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At least 973 records · Page 54Linked to original sources
PubMed1998

Randomized controlled trial of teaching practice nurses to carry out structured assessments of patients receiving depot antipsychotic injections.

BACKGROUND: A third of patients with schizophrenia are out of contact with secondary services. Many of these patients receive maintenance medication as depot antipsychotics from practice nurses, most of whom have negligible training in mental health. AIM: To examine the impact of a structured assessment on the process of care and clinical status of schizophrenia patients by practice nurses who received a one-day training course. METHOD: All identified patients were randomly allocated to structured assessments and outcome, measured by the number of assessments and the changes in care recorded in primary care notes. A comprehensive assessment of clinical and social functioning and level of unmet need in intervention and control patients was carried out after one year by an independent researcher. RESULTS: A high rate of consultation and clinical need in this patient group was demonstrated. Practice nurses were more diligent in carrying out assessments than general practitioners (GPs), but there was no impact on treatment patterns or clinical outcome. CONCLUSIONS: Structured assessments by practice nurses are feasible with this patient group, but training, targeted at both nurses and GPs, is needed if this intervention is to translate into health gain.

Adolescent↗
PubMed2004

Promoting cognitive and metacognitive reflective reasoning skills in nursing practice: self-regulated learning theory.

BACKGROUND: Effective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skills. While a number of strategies have been implemented and tested to promote these skills, educators have not been able consistently to predict their development. Self-regulated learning theory suggests that this development requires concurrent attention to both the cognitive and metacognitive dimensions of reasoning in nursing care contexts. AIMS: This paper reports on a study to explore the impact of self-regulated learning theory on reflective practice in nursing, and to advance the idea that both cognitive and metacognitive skills support the development of clinical reasoning skills. METHODS: Integrative review of published literature in social science, educational psychology, nursing education, and professional education using the Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resource Information Center (ERIC), and American Psychological Association (PsychInfo) Databases. The search included all English language articles with the key words clinical reasoning, cognition, critical thinking, metacognition, reflection, reflective practice, self-regulation and thinking. FINDINGS: Reflective clinical reasoning in nursing practice depends on the development of both cognitive and metacognitive skill acquisition. This skill acquisition is best accomplished through teaching-learning attention to self-regulation learning theory. A critical analysis of the literature in the areas of critical thinking and reflective practice are described as a background for contemporary work with self-regulated learning theory. It is apparent that single-minded attention to critical thinking, without attention to the influence of metacognition or reflection, is but one perspective on clinical reasoning development. Likewise, single-minded attention to metacognition or reflection, without attention to the influence of critical thinking, is another perspective on clinical reasoning development. While strategies to facilitate critical thinking and reflective practice have been used in isolation from each other, there is evidence to suggest that they are inextricably linked and come together with the use of self-regulated learning prompts. CONCLUSIONS: Students and practising nurses are able to improve their cognitive and metacognitive skills in clinical contexts by using self-regulated learning strategies. The self-regulated learning model in nursing is offered to support teaching and learning of reflective clinical reasoning in nursing practice contexts.

Clinical Competence↗
PubMedDate not supplied

Autonomy and clinical practice. 2: Patient privacy and nursing practice.

This article, the second in a series of three considering issues of autonomy, privacy and informed consent in nurse/patient interactions, focuses on the wider conceptions of patient privacy and confidentiality. Given that patients in institutional care are likely to suffer intrusions into their privacy which would be considered unusual in normal social interaction, it is interesting to note the dearth of literature in this area. Some definitions of privacy are considered in an attempt to begin to raise readers' awareness of the complexity of this notion. It can be argued that privacy is a pertinent notion to consider, both in order to gain a greater understanding of what is meant by the term and in terms of the implications of this understanding for clinical practice.

Confidentiality↗
PubMed1988

Construct validity in instrument development: a vital link between nursing practice, research, and theory.

Construct validity provides a vital linkage between nursing practice, research, and theory. Seventeen articles published in Advances in Nursing Science that met the criterion of reporting instrument development or modification were examined for evidence of these linkages. All were based on theoretical constructs; nursing problems were identified in 15, and 14 provided evidence of construct validity. Factor analysis was the primary method of construct validity reported. Implications for nursing practice were limited, suggestions for research focused on further instrument development, and only half reported implications for theory development. The findings indicate the need to strengthen links between practice, research, and theory.

Humans↗
PubMed1999

Practice nurses' perceptions of services for clients with psychological problems in primary care.

Over a third of people presenting in primary care in the United Kingdom (UK) have a mental health problem causing some degree of disruption in their lives. Approximately 90% of these are treated and managed by primary care staff without any support from mental health services. Following the White Paper published by the UK Department of Health in 1997 (Department of Health, 1997. The New NHS--Modern and Dependable, HMSO, London), the influence of primary care both in the commissioning and provision of mental health services is likely to increase. By far the largest professional group currently involved in mental health in primary care are practice nurses. Although their numbers have increased dramatically during this decade, little is known of the work they do or of their perceptions of it. The present questionnaire-based study sought to elicit the types of mental health problems encountered by practice nurses in primary care, the interventions they provide and the skills they utilise. The data indicates that practice nurses care for people with a wide variety of mental health problems ranging from mild to severe. Many feel unprepared for this type of work and are reluctant to get too involved with clients in case they uncover problems they are not able to cope with. Lack of access to appropriate educational support is identified as the main problem currently faced by practice nurses alongside poor inter-professional relationships with mental health personnel. This paper discusses ways of meeting the needs of practice nurses and of improving collaboration in primary care settings.

England↗
PubMed1994

Theory for nursing practice.

This article chronicles the development of nursing theory and research over the past 30 years as it parallels the author's own development as a theorist-researcher. Dorothy Johnson and Martha Rogers are considered the contemporary forerunners of a shift from an emphasis on medical knowledge to an emphasis on distinctly nursing knowledge. The paradigm shift Rogers called for was largely misunderstood at the time of its inception, resulting in attempts to force holistic thinking into reductionistic methods of research. The epistemology of nursing research lagged behind the ontology of the discipline. Moreover, the absence of an agreed-upon focus of the discipline created a void in the development of theory specific to nursing practice. The author asserts that the focus and paradigm of the discipline of nursing are now clear. The core, purpose, and societal commitment of nursing as a practice discipline are captured in the phrase, caring in the human health experience. Research methods that reflect a unitary, transformative paradigm make it possible to develop theory that structures practice.

Empathy↗
PubMed1996

A nursing practice paradigm for depressed rural women: theoretical basis.

Depression is common among disadvantaged, rural women. Few of these women are treated because of access barriers or because treatment does not meet their needs. A treatment program for major depressive disorder (MDD) was designed based on biopsychosocial perspectives of the cause of MDD and practice roles of psychiatric nurses. The Nursing Practice Paradigm for Depressed Rural Women (NPP) guides a structured short-term nursing care program for MDD, the Women's Affective Illness Treatment Program (WAIT). The NPP and its theoretical basis are described.

Depression↗
PubMedDate not supplied

[Incorporation perspectives of the International Classification for Nursing Practice (ICNP) in Brazil].

In this paper some aspects concerning the nursing classification systems are discussed, with emphasis in the International Classification for Nursing Practice (ICNP) and the perspectives of its incorporation in Brazilian nursing practice. The authors present three Brazilian experiences of incorporation of that classification system: the project of implementation of the language CIPE/CIPESC in electronic record of the Health Department of Curitiba - PR; the project of systematization of nursing care in UTI, that is being developed in Florianópolis - SC; and the development of a technological instrumental, based on the terms used by the nursing team components, for insertion in information systems of a school hospital, in João Pessoa - PB.

Brazil↗
PubMed1998

Development of a Web-based CAI program for maternity nursing practice.

This quasi-experimental study was conducted to explore what kind of impact a Web-based educational program can have on nursing students and how nursing students react to this educational program. A Web-based computer assisted instruction for maternity nursing practice was developed by researchers using Instruction System Design model and serviced for nursing students on the WWW. To study educational effect of this program on nursing students 30 senior students at a school of nursing were selected. They were assigned into experimental and control groups based on their maternity nursing practice schedule. The effect of the Web-based CAI was measured using Achievement score, attitude toward learning experience and attitude toward computer and Internet, and compared between two groups. There were significant differences between two groups in achievement and attitude score. And students in the experimental group showed positive response to the Web-based CAI program. These results suggest that Web-based CAI is useful as a new teaching tool for maternity nursing practice as well as other nursing courses. Comments on program improvement and operational issues were collected from students. These will be used for program improvement in future.

Attitude to Computers↗
PubMed2006

Latest review shows rise in calls related to nursing practice standards.

Questions and concerns related to nursing practice standards increased to 28 percent from 18 percent of all consultations in the latest review of consultations by the College and Association of Registered Nurses of Alberta (CARNA). Consultations were initiated by phone, e-mail, fax or in person by registered nurses (RNs), employers or others who sought assistance with issues that directly or indirectly affected the delivery of safe, competent and ethical nursing care. Increases were also noted in the categories related to health-care reform and scope of practice, showing an increase to 12 percent from seven and to 17 percent from 15 respectively. These increases were offset by a decrease in calls related to legal/ethical issues to six percent of all calls from 22 percent in the previous review period.

Alberta↗
PubMed2006

Authentic leaders creating healthy work environments for nursing practice.

Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the "glue" needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.

Critical Care↗
PubMed2006

Characterising Māori nursing practice.

This paper summarises research which addresses the question What might constitute Māori nursing practice? The research design adopted was influenced by Kaupapa Māori methodology and used a semi-structured, qualitative, in-depth interview process. It was found that by understanding the current experiences of Māori registered nurses, their reflections on their preparation for practice, and their current practice, we are able to identify the present and future training and practice needs of Māori nurses. Māori nursing practice can be characterised as having five features: the promotion of cultural affirmation including cultural awareness and identity; the support of, and access to Māori networks; the adoption of Māori models of health; the enabling of visibility and pro-activity as Māori nurses; and, the validation of Māori nurses as effective health professionals. Three recommendations for promoting Māori nursing practice are made in relation to staff in the workplace and in nurse education programmes. All nursing staff need to be alert to: 1. The impact of western scientific models on Māori healthcare; 2. The (often passive) non-acceptance of Māori within mainstream institutions; and 3. The benefits of valuing Indigenous nursing programmes.

Awareness↗
PubMed2006

School nurse practice: a decade of change.

Good practice requires an evidence base and criteria for assessment, which was the subject of a scope review of school nurse practice across the four countries of the UK. The findings demonstrate a rich base of research into service practice, particularly in the last decade. School nursing practice has experienced a paradigm shift from a medical to a social model of care. The service now works from a public health ethos and has a preventive agenda. The focus is on the child rather than a service for schools and school nurses work in teams rather than alone. Under-resourcing continues to beleaguer school nurse practice and there are areas that need further study, particularly large-scale research into the costs and benefits of school nursing.

Adolescent↗
PubMedDate not supplied

Developing an eclectic model for nursing practice in a community hospital.

The literature documents the importance of using a conceptual model to explain and guide nursing practice (Fawcett, 1989; Riehl-Sisca, 1988; Meleis, 1991). However, can a single model describe and guide practice for an entire nursing service department? In this article, the author describes and analyzes the process of developing an eclectic conceptual nursing practice model as experienced by the nursing division of a 250-bed community hospital in the midwest.

Hospitals, Community↗