[Development of independent practicing nurses--how I started independent practice].
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Entrepreneurship↗
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Results for “nursing practice”
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.
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Factors that influence practice nurses to promote physical activity.
OBJECTIVE: To investigate what factors may influence practice nurses to promote physical activity. METHODS: Postal questionnaires were sent to all practice nurses in the county of Avon, UK in 1994. Specifically, the questionnaire survey explored whether patient, provider, and practice factors influenced practice nurses promotion behaviour. In addition, the stages of change model was used to measure current levels of promoting behaviour. RESULTS: A response rate of 80.9% was achieved. Over 80% of the sample reported currently promoting physical activity to some degree. "Promoting" nurses more frequently followed up all (new, established or targeted) patients' activity progress when compared with "restricted promoting" nurses (P < 0.05). Nurses who engaged in regular exercise were more likely to encourage physical activity as a treatment than "irregularly active" nurses (P < 0.05) for five of six clinical groups with the single exception of people with diabetes. CONCLUSIONS: This study shows that the two stage measures (activity promotion and personal behaviour) of the health care professional are associated with important differences in patient and practice factors for physical activity promotion. Further investigations into the content and quality of delivery are required before planning strategies to develop physical activity in the general practice.
Adult↗
Evaluating the workload of practice nurses: a study.
In 1990 and 1991, 67 practice nurses with a total of 12,725 consultations took part in a before and after study of health board attached and practice-employed nurse workload. The intervention of the New General Practitioner Contract (DoH 1989) and other primary care changes in April 1990 provided an opportunity to examine the process of care, and identify and changes in workload or differences in working patterns of attached and practice-employed nurses, as a result of these modifications. Practice-employed nurses initiated more of their own appointments following implementation of the New Contract and saw fewer GP referrals. Routing treatment room work had decreased for both groups of nurses in the second year. Both groups of nurses had also increased their level of therapeutic listening in the second year, but practice-employed nurses reported higher levels of therapeutic listening than their attached colleagues during both recording periods.
Adult↗
The practice nurse.
This is a review of one year of operation of the practice nurse scheme immediately following the introduction of a subsidy for practice nurses in urban practices. The versatility and competence of the nurse is illustrated. The contribution of the nurse to prevention, surveillance and practice efficiency is emphasised.
Community Health Nursing↗
Advanced practice nursing: playing a vital role.
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.
Clinical Competence↗
Nursing practice in the next decade: the impact on nursing and pharmacy systems.
Nursing practice in the year 2000 will occur within more regulated health care systems, with a much higher focus on the cost and the quality of the service that is delivered. Patients will have more complex illnesses and treatment regimens that will require that nurses have appropriate levels of education, experience, and clinical specialization. The nursing work force will change in its nature, cost, and composition. Nurses will operate in flatter organizations and within productive multiprofessional and technical work groups that operate as flexible, self-directed teams. New clinical practice models will be operational, and they will be adapted to the unique work and environment of each patient care unit. Practice will be restructured to incorporate clinical and nonclinical support. Work redesign and restructured practice environments will be essential to meeting the requirements for the future. Patients with complicated illnesses will continue to move through hospital systems at high speeds. Treatment regimens will be extremely complex. The requirement will be to emphasize high-quality and affordable care, while minimizing errors and complications. Technology will provide new challenges, new excitement, new dilemmas, and new demands. The ethical dimensions of care will become ever more challenging. The pharmacological aspects of treatment will gain in prominence. Mutual respect and mutual support will be the hallmarks of the nursing and pharmacy interface in the year 2000.
Education, Nursing↗
Participation in the International Classification for Nursing Practice (ICNP) programme.
The International Council of Nurses (ICN) is a federation of 129 national nurses associations. The International Classification for Nursing Practice (ICNP) is a programme of the ICN. The purpose of this paper is to describe the development and maintenance processes of the ICNP Programme that are used to increase participation. These include processes by which the ICNP was and continues to be developed, tested, distributed and implemented worldwide, with emphasis on the current version, ICNP Version 1.0. The ICNP is a unified nursing language that facilitates cross-mapping among local terms and existing terminologies. ICNP conforms to current terminology standards and criteria, for example, ISO standards and HL7. The ICNP Alpha and Beta Versions documented the progress of concept validation and classification of nursing phenomena and interventions. The ICNP Beta 2 Version was a combinatorial terminology organized in two multi-axial structures representing nursing phenomena and nursing actions. The ICNP Version 1.0, launched in 2005, changed the relatively straight-forward multi-axial structure into a compositional terminology through the application of description logics using Web Ontology Language (OWL) within Protégé, an ontology development environment. ICNP Version 1.0 is also represented in a multiaxial model (7-Axis) for nurses to compose nursing diagnosis, intervention and outcome statements. Language translations and clinical information systems applications are required to make the ICNP Version 1.0 available to nurses at the point of healthcare delivery. ICNP data collected in healthcare environments provide standardized terminology for nursing that allows comparison of nursing practice across health care settings, specialties and countries; facilitate data-based clinical and management decision making; and contribute to the development of guidelines and standards for best practices and optimal outcomes for patients, families and communities.
Nursing Informatics↗
Scope of nursing practice and business relationships between nurses and physicians in California: Part 1.
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California↗
Uncovering the evidence of non-expert nephrology nursing practice.
Expertise in nursing has been widely studied although there have been no previous studies into what constitutes expertise in nephrology (renal) nursing. This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, provides evidence of the characteristics and practices of non-expert nephrology nurses. Using the grounded theory method, the study took place in one renal unit in New South Wales, Australia, and involved six non-expert and 11 expert nurses. Sampling was purposive then theoretical. Simultaneous data collection and analysis using participant observation, review of nursing documentation and semistructured interviews was undertaken. The study revealed a three-stage skills-acquisitive process that was identified as non-expert, experienced non-expert and expert stages. Non-expert nurses showed superficial nephrology nursing knowledge and limited experience; they were acquiring basic nephrology nursing skills and possessed a narrow focus of practice.
Attitude of Health Personnel↗
Just-in-time evidence-based e-mail "reminders" in home health care: impact on nurse practices.
OBJECTIVE: To test the effectiveness of two interventions designed to improve the adoption of evidence-based practices by home health nurses caring for heart failure (HF) patients. DATA SOURCES/STUDY SETTING: Information on nurse practices was abstracted from the clinical records of patients admitted between June 2000 and November 2001 to the care of 354 study nurses at a large, urban, nonprofit home care agency. STUDY DESIGN: The study employed a randomized design with nurses assigned to usual care or one of two intervention groups upon identification of an eligible patient. The basic intervention was a one-time e-mail reminder highlighting six HF-specific clinical recommendations. The augmented intervention consisted of the initial e-mail reminder supplemented by provider prompts, patient education material, and clinical nurse specialist outreach. DATA COLLECTION: At each home health visit provided by a study nurse to an eligible HF patient during the 45-day follow-up period, a structured chart abstraction tool was used to collect information on whether the nurse provided the care practices highlighted in the e-mail reminder. PRINCIPAL FINDINGS: Both the basic and the augmented interventions greatly increased the practice of evidence-based care, according to patient records, in the areas of patient assessment and instructions about HF disease management. While not all results were statistically significant at conventional levels, intervention effects were positive in virtually all cases and effect magnitudes frequently were large. CONCLUSIONS: The results of this randomized trial strongly support the efficacy of just-in-time evidence-based reminders as a means of changing clinical practice among home health nurses who are geographically dispersed and spend much of their time in the field.
Adult↗
Outcomes research: an essential component of the advanced practice nurse role.
More research is needed that focuses on the effectiveness of nursing interventions in clinical settings. Advanced practice nurses are in the best position to conduct these studies, given their clinical expertise, access to subjects, master's-level research education, and need to demonstrate the effectiveness of their own care practices. This article describes how to develop outcomes studies and to use and disseminate the findings. Advanced practice nurses are encouraged to develop and replicate outcomes studies and to broadly disseminate findings to build the evidence base needed to support advanced practice in nursing.
Humans↗
Critical reflective inquiry for knowledge development in nursing practice.
This paper presents a method of inquiry which uses nurses' situated, individual instances of nursing practice as the basis for developing knowledge for nursing and improving practice. This method of inquiry is founded upon the ideas in action science and reflective practice, and critical philosophy. Nursing practice is viewed as a rich source of new knowledge as practitioners are engaged in creating as well as modifying knowledge to respond to specific clinical situations. At the same time, practitioners may be in practice without recognizing deficiencies or ineffectiveness. As a method to tap these two aspects of practice, the inquiry is designed to encompass three phases, i.e. descriptive, reflective and critical/emancipatory, and is oriented to provide understanding to practitioners of the nature and meaning of their own practice, to correct and improve practice through self-reflection and critique, and to generate models of 'good' practice and theories of application as well as to discover processes of practice as played out in clinical situations. This method of inquiry can be used by nurses and nursing students in collaboration with researches or mentors to develop nursing knowledge about practice, improve individual practice, and engage in shared learning.
Communication↗
Advanced practice nursing: continuation of the dialogue.
This column continues the dialogue about advanced practice nursing. Professor Iain Graham of Bournemouth University shares his ideas about advanced practice nursing in the United Kingdom and answers questions about the tasks and responsibilities of advanced practice nurses within the National Health Service.
Career Mobility↗
Walking the talk: one hospital's experience in implementing a conceptual framework for nursing practice.
There has been considerable impetus to use conceptual frameworks to guide nursing practice, yet many nursing theories are not supported by research or understood by nurses. At Foothills Hospital, a Committee developed and implemented a conceptual framework based on self-care. Concepts within the framework are grounded in current nursing practice, consistent with consumer expectations and supported by philosophical statements about patient, society/environment, health and nursing.
Humans↗
The ethical problems encountered in psychiatric nursing practice with dangerous mentally ill persons.
Psychiatric nursing practice in acute inpatient and emergency settings requires that practitioners identify and manage dangerous patients. The analyses reported here are part of a broader study that sought to understand how psychiatric nurses define and manage the dangerous mentally ill. This paper identifies three ethical problems encountered in the day-to-day practices of psychiatric nurses, as they cared for and managed the dangerous mentally ill. The three ethical problems, balancing support for patient autonomy with the need to maintain unit control; balancing the need for distancing with the desire to establish therapeutic relationships; and balancing the desire to "do the right thing" with the need to get along with colleagues, have implications for psychiatric nursing practice and the institutional settings that treat the dangerous mentally ill. Additionally, this study provides direction for further inquiry into the actual ethical problems encountered in practice.
Adult↗
Titling for advanced practice nurses.
PURPOSE/OBJECTIVES: To describe salient discussion points and the recommendations for titling of the advanced practice nurse (APN). DATA SOURCES: Discussion points, professional literature on titling for APNs, and rationale and recommendations generated by conference participants. DATA SYNTHESIS: The recommendation for a single title--advanced practice nurse--as an umbrella term to include clinical nurse specialists and nurse practitioners within the Oncology Nursing Society evolved from the desire to facilitate advancement of these roles. CONCLUSION: A common title for all nurses in advanced practice will help them to speak with one voice. IMPLICATIONS FOR NURSING PRACTICE: The existing healthcare environment provides numerous opportunities for APNs. Single titling may produce unity among APNs, provide the ability to speak with a single voice, and result in new opportunities for leadership roles in directing health care for the future.
Humans↗
Standards of perianesthesia nursing practice: advocating patient safety.
The practice continuum of perianesthesia nursing interacts in concert with other nursing and medical professional organizations. Professional standards of care establish frameworks that guide these practitioners in the delivery of care. ASPAN is charged with the ethical responsibility of defining and promulgating minimum standards of perianesthesia nursing practice. This article discusses the various definitions and uses of standards, as well as the vital importance of using ASPAN Standards. How standards differ from position statements, laws, and regulations, and how standards advocate for patient safety and protect the nurses in their specialty practice are also discussed. In addition, case scenarios will be presented to show how the American Society of Anesthesiologists' (ASA) standards play a major role in the surgical patient's care.
Accreditation↗
Limited obstetric ultrasound in nursing practice.
During the past decade, nurses have begun to incorporate limited ultrasound into obstetric nursing practice. Guidelines have been established that provide the recommended content for the didactic and clinical preparation needed before implementing this technique. Fetal sonography provides useful information on fetal status and complements the fetal heart assessment. With appropriate education and institutional policies, nurses can enhance their role with this new skill. Acquiring an understanding of the educational and clinical guidelines for limited sonography is the first step for perinatal nurses who want to incorporate this skill into their clinical practice.
Certification↗