Search PubMed⌕ Search

Biomedical subjects

R Axford

Publications and source records attributed to R Axford.

5 recordsLinked to original sources
PubMed2000

The contribution of nurses' perceptions and actions in defining scope and stabilising professional boundaries of nursing practice.

This paper reports on the findings of a naturalistic inquiry study that explored the scope and boundaries of nursing practice. Findings from interview and observation data suggest that nurses negotiate and adjust professional boundaries on an individual, case-by-case basis, thereby managing the scope of their practice as they see it in that circumstance. The strategies they used are presented in four major categories: 1) maintaining a comfort zone, 2) expanding into safe territory, 3) moving into the grey zone and 4) stepping over the line. Findings show that nurses' efforts to maintain the comfort zone serve to perpetuate the status quo and may threaten holistic care. Expanding nursing actions to include functional roles such as coordinating care, sharing information, advocating (for patients), collaborating and innovating offers the profession critical building blocks for defining the scope of nursing practice. Clarifying the grey zone (or overlapping territory) is an essential task for the profession in determining the boundaries of nursing practice. The data revealed that, partly due to the ambiguity of the grey zone, nurses may step over the line into medical decision-making and outside the legal sanctions for the professional nursing role. The implications of this study highlight the need for nursing to define its scope of practice and in so doing stabilise professional boundaries.

Adult↗
PubMed1997

Exploring nursing knowledge by using digital photography.

Clinical decision making is in part, an interpretation of visual cues manifested by the patient. The colour of a patient's skin, his or her degree of mobility, or the posture adopted by the patient are examples. Clinicians compare presenting cues with previous representations of those cues to determine significant change. Literature suggests that the sources of data for this comparison are; the long term memory of the clinician, verbal interaction with colleagues and patient, and professional documentation. This paper describes findings of a study based on the assertion that contemporary documentation systems fail to provide sufficient information for nurses to make accurate comparisons between currently presenting visual cues and cues from the past. It is argued that interpretation of visual cues is primarily a visual/spatial activity (Gardiner, 1983) and, as current documentation systems rely on language they cater for linguistic rather than the visual/spatial activities. For example, subtle shades of red exhibited by the skin surrounding a surgical wound are reduced to the word "inflamed". Digital photography was explored as a documentation format that addressed this deficit. Forty nine nurse clinicians were asked to assess and plan management for one of four external sternotomy wound. Subjects were given access to a range of documentation formats including sequential daily wound photographs. Findings demonstrated that nurse clinicians are willing to use digital photographs and there is beginning evidence that photographic documentation may decrease the differences between novice and expert when comparing visual cues.

Cues↗
PubMedDate not supplied

Nursing informatics: a Victorian survey.

Interviews of selected personnel from a stratified random sample of Victoria's public and private acute care hospitals provided data about current computer systems implementation in nursing departments. Key informants were asked about their hospitals' present level of computerisation and plans for the future. The study found that stand-alone microcomputers are currently driving systems development in nursing. This strategy limits nurses' ability to access data, diminishes their influence in decision-making and undervalues the contribution of nursing information to interdisciplinary health care.

Forecasting↗