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PubMed2000

The current scope and future direction of perioperative nursing practice in Victoria, Australia.

The current scope and future direction of perioperative nursing practice in Victoria, Australia Unlike some overseas countries, perioperative nursing roles in Australia are largely undeveloped, and very little research has explored the opinions of perioperative nurses regarding the development of their specialty. This study was undertaken to identify the current scope, possible future directions, and the barriers to developing perioperative nursing practice in the state of Victoria (Australia). The study design was descriptive and utilized survey methodology. An instrument was constructed by the researcher for the specific purposes of the study, and comprised three stages of development: questionnaire development; validation by a panel of experts; and a pilot study. The questionnaire was sent randomly to selected perioperative nurses (n=224) and a response rate of 79% (n=176) was obtained. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were used to summarize data, and independent sample t-tests, one-way ANOVA and Wilcoxon signed rank tests were used to test differences between groups. For the purpose of data reduction factor analysis was undertaken. The findings of the study indicated that the perioperative nursing model in its espoused form is not being practised, but a large majority of participants believe that perioperative nursing practice should not be restricted to the intraoperative phase of the perioperative model. Expanded rather than extended activities and functions were perceived as more important for development of the specialty, and perceived barriers to advanced perioperative nursing practice centred predominantly on the current application of the perioperative model. Recommendations include refinement of the perioperative nursing model to reflect changes in the delivery of healthcare, addressing issues of cost associated with further education, and undertaking interpretive research to provide more detailed information on the possible future direction for perioperative nursing.

Adult↗

PubMedDate not supplied

Ombudsman: a new role for advanced practice nurses in psychiatric-mental health nursing.

TOPIC: The role of ombudsman for advanced practice nurses in psychiatric mental health nursing. PURPOSE: To describe the role of ombudsman and its fit with nursing as seen in the Price Spratlen Ombudsing Model. SOURCE: The author's own experiences as both an advanced practice nurse and an ombudsman. CONCLUSION: Because of downsizing, reorganization, and a general trend toward mutual distrust in large organizations, being an ombudsman has been named one of the "25 hottest careers." Advanced practice nurses in psychiatric mental health nursing, by virtue of their knowledge of interpersonal, preventive, and systems theories, are in a unique position to fill this role.

Career Mobility↗

PubMed1991

Barriers to the retention of registered and licensed practical nurses in small rural hospitals.

The availability of nursing resources is one of the most critical issues facing health care organizations in the country. The study investigated the potential factors that relate to the desire of registered nurses (RNs) and licensed practical nurses (LPNs) to continue practicing in rural hospitals of North Dakota. All RNs and LPNs who worked in North Dakota hospitals with fewer than 100 beds (490 hospitals) were mailed survey questionnaires. Approximately eight weeks later, responses were received from 291 respondents for an overall return rate of 59 percent. Correlational analyses were used to examine the subjects' responses. A moderate relationship was found among the work-related variables. Overall job satisfaction and performance constraints were the only variables to make significant contributions to the prediction of turnover intention for both RNs and LPNs. Overall job satisfaction accounted for the largest percentage of the variance (R2 = 0.42 and R2 = 0.44) for RNs and LPNs, respectively. Satisfaction with promotion was the only work-related variable to make a significant contribution to the prediction of turnover intention for RNs (R2 = 0.23). Performance constraints, role ambiguity, and shift worked were the only work-related variables contributing to the prediction of turnover for LPNs. These results are discussed in terms of their implications for the management of RNs and LPNs in rural hospitals. Clinical ladders for promotions, the identification of potential performance constraints, and supervisory training are suggested as target areas in which rural hospitals might focus attention for managing turnover in RNs and LPNs.

Attitude of Health Personnel↗

PubMed1997

Outcomes manager: a role for the advanced practice nurse.

Outcomes management offers the advanced practice nurse an opportunity to lead interdisciplinary providers in the restructuring of health care services across the continuum of care. Within an outcomes management framework, the advanced practice nurse functions as an attending nurse for a population of patients by overseeing interdisciplinary care delivery and outcomes measurement and refining standardized practices to achieve best practice.

Case Management↗

PubMed1991

Patients' perceptions of nursing practice. A rationale for a qualitative research approach.

The discipline of nursing is, in Sweden, in the early stages of discovering and expanding specific knowledge embedded in nursing practice. This is a challenging as well as a problematic venture. It is important to evaluate nursing practice within the specific cultural context before applying terminology and meaning of concepts used. The purpose of this paper is to present a basis for the study of perceptions of nursing practice as experienced by the patient himself in a specific cultural context. The historical context, the terminology commonly used, and relevant research in this domain of inquiry is critically examined as a means of determining appropriate research methods for further study in the domain of nursing practice.

Culture↗

PubMed1999

Practice nurses in the Waikato, 1991-1992, I: Occupational profile.

AIMS: To describe the personal characteristics, working conditions, clinical activities and professional development of a representative sample of practice nurses in the Waikato during the period 1991-1992. METHODS: The data are from a survey of practice nurses drawn from a larger study of general practice carried out in the Waikato (the WaiMedCa Study). Eighty-nine percent of the 107 practices in the region participated in the study. The practice nurse survey was carried out on the 189 nurses working in these practices. Of these 149 replied, representing a response rate of 79%. RESULTS: On average, there was one nurse for each solo practice and two in most other practices. Only two practices--both solo--did not employ a nurse. Practice nurses were female and aged between 30 and 50. While only one-third had received a postgraduate qualification, two-thirds had been to recent professional development courses. The majority had worked as a practice nurse for between one and ten years. Nurses averaged just under 15 telephone contacts a day and 28 face-to-face contacts a week. Nurses' workload comprised general measurements and assessments, monitoring and surveillance procedures (such as diabetes, asthma and child development), and counselling and women's health activities. CONCLUSION: Practice nurses are an accepted and essential part of primary health care in New Zealand. However, their potential is probably underdeveloped and they could be more fully utilised for a wider range of nursing functions.

Adult↗

PubMed1994

Critical care obstetrics: the role of advanced practice nursing.

The role of the advanced practice nurse in the specialty of critical care obstetric nursing is emerging to meet the dynamic needs of health care under reform. Advanced practice components, including case management, research utilization, collaborative consultation, and advanced educational preparation, give light to a new model of caregiver. This article details the educational preparation and specific roles of the advanced practice nurse in the specialty of critical care obstetrics.

Critical Care↗

PubMed2006

Clinical practice guideline use by oncology advanced practice nurses.

Understanding how clinical practice guidelines (CPGs) are utilized and the effects of their implementation on outcomes is an important goal. The purpose of this investigation was to determine if oncology advanced practice nurse (APN) interventions provided to men with prostate cancer were consistent with Agency for Healthcare Policy and Research CPGs regarding pain [U.S. Department of Health and Human Services. (1993). Acute pain management in adults: Operative procedures. Quick reference guide for clinicians number 1a (AHCPR Publication No. 92-0019). Retrieved, February 23, 2002, from National Library of Medicine HSTAT Collection Online ], depressive symptoms [U.S. Department of Health and Human Services. (1993). Depression in primary care: Detection, diagnosis, and treatment. Quick reference guideline number 5 (AHCPR Publication No. 93-0552). Retrieved, February 23, 2002, from National Library of Medicine HSTAT Collection Online ], and urinary incontinence [U.S. Department of Health and Human Services. (1996). Managing acute and chronic urinary incontinence. Quick reference guide for clinicians number 2 (1996 update) (AHCPR Publication No. 96-0686). Retrieved, February 23, 2002, from National Library of Medicine HSTAT Collection Online ] and to evaluate if levels of consistency affected pain, depressive symptom, and incontinence outcomes. Mean levels of consistency between interventions and pain, incontinence guidelines, and depression were 91%, 80%, and 69%, respectively. Consistency did not predict outcomes in this sample. High levels of consistency suggest that oncology APNs are aware of practices outlined in CPGs.

Aged↗

PubMedDate not supplied

Practice nurses' use of evidence--based research.

Practice nurses are involved in activities related to the prevention of cardiovascular disease and stroke. But the degree to which they use evidence-based practice in this area varies considerably. A Department of Health-funded study of 1,187 practice nurses in 11 health authorities identified significant links between individual and organisational factors and the use of research to guide practice. The study's authors discuss issues surrounding educational preparation, accessibility of research findings, the use of protocols and organisational influences.

Adult↗

PubMed1990

Gerontological nursing practice standards: achievement and importance.

The 1987 ANA Standards of Gerontological Nursing Practice is compared with the 1976 Standards and found to be a new document, not simply a revision. These 1987 standards are assessed using five queries: progression, timeliness, adequacy of scope, substance, and form. Eighteen nurses practicing at a long term care facility in the midwest rated both the achievement and importance of these new standards. Descriptive data analysis demonstrated unmet expectations for all but 1 of the 11 standards. One appropriate function of the gerontological clinical nurse specialist is ongoing evaluation of these nursing practice standards which will continue to describe and prescribe professional nursing practice.

Geriatric Nursing↗

PubMed2002

Facets of private practice nursing: a conceptual model.

AIM: This paper critically examines the literature relating to private practice nursing. Particular attention is given to the reasons nurses choose private practice and the major issues involved. A conceptual model has been developed based on this information. BACKGROUND: Nurses' roles are expanding into different work domains. Private practice nursing is one of the advanced practice options available. It also requires the nurse to develop business knowledge and skills. METHODS: A literature search was conducted of Pub-Med, Cinahl, Medline and InfoTrac databases using the terms 'private practice', 'nurse entrepreneur', 'nurses in business', Inurse practitioners', 'self-employed nurse', 'advanced practice' and 'clinical nurse specialist'. Further relevant articles were identified from the reference lists of papers detected by this literature search. In addition, conference proceedings were examined for any other material on this topic. FINDINGS: A thorough search of the existing literature revealed one unpublished theoretically based study which examined limited aspects of private practice nursing in Victoria. A reasonable number of articles and publications that provided anecdotal and personal accounts of being a nurse in business were identified. This review highlights the need for further theoretically based research in this area of nursing, so as to expand nursing knowledge. Suggestions are given for further research in this topical area. CONCLUSIONS/IMPLICATIONS: Existing research into private practice nursing is limited and not sufficient to inform changes to policy and nurse education. More research is needed.

Australia↗

PubMedDate not supplied

Classification for nursing practice in Brazil.

The nursing activities--diagnosis, intervention and client outcome-have several synonyms, different meanings and antagonistic frame-works. Although the study results can be considered as potential barriers to the Classification for Nursing Practice project in Brazil, or anywhere else, they also indicate a high number of references related to this theme, leading us to conclude that there is motivation for defining and classifying nursing phenomena.

Brazil↗

PubMed1994

Changes in maternity care and the impact on nurses and nursing practice.

OBJECTIVE: To determine changes maternity nurses have experienced and the impact these changes have had on nursing practice. DESIGN: Descriptive survey using a randomized sample. PARTICIPANTS: Four hundred fifty-one inpatient female maternity nurses. MAIN OUTCOME MEASURES: Changes in maternity care, impact of the changes on nursing practice, and personal and professional perceptions and activities before and after the changes. RESULTS: Reported changes were use of technology, legal climate, shorter patient stay, cost containment, inclusion of family, cross training, consumer demand, and single-room maternity care. Inclusion of the family, technology, and single-room care were rated highly for worth and improvement in quality of care. Though described as challenging and rewarding, change was an energy drain. Change was often seen as a result of administrative mandate. CONCLUSIONS: Perceptions of change vary, but no change is easy to implement. Opportunities for staff input, administrative support, and adequate time and staffing levels during change facilitate adjustment.

Cost Control↗

PubMed1995

Concern, continuity, and choice: a health promotion formula for advanced practice nurses.

Promoting health in a newly established nurse practitioner family practice was a major undertaking for one advanced practice nurse (APN) in a semi-rural community in southern California. The alignment of the resources necessary to begin such a practice opened many doors not previously traversed by nurses in this community. Likewise, the development of a formula and model for health promotion came about as a result of overcoming the obstacles to starting this private practice as well as the positive rewards of patient encounters over time. Episodes of concern for patients, continuous care, and choices in health care decisions come together to illustrate this formula. The research data supporting the practice further demonstrate the plausibility of the APN becoming a provider of health promotion in the primary care setting.

Adolescent↗

PubMed2000

Barriers to using research evidence in nursing practice.

Barriers to using research evidence in nursing practice The nursing profession has long recognized the importance of research as an essential basis for its development. More recently, the movement supporting evidence-based practice has brought this point into focus. However, relatively little research has been conducted to identify factors that interfere with the ability of nurses to base their practice on research evidence. Using factor analysis procedures, barriers to the use of research evidence in practice which were perceived to be present by 400 registered nurses working in an Australian hospital, were grouped under four main factors. These were accessibility of research findings, anticipated outcomes of using research, organizational support to use research and support from others to use research. The most important factor was perceived to be organizational support, particularly in relation to providing time to use and conduct research.

Adult↗

PubMed1997

Guided Imagery. A psychoneuroimmunological intervention in holistic nursing practice.

Guided imagery is an independent nursing intervention that uses psychoneuroimmunology (PNI) principles to assist an individual in the management of distressing symptoms. The purpose of this article is to discuss the use of guided imagery in holistic nursing practice. The concepts of PNI are described and the basic steps of guided imagery are presented. PNI research and nursing research on guided imagery as an intervention are reviewed. The principles of guided imagery and PNI are applied to holistic nursing practice. Suggestions for future research methodologies, including psychological, neuroendocrine, and immunological measurements to evaluate the effectiveness of guided imagery, are offered. Rationale for using human immunodeficiency virus infection as a disease model to study the effectiveness of guided imagery is provided.

Holistic Nursing↗

PubMed2002

Indicators for competent nursing practice.

AIMS AND BACKGROUND: This paper identifies and classifies indicators for competent nursing practice and validates these indicators in a variety of settings. Descriptive data to address competent practice in a variety of settings were collected from staff nurses, head nurses and nursing directors in an acute 1000-bed university hospital in Finland. METHOD: The data obtained from 25 expert groups were analysed to identify a clinical set of indicators for competent nursing practice from the data. The relevance of this set of indicators in a variety of clinical settings was further validated with a second sample of expert nurses (n = 26). Thereafter, data were analysed to identify generic competencies that were applicable to all clinical working environments. RESULTS: Twenty-three generic indicators of competent nursing practice were identified in a variety of settings. The findings suggest that these competence indicators are meaningful to nurses with various backgrounds and practice settings. CONCLUSIONS: Collaboration and coordination, as well as the holistic management of the situation, are highly recognized as meaningful characteristics of competent nursing practice.

Attitude of Health Personnel↗

PubMed1998

Cut from the right wood: spiritual and ethical pluralism in professional nursing practice.

Today, different cultures and contexts of nursing adhere to different codes of ethics. This pluralism may be traced back to differing beliefs about the nature of man and the world, involving different approaches to, and understandings of, spirituality. How significant is this pluralism of beliefs surrounding spirituality for proper nursing practice? I argue that certain introductory nursing textbooks perceive the significance of spirituality for nursing practice as marginal, because of certain assumptions as to what constitutes a proper, or professional, practice. After arguing that such assumptions are problematic, especially from an ethical point of view, I will advance an alternative understanding of professional practice, by drawing upon Alasdair MacIntyre's work. The aim is to give the spiritual dimension of nursing care its rightful place.

Cultural Diversity↗