HIGH SCHOOL PRACTICAL NURSING COURSE STRESSES CLINICAL EXPERIENCE IN SENIOR YEAR.
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Breast Feeding↗
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[Survey of nursing students heading toward graduate nursing after the course of practical nursing].
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Education, Nursing, Diploma Programs↗
Practice nurses and GPs. Present practice.
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England↗
A comparative analysis of the changes in nursing practice related to health sector reform in five countries of the Americas.
OBJECTIVE: To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. METHODS: An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nurses about their perceptions of nursing practice and changes in work environments. Descriptions of characteristics and trends in nursing practice in the study sites were also obtained. RESULTS: Reorganization of health services has occurred in all five of the countries, responding to health sector reform initiatives and affecting nursing practice in each country. Respondents from all five countries mentioned an emphasis on private enterprise, changes in payment systems for patients and providers, redistributions in the nursing workforce, changes in the personnel mix and nursing-practice functions, work shifting from the hospital to the community, and greater emphasis on cost control and prevention in practice settings. CONCLUSIONS: The study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries. Nurses maintain their core values despite increased work stress and greater patient care needs in all the countries as well as economic crises in the Latin American countries.
Americas↗
Transcultural care values and nursing practices of Philippine-American nurses.
The purpose of this ethnonursing research was to discover, explicate, and analyze the nursing care values and caregiving practices of Philippine nurses working in an American hospital context. The study, which was part of a larger study, was conceptualized within Leininger's theory of culture care. Consistent with the tenets of the theory, a brief overview of Philippine world view, social structure, culture, and ethnohistory was provided. Qualitative analysis of observation-participation and interview data revealed a major care theme of obligation to care. This care theme was supported by three care patterns which were: 1) expressed seriousness and dedication to work, 2) attentiveness to physical care as comfort, and 3) respect and patience as caring modalities. The study also showed that Philippine-American nurses attempted to achieve cultural care congruence by preserving some generic care values and practices, by accommodating to some of the host professional culture's values and practices, and by restructuring or repatterning less serviceable values. Implications for transcultural nursing education, practice, and research were discussed.
Humans↗
Nursing's next advance: an internal classification for nursing practice.
An International Classification of Nursing Practice (ICNP) is needed to support the processes of nursing practice and advance the knowledge necessary for cost-effective delivery of quality nursing care. Below, the authors present their case for developing such a system that will provide nursing with a nomenclature, a language and a classification that can be used to describe and organize nursing data. It is their belief that this landmark project is achievable and that ICN should lead the work in collaboration with its member associations, the World Health Organization and key national, international, governmental and nongovernmental groups. But to ensure that the system will be adaptable across borders, nurses and organizations are being encouraged to share their ideas and research on such a system.
Databases, Factual↗
REAPPRAISING THE ROLE OF THE PRACTICAL NURSE.
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Nursing, Practical↗
Influence of managed care on professional nursing practice.
PURPOSE: To explore how nurses in one U.S. state perceived that managed care influenced professional nursing in that state. The nursing community is challenged to move with haste in demonstrating, through research, the clinical and economic value that nurses add to cost-effective outcomes. DESIGN: A Delphi survey in 1996 of a convenience sample of 84 clinical nurse specialists (CNSs) and nurse practitioners (NPs) in California. METHODS: CNSs and NPs contributed to the list of managed care influences on nursing practice. fifty-seven (68%) completed the third and final round. FINDINGS: Panelist agreement was the highest for (a) exploring new approaches to providing quality care more cost-effectively, (b) expanding nurse practitioners' role in primary care, and (c) more effectively partnering with clients in helping them assume greater self-responsibility for their health. Greatest threats were perceived to be hassles involved in seeking authorization for care and responding to payment denials; the tenuous job market for nurses; and encroachment on nursing practice by others. CONCLUSIONS: The findings can assist nurses in states with low managed-care concentration to create their preferred future within health care delivery. A more highly educated nurse workforce will be needed for 21st century health systems in which more care is likely to be delivered outside hospitals.
Adult↗
How do practice nurses see their role in childhood injury prevention?
OBJECTIVES: To assess the knowledge of unintentional injury epidemiology, the attitudes towards, and current practices in injury prevention among practice nurses. SETTING: Practice nurses employed by general practitioners in Nottinghamshire, United Kingdom. METHOD: A postal questionnaire was sent to all practice nurses on the Family Health Services Authority list (n = 322) with questions covering sociodemographic details, occupational details, unintentional injury epidemiology, attitudes towards the injury prevention activities suggested by a government report as part of the role of the primary health care team, and current practices in injury prevention. RESULTS: A response rate of 71.1% was achieved. More than 50% knew that unintentional injuries were the most common cause of death in childhood. A similar per cent knew the site of most fatal injuries in the under 1 and 5-16 year age groups. More than two thirds correctly identified a range of risk factors for unintentional injury. However, only two fifths of nurses believed they could be effective in preventing injuries. There were considerable gaps between attitudes and practice for most activities. The activities most commonly undertaken include displaying posters and leaflets (69.4%), giving advice on prevention (51.1%), and advice on first aid (45.0%) during injury consultations. CONCLUSIONS: Most practice nurses hold positive attitudes towards injury prevention activities, but fewer undertake these activities regularly. The activities most commonly undertaken employ an educational model. Further research is needed on the barriers to practice nurses undertaking more injury prevention work, the effectiveness of systems to overcome such barriers, and the effectiveness of these injury prevention activities.
Adolescent↗
Advanced practice nurses in emergency care settings: A demographic profile.
INTRODUCTION: Very little is known about clinical nurse specialists and nurse practitioners (advance practice nurses [APNs]) who practice in emergency care settings. The Advanced Practice Committee of the ENA sought to determine a profile of these individuals. METHODS: Surveys were distributed to all registrants at 2 ENA conferences and posted on the ENA Web site. This survey asked 17 questions concerning the demographic characteristics of the APN respondents (eg, education, experience, certification, state recognition, and practice area). The survey was completed by 166 APNs. RESULTS: APNs had considerable experience as ED registered nurses before becoming an APN. They obtained their APN education at the master's degree or post-master's degree level. State recognition was required for 89.2% of the APNs. The majority of APNs (61.4%) obtained their certification through the American Nurses Credentialing Center. Nurse practitioners were predominantly family nurse practitioners (43%), and clinical nurse specialists were either critical care clinical nurse specialists (8.9%) or had other certifications (5.9%). APNs provided services in both the main emergency department and the fast track (45.7%) and were relatively new to their role as an APN. DISCUSSION: Consistent with current educational and certification requirements, the vast majority of APNs held a master's degree. Although relatively new to their role as APNs in emergency care, they were nonetheless very experienced as ED registered nurses. The majority of APNs were certified, even though that is not required for practice in all states. Continued research is needed to identify the most effective utilization of APNs, document their contributions to patient care outcomes, and develop strategies to meet their educational and practice needs.
Certification↗
Critical care nurse practitioners: evolution of the advanced practice nursing role.
This literature review was done to explore the use of master's-prepared nurse practitioners to manage critically ill patients. Data-based, anecdotal, clinical, analytic, and position papers published over the past 10 years in the medical and nursing literature were reviewed. This article synthesizes findings on the use of nurse practitioners in clinical settings including primary and specialty care settings, describes favorable outcomes of advanced practice nurses, and identifies factors that must be addressed as these roles increase in use in critical care settings. Nurse practitioners' movement into critical care settings should be undertaken. Additional federal support to ensure the preparation of these practitioners in adequate numbers is needed. Attention to issues of direct reimbursement, salaries, impact of changing role boundaries, malpractice coverage, and prescription privileges must be addressed. Research programs to examine the effect of nurse practitioners in specialized care should continue.
Critical Care↗
[Nursing practice in family medicine groups and its interdisciplinary context].
Nursing practice in family medicine groups (FMGs) is a major issue in the implementation of this new healthcare organization model in Quebec. Using a constructivist qualitative research approach, a case study of a FMG in a region of Quebec looked at how the partners involved in the project defined nursing practice, and highlighted the similarities and differences in their views. The results of this study show that nursing practice as a concept is perceived in two different ways: independent practice, associated with the recognition of nurses' potential, and interdisciplinary collaborative practice. Nurses view nursing practice from a client-base approach, whereas doctors view it from the perspective of how services are organized. The study found that trust is the fundamental element that makes interdisciplinary collaboration possible.
Adult↗
The academic nursing practice dean: an emerging role.
This article describes the contributions of academic nursing practice to nursing education; delineates the role characteristics and competencies needed by academic practice deans; and provides examples of the challenges and issues academic practice deans face related to nursing education, research, and practice. While schools' missions vary from a strong focus on education to multiple emphases on education, research, and practice, academic nursing practice has the potential to facilitate achievement in each of these areas. Academic nursing practice deans play important roles in advancing the missions of their schools through the clinical practice activities within the schools. Strong academic nursing practice programs can serve as catalysts for the development and refinement of new models of care delivery and for the development of future nursing leaders who are comfortable with innovation.
Education, Nursing, Baccalaureate↗
Advanced nursing practice: new ideas and new perspectives.
The authors of this paper contend that advanced nursing practice differs substantially from other forms of nursing practice, such as expert and specialist practice. Additionally, they contend that the difference residues in the way that advanced nurse practitioners think about, see and experience clinical practice. Historically, nursing in Australia has been strongly influenced by events and ideas generated in North America. The authors argue this has led to the development of an emphasis on the nature, role and function of specialist and expert nursing practice to the detriment of ascertaining and fostering the notion and nature of advanced nursing practice. This influence of North American nursing has also significantly directed and influenced the way in which we use and understand the term 'advanced nursing practice', and further, that the way in which we use the term does not give full regard to the context of Australian nursing. The authors outline some of the key issues and ideas emerging in South Australia with respect to advanced nursing practice and in particular offer beginning theorizations into the different ways in which advanced nurse practitioners think, see and experience nursing practice.
Australia↗
Ambulatory surgery and prepared discharges. Effects on orthopedic patients and nursing practice.
Orthopedic medical and nursing practice has changed dramatically partly as a result of three trends: cost containment, technology, and consumer activism. Many orthopedic procedures previously requiring inpatient hospital stays are routinely performed on an outpatient, day-surgery basis. it is imperative that nurses working in the ambulatory surgery environment be diligent in practicing the nursing process to ensure comprehensive patient care. Patients requiring hospitalization for orthopedic procedures now have shorter lengths of stay. The brevity of stay means that a great deal of coordination, education, and referral efforts are necessary before the patient's discharge. Prepared discharge programs, with the nurse assuming the coordinator role, are one way of ensuring that patients are ready to make the transition from the hospital to their postdischarge environment.
Ambulatory Surgical Procedures↗
An ontological approach to support the description of nursing practice in Japan with the ICNP.
BACKGROUND: With increasing computerization of nursing records in Japan, standardization of nursing terminology is becoming imperative. Although some efforts have been made to formalize description of nursing practice in Japan with the International Classification of Nursing Practice (ICNP), lack of effective description tools has impacted negatively on the initiatives. PURPOSE: To develop and evaluate an ontological approach that could be used to facilitate the description of nursing practice in Japan with the ICNP. METHODOLOGY: An ontology-based support system was developed using Protégé-2000, mainly by the following three steps: (1) representing a standard classification of nursing practice (the Nursing Master) in Japan; (2) representing a Japanese version of the ICNP; (3) designing an ontology-based framework. A heuristic matching algorithm was developed to automatically match the action labels in the Nursing Master with the terms of the eight axes of the ICNP Nursing Actions Classification. A preliminary evaluation was performed to examine the usefulness of the system. RESULTS: High hit rate was shown on the ICNP axes ActionType, Target, and Location. The evaluation indicated that 51.7+/-5.8% (mean+/-S.D.) of the action labels with only one action type were properly matched, and that in 80+/-4% (mean+/-S.D.) of action labels with more than one action type, at least one valid action type was matched correctly. CONCLUSION: The ontology-based approach using a frame-based knowledge representation system (e.g., Protégé-2000) is useful for supporting the formal description of nursing practice in Japan with the ICNP.
Japan↗
An educational initiative in anaesthetic nursing practice.
The National Board for Nurses, Midwives and Health Visitors in Northern Ireland (NBNI) has adopted the principles of the UKCC's recommendations for specialist nursing practice and Incorporated these within their continuing education framework. Stage two of this framework decrees the standard required for specialist nursing practice (NBNI, 1995) and, as a result, a specialist anaesthetic nursing course has been instigated. The course extends over 44 weeks and includes 8 weeks of consolidation practice, comprising seven modules at degree and diploma level. The course gives the students an opportunity to deepen their knowledge, skills and attitudes in the field of anaesthetic nursing. Nurses were taught the necessary skills to work in collaboration with other professionals, patients and families in order to coordinate a patient-centred approach to perianaesthetic care. The role of the anaesthetic nurse specialist should be viewed as complementary to that of the anaesthetist. This course facilitates and encourages practitioners to move beyond registered practice on qualifying to a more specialized role where care is delivered in an innovative and creative manner.
Clinical Competence↗
Practice nurses' beliefs about obesity and weight related interventions in primary care.
OBJECTIVE: To examine practice nurses' beliefs about obesity and their current practices and the role of the weight management context and their own BMI on these factors. DESIGN: Cross sectional questionnaire. SUBJECTS: Questionnaires concerning beliefs about obesity and current practices were completed by 586 practice nurses. RESULTS: The subjects rated lifestyle as the main cause and cardiovascular problems as the main consequences of obesity, regarded weight loss as beneficial and reported high confidence in their ability to give advice to obese patients. However, their expectations of patient compliance and actual weight loss were low indicating that practice nurses rate their advice giving skills as independent to the outcome of this advice. Further, failed weight loss was explained in terms of patient and not professional factors. In addition, the results indicated variability in their beliefs and behaviour according to the location of this advice and the practice nurse's own BMI. In particular, practice nurses who run weight loss clinics reported giving weight loss advice more frequently, spending longer counselling obese patients, reported greater confidence in giving weight loss advice and more optimism about outcomes. Further, those with low BMIs rated obesity as more preventable, reported being less likely to advise patients to use a calorie controlled diet and more likely to suggest eating less in general. CONCLUSION: Education programmes for practice nurses should not only include skills training but emphasise both the factors involved in advice giving and self appraisal. Such appraisal should include a role for both the practice nurse's and the patient's behaviour to minimise the 'operation was a success but the patient died' approach to obesity management.
Adult↗