SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Risk management is defined in the Intravenous Nursing Standards of Practice as a "process that centers on identification, analysis, treatment and evaluation of renal and potential hazards." Just what type of risk do these hazards pose and what types of "real and potential hazards" are there? The first question is the easiest to answer.
During their Ninth Annual Meeting, international nursing editors were told of the visit of Norah Casey, editor of Nursing Standard, to Romania on behalf of the Care for Romania Appeal. She found children dying of acquired immunodeficiency syndrome, malnutrition, and other diseases. Through the Appeal nurses are being sent to care for the children and to provide education for their care givers.
Documentation demonstrates that nursing standards of care have been met. To be an effective tool, a record must be complete and concise. A request to develop PACU care plans became the impetus to revise the PACU record. Perioperative information and physical assessments are data required to formulate individualized plans. Development and implementation of a comprehensive record was a positive outcome of a lengthy but interesting and worthwhile project.
The monitoring of specialty bed use by the certified ET nurse and the NQAC has been in full implementation since June 1989 with significant yearly cost reductions in the use of specialty care beds. The $238,000 costs from fiscal year 1987 (July 1986 to June 30, 1987) were reduced to $60,000 in fiscal year 1989 with an approximate cost savings of 75%. Additional cost savings have been achieved through the implementation of the other recommendations in this study. Although cost savings would have resulted from a stricter policy in specialty bed approval and utilization alone, such savings probably would have affected the quality of patient care. This project allowed nursing and medical staff members to work with the departments of Administration and Finance to ensure that patient care would not be significantly affected. Significant cost savings were obtained through use of the five interventions that are indicated in the introduction. Nursing was permitted to examine its own practice and implement changes in documentation, nursing standards, skin-care products, policies and procedures, and in other areas to strive for clinical excellence as monitored through its quality assurance plan. The addition of a certified ET nurse to coordinate a hospital-wide multidisciplinary approach that is consistent with and clinically relevant to current practice standards is essential to a successful program for pressure-sore prevention and management within the current reimbursement systems.
Quality assessment methods are not new. They have been used in industry since the beginning of the century. But, as healthcare services take on some of the characteristics of industrial organizations, so systems to measure quality in healthcare services are becoming of increasing importance. Below, a description of a model for assessing the quality of care in cancer nursing, which has been designed to suit healthcare settings at the local, national, regional and international levels. It has been tested at local level within The Royal Marsden Hospital and at national level in conjunction with the Royal College of Nursing Standards of Care Project to define national standards for cancer care.
Staff development's role in the selection and implementation of a computer system based on nursing standards of practice is described. The department's instructors successfully helped staff adapt to the change and understand the integrated, automated nurse-information system. The importance of having a teaching plan to provide consistency in training sessions is discussed.
In an attempt to clearly define nursing practice in the PACU, nurses and anesthesiologists worked collaboratively to develop an extubation protocol. The protocol is for patients no longer requiring mechanical ventilation and who will be extubated in the PACU. The protocol is unique in that it is written in a format derived from the Marker Model. Using a hierarchical concept, the Marker Model provides a framework for dividing nursing standards into three categories: structure, process, and outcome. While the extubation protocol illustrates an example of a process standard, the article also focuses on briefly describing the major components of the Marker Model and how they interrelate.
1. Lawyers hire expert witnesses to give opinions as to whether the nursing care administered to the patient met the "acceptable standard of care." 2. The lawyer who offers testimony from a nurse expert must show that the witness is qualified to offer an opinion on the case being discussed. 3. Careful preparation for serving as a nurse expert witness includes reviewing the documentation of the case as well as published nursing standards.
This year, the JCAHO will issue revised nursing standards that make the patient the center of care. This new focus is a significant switch from the existing standards, and nursing experts predict that the structures of all other direct patient care jobs in the hospital will be affected.
This paper describes the development of nursing standards in the management of patients with glaucoma. A key aspect was the development of understanding by patients of their problems. A survey was conducted to assess the respondents knowledge about glaucoma after application of the standard. The results achieved by the survey are explored.
This article describes the importance of clear, specific methods of evaluating nursing care. Nursing standards and job descriptions are explained within the context of performance evaluations for nurses.
Standardization of performance expectations and accountability for nursing care have been an integral part of nursing departments for many years. The Joint Commission on Accreditation of Hospitals (JCAHO) has used the nursing standards manual to evaluate a nursing division's capability to provide quality care. In this article, the way in which a meaningful quality assurance system is developed is discussed. The aspects discussed in depth are (1) development of standards that define performance; and (2) quality assurance measures that audit performance. By following the steps outlined, a nursing department will have progressed from describing the nurse's capability to provide optimum care to demonstrating optimum performance.
Facilitating use of professional practice models is a goal of nursing administrators and educators. A plan for decentralized unit orientation designed to foster use of nursing process and nursing standards was developed within the division of surgical nursing. Conceptual frameworks, topic selection, behavioral objectives, content outline, teaching strategies, operationalization of the plan, and methods to evaluate learning are described in this article. Staff development educators can use the information to assist unit managers in developing a decentralized unit orientation plan that emphasizes professional practice.
Today patient outcomes have become an important indicator of quality in health care agencies that are attempting to insure high quality, cost-effective care. These patient outcomes must be developed in the context of nursing standards. This article addresses the establishment of such standards according to specific guidelines and measurable by methods or tools that adhere to the principles of measurement theory.
Nursing diagnosis as a critical component of the nursing process provides a common taxonomy to describe problems that nurses can treat and is a convenient, logical way to reference nursing standards. Theory is translated into practice with the use of population-specific prototype care guides and a written orders system. Nurses in leadership are responsible for providing the necessary resources to promote professional growth and facilitate desired change. Recommendations to assist with the implementation of nursing diagnosis are identified in Table 1. The system is dependent on staff nurses' professional commitment to learning and willingness to actively participate in change. Involvement of staff nurses continues to be a critical factor in the improvement of nursing practice.
Individual items identified as components of restrictiveness were conceptualized to form six dimensions: structure, treatment, institutional policy, enforcement, psychological attitudes and patient characteristics. These varying perspectives complicate implementation of a nursing standard requiring least restrictive intervention since least restrictiveness is more than just a set of techniques. It also involves the adoption and incorporation of the underlying social and philosophical issues implicit in this term. This incorporation should not occur casually but should proceed following careful consideration of the congruency between the current legal and social values and the values basic to nursing.
By providing specific, job-related performance requirements, standards of nursing performance can play an important role in assuring the quality of nursing care. Nursing standards, such as those implemented at the Jewish Hospital of Cincinnati, help orient and educate new staff nurses; promote consistent, acceptable nursing care throughout the hospital; enhance communication between nursing staff and nurse managers; and form the basis of equitable, objective performance appraisal--all of which have an impact on the quality of nursing care. In addition, valuable quality assessment data can be gained from performance evaluations based on standards. When combined with informatin from other quality assurance mechanisms, such as patient care evaluation studies and nursing staff surveys, these data can contribute significantly to comprehensive assessment of nursing performance and lead to overall improvement in the quality of nursing care. To be most effective, however, the standards must be flexible so that they can be adapted to particular jobs and levels of training and experience and so that they can be appropriately modified as job requirements change. They will thus remain valuable tools for assuring the quality of nursing care.
To clarify the education preparation of advanced practice nurses, a survey of all 50 states was performed. Results show a high degree of variability from state to state in tracking advanced practice nurses. Standardizing the educational preparation for the nurse practitioner, clinical nurse specialist, certified nurse midwife and the certified registered nurse anesthetist will clarify advanced practice nursing.