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Asare P, Ansah EW, Sambah F. Ethics in healthcare: Knowledge, attitude and practices of nurses in the Cape Coast Metropolis of Ghana. PLoS One 2022; 17:e0263557. [PMID: 35171946 PMCID: PMC8849504 DOI: 10.1371/journal.pone.0263557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/21/2022] [Indexed: 11/19/2022] Open
Abstract
Background Nursing is a profession that care for personal and private aspects of people’s lives. Therefore, nurses need to know the basic ethical aspects of nursing which is integral in nursing practices. The purpose of the study was to describe the ethical knowledge, attitude and practice of nurses in the Cape Coast Metropolis of Ghana. Method A cross-section design was used to collect data from 264 nurses in three selected healthcare facilities in the Metropolis. A structured questionnaire was administered to all the categories of these nurses in the selected facilities. Frequency counts and multiple regression statistics were used to analyze the data. Results The results show 78% of nurses possess good ethical knowledge, 84% had a positive attitude, while 98% had good ethical practices. The results further show that nurses’ professional rank [F (1, 259), 2.35, p = .02] and academic qualification [F (1, 259), 2.67, p = .008] were significant predictors of their ethical knowledge and attitude, respectively. Conclusion Inadequate resources, poor set up of working areas and understaffing are the major barriers limiting the practice of good ethical standards among the nurses. The Regional Health Directorate, the Ministry of Health and the Managers in charge of the health facilities need to work together to eliminate these barriers as they have the potential to negatively impact quality healthcare delivery in the Metropolis.
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Affiliation(s)
- Patience Asare
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Edward W. Ansah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Francis Sambah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- * E-mail:
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2
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Heimro LS, Hermann M, Davies TT, Haugstvedt A, Haltbakk J, Graue M. Documented diabetes care among older people receiving home care services: a cross-sectional study. BMC Endocr Disord 2021; 21:46. [PMID: 33691687 PMCID: PMC7945364 DOI: 10.1186/s12902-021-00713-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 03/03/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Home care services plays an important role in diabetes management, and to enable older adults remain home-dwellers. Adequate follow-up and systematic nursing documentation are necessary elements in high quality diabetes care. Therefore, the purpose of this study was to examine the diabetes treatment and management for older persons with diabetes receiving home care services. METHODS A cross-sectional study was used to assess the diabetes treatment and management in a Norwegian municipality. Demographic (age, sex, living situation) and clinical data (diabetes diagnose, type of glucose lowering treatment, diabetes-related comorbidities, functional status) were collected from electronic home care records. Also, information on diabetes management; i.e. follow-up routines on glycated haemoglobin (HbA1c), self-monitoring of blood glucose, insulin administration and risk factors (blood pressure, body mass index and nutritional status) were registered. HbA1c was measured upon inclusion. Descriptive and inferential statistics were applied in the data analysis. RESULTS A total of 92 home care records from older home-dwelling persons with diabetes, aged 66-99 years were assessed. Only 52 (57 %) of the individuals had the diabetes diagnosis documented in the home care record. A routine for self-monitoring of blood glucose was documented for 27 (29 %) of the individuals. Only 2 (2 %) had individual target for HbA1c documented and only 3 (3 %) had a documented routine for measuring HbA1c as recommended in international guidelines. Among 30 insulin treated older individuals, a description of the insulin regimen lacked in 4 (13 %) of the home care records. Also, documentation on who performed self-monitoring of blood glucose was unclear or lacking for 5 (17 %) individuals. CONCLUSIONS The study demonstrates lack of documentation in home care records with respect to diagnosis, treatment goals and routines for monitoring of blood glucose, as well as insufficient documentation on responsibilities of diabetes management among older home-dwelling adults living with diabetes. This indicates that home care services may be suboptimal and a potential threat to patient safety.
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Affiliation(s)
- Lovise S Heimro
- Dept. of Health and Caring Sciences, Western Norway University of Applied Sciences, Stord, Norway.
| | - Monica Hermann
- Dept. of Health and Caring Sciences, Western Norway University of Applied Sciences, Stord, Norway
| | - Therese Thuen Davies
- Dept. of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Anne Haugstvedt
- Dept. of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Johannes Haltbakk
- Dept. of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Marit Graue
- Dept. of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Patel A, Emerick M, Cabunoc MK, Williams MH, Preas MA, Schrank G, Rabinowitz R, Luethy P, Johnson JK, Leekha S. Rapid Spread and Control of Multidrug-Resistant Gram-Negative Bacteria in COVID-19 Patient Care Units. Emerg Infect Dis 2021; 27:1234-1237. [PMID: 33565961 PMCID: PMC8007317 DOI: 10.3201/eid2704.204036] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We describe rapid spread of multidrug-resistant gram-negative bacteria among patients in dedicated coronavirus disease care units in a hospital in Maryland, USA, during May–June 2020. Critical illness, high antibiotic use, double occupancy of single rooms, and modified infection prevention practices were key contributing factors. Surveillance culturing aided in outbreak recognition and control.
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ARJUNAN P, TRICHUR RV. The Impact of Nurse-Led Cardiac Rehabilitation on Quality of Life and Biophysiological Parameters in Patients With Heart Failure: A Randomized Clinical Trial. J Nurs Res 2020; 29:e130. [PMID: 33031130 PMCID: PMC7808349 DOI: 10.1097/jnr.0000000000000407] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Cardiovascular diseases are the leading cause of mortality in the Indian subcontinent, accounting for 38% of deaths annually. One cardiovascular disease in particular, heart failure, is a growing public health problem both in India and worldwide. PURPOSE Heart failure is a chronic, progressive disease with increasing rates of incidence and prevalence. This study was conducted to determine the influence of a nurse-led cardiac rehabilitation program on quality of life and biophysiological parameters in patients with chronic heart failure. In this study, it was hypothesized that participants in the cardiac rehabilitation program would report significantly more-positive changes in quality of life and biophysiological parameters than their peers who did not participate in this program. METHODS In this randomized controlled trial, the participants were patients with chronic heart failure who had been admitted to a tertiary care hospital in India. The participants assigned to the intervention group received both nurse-led cardiac rehabilitation and routine care. In addition, intervention group participants received a booklet on cardiac rehabilitation, Healthy Way to Healthy Heart, at discharge and fortnightly telephone reminders about good cardiac rehabilitation practices. A standard questionnaire was used to collect targeted information on participants' general and disease-specific quality of life at 1 and 3 months postintervention. Biophysiological parameters such as body mass index, blood pressure, and serum cholesterol values were also measured. RESULTS Two thirds of the participants in each group (65% in the intervention group and 66% in the control group) were between 51 and 70 years old. The mean score for the mental component summary of generic quality of life steadily decreased in the control group and steadily increased in the intervention group at the first and second posttests. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Nurses working in cardiology units play a pivotal role in educating and managing the health status of patients with heart failure. Providing cardiac rehabilitation to patients with heart failure benefits the quality of life of these patients. Nurses working in cardiology units should encourage patients with heart failure to practice cardiac rehabilitation for a longer period to further improve their quality of life.
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Affiliation(s)
- Porkodi ARJUNAN
- PhD, RN, Reader, Faculty of Nursing, Sri Ramachandra Institute of Higher Education & Research (DU), Chennai, India
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Bosun-Arije FS, Ling J, Graham Y, Hayes C. Organisational factors influencing non-pharmacological management of type 2 diabetes mellitus (T2DM) in public hospitals across Lagos, Nigeria: A qualitative study of nurses' perspectives. Diabetes Res Clin Pract 2020; 166:108288. [PMID: 32615277 DOI: 10.1016/j.diabres.2020.108288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/24/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prevalence and incidence of Type 2 Diabetes mellitus (T2DM) are significantly increasing in Nigeria. Effective management of the condition, in clinical settings, can be achieved with a minimal financial cost, but this is often overlooked. It is crucial to understand organisational factors influencing non-pharmacological management of T2DM in Nigerian public hospitals for effective management of patients diagnosed with the condition. AIM To examine healthcare delivery services influencing patient management and seek approaches to heighten optimisation of patient health outcomes. METHODS Adopting a qualitative case study design, we used the Constant Comparative Method and semi-structured questions to interview17 nurses in public hospitals across Lagos. Using the five stages of the Framework Analysis process, the transcribed interviews were thematically analysed. RESULTS Nurses suggested that a complex, multifaceted system constituted organisational factors influencing T2DM management in public hospitals across Lagos, Nigeria. Specific factors identified were levels of available information and knowledge, relationship, policy and decision-making management. These factors were, in turn, linked to political, infrastructural, health professional and the environments within which patients were given health services. CONCLUSIONS The study revealed a significant gap in the organisation of care for individuals diagnosed with T2DM in public hospitals across Lagos. Timely and affordable strategies have been highlighted to secure effective care delivery to patients.
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MESH Headings
- Adult
- Attitude of Health Personnel
- Decision Making, Organizational
- Delivery of Health Care/organization & administration
- Delivery of Health Care/standards
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/nursing
- Diabetes Mellitus, Type 2/therapy
- Female
- Health Knowledge, Attitudes, Practice
- Health Services/standards
- Hospitals, Public/organization & administration
- Hospitals, Public/standards
- Hospitals, Public/statistics & numerical data
- Humans
- Male
- Middle Aged
- Nigeria/epidemiology
- Nurses/organization & administration
- Nurses/psychology
- Nurses/standards
- Nurses/statistics & numerical data
- Perception
- Practice Patterns, Nurses'/organization & administration
- Practice Patterns, Nurses'/standards
- Practice Patterns, Nurses'/statistics & numerical data
- Qualitative Research
- Socioeconomic Factors
- Surveys and Questionnaires
- Treatment Outcome
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Affiliation(s)
- Foluke Stella Bosun-Arije
- Manchester Metropolitan University, Faculty of Health, Psychology and Social Care, Department of Nursing, United Kingdom.
| | - Jonathan Ling
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
| | - Yitka Graham
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
| | - Catherine Hayes
- University of Sunderland, City Campus, Chester road, SR1 3SD Sunderland, United Kingdom.
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Abstract
BACKGROUND Hypertension is a silent disease of the masses with an increasing prevalence and poor control rates. This study aims to establish and test the efficacy of a nurse-led hypertension management model in the community. METHODS A single-blind, randomized controlled trial was performed. 156 hypertensive patients with uncontrolled blood pressure were equally and randomly allocated into 2 groups. Patients in the study group received a 12-week period of hypertension management. Blood pressure, self-care behaviors, self-efficacy, and satisfaction were assessed at the start of recruitment, 12 and 16 weeks thereafter. RESULTS After the intervention, blood pressure of patients in the study group had greater improvement in self-care behaviors and a higher level of satisfaction with the hypertensive care compared to the control group (both P < .05). CONCLUSIONS The nurse-led hypertension management model is feasible and effective for patients with uncontrolled blood pressure in the community.
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Affiliation(s)
| | | | - Na Liu
- TangShan Chinese Medicine Hospital, Heibei, P.R. China
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Mwakawanga DL, Mselle LT. Early or delayed umbilical cord clamping? Experiences and perceptions of nurse-midwives and obstetricians at a regional referral hospital in Tanzania. PLoS One 2020; 15:e0234854. [PMID: 32569338 PMCID: PMC7307749 DOI: 10.1371/journal.pone.0234854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/03/2020] [Indexed: 11/22/2022] Open
Abstract
Background Umbilical cord clamping is a crucial step during the third stage of labour that separates the newborn from the placenta. Despite the available evidence that delayed umbilical cord clamping is more beneficial to infants, as well as the existence of 2014 WHO recommendation that the umbilical cord should be clamped between 1 and 3 minutes, its implementation is still low in many countries including Tanzania. Objective This study describes the experiences and perceptions of nurse-midwives`and obstetricians`about the timing of umbilical cord clamping at a regional referral hospital in Tanzania. Methods A descriptive qualitative study design that adopted a purposeful sampling strategy to recruit 19 participants was used. Nine semi-structured interviews with six nurse-midwives`and three obstetricians`, as well as one focus group discussion with ten nurse-midwives`were conducted. Thematic analysis guided the analysis of data. Results Three main themes generated from the data, each having 2 to 5 subthemes. 1. Experiences about the timing of umbilical cord clamping. 2. Perceptions about the umbilical cord clamping. 3. Factors influencing the practice of delayed umbilical cord clamping to improve newborn health outcomes. Conclusion Although the nurse-midwives`and obstetricians`commonly practiced clamping the umbilical cord immediately after delivery, they understood that delayed cord clamping has a potential benefit of oxygenation to the newborn in the event of the need for resuscitation. To move forward with the good practice in maternal and newborn care, proper pre-service and providers training on matters underlying childbirth is essential to address the gap of knowledge. Delayed cord clamping should be practiced widely to improve the health outcomes of the newborn.
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Affiliation(s)
- Dorkasi Lushindiho Mwakawanga
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- * E-mail:
| | - Lilian Teddy Mselle
- Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Abstract
Some nurses continue to routinely dilute I.V. push medications, a practice associated with a high risk of errors. This article reviews correct practices for administering I.V. push medications.
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Affiliation(s)
- Lynn Deutsch
- Lynn Deutsch is a vascular access specialist for the Ascension Seton Hospital System in Austin, Tex., an adjunct professor of nursing for Austin Community College, and president of the Infusion Nurses Society (2019-2020)
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Moosavi S, Borhani F, Akbari ME, Sanee N, Rohani C. Recommendations for spiritual care in cancer patients: a clinical practice guideline for oncology nurses in Iran. Support Care Cancer 2020; 28:5381-5395. [PMID: 32144583 DOI: 10.1007/s00520-020-05390-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND In spite of the necessity of implementing spiritual care practices for cancer patients, there is no clear process in this regard in palliative care programs of the health system of countries. The present study was designed with the aim of developing a clinical practice guideline of spiritual care in cancer patients for oncology nurses in the current context. METHODS This is a multi-method study which was conducted in five stages within the framework of the National Institute for Health and Care Excellence (NICE) guideline. A research committee consisting of four focal and 16 secondary members was formed. The stages included determining the scope of the study, developing guideline (a qualitative study and a systematic review, triangulation of the data, and producing a preliminary draft), consultation stage (validation of the guideline in three rounds of the Delphi study), as well as revision and publication stages. RESULTS The clinical guideline of spiritual care with 84 evidence-based recommendations was developed in three main areas, including the human resources, care settings, and the process of spiritual care. CONCLUSIONS We are hoping by applying this clinical guideline in oncology settings to move towards an integrated spiritual care plan for cancer patients in the context of our health system. Healthcare organizations should support to form spiritual care teams under supervision of the oncology nurses with qualified healthcare providers and a trained clergy. Through holistic care, they can constantly examine the spiritual needs of cancer patients alongside their other needs by focusing on the phases of the nursing process.
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Affiliation(s)
- Soolmaz Moosavi
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Borhani
- Medical-Surgical Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nadia Sanee
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Community Health Nursing Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali-Asr Avenue, Cross of Vali-Asr Avenue and Hashemi Rafsanjani (Neiaiesh) Highway, Opposite to Rajaee Heart Hospital, Tehran, 1996835119, Iran.
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10
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Oyeleye OA. A costly failure to report changes in a patient's condition. Nursing 2019; 49:11-14. [PMID: 31651767 DOI: 10.1097/01.nurse.0000585940.43535.f2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Omobola Awosika Oyeleye
- Omobola Awosika Oyeleye is an assistant professor of nursing at the University of Texas at Houston Cizik School of Nursing
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Abstract
The purpose of this study was to survey knowledge on, and attitudes to, pain and pain management among a cohort of Norwegian Nurses in cancer care, and to explore whether there is any association between various demographic variables and knowledge level. This is a web-based survey and nurses were recruited from the Forum for Cancer Nursing. Nurses completed the questionnaire "Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS)". Univariate and multivariate linear regression analysis were used to evaluate the association between knowledge and attitudes and demographic variables. Nurses from all over Norway answered. The majority were women and most had education above bachelor level. Mean NKAS total score was 31 points (75%). Significant associations were found between NKAS total score and pain management course (p = 0.01) and workplace (p = 0.04). Nurses in cancer care in Norway have relatively good pain knowledge. The potential for improvement is the greatest with regard to pharmacology and nurses' attitudes to how patients express pain. Our findings suggest that an extensive pain management course with patient histories may result in more theoretical knowledge being applied to the patients. In a time with large migration among nurses, our findings indicate that pain management courses should be aware of cultural differences in the educational training.
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Affiliation(s)
- Inger Utne
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, NO-0130, Oslo, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St. Olavs Plass, NO-0130, Oslo, Norway
| | - Ulla Nyblin
- Department of Surgery, Vestre Viken Hospital Trust, PO 800, NO-3004, Drammen, Norway
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Jaffe G, Moriber N. Use of a Double Gloving Technique to Decrease Cross-Contamination by Anesthesia Providers. AANA J 2019; 87:307-312. [PMID: 31587715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The purpose of this project was to determine the impact of double gloving during the induction of general anesthesia on the incidence of cross-contamination by the anesthesia provider. In a representative sample of anesthesia providers, induction sequences were initially evaluated using the providers' standard technique (group 0). The same providers were reevaluated after being educated on the double gloving technique (group 1). One month later the providers were reevaluated to identify which ones continued the double gloving technique (group 2). For each sequence, all providers were asked to complete a general anesthesia induction following a standard sequence (n = 30). Every anesthesia workstation was cleaned before each induction using the same supplies, and a black light was used to iden-tify any contamination. The workstations included the anesthesia circuit/face mask, breathing bag, anesthesia machine (adjustable pressure-limiting valve/vaporizer), medication cart, intravenous (IV) stopcock, and IV fluid bag. Each group's workstation was evaluated before and after induction for foreign body changes. The 3 groups were compared using a related-samples Friedman test, which demonstrated that the double gloving technique significantly decreased contamination in most areas studied (P < .01). Use of a double gloving technique decreased cross-contamination by greater than 50%.
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Affiliation(s)
- Garrett Jaffe
- graduated from the Fairfield (Connecticut) University and Bridgeport (Connecticut) Hospital Nurse Anesthesia Program in May 2018. He is the former president of the New England Assembly of Student Registered Nurse Anesthetists (NEARNA)
| | - Nancy Moriber
- is an assistant professor in the Fairfield (Connecticut) University School of Nursing and the program director for the Fairfield (Connecticut) University and Bridgeport (Connecticut) Hospital Nurse Anesthesia Program
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13
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Affiliation(s)
- Kay S Lytle
- Kay S. Lytle is the chief nursing information officer at Duke University Health System in Durham, N.C
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14
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Lasater KB, Sloane DM, McHugh MD, Aiken LH. Quality of End-of-Life Care and Its Association with Nurse Practice Environments in U.S. Hospitals. J Am Geriatr Soc 2019; 67:302-308. [PMID: 30506666 PMCID: PMC6367037 DOI: 10.1111/jgs.15671] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/18/2018] [Accepted: 09/26/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The purpose of this study is twofold: (1) to describe the quality of end-of-life care in US hospitals from the perspective of hospital nurses; and (2) to evaluate the relationship between the nurse practice environment and end-of-life care quality. DESIGN Cross-sectional analysis of multiple linked secondary data sources. PARTICIPANTS AND SETTING A total of 12,870 direct care registered nurses in 491 acute-care hospitals. MEASUREMENTS Measures of end-of-life care quality and nurse practice environment were derived from the 2016 RN4CAST-US survey of nurses. Nurses reported on end-of-life care quality for patients for whom death within a year would not be surprising. Nurse practice environment was measured using the Practice Environment Scale of the Nursing Work Index, a National Quality Forum validated scale. RESULTS Most nurses gave their hospitals an unfavorable evaluation of end-of-life care overall (58%) and said patients often experience painful procedures that were unlikely to change their outcome (53%). The best predictor of poor quality was the nurse practice environment. Nurses in the best environments were 55% less likely than nurses in poor environments to rate their hospital's overall end-of-life care quality unfavorably (odds ratio = 0.45; 95% confidence interval = 0.39-0.52; P < .001). CONCLUSION Quality of end-of-life care in US hospitals is imperfect and is significantly worse in hospitals with poor nurse practice environments than in hospitals with the best environments. This study reinforces the importance of nurses in providing high-quality end-of-life care. J Am Geriatr Soc 67:302-308, 2019.
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Affiliation(s)
- Karen B. Lasater
- Assistant Professor of Nursing, Senior Fellow, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania
| | - Douglas M. Sloane
- Adjunct Professor of Nursing, Senior Fellow, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania
| | - Matthew D. McHugh
- The Independence Chair for Nursing Education Professor of Nursing Associate Director, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania
| | - Linda H. Aiken
- Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology, School of Arts and Sciences, Director, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania
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15
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Kumar CM, Seet E, Koh SL, Lai FW. Outcomes of nurse vs. anesthesiologist monitoring during cataract surgery under topical anesthesia. J Fr Ophtalmol 2018; 41:e491-e492. [PMID: 30449640 DOI: 10.1016/j.jfo.2018.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 11/19/2022]
MESH Headings
- Anesthesia, Local/methods
- Anesthesia, Local/nursing
- Anesthesia, Local/standards
- Anesthesiologists/standards
- Anesthetics, Local/administration & dosage
- Anxiety/etiology
- Anxiety/nursing
- Anxiety/therapy
- Cataract/diagnosis
- Cataract/nursing
- Cataract/therapy
- Cataract Extraction/methods
- Cataract Extraction/nursing
- Cataract Extraction/standards
- Female
- Humans
- Hypertension/etiology
- Hypertension/nursing
- Hypertension/therapy
- Male
- Monitoring, Intraoperative/methods
- Monitoring, Intraoperative/nursing
- Monitoring, Intraoperative/standards
- Nurse Anesthetists/standards
- Phacoemulsification/methods
- Phacoemulsification/nursing
- Phacoemulsification/standards
- Postoperative Complications/etiology
- Postoperative Complications/nursing
- Postoperative Complications/therapy
- Practice Patterns, Nurses'/standards
- Practice Patterns, Nurses'/statistics & numerical data
- Practice Patterns, Physicians'/standards
- Practice Patterns, Physicians'/statistics & numerical data
- Prognosis
- Retrospective Studies
- Treatment Outcome
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Affiliation(s)
- C M Kumar
- Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, 768828 Singapore.
| | - E Seet
- Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, 768828 Singapore
| | - S L Koh
- Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, 768828 Singapore
| | - F W Lai
- Department of Anaesthesia, Khoo Teck Puat Hospital, 90 Yishun Central, 768828 Singapore
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17
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Abstract
MANAGING THE TRANSITION FROM NURSE TO ADVANCED PRACTICE NURSE Qualified nurses who go on to undertake further training often find the transition difficult. This phenomenon has been studied more specifically in the field of advanced practice nursing. As France prepares to train and deploy state registered advanced practice nurses, it is essential to incorporate the learnings arising from research, in order to facilitate their training programme and their integration into their first role. Taking these elements into account will have a direct impact on the clinical results for which they will be accountable and their quality of working life.
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Affiliation(s)
- Christophe Debout
- c/o Soins, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux, France.
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18
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Drury V, Aw AT, Lee AHS. An Integrative Literature Review of the Effectiveness of Nurse-led Clinics in Ophthalmology. Insight 2018; 42:22-28. [PMID: 30074719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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19
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Abstract
INTEGRATION OF THE QUALITY APPROACH INTO NURSING PRACTICES, CHALLENGES AND IMPROVEMENT LEVERS.: The deployment of the care quality and safety approach is integrated into the strategic policies of healthcare facilities. Despite significant investment by management and a desire on the part of caregivers to provide quality care, certain tools and practices are still not widely used. A qualitative survey carried out with nurses and healthcare managers reveals the obstacles to the long-term survival of such an approach and the levers which can be used to develop this quality culture.
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Affiliation(s)
- Anne-Claire Duval
- Haute Autorité de santé, service Certification des établissements de santé, 5, avenue du Stade-de-France, 93218 Saint-Denis-La-Plaine, France.
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20
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Shili H, Ben Hadj Hassen S, Daoud T, Denguir H, Ounalli F. The nursing profession in Tunisia. Tunis Med 2018; 96:826-833. [PMID: 30746675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Tunisian health care system is experiencing a significant period of change and needs reforms so as to adapt. The nursing profession, which is the main actor of this system, in terms of number and function, is barely known or utterly unknown. The present paper's authors, who are paramedical teachers, aim to shed light on the specificity of the nursing and the nursing profession based on data collecting, and rare articles and legislation texts. In four sections, the paper will discuss the following issues: the nursing population demography, providing several indicators, their training throughout the reforms period, their training which has been "hooked" to university studies, their job profile and career plan. This presentation will also address the situation in Algeria and Morocco, based on data available on the Web. The acquisition of "core" skills and skills "shared with other caregivers" represents the roadmap for the drafters of the training benchmarks currently under drafting. The higher institutes of nursing are looking of ways to secure the required trainers and resources needed to the opening of departments, prior to the launch of a 'doctoral school', which represents the only incubator of future teachers and researchers. Private training institutions representing a new investment sector are to be assessed in terms of overall employability. Perspectives, in 12 points, should be planned for a pedagogically accredited, professionally performing and socially responsible profession.
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Berger V, Germain C, Lacomère R, Bader C, Gerbouin O, Bénard A. [Consensus approach: Prior to the construction of an evaluation scale of risk constipation patients hospitalized for nursing practice]. Rev Epidemiol Sante Publique 2018; 66:301-309. [PMID: 30181005 DOI: 10.1016/j.respe.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 03/16/2018] [Accepted: 07/09/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Constipation is a frequent issue during hospitalization. Multiple causes such as the existence of irregular habits, lack of exercise as well as medical history have been identified. Drugs such as strong painkillers, central nervous system therapies and treatments of the digestive tract are a major cause of constipation. Additionally, unbalanced diet, fluid deficiency, and anxiety may aggravate constipation. The consideration of all these risk factors being under the responsibility of nurses. The difficulty to take into account such a multifactorial aetiology in nursing practice and the fact that there is no easy to use and validated tool to assess the risk of constipation in current nurse practice has led us to consider the development of a Risk Assessment scale of Constipation in Patient Hospitalized (ERCoPH) to facilitate preventive management of this trouble. We present here the first step of the elaboration of this scale, the identification of risk factors through a consensus approach after a systematic literature review. METHODS The key informants consensus-based approach proposed by Pineault and Daveluy is based on five steps: (1) a literature review to identify risk factors for constipation; (2) the elaboration of a questionnaire containing the factors identified in the first step; (3) pre-select a panel of experts; (4) submission the questionnaire to the panel; (5) analysis the results of the consensus survey. Only factors that received a rating>6 by at least 80 % of the experts were retained. RESULTS The systematic literature review identified 69 risk factors submitted to the 23 experts of the panel. Fifteen risk factors were retained after analyzing the answers of the experts. The Scientific Committee added eight risk factors because of their importance in the literature and decided to group together some factors of the same domain. CONCLUSION A total of 19 risk factors were selected and grouped by major class (age, physical activity, medication, social data, food/hydration, medical and surgical history and environmental data). These factors have been tested among 300 patients enrolled in different clinical settings as part of the construction and validation of ERCoPH.
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Affiliation(s)
- V Berger
- Direction des soins, CHU de Bordeaux, Place Amélie Rabat Léon, 33000 Bordeaux, France.
| | - C Germain
- Pôle de santé publique, unité de soutien méthodologique à la recherche clinique et épidémiologique, CIC 1401, module EC, CHU de Bordeaux, 33000 Bordeaux, France
| | - R Lacomère
- Direction de la recherche clinique et de l'innovation, CHU de Bordeaux, 33000 Bordeaux, France
| | - C Bader
- Pôle de santé publique, unité de soutien méthodologique à la recherche clinique et épidémiologique, CIC 1401, module EC, CHU de Bordeaux, 33000 Bordeaux, France
| | - O Gerbouin
- Pôle des produits de santé, CHU de de Bordeaux, 33000 Bordeaux, France
| | - A Bénard
- Pôle de santé publique, unité de soutien méthodologique à la recherche clinique et épidémiologique, CIC 1401, module EC, CHU de Bordeaux, 33000 Bordeaux, France
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Rose PM. Patients' characteristics informing practice: improving individualized nursing care in the radiation oncology setting. Support Care Cancer 2018; 26:3609-3618. [PMID: 29728842 DOI: 10.1007/s00520-018-4210-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 04/13/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE A large number of patients attend for radiotherapy daily. Primary nurses in the study settings aim to individualize care for their patients. The individual characteristics of patients may determine their perceptions of nursing care, and provide guidance in tailoring their care. This study aimed to assess patients' personal characteristics on their perceptions of individualized care (IC) provided by nurses during a course of radiotherapy, and to determine predictor variables that may inform nursing practice. METHODS This cross-sectional, exploratory study was conducted in three radiotherapy departments in Australia. Patients (n = 250) completed the Individualized Care Scale_Patient (ICS_P). Data were analyzed using descriptive and inferential statistics, univariate analysis, and multiple regression analysis. RESULTS Males reported significantly higher perceptions of IC than females in 7/9 subscales. Patients with head and neck and prostate cancer, as well as those requiring hospitalization during radiotherapy, scored significantly higher in 5/9 subscales. Courses > 30 days, those not receiving chemotherapy, and partnered patients reported greater IC across all subscales. Gender and hospitalization were the main predictor variables for IC. CONCLUSION Patients reported moderately high levels of IC during their radiotherapy; however, standard demographic information may provide limited insight into improving care for the individual. Patient characteristics routinely chosen, such as age, gender, and education may not predict how patients perceive their care or support the tailoring of interventions to improve IC. Researching a range of related patient characteristics may prove a more useful concept for future nursing studies aiming to predict outcomes to tailor nursing practice.
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Affiliation(s)
- Pauline M Rose
- Radiation Oncology, Princess Alexandra Hospital, Queensland Health, 31 Raymond Terrace, South Brisbane, Queensland, 4101, Australia.
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23
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Boyd AD, Dunn Lopez K, Lugaresi C, Macieira T, Sousa V, Acharya S, Balasubramanian A, Roussi K, Keenan GM, Lussier YA, Li J'J, Burton M, Di Eugenio B. Physician nurse care: A new use of UMLS to measure professional contribution: Are we talking about the same patient a new graph matching algorithm? Int J Med Inform 2018; 113:63-71. [PMID: 29602435 PMCID: PMC5909845 DOI: 10.1016/j.ijmedinf.2018.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/22/2017] [Accepted: 02/03/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Physician and nurses have worked together for generations; however, their language and training are vastly different; comparing and contrasting their work and their joint impact on patient outcomes is difficult in light of this difference. At the same time, the EHR only includes the physician perspective via the physician-authored discharge summary, but not nurse documentation. Prior research in this area has focused on collaboration and the usage of similar terminology. OBJECTIVE The objective of the study is to gain insight into interprofessional care by developing a computational metric to identify similarities, related concepts and differences in physician and nurse work. METHODS 58 physician discharge summaries and the corresponding nurse plans of care were transformed into Unified Medical Language System (UMLS) Concept Unique Identifiers (CUIs). MedLEE, a Natural Language Processing (NLP) program, extracted "physician terms" from free-text physician summaries. The nursing plans of care were constructed using the HANDS© nursing documentation software. HANDS© utilizes structured terminologies: nursing diagnosis (NANDA-I), outcomes (NOC), and interventions (NIC) to create "nursing terms". The physician's and nurse's terms were compared using the UMLS network for relatedness, overlaying the physician and nurse terms for comparison. Our overarching goal is to provide insight into the care, by innovatively applying graph algorithms to the UMLS network. We reveal the relationships between the care provided by each professional that is specific to the patient level. RESULTS We found that only 26% of patients had synonyms (identical UMLS CUIs) between the two professions' documentation. On average, physicians' discharge summaries contain 27 terms and nurses' documentation, 18. Traversing the UMLS network, we found an average of 4 terms related (distance less than 2) between the professions, leaving most concepts as unrelated between nurse and physician care. CONCLUSION Our hypothesis that physician's and nurse's practice domains are markedly different is supported by the preliminary, quantitative evidence we found. Leveraging the UMLS network and graph traversal algorithms, allows us to compare and contrast nursing and physician care on a single patient, enabling a more complete picture of patient care. We can differentiate professional contributions to patient outcomes and related and divergent concepts by each profession.
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Affiliation(s)
- Andrew D Boyd
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, United States.
| | - Karen Dunn Lopez
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, United States
| | - Camillo Lugaresi
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
| | - Tamara Macieira
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, United States
| | - Vanessa Sousa
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL 60612, United States
| | - Sabita Acharya
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
| | - Abhinaya Balasubramanian
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
| | - Khawllah Roussi
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, United States
| | - Gail M Keenan
- Department of Health Care Environments and Systems, College of Nursing, University of Florida, PO Box 100187, Gainesville, FL 32610, United States
| | - Yves A Lussier
- Department of Medicine, College of Medicine, University of Arizona, 1501 N. Campbell Dr, Tucson, AZ 85724, United States; The University of Arizona Health Sciences Center, 1295 North Martin Ave, Tucson, AZ 85721, United States
| | - Jianrong 'John' Li
- Department of Medicine, College of Medicine, University of Arizona, 1501 N. Campbell Dr, Tucson, AZ 85724, United States; The University of Arizona Health Sciences Center, 1295 North Martin Ave, Tucson, AZ 85721, United States
| | - Michel Burton
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W Taylor St., Chicago, IL 60612, United States
| | - Barbara Di Eugenio
- Department of Computer Science, College of Engineering, University of Illinois at Chicago, 851 South Morgan Street, Chicago, IL 60607, United States
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Ikegami C, Ota K. Development of a Self-Report Checklist to Assess Dementia Care by Nurses in Hospital Settings. Res Gerontol Nurs 2018; 11:91-102. [PMID: 29451934 DOI: 10.3928/19404921-20180131-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/22/2017] [Indexed: 11/20/2022]
Abstract
Nurses working at general hospitals face difficulties in providing dementia care. The current study examined aged care nurses' dementia care practices in the hospital setting and developed a dementia care checklist that nurses can use to review their own care practice. A self-administered questionnaire was given to 676 participants; responses were collected from 595 participants. Exploratory factor analysis identified six factors (e.g., patient understanding prompted by concern and interest for the patient, respect for patients' voluntary behavior, early detection of abnormalities) among the questionnaire's 28 items. This analysis provided a framework for the checklist and verified that it had satisfactory internal consistency and construct validity. The frequency of care practices varied with participants' knowledge of dementia care requirements, satisfaction with their own dementia care practice, confidence in their ability to judge patients' physical condition, and cooperation with colleagues. This checklist might improve dementia care in hospital settings. [Res Gerontol Nurs. 2018; 11(2):91-102.].
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25
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Affiliation(s)
- Christophe Debout
- c/o Soins, Elsevier Masson SAS, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux, France.
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26
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Stern G. Taking the Temperature of Clinical Technology Efficiency. Biomed Instrum Technol 2018; 52:64-66. [PMID: 29350980 DOI: 10.2345/0899-8205-52.1.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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27
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Schutijser B, Klopotowska JE, Jongerden I, Spreeuwenberg P, Wagner C, de Bruijne M. Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies. BMJ Open 2018; 8:e019648. [PMID: 29306893 PMCID: PMC5781013 DOI: 10.1136/bmjopen-2017-019648] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Medication administration errors with injectable medication have a high risk of causing patient harm. To reduce this risk, all Dutch hospitals implemented a protocol for safe injectable medication administration. Nurse compliance with this protocol was evaluated as low as 19% in 2012. The aim of this second evaluation study was to determine whether nurse compliance had changed over a 4-year period, what factors were associated over time with protocol compliance and which strategies have been implemented by hospitals to increase protocol compliance. METHODS In this prospective observational study, conducted between November 2015 and September 2016, nurses from 16 Dutch hospitals were directly observed during intravenous medication administration. Protocol compliance was complete if nine protocol proceedings were conducted correctly. Protocol compliance was compared with results from the first evaluation. Multilevel logistic regression analyses were used to assess the associations over time between explanatory variables and complete protocol compliance. Implemented strategies were classified according to the five components of the Systems Engineering Initiative for Patient Safety (SEIPS) model. RESULTS A total of 372 intravenous medication administrations were observed. In comparison with 2012, more proceedings per administration were conducted (mean 7.6, 95% CI 7.5 to 7.7 vs mean 7.3, 95% CI 7.3 to 7.4). No significant change was seen in complete protocol compliance (22% in 2016); compliance with the proceedings 'hand hygiene' and 'check by a second nurse' remained low. In contrast to 2012, the majority of the variance was caused by differences between wards rather than between hospitals. Most implemented improvement strategies targeted the organisation component of the SEIPS model. CONCLUSIONS Compliance with 'hand hygiene' and 'check by a second nurse' needs to be further improved in order to increase complete protocol compliance. To do so, interventions focused on nurses and individually tailored to each ward are needed.
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Affiliation(s)
- Bernadette Schutijser
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Joanna Ewa Klopotowska
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Irene Jongerden
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Peter Spreeuwenberg
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Cordula Wagner
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Martine de Bruijne
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
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28
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Affiliation(s)
- Sandrine Iniesta
- C/o La revue de l'infirmière, Elsevier Masson, 65 rue Camille-Desmoulins, 92442 Issy-les-Moulineaux Cedex, France.
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30
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Abstract
School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 2 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 2 describes how Ellen's actions led the Broken Arrow Public Schools to revise its unsafe and illegal medication administration policy, which brought the policy into partial compliance with the nurse practice act but culminated in Ellen losing her job. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.
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32
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Abstract
This article reviews the 2015-2020 Dietary Guidelines for Americans released in 2016. Key recommendations are summarized and significant changes in the guidelines are highlighted. Implications for nursing practice to promote nutrition health are identified and resources to support implementation are included.
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Affiliation(s)
- Patricia A Rouen
- Patricia A. Rouen, PhD, FNP-BC, is an Associate Professor at McAuley School of Nursing, University of Detroit Mercy, Detroit, Michigan. Brenna R. Wallace is a Senior Dietetics student at Michigan State University, East Lansing, Michigan
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33
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Harris R, Sims S, Levenson R, Gourlay S, Ross CBE F, Davies N, Brearley S, Favato G, Grant R. What aspects of intentional rounding work in hospital wards, for whom and in what circumstances? A realist evaluation protocol. BMJ Open 2017; 7:e014776. [PMID: 28069627 PMCID: PMC5223681 DOI: 10.1136/bmjopen-2016-014776] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Intentional rounding (IR) is a structured process whereby nurses in hospitals carry out regular checks, usually hourly, with individual patients using a standardised protocol to address issues of positioning, pain, personal needs and placement of items. The widespread implementation of IR across the UK has been driven by the recommendations of the Francis Inquiry although empirical evidence of its effectiveness is poor. This paper presents a protocol of a multimethod study using a realist evaluation approach to investigate the impact and effectiveness of IR in hospital wards on the organisation, delivery and experience of care from the perspective of patients, their family members and staff. METHODS AND ANALYSIS The study will be conducted in four phases. Phase 1: theory development using realist synthesis to generate hypotheses about what the mechanisms of IR may be, what particular groups may benefit most or least and what contextual factors might be important to its success or failure which will be tested in subsequent phases of the study. Phase 2: a national survey of all NHS acute trusts to explore how IR is implemented and supported across England. Phase 3: case studies to explore how IR is implemented 'on the ground', including individual interviews with patients, family members and staff, non-participant observation, retrieval of routinely collected patient outcomes and cost analysis. Phase 4: accumulative data analysis across the phases to scrutinise data for patterns of congruence and discordance and develop an overall evaluation of what aspects of IR work, for whom and in what circumstances. ETHICS AND DISSEMINATION The study has been approved by NHS South East Coast-Surrey Research Ethics Committee. Findings will be published in a wide range of outputs targeted at key audiences, including patient and carer organisations, nursing staff and healthcare managers.
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Affiliation(s)
- Ruth Harris
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Sarah Sims
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | | | - Stephen Gourlay
- Kingston Business School, Kingston University, Kingston-Upon-Thames, London, UK
| | - Fiona Ross CBE
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
| | - Nigel Davies
- Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK
| | - Sally Brearley
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - Giampiero Favato
- Institute of Leadership and Management in Health (ILMH), Kingston University, Kingston-Upon-Thames, London, UK
| | - Robert Grant
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
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34
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Déry J, d'Amour D, Roy C. [Not Available]. Perspect Infirm 2017; 14:51-55. [PMID: 29341547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | - Danielle d'Amour
- Faculté des sciences infirmières de l'Université de Montréal, Québec, Canada
| | - Caroline Roy
- Ordre des infirmières et infirmiers du Québec, Montréal, Québec, Canada
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35
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Albert A. [Role of the advanced practice nurse in gerontology]. Rev Infirm 2017; 66:27-28. [PMID: 28048989 DOI: 10.1016/j.revinf.2016.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
An advanced practice nurse in gerontology, working in an in-home nursing care department, describes her missions with the teams, the patient and the carers.
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Affiliation(s)
- Aude Albert
- SSIAD, ADMR 3 Étangs, 52 boulevard Dethez, 13800 Istres, France.
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36
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Affiliation(s)
- Olivier Morenon
- Ifsi du centre psychothérapique de l'Ain, 12 Rue du Peloux, 01000 Bourg-en-Bresse, France.
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37
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Roberts T, Schoenfeld T, Schneider S, Cohen R, Bergum S. Nurse Practice Act (NPA): Analysis Summary December 2016 AMERICAN HOLISTIC NURSES ASSOCIATION (AHNA). Beginnings 2016; 36:32. [PMID: 29890065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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38
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Canipel L. [Telemedicine, cementing the nursing team]. Soins 2016; 61:35-37. [PMID: 27894477 DOI: 10.1016/j.soin.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Communication technologies have an impact on our healthcare system. We care for human beings in an environment which is now digital and which influences their experience, their treatment and their perception of their disease. Telemedicine will become a key tool for all caregivers. It has no bearing on nurses' skills, but changes the way care is organised, for the benefit of patients as well as healthcare professionals.
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Affiliation(s)
- Lydie Canipel
- Société française de télémédecine (SFT-Antel), 95, rue des Trois-Tisserands, 76560 Robertot, France.
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PRACTICE STATEMENT Scope of Practice of the Registered Nurse in Light Based (Laser) Therapies Nursing Practice Statement NP 64 - Developed: 5/92 - Revised: 4/04,5/16. Ohio Nurses Rev 2016; 91:14-5. [PMID: 30561947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Létourneau D, Cara C, Goudreau J. [Not Available]. Perspect Infirm 2016; 13:32-34. [PMID: 29381278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Dimitri Létourneau
- Faculté des sciences infirmières de l'Université de Montréal, Montréal, Québec, Canada
| | - Chantal Cara
- Faculté des sciences infirmières de l'Université de Montréal, Montréal, Québec, Canada
| | - Johanne Goudreau
- Faculté des sciences infirmières de l'Université de Montréal, Montréal, Québec, Canada
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41
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Gagné C, Roberge S, Harvey B. [Not Available]. Perspect Infirm 2016; 13:29-31. [PMID: 29381277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Claire Gagné
- CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Québec, Canada
| | - Sylvie Roberge
- Centre hospitalier universitaire Sainte-Justine, Montréal, Québec, Canada
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Firth J, Snowden N, Ledingham J, Rivett A, Galloway J, Dennison EM, MacPhie E, Ide Z, Rowe I, Kandala N, Jameson K. The first national clinical audit for rheumatoid arthritis. Br J Nurs 2016; 25:613-7. [PMID: 27281595 PMCID: PMC4941919 DOI: 10.12968/bjon.2016.25.11.613] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The first national audit for rheumatoid and early inflammatory arthritis has benchmarked care for the first 3 months of follow-up activity from first presentation to a rheumatology service. Access to care, management of early rheumatoid arthritis and support for self care were measured against National Institute for Health and Care Excellence quality standards; impact of early arthritis and experience of care were measured using patient-reported outcome and experience measures. The results demonstrate delays in referral and accessing specialist care and the need for service improvement in treating to target, suppression of high levels of disease activity and support for self-care. Improvements in patient-reported outcomes within 3 months and high levels of overall satisfaction were reported but these results were affected by low response rates. This article presents a summary of the national data from the audit and discusses the implications for nursing practice.
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Affiliation(s)
- J Firth
- Consultant Nurse Rheumatology and Director for Service Improvement, Pennine MSK Partnership, Oldham
| | - N Snowden
- Consultant Rheumatologist, Pennine MSK Partnership, Oldham
| | - J Ledingham
- Consultant Rheumatologist, Portsmouth Hospitals NHS Trust
| | - A Rivett
- Director of Clinical Affairs, British Society for Rheumatology, London
| | - J Galloway
- Consultant Rheumatologist, Kings College Hospital, London
| | - E M Dennison
- Professor of Musculoskeletal Epidemiology and Honorary Consultant in Rheumatology, MRC Lifecourse Epidemiology Unit, Southampton University
| | - E MacPhie
- Consultant Rheumatologist, Lancashire Care NHS Foundation Trust, Preston
| | - Z Ide
- Patient representative, Project Working Group, British Society for Rheumatology, London
| | - I Rowe
- Consultant Rheumatologist, c/o British Society for Rheumatology, London
| | - N Kandala
- Statisticians, MRC Lifecourse Epidemiology Unit, Southampton Universitys
| | - K Jameson
- Statisticians, MRC Lifecourse Epidemiology Unit, Southampton Universitys
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Laporte P, Vonarx N. [Dying well seen in the light of self-transcendence and transition : two theories of care helpful to nurses]. Rech Soins Infirm 2016:6-19. [PMID: 28169822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Accompanying a dying person up to and at the actual moment of death is a duty that often leaves carers at a loss. We shall show how far theoretical nursing knowledge can help practitioners who accompany the end of life by applying two theories of care : Reed’s theory of self-transcendence and Meleis’s theory of transition. Our interpretation of the theory of self-transcendence designates three points of reference in the concept of dying well. The first relates to the overtures prompted by the vulnerability that the context of dying inspires. The second concerns the capacity of the patient to summon up intrapersonal, interpersonal and transpersonal strategies, and the third considers the benefits when self-transcendence is achieved. The theory of transition similarly presents three points of reference. The first is based on informing the patient about palliative care and telling him or her the truth about the prognosis. The second relates to coordinating the interprofessional team that is looking after the dying person. The last criterion is that the palliative care should be started at a suitable moment. This makes it possible to educate a patient who wishes to die at home and thus create an environment favourable to the transition.
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Chen CC, Chen Y, Liu X, Wen Y, Ma DY, Huang YY, Pu L, Diao YS, Yang K. The Efficacy of a Nurse-Led Disease Management Program in Improving the Quality of Life for Patients with Chronic Kidney Disease: A Meta-Analysis. PLoS One 2016; 11:e0155890. [PMID: 27191392 PMCID: PMC4871412 DOI: 10.1371/journal.pone.0155890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 05/05/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The impacts of nurse-led disease management programs on the quality of life for patients with chronic kidney disease have not been extensively studied. Furthermore, results of the existing related studies are inconsistent. The focus of the proposed meta-analysis is to evaluate the efficacy of nurse-led disease management programs in improving the quality of life for patients with chronic kidney disease. METHODS Literature survey was performed to identify the eligible studies from PubMed, Current Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials with predefined terms. The outcome measured was quality of life. This meta-analysis was conducted in line with recommendations from the preferred reporting items for systematic reviews and meta-analyses. RESULTS Eight studies comprising a total of 1520 patients were included in this meta-analysis, with 766 patients assigned to the nurse-led disease management program. Nurse-led disease management improved the quality of life in terms of symptoms, sleep, staff encouragement, pain, general health perception, energy/fatigue, overall health and mental component summary when evaluated 6 weeks after the beginning of intervention. When evaluated 12 weeks later, the quality of life in terms of symptoms, sleep, staff encouragement, energy/fatigue, and physical component summary was improved. Stratified by the modalities of dialysis, similar results of pooled analyses were observed for patients with peritoneal dialysis or hemodialysis, compared with the overall analyses. The results of sensitivity analyses were the same as the primary analyses. The symmetric funnel plot suggested that the possibility of potential publication bias was relatively low. CONCLUSION Nurse-led disease management program seems effective to improve some parameters of quality of life for patients with chronic kidney disease. However, the seemingly promising results should be cautiously interpreted and generalized and still need to be confirmed through well-designed large-scale prospective randomized controlled trials.
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Affiliation(s)
- Chong-Cheng Chen
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yi Chen
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Xia Liu
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yue Wen
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Deng-Yan Ma
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yue-Yang Huang
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Li Pu
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yong-Shu Diao
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
- * E-mail: (YSD); (KY)
| | - Kun Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
- * E-mail: (YSD); (KY)
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Shihundla RC, Lebese RT, Maputle MS. Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province. Curationis 2016; 39:1545. [PMID: 27246793 PMCID: PMC6091764 DOI: 10.4102/curationis.v39i1.1545] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 02/15/2016] [Accepted: 12/05/2015] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. OBJECTIVES The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. METHODS The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who work at PHC facilities in Vhembe District. Purposive sampling was used to select nurses and three professional nurses were sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide. RESULTS PHC facilities encountered several effects due to increased nurses' workload where incomplete patient information is documented. Unavailability of patient information was observed, whilst some documented information was found to be illegible, inaccurate and incomplete. CONCLUSION Documentation of information at PHC facilities is an evidence of effective communication amongst professional nurses. There should always be active follow-up and mentoring of the nurses' documentation to ensure that information is accurately and fully documented in their respective facilities. Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurses at facilities should be increased to reduce the increased workload.
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Affiliation(s)
| | - Rachel T Lebese
- Department of Advanced Nursing Science, School of Health Sciences, University of Venda.
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McCormick K. Understanding New Types of Evidence Ready for Translation into Nursing Informatics. Stud Health Technol Inform 2016; 225:686-688. [PMID: 27332305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Nurses are the primary deliverers of patient care and observers of patient side effects to medications. The primary objective of this tutorial is to bring the participants up to date in genomic applications for nursing from birth until death. A secondary objective is to define at least 17 pharmacogenomics evidence guidelines ready for implementation into the Electronic Health Record. The target audience are nurses in practice, implementers of EHRs, nursing in leadership and policy-making positions, those focused on defining new areas for nursing research, and educators who are in need of defining criteria for integrating genomics into nursing education.
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Mykkänen M, Miettinen M, Saranto K. Standardized Nursing Documentation Supports Evidence-Based Nursing Management. Stud Health Technol Inform 2016; 225:466-470. [PMID: 27332244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Nursing documentation is crucial to high quality, effective and safe nursing care. According to earlier studies nursing documentation practices vary and nursing classifications used in electronic patient records (EPR) are not yet standardized internationally nor nationally. A unified national model for documenting patient care improves information flow in nursing practice, management, research and development toward evidence-based nursing care. Nursing documentation quality, accuracy and development requires follow-up and evaluation. An audit instrument is used in the Kuopio University Hospital (KUH) when evaluating nursing documentation. The results of the auditing process suggest that the national nursing documentation model fulfills nurses' expectations of electronic tools, facilitating their important documentation duty. This paper discusses the importance of using information about nursing documentation and how we can take advantage of structural information in evidence-based nursing management.
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Hou IC, Chen MJ. The Pilot Evaluation of Using the International Classification for Nursing Practice. Stud Health Technol Inform 2016; 225:437-441. [PMID: 27332238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
International Classification for Nursing Practice (ICNP®) was developed as the standardized terminology by the International Council of Nursing (ICN) since 1999. It is important to evaluate the applicability of using ICNP® as the electronic nursing data exchange standardization when adopting in Taiwan. A total of 87% clinical nursing problems could be cross-mapped to DC axis of ICNP® version 2 in traditional Chinese language (Kappa = .96). Only five nursing problems (following care problem; blood transfusion; potential risk for unstable blood sugar level; hyperbilirubinemia; and caregiver anxiety) couldn't be matched. ICNP® could mostly support the electronic nursing data exchange standardization. Developing Taiwan-ICNP® as the local terminology was seemed to be the strategy to create a more adoptive standardization across the country for Taiwan health care data exchange in the future.
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Affiliation(s)
- I-Ching Hou
- School of Nursing, National Yang Ming University, Taipei, Taiwan
| | - Meng-Jun Chen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Taylor L, Greeley R, Dinitz-Sklar J, Mazur N, Swanson J, Wolicki J, Perz J, Tan C, Montana B. Notes from the Field: Injection Safety and Vaccine Administration Errors at an Employee Influenza Vaccination Clinic--New Jersey, 2015. MMWR Morb Mortal Wkly Rep 2015; 64:1363-4. [PMID: 26678414 DOI: 10.15585/mmwr.mm6449a3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
On September 30, 2015, the New Jersey Department of Health (NJDOH) was notified by an out-of-state health services company that an experienced nurse had reused syringes for multiple persons earlier that day. This occurred at an employee influenza vaccination clinic on the premises of a New Jersey business that had contracted with the health services company to provide influenza vaccinations to its employees. The employees were to receive vaccine from manufacturer-prefilled, single-dose syringes. However, the nurse contracted by the health services company brought three multiple-dose vials of vaccine that were intended for another event. The nurse reported using two syringes she found among her supplies to administer vaccine to 67 employees of the New Jersey business. She reported wiping the syringes with alcohol and using a new needle for each of the 67 persons. One of the vaccine recipients witnessed and questioned the syringe reuse, and brought it to the attention of managers at the business who, in turn, reported the practice to the health services company contracted to provide the influenza vaccinations.
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Cowling WR. The Scope and Standards of Holistic Nursing Practice: Guideposts for Development of Manuscripts. J Holist Nurs 2015; 33:288. [PMID: 26574549 DOI: 10.1177/0898010115614094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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