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PubMed2004

Mapping the nursing process: a new approach for understanding the work of nursing.

The work of nursing is nonlinear and involves complex reasoning and clinical decision making. The use of human factors engineering (HFE) as a sole means for analyzing the work of nursing is problematic. Combining HFE analysis with qualitative observation has created a new methodology for mapping the nursing process. A cognitive pathway offers a new perspective for understanding the work of nursing and analyzing how disruptions to the nursing process may contribute to errors in the acute care environment.

Acute Disease↗
PubMed1991

Does the nursing process reflect quality care?

The nursing process is a very linear method that does not require that the nurse use knowledge gathered over the years; instead it requires an objective assessment of data accessible to the senses. Although this method should assure uniform practice, it will not assure quality practice. Some authors liken it to the scientific method. It is not. The scientific method begins with a perceived problem which is defined as facts, events, or situations that lack explanation or that are incongruent with accepted beliefs, expectations, or preconceptions. Without expectations, and beliefs, life holds no surprises and no problems. Only with years of accumulated experiences can expert nurses quickly determine the problems and "the solutions to problems using experience-based holistic recognition of similarity which produces deep situational understanding." This understanding and the solutions to problems may be and should be different for each nurse. This is not so when nurses use the nursing process. All phenomena are abstracted from the personal; they are context free. The Dreyfus Model of Skill Acquisition, related to nursing by Benner, explains this kind of practice as Novice. The Expert, on the other hand, "knows what to do based on mature and practiced understanding. Experts solve problems using know-how, the sort of ability we all use all the time as we go about our everyday tasks." They know problems without analyzing them; they sense them. Benner states, "If experts are made to attend to the particulars or to a formal model or rule, then performance actually deteriorates."(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗
PubMedDate not supplied

Application of the nursing process to a continuing education course.

The nursing process is a fundamental component of curricula in schools of nursing. The nursing process also is adaptable to continuing education offerings provided by a nursing education and research department of an urban, community teaching hospital. This article describes how nurse educators used the nursing process as the basis for development, implementation, and evaluation of an advanced medical-surgical continuing education program.

Curriculum↗
PubMedDate not supplied

Nurses' attitudes toward nursing process as measured by the Dayton Attitude Scale.

This study measured the knowledge of and attitudes toward the nursing process held by nurses who provide direct patient care. The Dayton Attitude Scale Toward Care Planning (DASC) was returned by 1,096 nurses practicing in nine hospitals. Overall, participants were knowledgeable of the nursing process and held a relatively positive attitude toward the nursing process and nursing diagnosis. Higher nursing degrees were associated with more positive attitudes. The most common barrier to the use of the nursing process was insufficient time. The study found that less than 30% of the subjects liked the way care planning was done. These findings suggest that improving care planning systems would further promote consistency in the process.

Educational Status↗
PubMed1992

Nursing process approach improves receivables management.

The "nursing process" is a systematic decision-making approach to problem solving based on open-system theory. This theory assumes that there is an on-going interchange between all system components. Components cannot be viewed in isolation, because decisions regarding one component will affect other components. Receivables management is similar to the nursing process, in that it involves constant diagnosis, assessment, and intervention in the work in process during all phases of the receivables cycle. In experiments that applied the nursing process concept to the management of accounts receivable in several hospitals, gross days in accounts receivable were reduced and cash flow was increased.

Accounts Payable and Receivable↗
PubMedDate not supplied

[Nursing process in heart failure].

The nursing process is a method that guides nursing actions, which are necessary to foster a fast recovery in patients. This process may be developed in a holistic way based on several nursing models, according to the needs of the patient coursing with some kind of cardiac failure. The objective of this investigation was to collect epidemiological and clinical data, as well as on diagnostic and therapeutic actions for cardiac failure. We also describe the physiopathology of the diseases to inform the nursing staff on the relevance of the nursing process within hospitals and how it will result in better care, decreasing time and costs of hospitalization and increasing benefits, which are the goals proposed.

Heart Failure↗
PubMed1989

The nursing process: improving psychiatric admission assessment?

The nursing process is a philosophy of individualized patient care, which states that all care should be planned on the basis of a nursing evaluation of patients' problems. The first stage of the nursing process is assessment, which for good planning requires more information about patients than is usually collected. In this study, in a psychiatric setting, an exploratory first phase was carried out to investigate whether the current admission assessment procedure assisted systematic care planning. The results revealed that nurses were dissatisfied with the admission assessment procedure, although half of them had received no training in the patient-centred approach. During phase 2 of the study a structured assessment form was introduced into two wards in separate hospitals for a period of 3 months. In order to assess the form's usefulness in identifying patients' nursing needs, and its acceptability to patients, an evaluative third phase was undertaken. Respondents recorded satisfaction with the structured form in practice, whilst analysis of care plan statements suggested that assessment had improved. The patients interviewed found the questions acceptable and viewed the assessment as a valued opportunity to talk to their nurse.

Attitude of Health Personnel↗
PubMedDate not supplied

[The nursing process in the care of the mental patient--nursing diagnosis].

The nursing process, in the area of mental health nursing, is a philosophy and a scientific method of holistic and personalized nursing care. It includes four main nursing theories: the holistic theory, the theory of human needs, the general systems theory and the interpersonal theory. Nursing diagnosis, the crucial part of the first stage of the process, is especially discussed with emphasis on the criteria of its appropriateness, the dimensions of the patient to be assessed and the already available psychiatric nursing diagnoses system as a frame of reference.

Holistic Health↗
PubMed1982

The nursing process--is the title right?

The use of the term nursing process is traced from the 1950s. The author argues that the nursing process is now used as a substitute for nursing. In this paper questions are raised as to whether problem-solving is all there is to nursing and whether problem solving is peculiar to nursing. It is further argued that whilst the nursing process recognizes the purpose of the problem-solving aspects of the nurse's work, it ignores the subjective or intuitive aspects of nursing. It also ignores the role of experience, logic and expert opinion as bases for nursing practice, the author contends. She concludes that because the nursing process stresses a dominant and independent function for the nurse this may undermine the value of collaboration of health professionals and the development of the client's self reliance.

Interprofessional Relations↗
PubMedDate not supplied

Nursing process: help or hindrance?

Many standard nursing texts effectively treat 'the nursing process' and 'nursing' as one and the same, yet there have been few attempts to critically analyse the concept and its implications. This paper seeks to do both.

Humans↗
PubMed1981

Classification and framing: a sociological analysis of task-centred nursing and the nursing process.

Sections of the British nursing profession have recently become interested in the nursing process as a means of providing better patient care and increased job satisfaction for nurses. Bernstein's code theory is used in this article to analyse theoretically the change from a task-oriented to a patient-oriented mode of organization of nursing care, and to suggest hypotheses regarding the possible effects of the change. The new mode is analysed as a different and more pervasive form of social control of patients and nurses, and, although it appears to be a radical initiative, the fundamental power structure within which nursing care is given is shown to be unchanged. Whether patients will be more satisfied with their care and nurses will experience less stress in the new mode cannot be taken for granted; they are matters which call for empirical investigation.

Female↗
PubMed1986

The influence of a positive environment on the attitudes of student nurses towards the nursing process.

The attitudes of 67 student nurses towards the nursing process were studied by means of a questionnaire. Attitudes became more favourable over the 8-week study period. The results indicate that a positive environment is influential in changing the attitudes of student nurses towards the nursing process. These findings lend further support to our original work.

Attitude of Health Personnel↗
PubMedDate not supplied

[Use of computers as a tool for the implementation of the nursing process].

A group of nurses of the Hospital of Clinics of Porto Alegre-RS, aware that the Process of Nursing is a theoretical model that it provides a logical structure and it bases the nursing actions, developed and it implanted a tool to facilitate the implementation of the stages of the nursing Process. This tool is part of a corporate system of attendance to the patient, it's have as focus the Diagnoses and Interventions of Nursing. The model is based on tables with the following contents, basic human needs, signs and symptoms, to cause, diagnoses and nursing interventions. The professionals' access feels through profiles and passwords. The system presents a positive acting as for the aspect activation in the determination of the diagnosis and prescription of the nursing interventions allowing the nurse to be close to the patient.

Brazil↗
PubMed2001

Nursing process documentation systems in clinical routine--prerequisites and experiences.

Documentation of the nursing process is an important, but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems, such as low quality and high writing efforts, are reported. However, it is still unclear if computer-based documentation systems can reduce these problems. At the Heidelberg University Medical Center, computer-based nursing process documentation projects began in 1998. A computer-based nursing documentation system has now been successfully introduced on four wards of three different departments, supporting all six phases of the nursing process. The introduction of the new documentation system was accompanied by systematic evaluations of prerequisites and consequences. In this paper, we present preliminary results of this evaluation, focusing on prerequisites of computer-based nursing process documentation. We will discuss in detail the creation and use of predefined nursing care plans as one important prerequisite for computer-based nursing documentation. We will also focus on acceptance issues and on organizational and technical issues.

Adult↗
PubMed2004

Problem solving strategies integrated into nursing process to promote clinical problem solving abilities of RN-BSN students.

A set of problem solving strategies integrated into nursing process in nursing core courses (PSNP) was developed for students enrolled in a post-RN baccalaureate nursing program (RN-BSN) in a university in Taiwan. The purpose of this study, therefore, was to evaluate the effectiveness of PSNP on students' clinical problem solving abilities. The one-group post-test design with repeated measures was used. In total 114 nursing students with 47 full-time students and 67 part-time students participated in this study. The nursing core courses were undertaken separately in three semesters. After each semester's learning, students would start their clinical practice, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. The overall score of problem solving indicated that score on the post-test III was significantly better than that on post-test I and II, meaning both full-time and part-time students' clinical problem solving abilities improved at the last semester. In conclusion, problem-solving strategies integrated into nursing process designed for future RN-BSN students are recommendable.

Adult↗
PubMed1994

Evaluation of nursing process documentation.

Following the introduction of a nursing process and associated documentation in one hospital, an attempt was made to evaluate the effectiveness of the documentation as a record of the nursing process. Two questionnaires were developed, based on previous research in this field, one for the assessment of the documentation, and the other to assess the attitudes and practices of the ward sisters regarding its implementation. The findings indicated that, generally, the assessment phase of the process was poorly documented and that many psychological and social problems were not addressed as well as others. The interventions were relevant but contained little detail. The evaluation section was fair but updating and re-assessment where relevant were poor. Some sisters seemed to display a lack of understanding of the principles or the practice of the process, despite in-service education. Lessons to be learnt from the exercise are suggested.

Activities of Daily Living↗