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PubMed2003

Stress in assisted reproductive technology: implications for nursing practice.

In a follow-up study about women's experience of assisted reproductive technology (ART) some events were identified as particularly stressful, including making the decision to try ART, starting treatment, waiting for results after a scan, having oocyte collection, the 2 week wait after embryo transfer and finding out that the treatment was unsuccessful. On the basis of these findings, a review of the literature and extensive clinical practice as a nurse co-ordinator in an ART programme, implications for nursing practice are discussed and strategies to use that may help reduce stress and improve the well-being of ART participants are suggested.

Embryo Transfer↗

PubMed2005

Moral competence in nursing practice.

This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, compassion, sympathetic joy, equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand.

Empathy↗

PubMed2004

Academic nursing practice in rural West Virginia.

This exemplar highlights how a rural academic nursing practice has been effective in facilitating the integration of the tripartite academic role of education, research, and service for one university faculty member. The integration of students into the practice is described. The experience provided them with critical insights into rural academic practice during their delivery of prenatal care services to a vulnerable population of women in rural Appalachia. This exemplar also describes the use of the academic nursing practice as a laboratory both for studying the specific problems of this vulnerable population of women and their families, and testing interventions tailored to the needs of the community. Finally, the other ways the academic nursing practice benefits faculty and students, including integration of educational technology into the practice setting and opportunities for faculty leadership in rural community development, are discussed.

Community Health Centers↗

PubMed1997

The advanced practice nurse in primary care: responsibility for reporting infectious diseases.

Advanced practice nurses are increasingly practicing in primary care settings where they are diagnosing and treating infectious diseases. Care is not complete until these conditions are reported to the local health department. Reporting is not optional--it is the law in every state. This article critiques case studies where disease reporting did not occur, reviews the evidence on noncompliance with reporting laws, discusses reasons for reporting, describes how state laws vary with respect to reporting, and presents steps to assist the advanced practice nurse in reporting infectious diseases.

Disease Notification↗

PubMed2004

Evidence for psychiatric nursing practice: an analysis of three years of published research.

Psychiatric and mental health nursing practice continues to be strongly influenced by tradition, unsystematic trial and error, and authority. Yet the need for quality care that is based on the best and most current empirical research is well documented. Achieving evidence-based practice in the psychiatric nursing specialty will require that qualified nurse researchers conduct research relevant for practice and appropriately disseminate that research to those who can best use it, practicing nurses. This State of the Evidence Review analyzed the 227 data-based studies published in the five most commonly read American psychiatric nursing journals from January 2000 through December 2002. Five major research foci were found: global perspectives, psychiatric nurses as subjects, studies of family caregivers, research with clients across the life span, and testing of nursing interventions. About 88% of the studies were conducted in the United States; 63% involved recipients of mental health care services; but only 11% tested psychiatric nursing interventions. Promoting evidence-based practice in psychiatric nursing will require increasing the numbers of psychiatric nurse researchers, enriching the research process (i.e., increasing relevance and appropriate dissemination), and implementing changes in practice that are based on the best and most currently available evidence, rather than on the equivalents of "Old Wives' Tales."

Adolescent↗

PubMed1998

A reflective approach to career trajectory in advanced practice nursing.

Opportunities in nursing continue to expand. Advanced practice nurses today have greater control over the scope of their practice and can look forward to mapping a career pathway using personal and professional talents and interests. This article offers a reflective process approach to evaluating and relating career satisfaction and satisfactoriness to personal development needs. Through implementation of the suggested reflective exercise, a 3- to 5-year career plan can be constructed that will guide change and affect growth for the advanced practice nurse.

Career Mobility↗

PubMed2000

Pod people. Response of family physicians and family practice nurses to Kosovar refugees in Greenwood, NS.

OBJECTIVE: To explore roles of family physicians and family practice nurses who provided care to Kosovar refugees at Greenwood, NS. DESIGN: Qualitative study based on individual interviews with family physicians and family practice nurses. SETTING: Family practices in Halifax, NS. PARTICIPANTS: Six family practice nurses, four physician faculty members, four community-based family physicians, and two family medicine residents were interviewed. Participants were purposefully chosen from the roster of service providers. METHOD: All interviews were conducted by one of the researchers and were semistructured. Interviews lasted approximately 30 minutes and were immediately transcribed. Key words and phrases were identified and compared with subsequent interviews until saturation was achieved. MAIN FINDINGS: Data yielded four analytical categories: the clinical encounter, expectation and experience, role and team functioning, and response. Participants reported how providing care in the context of a refugee camp was both similar to and different from their daily activities in family practice, as were their working relationships with other health care professionals. CONCLUSION: Primary care for refugees during complex health emergencies is often underreported in the literature. Yet family practice physicians and nurses recounted that they had the requisite skills to provide care in such a context.

Adult↗

PubMed2002

The impact of restructuring on professional nursing practice.

Through the 1990s most hospitals were involved in restructuring. As a result, maintaining professional nursing practice is challenging in these cost-constrained hospital environments. In new models of care, professional nursing practice expectations are often reconceptualized into multidisciplinary care team structures in which the team is empowered and becomes the focus rather than the individual nurse caring for her or his patient. Given that nurses provide the greatest part of patient care in hospitals, professional nursing practice has the potential to differentiate one hospital from another. Consequently, it is in the strategic interest of organizational policy makers to implement initiatives that support professional nursing practice.

Hospital Restructuring↗

PubMed2001

Screening for renal disease: the role of the practice nurse.

Screening tests for renal disease are inexpensive, easy to carry out and simple to interpret. Nurses in general practice can provide screening for high-risk populations and interpret the results of these tests. Practice nurses can also provide patient information about renal disease, which will both improve patients' quality of life and save time and money for the NHS.

Humans↗

PubMed2000

The effectiveness of an educational intervention in changing nursing practice and preventing catheter-related infection for patients receiving total parenteral nutrition.

Catheter-related infections are one of the most serious complications of TPN therapy. Nurses have important responsibilities in the care of patients who are receiving TPN. This quasi-experimental study was conducted for the purpose of investigating the effectiveness of an educational intervention on changing nursing practice and preventing catheter-related infections in patients receiving total parenteral nutrition. The nurses' practice and the colonisation rate of control and comparative group patients in the surgical clinics of Hacettepe University Hospital (Turkey), and related variables were examined before and after an educational intervention. The findings of the study indicate that the intervention was successful in improving appropriate nursing practice, mean scores of nurses' practices were 45.7 before and 66.5 after the intervention (p<0.05). The rate of microorganism colonisation was also decreased but statistical analysis demonstrated no association between nursing practices and microorganism colonisation of catheter cultures.

Adult↗

PubMed2000

Professional nursing practice in an HMO: the future is now.

Managed care forms of service delivery now dominate the nursing practice environment. Nursing is potentially a key resource for helping the system to meet the increased and evolving demands, maintaining quality while decreasing costs. However, nurses need additional competencies to function effectively in this environment. Nurse educators need to prepare nurses for these new roles. This paper describes trends influencing nursing roles and identifies the nine categories of competencies needed by professional nurses practicing in HMO settings. Cost-reduction pressures have driven profound changes in the health care system in recent years. Countering these demands for cost-reduction are increases in costs driven by new, more expensive treatments and higher patient expectations. While the future of health care is anything but clear, certain features of the health care system seem relatively certain: major changes will continue to be cost-driven; more hospitals will close, or consolidate or collaborate to compete; and inpatient acuity will continue to increase. In addition, corporate America will increasingly influence how care is delivered and demands for information on health plan performance, such as the Health Employers Data Information System (HEDIS) (National Committee for Quality Assurance, 1997) will increase. These forces will inevitably redirect use of resources within health care organizations. Other external forces that will continue to influence how care is delivered are discussed below.

Cost-Benefit Analysis↗

PubMed2002

Excellence in school nursing practice: developing a national perspective on school nurse competencies.

Developing a national position on competencies for school nurses can directly influence professional practice, which ultimately affects the well-being and academic success of students. Collaboration between national experts, such as school nurse educators and school nurse consultants, interested in moving this development forward is key. Closely aligning the work done by the Southern Regional Education Board Council on Collegiate Education for Nursing on entry-level competencies with the Standards of Professional School Nursing Practice provides a framework to carry the school nurse competency initiative forward. Continued competency development will provide guidance for the academic programs that design curricula to prepare school nurses and for the practice settings that hire school nurses.

Humans↗

PubMed1992

Family nursing practice paradigm perspectives and diagnostic approaches.

Family nursing practice reflects different belief systems about the nature of the family and family health. Competing belief systems (paradigms) are examined as they relate to the concepts of concern to family nursing. Using a family case study, divergent diagnostic approaches emerging from the paradigms are described and demonstrated. Implications are delineated for the further development of family nursing practice.

Adolescent↗

PubMed1998

A shared community-based practice: an alternative model for WOC nursing practice.

In the past, as the populations in many communities have grown, WOC nurses have been hired for each of the major health care facilities located in that community. However health care restructuring has caused many local hospitals to reevaluate their use of specialty practice nurses, including ET/WOC specialists. In response to this trend, a shared community practice model was established that has allowed each agency to make use of ET nursing service on an "as needed" basis, while maintaining daily accessibility to this important resource person. This article describes the evolution and growth of this practice model during the past two decades of intense reform in health care delivery.

Community Health Services↗

PubMedDate not supplied

Preparing advanced practice nurses for clinical decision making in specialty practice.

Dramatic changes in the delivery of healthcare have placed an increased emphasis on developing critical thinking skills and clinical decision making abilities of nurses on both the undergraduate and graduate levels. The authors discuss teaching-learning strategies that promote clinical decision making skills of advanced practice nurses. Particular attention is paid to advanced practice nurses who are being prepared to work within specialty practice settings. An algorithm to guide educators to teach clinical decision making is presented.

Algorithms↗

PubMed1997

The effect of a clinical practicum on undergraduate nursing students' self-efficacy for community-based family nursing practice.

Providing family nursing care using a collaborative practice model presents a challenge to undergraduate students and to faculty who structure their learning experiences. A pre-test-post-test design was used to assess the impact of a 13-week family nursing clinical practicum on the perceived self-efficacy of two groups of nursing students in three areas: knowledge related to family nursing, home visiting, and collaborative practice. Students completed the Family Nursing Self-Efficacy Questionnaire (FNSE) at the beginning of the academic year and 4 and 8 months later to coincide with the timing of the practicum for each group (fall or winter term). A two-factor repeated measures analysis of variance (ANOVA) revealed a significant group X time effect (lambda = .80, p < .001). Students' self-efficacy differed significantly by group at time 2 only (t = 4.3, p < .001), supporting the positive effects of the clinical practicum on students' self-efficacy. Consistent with Bandura's (1977, 1986) theory, students rated actual performance of family nursing skills in a clinical setting as the most important source of efficacy information. Implications for designing meaningful clinical experiences in family nursing are discussed.

Adult↗

PubMed2003

Part one: Restoring patients to health outcomes and indicators of advanced nursing practice in adult critical care.

The key characteristics of advanced nursing practice have been a subject of international debate over the past decade. To address this debate, a grounded theory study was undertaken by one of the authors which sought to identify the key characteristics of advanced nursing practice in adult critical care. The outcome of the main study was a theory of legitimate influence in which enhancing patient stay and improving patient outcome represented the dual purpose of advanced nursing practice in critical care. Fundamental to these factors is strategic activity. This encompasses improving patient care, facilitating continuity of care and engaging in patient education. The outcome of these strategic activities can be evaluated through evidence of eased transition across complex hospital networks, patient satisfaction and enabling of independence. The findings reflect a change in the focus and delivery of care to the critically ill and their relatives by nurses practising at an advanced level. In the second paper of this series, the intervening conditions that affect the expression of legitimate influence will be discussed.

Adult↗

PubMed2004

Fear of the known? District nurses' practice of compression bandaging.

District nurses are the acknowledged experts when it comes to the care of leg ulcers in the community setting. An audit in one trust nevertheless highlighted a degree of diagnostic caution among district nurses that led to some patients not receiving the compression therapy that national guidelines recommend. This article reports on a small-scale qualitative study that sought to explore this issue in more depth. The results highlight that there is some conflict between district nurses' practice as expert practitioners and strict adherence to guidelines, which the nurses resolve in various ways. The implications for practice are explored.

Adult↗