive by the nurses, mainly for its applicability in clinical practice.

Challenges associated with the implementation of the nursing process: A systematic review

BACKGROUND

Nursing process is a scientific approach in the provision of qualified nursing cares. However, in practice, the implementation of this process is faced with numerous challenges. With the knowledge of the challenges associated with the implementation of the nursing process, the nursing processes can be developed appropriately. Due to the lack of comprehensive information on this subject, the current study was carried out to assess the key challenges associated with the implementation of the nursing process.

MATERIALS AND METHODS

To achieve and review related studies on this field, databases of Iran medix, SID, Magiran, PUBMED, Google scholar, and Proquest were assessed using the main keywords of nursing process and nursing process systematic review. The articles were retrieved in three steps including searching by keywords, review of the proceedings based on inclusion criteria, and final retrieval and assessment of available full texts.

RESULTS

Systematic assessment of the articles showed different challenges in implementation of the nursing process. Intangible understanding of the concept of nursing process, different views of the process, lack of knowledge and awareness among nurses related to the execution of process, supports of managing systems, and problems related to recording the nursing process were the main challenges that were extracted from review of literature.

CONCLUSIONS

On systematically reviewing the literature, intangible understanding of the concept of nursing process has been identified as the main challenge in nursing process. To achieve the best strategy to minimize the challenge, in addition to preparing facilitators for implementation of nursing process, intangible understanding of the concept of nursing process, different views of the process, and forming teams of experts in nursing education are recommended for internalizing the nursing process among nurses.

Application of Nursing Process and Its Affecting Factors among Nurses Working in Mekelle Zone Hospitals, Northern Ethiopia

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.

Desarrollo y validación de un instrumento para la evaluación inicial de enfermeira

Este estudio, desarrollado de abril a julio de 2008, objetiva desarrollar y validar un instrumento para orientar la evaluación de enfermería en parámetros asistenciales y docentes en Santa Cruz, Bolivia. Participaron doce enfermeras bolivianas y se utilizaron el análisis de documentos y técnicas de consenso para definir las categorías y criterios a ser incluidas en el instrumento. Estas categorías son: la evaluación física y los 11 Patrones Funcionales de Salud de Gordon. El instrumento se caracteriza por ser breve, de sencilla comprensión y por centrarse en el enfermero. No incluye elementos de evaluación física avanzada, pero sí criterios de estilos de vida y autonomía del paciente. El desarrollo de estos instrumentos contribuye a la calidad de los registros, favorece el juicio clínico y la aplicación del proceso a la enfermería, refuerza el papel del enfermero, favoreciendo la sistematización de su práctica.

Cross-cultural adaptation of the Quality of Diagnoses, Interventions and Outcomes (Q-DIO) instrument into Brazilian Portuguese

PURPOSE

  To describe the cross-cultural adaptation of the Quality of Diagnoses, Interventions and Outcomes instrument into Brazilian Portuguese.

METHOD

  This process entailed translation, synthesis, back-translation, expert committee review, and pretesting.

FINDINGS

  Six items were altered in the Brazilian version, and the scoring system was changed from a five-point to a three-point Likert-type scale. Pretesting was conducted on a sample of 40 randomly selected nursing records. Overall reliability as measured by Cronbach's alpha was 0.96.

CONCLUSIONS

  Adaptation resulted in a preliminary version of the instrument.

IMPLICATIONS FOR NURSING PRACTICE

  Assessment of the psychometric properties of the instrument in a larger sample of nursing records is required, and such a study is underway.

Use of the nursing process at public and private centers in a health area

AIM: to analyze whether the nursing process method is used at public and private centers in the health area Gipuzkoa (Basque Country) and, if yes, to analyze in the framework of which model and how it is used. METHOD: cross-sectional study, based on the analysis of the nursing records used at the 158 centers studied. RESULTS: the nursing process is applied at 98% of the centers. It is applied at all public and 18 out of 21 private centers. Virginia Henderson's model is the most used to apply it, and most centers use nursing diagnoses, the NIC-NOC terminology and standardized care plans. CONCLUSION: the use of the nursing process is widespread in Gipuzkoa, with greater use at public than at private centers.

The role of the nurse in the neonatal intensive care unit: between the ideal, the real and the possible

The nurse is one of the professionals responsible for the care directed toward the physical, mental and social development of newborns in the Neonatal Intensive Care Unit. This study aimed to comprehend the experience of nurses working in a Neonatal Intensive Care Unit. Data collection was performed in 2008, through interviews with 12 nurses working in public and private hospitals of the city of São Paulo. The units of meaning identified were grouped into three categories: Developing actions; Perceiving their actions and Expectations. The analysis was based on social phenomenology. It was concluded that the overload of activities, the reduced number of staff, the lack of materials, equipment and the need for professional improvement are the reality of the work of the nurse in this sector. To supervise the care is the possible; integral care of the newborn, involving the parents, is the ideal desired.

The visibility of hygiene self-care in nurse-to-nurse shift change reports

This study aimed to understand the visibility of hygiene care related to inpatients with compromised self-care through the nurse-to-nurse shift change report. A qualitative approach was used and data were collected through observation and semi-structured interviews. A total of 33 nurses from medical and surgical units were observed and eight of them were interviewed. The results indicate that the nurse-to-nurse shift change report is a cyclically recreated practice that results in group coherence in updating information and in the continuity of care, and keeps nurses united. Hygiene care activities are present in the shift change reports; they are frequent in the shift change from morning to afternoon and less frequent in the remaining. Information concerning these activities helps to determine the type of aid necessary to the continuity of hygiene and of many other care activities and the rhythm of the following shifts.

Nursing Interventions in the Clinical Practice of an Intensive Care Unit

This cross-sectional study was carried out at a university hospital to describe the nursing interventions most frequently performed in the clinical practice of an intensive care unit, based on nursing care prescriptions, and to investigate their similarity to the Nursing Interventions Classification (NIC). The sample consisted of 991 hospitalizations of patients. Data were retrospectively collected from the computer database and analyzed through descriptive statistics and cross-mapping. A total of 57 different NIC interventions frequently used in the unit were identified; most of them in the complex (42%) and basic physiological (37%) domains, in the classes ‘respiratory management’ and ‘self-care facilitation’. Similarity between the nursing care prescribed and nursing interventions/NIC was found in 97.2% of the cases. The conclusion is that the interventions/NIC used in the clinical practice of this intensive care unit reflects the level of complexity of nursing care, which is mainly directed at the regulation of the body’s physical and homeostatic functioning.